HDR CPT CODES AND DESCRIPTIONS ONLY ARE COPYRIGHT
HDR 2012 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 2011/12 AMERICAN DENTAL ASSOCIATION.  ALL RIGH
HDR RESERVED.
A0021  Outside state ambulance serv                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0100  Nonemergency transport taxi                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0110  Nonemergency transport bus                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0120  Noner transport mini-bus                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0130  Noner transport wheelch van                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0140  Nonemergency transport air                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0160  Noner transport case worker                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0170  Transport parking fees/tolls                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0180  Noner transport lodgng recip                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0190  Noner transport meals recip                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0200  Noner transport lodgng escrt                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0210  Noner transport meals escort                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0225  Neonatal emergency transport                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0380  Basic life support mileage                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0382  Basic support routine suppls                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0384  Bls defibrillation supplies                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0390  Advanced life support mileag                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0392  Als defibrillation supplies                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0396  Als esophageal intub suppls                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0398  Als routine disposble suppls                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0422  Ambulance 02 life sustaining                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0424  Extra ambulance attendant                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0425  Ground mileage                                    X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0426  Als 1                                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0427  ALS1-emergency                                    X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0428  bls                                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0429  BLS-emergency                                     X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0430  Fixed wing air transport                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0431  Rotary wing air transport                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0432  PI volunteer ambulance co                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0433  als 2                                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0434  Specialty care transport                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0435  Fixed wing air mileage                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0436  Rotary wing air mileage                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0888  Noncovered ambulance mileage                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0998  Ambulance response/treatment                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A0999  Unlisted ambulance service                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4210  Nonneedle injection device                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4213  20+ CC syringe only                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4215  Sterile needle                                    X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4218  Sterile saline or water                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4220  Infusion pump refill kit                          P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4222  Infusion supplies with pump                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4231  Infusion insulin pump needle                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4245  Alcohol wipes per box                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4246  Betadine/phisohex solution                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4247  Betadine/iodine swabs/wipes                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4248  Chlorhexidine antisept                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4250  Urine reagent strips/tablets                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4253  Blood glucose/reagent strips                      P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4255  Glucose monitor platforms                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4256  Calibrator solution/chips                         P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4257  Replace Lensshield Cartridge                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4258  Lancet device each                                P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4259  Lancets per box                                   P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4261  Cervical cap contraceptive                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4262  Temporary tear duct plug                          B   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4263  Permanent tear duct plug                          B   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4264  Intratubal occlusion device                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4265  Paraffin                                          P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4266  Diaphragm                                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4267  Male condom                                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4268  Female condom                                     I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4269  Spermicide                                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4270  Disposable endoscope sheath                       B   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4280  Brst prsths adhsv attchmnt                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4281  Replacement breastpump tube                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4282  Replacement breastpump adpt                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4283  Replacement breastpump cap                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4284  Replcmnt breast pump shield                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4285  Replcmnt breast pump bottle                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4286  Replcmnt breastpump lok ring                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4301  Implantable access syst perc                      P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4320  Irrigation tray                                   P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4321  Cath therapeutic irrig agent                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4322  Irrigation syringe                                P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4326  Male external catheter                            P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4328  Fem urinary collect pouch                         P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4330  Stool collection pouch                            P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4331  Extension drainage tubing                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4332  Lube sterile packet                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4333  Urinary cath anchor device                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4334  Urinary cath leg strap                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4335  Incontinence supply                               P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4336  Urethral insert                                   X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4338  Indwelling catheter latex                         P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4340  Indwelling catheter special                       P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4349  Disposable male external cat                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4351  Straight tip urine catheter                       P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4352  Coude tip urinary catheter                        P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4353  Intermittent urinary cath                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4355  Bladder irrigation tubing                         P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4357  Bedside drainage bag                              P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4360  Disposable ext urethral dev                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4361  Ostomy face plate                                 P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4362  Solid skin barrier                                P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4363  Ostomy clamp, replacement                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4364  Adhesive, liquid or equal                         P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4366  Ostomy vent                                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4367  Ostomy belt                                       P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4368  Ostomy filter                                     X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4373  Skin barrier with flange                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4384  Ostomy faceplt/silicone ring                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4394  Ostomy pouch liq deodorant                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4395  Ostomy pouch solid deodorant                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4396  Peristomal hernia supprt blt                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4397  Irrigation supply sleeve                          P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4398  Ostomy irrigation bag                             P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4400  Ostomy irrigation set                             P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4402  Lubricant per ounce                               P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4404  Ostomy ring each                                  P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4405  Nonpectin based ostomy paste                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4406  Pectin based ostomy paste                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4421  Ostomy supply misc                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4422  Ost pouch absorbent material                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4435  1pc ost pch drain hgh output                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4450  Non-waterproof tape                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4452  Waterproof tape                                   X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4455  Adhesive remover per ounce                        P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4456  Adhesive remover, wipes                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4458  Reusable enema bag                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4463  Surgical dress holder reuse                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4465  Non-elastic extremity binder                      P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4466  Elastic garment/covering                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4470  Gravlee jet washer                                P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4480  Vabra aspirator                                   P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4481  Tracheostoma filter                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4483  Moisture exchanger                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4490  Above knee surgical stocking                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4495  Thigh length surg stocking                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4500  Below knee surgical stocking                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4510  Full length surg stocking                         N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4520  Incontinence garment anytype                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4550  Surgical trays                                    B   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4554  Disposable underpads                              N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4556  Electrodes, pair                                  P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4557  Lead wires, pair                                  P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4558  Conductive gel or paste                           P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4559  Coupling gel or paste                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4561  Pessary rubber, any type                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4565  Slings                                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4566  Should sling/vest/abrestrain                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4570  Splint                                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4575  Hyperbaric o2 chamber disps                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4580  Cast supplies (plaster)                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4590  Special casting material                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4604  Tubing with heating element                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4608  Transtracheal oxygen cath                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4611  Heavy duty battery                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4612  Battery cables                                    X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4613  Battery charger                                   X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4614  Hand-held PEFR meter                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4615  Cannula nasal                                     X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4616  Tubing (oxygen) per foot                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4617  Mouth piece                                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4618  Breathing circuits                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4619  Face tent                                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4620  Variable concentration mask                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4623  Tracheostomy inner cannula                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4624  Tracheal suction tube                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4626  Tracheostomy cleaning brush                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4627  Spacer bag/reservoir                              N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4628  Oropharyngeal suction cath                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4629  Tracheostomy care kit                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4633  Uvl replacement bulb                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4634  Replacement bulb th lightbox                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4635  Underarm crutch pad                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4636  Handgrip for cane etc                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4640  Alternating pressure pad                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4641  Radiopharm dx agent noc                           C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A4642  In111 satumomab                                   C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A4648  Implantable tissue marker                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4649  Surgical supplies                                 P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4650  Implant radiation dosimeter                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4651  Calibrated microcap tube                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4652  Microcapillary tube sealant                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4653  PD catheter anchor belt                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4657  Syringe w/wo needle                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4663  Dialysis blood pressure cuff                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4670  Automatic bp monitor, dial                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4671  Disposable cycler set                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4672  Drainage ext line, dialysis                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4674  Chem/antisept solution, 8oz                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4680  Activated carbon filter, ea                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4690  Dialyzer, each                                    X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4714  Treated water per gallon                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4719  "Y set" tubing                                    X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4728  Dialysate solution, non-dex                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4730  Fistula cannulation set, ea                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4736  Topical anesthetic, per gram                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4740  Shunt accessory                                   X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4770  Blood collection tube/vacuum                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4771  Serum clotting time tube                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4772  Blood glucose test strips                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4773  Occult blood test strips                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4774  Ammonia test strips                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4860  Disposable catheter tips                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A4911  Drain bag/bottle                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4913  Misc dialysis supplies noc                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4918  Venous pressure clamp                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4927  Non-sterile gloves                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4928  Surgical mask                                     X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4929  Tourniquet for dialysis, ea                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4930  Sterile, gloves per pair                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4931  Reusable oral thermometer                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A4932  Reusable rectal thermometer                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A5053  Clsd ostomy pouch faceplate                       P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A5055  Stoma cap                                         P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A5056  1 pc ost pouch w filter                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A5057  1 pc ost pou w built-in conv                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A5071  Urinary pouch w/barrier                           P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A5081  Continent stoma plug                              P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A5082  Continent stoma catheter                          P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A5083  Stoma absorptive cover                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A5093  Ostomy accessory convex inse                      P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A5105  Urinary suspensory                                P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A5112  Urinary leg bag                                   P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A5113  Latex leg strap                                   P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A5114  Foam/fabric leg strap                             P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A5121  Solid skin barrier 6x6                            P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A5122  Solid skin barrier 8x8                            P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A5131  Appliance cleaner                                 P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A5200  Percutaneous catheter anchor                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A5501  Diabetic custom molded shoe                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A5504  Diabetic shoe with wedge                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A5507  Modification diabetic shoe                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A5508  Diabetic deluxe shoe                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A5510  Compression form shoe insert                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6000  Wound warming wound cover                         N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6010  Collagen based wound filler                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6024  Collagen dsg wound filler                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6025  Silicone gel sheet, each                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6154  Wound pouch each                                  P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6199  Alginate drsg wound filler                        P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6215  Foam dressing wound filler                        P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6240  Hydrocolld drg filler paste                       P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6241  Hydrocolloid drg filler dry                       P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6248  Hydrogel drsg gel filler                          P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6250  Skin seal protect moisturizr                      P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6407  Packing strips, non-impreg                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6410  Sterile eye pad                                   X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6411  Non-sterile eye pad                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6412  Occlusive eye patch                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6413  Adhesive bandage, first-aid                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6457  Tubular dressing                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6501  Compres burngarment bodysuit                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6502  Compres burngarment chinstrp                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6503  Compres burngarment facehood                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6504  Cmprsburngarment glove-wrist                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6505  Cmprsburngarment glove-elbow                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6506  Cmprsburngrmnt glove-axilla                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6507  Cmprs burngarment foot-knee                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6508  Cmprs burngarment foot-thigh                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6509  Compres burn garment jacket                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6510  Compres burn garment leotard                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6511  Compres burn garment panty                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6512  Compres burn garment, noc                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6530  Compression stocking BK18-30                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6531  Compression stocking BK30-40                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6532  Compression stocking BK40-50                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6544  Gc stocking garter belt                           N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A6549  G compression stocking                            N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7000  Disposable canister for pump                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7001  Nondisposable pump canister                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7003  Nebulizer administration set                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7004  Disposable nebulizer sml vol                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7005  Nondisposable nebulizer set                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7006  Filtered nebulizer admin set                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7007  Lg vol nebulizer disposable                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7008  Disposable nebulizer prefill                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7009  Nebulizer reservoir bottle                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7010  Disposable corrugated tubing                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7011  Nondispos corrugated tubing                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7012  Nebulizer water collec devic                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7013  Disposable compressor filter                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7014  Compressor nondispos filter                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7016  Nebulizer dome & mouthpiece                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7018  Water distilled w/nebulizer                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7020  Interface, cough stim device                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7025  Replace chest compress vest                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7027  Combination oral/nasal mask                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7030  CPAP full face mask                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7031  Replacement facemask interfa                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7032  Replacement nasal cushion                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7033  Replacement nasal pillows                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7034  Nasal application device                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7035  Pos airway press headgear                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7036  Pos airway press chinstrap                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7037  Pos airway pressure tubing                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7038  Pos airway pressure filter                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7041  Water seal drain container                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7042  Implanted pleural catheter                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7043  Vacuum drainagebottle/tubing                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7044  PAP oral interface                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7501  Tracheostoma valve w diaphra                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7502  Replacement diaphragm/fplate                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7504  Tracheostoma HMES filter                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7506  HMES/trachvalve adhesivedisk                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7507  Integrated filter & holder                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7508  Housing & Integrated Adhesiv                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7509  Heat & moisture exchange sys                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7521  Trach/laryn tube cuffed                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7522  Trach/laryn tube stainless                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7523  Tracheostomy shower protect                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7524  Tracheostoma stent/stud/bttn                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7525  Tracheostomy mask                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A7526  Tracheostomy tube collar                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A8000  Soft protect helmet prefab                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A8001  Hard protect helmet prefab                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A8002  Soft protect helmet custom                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A8003  Hard protect helmet custom                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A8004  Repl soft interface, helmet                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9152  Single vitamin nos                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9153  Multi-vitamin nos                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9155  Artificial saliva                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9180  Lice treatment, topical                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9272  Disposable mech wound suct                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9275  Disp home glucose monitor                         N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9276  Disposable sensor, CGM sys                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9277  External transmitter, CGM                         N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9278  External receiver, CGM sys                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9279  Monitoring feature/deviceNOC                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9280  Alert device, noc                                 N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9281  Reaching/grabbing device                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9282  Wig any type                                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9284  Non-electronic spirometer                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9300  Exercise equipment                                N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9500  Tc99m sestamibi                                   C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9501  Technetium TC-99m teboroxime                      C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9502  Tc99m tetrofosmin                                 C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9503  Tc99m medronate                                   C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9504  Tc99m apcitide                                    C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9505  TL201 thallium                                    C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9507  In111 capromab                                    C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9508  I131 iodobenguate, dx                             C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 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  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9510  Tc99m disofenin                                   C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9512  Tc99m pertechnetate                               C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 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  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9517  I131 iodide cap, rx                               C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9521  Tc99m exametazime                                 C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9524  I131 serum albumin, dx                            C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9526  Nitrogen N-13 ammonia                             C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 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  0.000XXX.00.00.0000000             25.0008 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  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9529  I131 iodide sol, dx                               C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9530  I131 iodide sol, rx                               C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9531  I131 max 100uCi                                   C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9532  I125 serum albumin, dx                            C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9536  Tc99m depreotide                                  C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9537  Tc99m mebrofenin                                  C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9538  Tc99m pyrophosphate                               C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9539  Tc99m pentetate                                   C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9540  Tc99m MAA                                         C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9541  Tc99m sulfur colloid                              C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9542  In111 ibritumomab, dx                             C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9543  Y90 ibritumomab, rx                               C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9544  I131 tositumomab, dx                              C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9545  I131 tositumomab, rx                              C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9546  Co57/58                                           C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9547  In111 oxyquinoline                                C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9548  In111 pentetate                                   C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9550  Tc99m gluceptate                                  C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9551  Tc99m succimer                                    C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9552  F18 fdg                                           C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9553  Cr51 chromate                                     C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9554  I125 iothalamate, dx                              C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9555  Rb82 rubidium                                     C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9556  Ga67 gallium                                      C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9557  Tc99m bicisate                                    C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9558  Xe133 xenon 10mci                                 C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9559  Co57 cyano                                        C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9560  Tc99m labeled rbc                                 C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9561  Tc99m oxidronate                                  C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9562  Tc99m mertiatide                                  C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9563  P32 Na phosphate                                  C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9564  P32 chromic phosphate                             C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9566  Tc99m fanolesomab                                 C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9567  Technetium TC-99m aerosol                         C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9568  Technetium tc99m arcitumomab                      C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 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  0.000XXX.00.00.0000000             25.0008 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  0.000XXX.00.00.0000000             25.0008 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  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9572  Indium In-111 pentetreotide                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9576  Inj prohance multipack                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9577  Inj multihance                                    X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9578  Inj multihance multipack                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9580  Sodium fluoride F-18                              C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9581  Gadoxetate disodium inj                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9582  Iodine I-123 iobenguane                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9583  Gadofosveset trisodium inj                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9584  Iodine I-123 ioflupane                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9585  Gadobutrol injection                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9586  Florbetapir F18                                   N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9600  Sr89 strontium                                    C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9604  Sm 153 lexidronam                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9698  Non-rad contrast materialNOC                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9699  Radiopharm rx agent noc                           C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
A9700  Echocardiography Contrast                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9900  Supply/accessory/service                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
A9901  Delivery/set up/dispensing                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0120  Periodic oral evaluation                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0145  Oral evaluation, pt < 3yrs                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0150  Comprehensve oral evaluation                      R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0180  Comp periodontal evaluation                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0190  Screening of a patient                            N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0191  Assessment of a patient                           N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0210  Intraor complete film series                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0220  Intraoral periapical first                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0230  Intraoral periapical ea add                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0240  Intraoral occlusal film                           R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D0250  Extraoral first film                              R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D0260  Extraoral ea additional film                      R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D0270  Dental bitewing single image                      R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D0272  Dental bitewings two images                       R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D0273  Bitewings - three images                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0274  Bitewings four images                             R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D0277  Vert bitewings 7 to 8 images                      R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0290  Skull/facial bone image                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0310  Dental saliography                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0321  Other TMJ images by report                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0322  Dental tomographic survey                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0330  Panoramic image                                   I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0340  Cephalometric image                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0350  Oral/facial photo images                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0363  Cone beam, three dimensional                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0364  Cone beam ct capt & interp                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0365  Cone beam ct interprete man                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0366  Cone beam ct interprete max                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0367  Cone beam ct interp both jaw                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0368  Cone beam ct interprete TMJ                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0369  Max MRI capture & interprete                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0370  Max ultrasound capt & interp                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0371  Sialoendoscopy capt & interp                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0380  Cone beam ct capture limited                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0381  Cone beam ct capt mandible                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0382  Cone beam ct capt maxilla                         N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0383  Cone beam ct both jaws                            N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0384  Cone beam ct capture TMJ                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0385  Max MRI image capture                             N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0386  Max ultrasound image capture                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0391  Imterprete diagnostic image                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0415  Collection of microorganisms                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0416  Viral culture                                     R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0417  Collect & prep saliva sample                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0418  Analysis of saliva sample                         N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0425  Caries susceptibility test                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0460  Pulp vitality test                                R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D0470  Diagnostic casts                                  N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0472  Gross exam, prep & report                         R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0473  Micro exam, prep & report                         R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0475  Decalcification procedure                         R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0476  Spec stains for microorganis                      R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0478  Immunohistochemical stains                        R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0479  Tissue in-situ hybridization                      R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0480  Cytopath smear prep & report                      R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0481  Electron microscopy diagnost                      R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0482  Direct immunofluorescence                         R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0483  Indirect immunofluorescence                       R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0484  Consult slides prep elsewher                      R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D0502  Other oral pathology procedu                      R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D0999  Unspecified diagnostic proce                      R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D1110  Dental prophylaxis adult                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D1120  Dental prophylaxis child                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D1206  Topical fluoride varnish                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D1208  Topical app of fluoride                           N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D1310  Nutri counsel-control caries                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D1320  Tobacco counseling                                N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D1330  Oral hygiene instruction                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D1351  Dental sealant per tooth                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D1510  Space maintainer fxd unilat                       R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D1515  Fixed bilat space maintainer                      R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D1520  Remove unilat space maintain                      R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D1525  Remove bilat space maintain                       R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D1550  Recement space maintainer                         R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D1555  Remove fix space maintainer                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2140  Amalgam one surface permanen                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2150  Amalgam two surfaces permane                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2160  Amalgam three surfaces perma                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2330  Resin one surface-anterior                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2331  Resin two surfaces-anterior                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2332  Resin three surfaces-anterio                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2394  Post >=4srfc resinbase cmpst                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2710  Crown resin-based indirect                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2740  Crown porcelain/ceramic subs                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2794  Crown-titanium                                    N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2799  Provisional crown                                 N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2920  Dental recement crown                             N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2929  Prefab porc/ceram crown pri                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2932  Prefabricated resin crown                         N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2933  Prefab stainless steel crown                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2934  Prefab steel crown primary                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2940  Protective restoration                            N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2951  Tooth pin retention                               N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2953  Each addtnl cast post                             N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2954  Prefab post/core + crown                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2955  Post removal                                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2957  Each addtnl prefab post                           N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2960  Laminate labial veneer                            N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2961  Lab labial veneer resin                           N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2962  Lab labial veneer porcelain                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2970  Temp crown (fractured tooth)                      R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2975  Coping                                            N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2980  Crown repair                                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2981  Inlay repair                                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2982  Onlay repair                                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2983  Veneer repair                                     N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2990  Resin infiltration of lesion                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D2999  Dental unspec restorative pr                      R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D3110  Pulp cap direct                                   N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D3120  Pulp cap indirect                                 N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D3220  Therapeutic pulpotomy                             N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D3221  Gross pulpal debridement                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D3222  Part pulp for apexogenesis                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D3230  Pulpal therapy anterior prim                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D3240  Pulpal therapy posterior pri                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D3310  End thxpy, anterior tooth                         N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D3320  End thxpy, bicuspid tooth                         N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D3330  End thxpy, molar                                  N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D3332  Incomplete endodontic tx                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D3333  Internal root repair                              N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D3346  Retreat root canal anterior                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D3347  Retreat root canal bicuspid                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D3348  Retreat root canal molar                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D3351  Apexification/recalc initial                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D3352  Apexification/recalc interim                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D3353  Apexification/recalc final                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D3354  Pulpal regeneration                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D3410  Apicoect/perirad surg anter                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D3421  Root surgery bicuspid                             N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D3425  Root surgery molar                                N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D3430  Retrograde filling                                N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D3450  Root amputation                                   N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D3460  Endodontic endosseous implan                      R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D3470  Intentional replantation                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D3920  Tooth splitting                                   N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D3999  Endodontic procedure                              R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D4210  Gingivectomy/plasty 4 or mor                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D4211  Gingivectomy/plasty 1 to 3                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D4212  Gingivectomy/plasty rest                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D4245  Apically positioned flap                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D4249  Crown lengthen hard tissue                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D4260  Osseous surgery 4 or more                         R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D4261  Osseous surg 1 to 3 teeth                         N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.000YYY.00.00.0000000             25.0008 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  0.000YYY.00.00.0000000             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D4266  Guided tiss regen resorble                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D4267  Guided tiss regen nonresorb                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D4268  Surgical revision procedure                       R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D4273  Subepithelial tissue graft                        R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D4274  Distal/proximal wedge proc                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D4275  Soft tissue allograft                             N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D4277  Soft tissue graft firsttooth                      R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D4278  Soft tissue graft addl tooth                      R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D4320  Provision splnt intracoronal                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D4321  Provisional splint extracoro                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D4341  Periodontal scaling & root                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D4342  Periodontal scaling 1-3teeth                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D4355  Full mouth debridement                            R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D4381  Localized delivery antimicro                      R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D4910  Periodontal maint procedures                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D4920  Unscheduled dressing change                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D4999  Unspecified periodontal proc                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5110  Dentures complete maxillary                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5120  Dentures complete mandible                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5130  Dentures immediat maxillary                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5140  Dentures immediat mandible                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5211  Dentures maxill part resin                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5212  Dentures mand part resin                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5213  Dentures maxill part metal                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5214  Dentures mandibl part metal                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5225  Maxillary part denture flex                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5226  Mandibular part denture flex                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5281  Removable partial denture                         N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5410  Dentures adjust cmplt maxil                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5411  Dentures adjust cmplt mand                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5421  Dentures adjust part maxill                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5422  Dentures adjust part mandbl                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5520  Replace denture teeth complt                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5610  Dentures repair resin base                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5630  Rep partial denture clasp                         N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5640  Replace part denture teeth                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5671  Replc tth&acrlc mandibular                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5710  Dentures rebase cmplt maxil                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5711  Dentures rebase cmplt mand                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5720  Dentures rebase part maxill                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5721  Dentures rebase part mandbl                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5810  Denture interm cmplt maxill                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5811  Denture interm cmplt mandbl                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5820  Denture interm part maxill                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5821  Denture interm part mandbl                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5850  Denture tiss conditn maxill                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5851  Denture tiss condtin mandbl                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5860  Overdenture complete                              N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5861  Overdenture partial                               N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5862  Precision attachment                              N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5867  Replacement of precision att                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5875  Prosthesis modification                           N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5899  Removable prosthodontic proc                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5911  Facial moulage sectional                          R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D5912  Facial moulage complete                           R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D5913  Nasal prosthesis                                  I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5914  Auricular prosthesis                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5915  Orbital prosthesis                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5916  Ocular prosthesis                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5919  Facial prosthesis                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5922  Nasal septal prosthesis                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5923  Ocular prosthesis interim                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5924  Cranial prosthesis                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5925  Facial augmentation implant                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5926  Replacement nasal prosthesis                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5927  Auricular replacement                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5928  Orbital replacement                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5929  Facial replacement                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5931  Surgical obturator                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5932  Postsurgical obturator                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5933  Refitting of obturator                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5934  Mandibular flange prosthesis                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5935  Mandibular denture prosth                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5936  Temp obturator prosthesis                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5937  Trismus appliance                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5951  Feeding aid                                       R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D5952  Pediatric speech aid                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5953  Adult speech aid                                  I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5954  Superimposed prosthesis                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5955  Palatal lift prosthesis                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5960  Modify speech aid prosthesis                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5982  Surgical stent                                    I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5983  Radiation applicator                              R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D5984  Radiation shield                                  R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D5985  Radiation cone locator                            R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D5986  Fluoride applicator                               N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5987  Commissure splint                                 R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D5988  Surgical splint                                   I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5991  Topical medicament carrier                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5992  Adjust max prost appliance                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5993  Main/clean max prosthesis                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D5999  Maxillofacial prosthesis                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6010  Odontics endosteal implant                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6012  Endosteal implant                                 N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6040  Odontics eposteal implant                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6050  Odontics transosteal implnt                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6051  Interim abutment                                  N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6054  Implnt/abtmnt spprt remvprtl                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6055  Implant connecting bar                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6056  Prefabricated abutment                            N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6057  Custom abutment                                   N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6058  Abutment supported crown                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6059  Abutment supported mtl crown                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6060  Abutment supported mtl crown                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6061  Abutment supported mtl crown                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6062  Abutment supported mtl crown                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6063  Abutment supported mtl crown                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6064  Abutment supported mtl crown                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6065  Implant supported crown                           N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6066  Implant supported mtl crown                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6067  Implant supported mtl crown                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6068  Abutment supported retainer                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6069  Abutment supported retainer                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6070  Abutment supported retainer                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6071  Abutment supported retainer                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6072  Abutment supported retainer                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6073  Abutment supported retainer                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6074  Abutment supported retainer                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6075  Implant supported retainer                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6076  Implant supported retainer                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6077  Implant supported retainer                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6080  Implant maintenance                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6090  Repair implant                                    I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6091  Repl semi/precision attach                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6092  Recement supp crown                               N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6093  Recement supp part denture                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6094  Abut support crown titanium                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6095  Odontics repr abutment                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6100  Removal of implant                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6101  Debridement of a periimplant                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6102  Debridement & contouring                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6103  Bone graft repair perimplant                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6104  Bone graft time of implant                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6190  Radio/surgical implant index                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6194  Abut support retainer titani                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6199  Implant procedure                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6205  Pontic-indirect resin based                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6210  Prosthodont high noble metal                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6211  Bridge base metal cast                            N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6212  Bridge noble metal cast                           N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6214  Pontic titanium                                   N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6240  Bridge porcelain high noble                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6241  Bridge porcelain base metal                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6242  Bridge porcelain nobel metal                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6245  Bridge porcelain/ceramic                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6251  Bridge resin base metal                           N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6253  Provisional pontic                                N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6545  Dental retainr cast metl                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6548  Porcelain/ceramic retainer                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6600  Porcelain/ceramic inlay 2srf                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6624  Inlay titanium                                    N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6634  Onlay titanium                                    N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6710  Crown-indirect resin based                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6740  Crown porcelain/ceramic                           N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6750  Crown porcelain high noble                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6751  Crown porcelain base metal                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6752  Crown porcelain noble metal                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6793  Provisional retainer crown                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6794  Crown titanium                                    N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6920  Dental connector bar                              R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D6930  Dental recement bridge                            N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6940  Stress breaker                                    N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6950  Precision attachment                              N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6975  Coping                                            N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6980  Fixed partial repair                              N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6985  Pediatric partial denture fx                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D6999  Fixed prosthodontic proc                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7111  Extraction coronal remnants                       R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7140  Extraction erupted tooth/exr                      R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.000YYY.00.00.0000000             25.0008 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  0.000YYY.00.00.0000000             25.0008 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  0.000YYY.00.00.0000000             25.0008 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  0.000YYY.00.00.0000000             25.0008 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  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D7250  Tooth root removal                                R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D7251  Coronectomy                                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7260  Oral antral fistula closure                       R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D7261  Primary closure sinus perf                        R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7270  Tooth reimplantation                              N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7272  Tooth transplantation                             N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7280  Exposure impact tooth orthod                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7282  Mobilize erupted/malpos toot                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7283  Place device impacted tooth                       R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7287  Exfoliative cytolog collect                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7288  Brush biopsy                                      R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7290  Repositioning of teeth                            N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7291  Transseptal fiberotomy                            R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D7292  Screw retained plate                              N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7310  Alveoplasty w/ extraction                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7320  Alveoplasty w/o extraction                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7321  Alveoloplasty not w/extracts                      R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7340  Vestibuloplasty ridge extens                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7350  Vestibuloplasty exten graft                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7412  Excision benign lesion compl                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7415  Excision malig les complicat                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7465  Lesion destruction                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7471  Rem exostosis any site                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7472  Removal of torus palatinus                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7473  Remove torus mandibularis                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7485  Surg reduct osseoustuberosit                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7490  Maxilla or mandible resectio                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7511  Incision/drain abscess intra                      R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7520  I&d abscess extraoral                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7521  Incision/drain abscess extra                      R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7540  Removal of fb reaction                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7560  Maxillary sinusotomy                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7610  Maxilla open reduct simple                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7670  Closd rductn splint alveolus                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7671  Alveolus open reduction                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7710  Maxilla open reduct compound                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7810  Tmj open reduct-dislocation                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7820  Closed tmp manipulation                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7830  Tmj manipulation under anest                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7840  Removal of tmj condyle                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7850  Tmj meniscectomy                                  I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7858  Tmj reconstruction                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7860  Tmj cutting into joint                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7865  Tmj reshaping components                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7870  Tmj aspiration joint fluid                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7871  Lysis + lavage w catheters                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7872  Tmj diagnostic arthroscopy                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7873  Tmj arthroscopy lysis adhesn                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7874  Tmj arthroscopy disc reposit                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7875  Tmj arthroscopy synovectomy                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7876  Tmj arthroscopy discectomy                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7877  Tmj arthroscopy debridement                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7880  Occlusal orthotic appliance                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7899  Tmj unspecified therapy                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7920  Dental skin graft                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7921  Collect & appl blood product                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7940  Reshaping bone orthognathic                       R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D7941  Bone cutting ramus closed                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7944  Bone cutting segmented                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7945  Bone cutting body mandible                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7946  Reconstruction maxilla total                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7947  Reconstruct maxilla segment                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7948  Reconstruct midface no graft                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7949  Reconstruct midface w/graft                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7950  Mandible graft                                    I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7951  Sinus aug w bone or bone sub                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7952  Sinus augmentation vertical                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7953  Bone replacement graft                            N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7955  Repair maxillofacial defects                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7960  Frenulectomy/frenectomy                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7963  Frenuloplasty                                     N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7970  Excision hyperplastic tissue                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7971  Excision pericoronal gingiva                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7972  Surg redct fibrous tuberosit                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7980  Sialolithotomy                                    I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7981  Excision of salivary gland                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7982  Sialodochoplasty                                  I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7983  Closure of salivary fistula                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7990  Emergency tracheotomy                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7991  Dental coronoidectomy                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7995  Synthetic graft facial bones                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7996  Implant mandible for augment                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7997  Appliance removal                                 N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D7999  Oral surgery procedure                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D8010  Limited dental tx primary                         N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D8020  Limited dental tx transition                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D8030  Limited dental tx adolescent                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D8040  Limited dental tx adult                           N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D8050  Intercep dental tx primary                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D8060  Intercep dental tx transitn                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D8070  Compre dental tx transition                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D8080  Compre dental tx adolescent                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D8090  Compre dental tx adult                            N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D8210  Orthodontic rem appliance tx                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D8220  Fixed appliance therapy habt                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D8660  Preorthodontic tx visit                           N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D8670  Periodic orthodontc tx visit                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D8680  Orthodontic retention                             N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D8690  Orthodontic treatment                             N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D8691  Repair ortho appliance                            N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D8692  Replacement retainer                              N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D8693  Rebond/cement/repair retain                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D8999  Orthodontic procedure                             N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D9120  Fix partial denture section                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D9211  Regional block anesthesia                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D9212  Trigeminal block anesthesia                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D9215  Local anesthesia                                  I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D9220  General anesthesia                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D9230  Analgesia                                         R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D9241  Intravenous sedation                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D9248  Sedation (non-iv)                                 R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D9310  Dental consultation                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D9410  Dental house call                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D9420  Hospital/ASC call                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D9430  Office visit during hours                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D9440  Office visit after hours                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D9450  Case presentation tx plan                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D9610  Dent therapeutic drug inject                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D9630  Other drugs/medicaments                           R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D9910  Dent appl desensitizing med                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D9911  Appl desensitizing resin                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D9920  Behavior management                               N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D9930  Treatment of complications                        R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D9940  Dental occlusal guard                             R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D9941  Fabrication athletic guard                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D9942  Repair/reline occlusal guard                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D9950  Occlusion analysis                                R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D9951  Limited occlusal adjustment                       R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D9952  Complete occlusal adjustment                      R   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
D9970  Enamel microabrasion                              N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D9971  Odontoplasty 1-2 teeth                            N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D9972  Extrnl bleaching per arch                         N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D9973  Extrnl bleaching per tooth                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D9974  Intrnl bleaching per tooth                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D9975  External bleaching home app                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
D9999  Adjunctive procedure                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0008  Admin influenza virus vac                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0009  Admin pneumococcal vaccine                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0010  Admin hepatitis b vaccine                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0027  Semen analysis                                    X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0101  CA screen;pelvic/breast exam                      A   0.45   0.64     0.32    0.03   1.12  0.800XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0102  Prostate ca screening; dre                        A   0.17   0.41     0.07    0.01   0.59  0.250XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0103  PSA screening                                     X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0104  CA screen;flexi sigmoidscope                      A   0.96   3.17     0.82    0.14   4.27  1.920000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
G0105  Colorectal scrn; hi risk ind                      A   3.69   7.79     2.20    0.59  12.07  6.480000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
G010553Colorectal scrn; hi risk ind                      A   0.96   3.17     0.82    0.14   4.27  1.920000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
G0106  Colon CA screen;barium enema                      A   0.99   5.65     5.65NA  0.04   6.68  6.681XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0106TCColon CA screen;barium enema                      A   0.00   5.29     5.29NA  0.01   5.30  5.301XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
G010626Colon CA screen;barium enema                      A   0.99   0.36     0.36    0.03   1.38  1.381XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0108  Diab manage trn  per indiv                        A   0.90   0.58     0.58NA  0.05   1.53  1.530XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0109  Diab manage trn ind/group                         A   0.25   0.15     0.15NA  0.01   0.41  0.410XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0117  Glaucoma scrn hgh risk direc                      T   0.45   1.14     1.14NA  0.03   1.62  1.620XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0118  Glaucoma scrn hgh risk direc                      T   0.17   0.98     0.98NA  0.01   1.16  1.160XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0120  Colon ca scrn; barium enema                       A   0.99   5.65     5.65NA  0.04   6.68  6.681XXX.00.00.0000000             25.0008 090 99      7.71   7.71   0.04
G0120TCColon ca scrn; barium enema                       A   0.00   5.29     5.29NA  0.01   5.30  5.301XXX.00.00.0000000             25.0008 090 99      7.35   7.35   0.01
G012026Colon ca scrn; barium enema                       A   0.99   0.36     0.36    0.03   1.38  1.381XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0121  Colon ca scrn not hi rsk ind                      A   3.69   7.79     2.20    0.59  12.07  6.480000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
G012153Colon ca scrn not hi rsk ind                      A   0.96   3.17     0.82    0.14   4.27  1.920000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
G0122  Colon ca scrn; barium enema                       N+  0.99   7.61     7.61NA  0.05   8.65  8.651XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0122TCColon ca scrn; barium enema                       N+  0.00   7.21     7.21NA  0.01   7.22  7.221XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G012226Colon ca scrn; barium enema                       N+  0.99   0.40     0.40    0.04   1.43  1.431XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0124  Screen c/v thin layer by MD                       A   0.42   0.48     0.48    0.03   0.93  0.930XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0127  Trim nail(s)                                      R   0.17   0.51     0.04    0.01   0.69  0.220000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
G0128  CORF skilled nursing service                      R   0.00   0.23     0.23NA  0.01   0.24  0.243XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0130  Single energy x-ray study                         A   0.22   0.78     0.78NA  0.02   1.02  1.021XXX.00.00.0000000             25.0008 090 99      2.88   2.88   0.05
G0130TCSingle energy x-ray study                         A   0.00   0.69     0.69NA  0.01   0.70  0.701XXX.00.00.0000000             25.0008 010 99      2.79   2.79   0.04
G013026Single energy x-ray study                         A   0.22   0.09     0.09    0.01   0.32  0.321XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0141  Scr c/v cyto,autosys and md                       A   0.42   0.48     0.48    0.03   0.93  0.930XXX.00.00.0000000             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0166  Extrnl counterpulse, per tx                       A   0.07   4.14     4.14NA  0.03   4.24  4.240XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0168  Wound closure by adhesive                         A   0.45   2.64     0.32    0.03   3.12  0.800000.00.00.0020100             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0176  OPPS/PHP;activity therapy                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0179  MD recertification HHA PT                         A   0.45   0.74     0.74NA  0.03   1.22  1.220XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0180  MD certification HHA patient                      A   0.67   0.85     0.85NA  0.04   1.56  1.560XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0181  Home health care supervision                      A   1.73   1.27     1.27NA  0.10   3.10  3.100XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0182  Hospice care supervision                          A   1.73   1.29     1.29NA  0.10   3.12  3.120XXX.00.00.0000000             25.0008 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  0.000YYY.00.00.0021011             25.0008 090 99      0.00   0.00   0.00
G0202  Screeningmammographydigital                       A   0.70   3.33     3.33NA  0.05   4.08  4.081XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
G0202TCScreeningmammographydigital                       A   0.00   3.05     3.05NA  0.01   3.06  3.061XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
G020226Screeningmammographydigital                       A   0.70   0.28     0.28    0.04   1.02  1.021XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
G0204  Diagnosticmammographydigital                      A   0.87   4.04     4.04NA  0.06   4.97  4.971XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
G0204TCDiagnosticmammographydigital                      A   0.00   3.69     3.69NA  0.01   3.70  3.701XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
G020426Diagnosticmammographydigital                      A   0.87   0.35     0.35    0.05   1.27  1.271XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
G0206  Diagnosticmammographydigital                      A   0.70   3.17     3.17NA  0.05   3.92  3.921XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0206TCDiagnosticmammographydigital                      A   0.00   2.89     2.89NA  0.01   2.90  2.901XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G020626Diagnosticmammographydigital                      A   0.70   0.28     0.28    0.04   1.02  1.021XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0219  PET img wholbod melano nonco                      N   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0219TCPET img wholbod melano nonco                      N   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0099999             25.0008 010 99      0.00   0.00   0.00
G021926PET img wholbod melano nonco                      N   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0235  PET not otherwise specified                       N   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0235TCPET not otherwise specified                       N   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0099999             25.0008 010 99      0.00   0.00   0.00
G023526PET not otherwise specified                       N   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0237  Therapeutic procd strg endur                      A   0.00   0.31     0.31NA  0.01   0.32  0.325XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0238  Oth resp proc, indiv                              A   0.00   0.33     0.33NA  0.01   0.34  0.345XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0239  Oth resp proc, group                              A   0.00   0.37     0.37NA  0.01   0.38  0.385XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0245  Initial foot exam pt lops                         R   0.88   0.98     0.30    0.05   1.91  1.230XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0246  Followup eval of foot pt lop                      R   0.45   0.64     0.13    0.03   1.12  0.610XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0247  Routine footcare pt w lops                        R   0.50   1.66     0.14    0.04   2.20  0.680ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0248  Demonstrate use home inr mon                      R   0.00   3.34     3.34NA  0.01   3.35  3.353XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
G0249  Provide INR test mater/equip                      R   0.00   3.30     3.30NA  0.01   3.31  3.313XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
G0250  MD INR test revie inter mgmt                      R   0.18   0.07     0.07NA  0.01   0.26  0.262XXX.00.00.0000000             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0252  PET imaging initial dx                            N   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0252TCPET imaging initial dx                            N   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G025226PET imaging initial dx                            N+  1.50   0.60     0.60    0.10   2.20  2.201XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0255  Current percep threshold tst                      N   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0255TCCurrent percep threshold tst                      N   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0099999             25.0008 010 99      0.00   0.00   0.00
G025526Current percep threshold tst                      N   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0259  Inject for sacroiliac joint                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0268  Removal of impacted wax md                        A   0.61   0.91     0.30    0.03   1.55  0.940000.00.00.0022100             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0270  MNT subs tx for change dx                         A   0.45   0.42     0.34    0.03   0.90  0.820XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0271  Group MNT 2 or more 30 mins                       A   0.25   0.20     0.19    0.01   0.46  0.450XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0275  Renal angio, cardiac cath                         A   0.25   0.09NA   0.09    0.01   0.35  0.350ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0278  Iliac art angio,cardiac cath                      A   0.25   0.09NA   0.09    0.01   0.35  0.350ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0281  Elec stim unattend for press                      A   0.18   0.21     0.21NA  0.01   0.40  0.407XXX.00.00.0050000             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0283  Elec stim other than wound                        A   0.18   0.21     0.21NA  0.01   0.40  0.407XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
G0288  Recon, CTA for surg plan                          A   0.00   1.15     1.15NA  0.01   1.16  1.163XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
G0289  Arthro, loose body + chondro                      A   1.48   0.79NA   0.79    0.29   2.56  2.560ZZZ.00.00.0001000             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0295  Electromagnetic therapy onc                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0307  CBC without platelet                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0328  Fecal blood scrn immunoassay                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0329  Electromagntic tx for ulcers                      A   0.06   0.23     0.23NA  0.01   0.30  0.307XXX.00.00.0050000             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0337  Hospice evaluation preelecti                      X+  1.42   0.57     0.57    0.10   2.09  2.099XXX.00.00.0099999             25.0008 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  0.000XXX.00.00.0000000             25.0008 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  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0341  Percutaneous islet celltrans                      A   6.98  59.87     3.06    0.49  67.34 10.530000.00.00.0020010             25.0008 090 99      0.00   0.00   0.00
G0342  Laparoscopy islet cell trans                      A  11.92   7.06NA   7.06    0.84  19.82 19.820090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
G0343  Laparotomy islet cell transp                      A  19.85  11.70NA  11.70    1.40  32.95 32.950090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
G0364  Bone marrow aspirate &biopsy                      A   0.16   0.19     0.08    0.01   0.36  0.250ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0365  Vessel mapping hemo access                        A   0.25   6.23     6.23NA  0.04   6.52  6.521XXX.00.00.0000000             25.0008 090 99      6.26   6.26   0.04
G0365TCVessel mapping hemo access                        A   0.00   6.15     6.15NA  0.01   6.16  6.161XXX.00.00.0000000             25.0008 010 99      6.18   6.18   0.01
G036526Vessel mapping hemo access                        A   0.25   0.08     0.08    0.03   0.36  0.361XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0372  MD service required for PMD                       A   0.17   0.08     0.08    0.01   0.26  0.260XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0378  Hospital observation per hr                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0379  Direct refer hospital observ                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0389  Ultrasound exam AAA screen                        A   0.58   2.66     2.66NA  0.04   3.28  3.281XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0389TCUltrasound exam AAA screen                        A   0.00   2.45     2.45NA  0.01   2.46  2.461XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
G038926Ultrasound exam AAA screen                        A   0.58   0.21     0.21    0.03   0.82  0.821XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0396  Alcohol/subs interv 15-30mn                       A   0.65   0.37     0.31    0.04   1.06  1.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0397  Alcohol/subs interv >30 min                       A   1.30   0.65     0.58    0.08   2.03  1.960XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0398  Home sleep test/type 2 Porta                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0398TCHome sleep test/type 2 Porta                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 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  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0399  Home sleep test/type 3 Porta                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0399TCHome sleep test/type 3 Porta                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 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  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0400  Home sleep test/type 4 Porta                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0400TCHome sleep test/type 4 Porta                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 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  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0402  Initial preventive exam                           A   2.43   2.26     1.05    0.12   4.81  3.600XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0403  EKG for initial prevent exam                      A   0.17   0.35     0.35NA  0.02   0.54  0.544XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0404  EKG tracing for initial prev                      A   0.00   0.29     0.29NA  0.01   0.30  0.303XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0405  EKG interpret & report preve                      A   0.17   0.06     0.06    0.01   0.24  0.242XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0406  Inpt/tele follow up 15                            A   0.76   0.31NA   0.31    0.05   1.12  1.120XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0407  Inpt/tele follow up 25                            A   1.39   0.59NA   0.59    0.08   2.06  2.060XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0408  Inpt/tele follow up 35                            A   2.00   0.85NA   0.85    0.12   2.97  2.970XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0409  CORF related serv 15 mins ea                      R   0.00   0.55     0.55NA  0.01   0.56  0.569XXX.00.00.0000000             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0412  Open tx iliac spine uni/bil                       A  10.45   9.00NA   9.00    2.04  21.49 21.490090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
G0413  Pelvic ring fracture uni/bil                      A  15.73  12.77NA  12.77    3.06  31.56 31.560090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
G0414  Pelvic ring fx treat int fix                      A  14.65  12.03NA  12.03    2.86  29.54 29.540090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
G0415  Open tx post pelvic fxcture                       A  20.93  15.42NA  15.42    4.21  40.56 40.560090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
G0416  Sat biopsy 10-20                                  A   3.09  16.48    16.48NA  0.12  19.69 19.691XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0416TCSat biopsy 10-20                                  A   0.00  14.33    14.33NA  0.01  14.34 14.341XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G041626Sat biopsy 10-20                                  A   3.09   2.15     2.15    0.11   5.35  5.351XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0417  Sat biopsy prostate 21-40                         A   5.86  32.20    32.20NA  0.25  38.31 38.311XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0417TCSat biopsy prostate 21-40                         A   0.00  28.00    28.00NA  0.01  28.01 28.011XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G041726Sat biopsy prostate 21-40                         A   5.86   4.20     4.20    0.24  10.30 10.301XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0418  Sat biopsy prostate 41-60                         A  10.30  54.97    54.97NA  0.42  65.69 65.691XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0418TCSat biopsy prostate 41-60                         A   0.00  47.82    47.82NA  0.01  47.83 47.831XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G041826Sat biopsy prostate 41-60                         A  10.30   7.15     7.15    0.41  17.86 17.861XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0419  Sat biopsy prostate: >60                          A  11.61  65.96    65.96NA  0.46  78.03 78.031XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0419TCSat biopsy prostate: >60                          A   0.00  57.39    57.39NA  0.01  57.40 57.401XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G041926Sat biopsy prostate: >60                          A  11.61   8.57     8.57    0.45  20.63 20.631XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0420  Ed svc CKD ind per session                        A   2.12   0.90     0.90NA  0.11   3.13  3.130XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0421  Ed svc CKD grp per session                        A   0.50   0.19     0.19NA  0.03   0.72  0.720XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0422  Intens cardiac rehab w/exerc                      A   1.64   1.47     1.47    0.09   3.20  3.200XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0423  Intens cardiac rehab no exer                      A   1.64   1.47     1.47    0.09   3.20  3.200XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0424  Pulmonary rehab w exer                            A   0.28   0.60     0.10    0.03   0.91  0.410XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0425  Inpt/ED teleconsult30                             A   1.92   0.81NA   0.81    0.18   2.91  2.910XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0426  Inpt/ED teleconsult50                             A   2.61   1.12NA   1.12    0.22   3.95  3.950XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0427  Inpt/ED teleconsult70                             A   3.86   1.66NA   1.66    0.29   5.81  5.810XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0428  Collagen Meniscus Implant                         N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0429  Dermal filler injection(s)                        A   1.19   1.52     0.69    0.24   2.95  2.120000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
G0431  Drug screen multiple class                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0436  Tobacco-use counsel 3-10 min                      A   0.24   0.16     0.10    0.01   0.41  0.350XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0437  Tobacco-use counsel>10min                         A   0.50   0.27     0.21    0.03   0.80  0.740XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0438  PPPS, initial visit                               A   2.43   2.42     2.42NA  0.12   4.97  4.970XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0439  PPPS, subseq visit                                A   1.50   1.76     1.76NA  0.03   3.29  3.290XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0442  Annual alcohol screen 15 min                      A   0.18   0.35     0.08    0.01   0.54  0.270XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0443  Brief alcohol misuse counsel                      A   0.45   0.27     0.20    0.03   0.75  0.680XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0444  Depression screen annual                          A   0.18   0.35     0.08    0.01   0.54  0.270XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0445  High inten beh couns STD 30m                      A   0.45   0.29     0.19    0.03   0.77  0.670XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0446  Intens behave ther cardio dx                      A   0.45   0.27     0.20    0.03   0.75  0.680XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0447  Behavior counsel obesity 15m                      A   0.45   0.27     0.20    0.03   0.75  0.680XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0448  Place perm pacing cardiovert                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0451  Devlopment test interpt&rep                       A   0.00   0.26     0.26NA  0.01   0.27  0.275XXX.00.00.0000000             25.0008 040 99      0.00   0.00   0.00
G045226Molecular pathology interpr                       A   0.37   0.15     0.15    0.03   0.55  0.556XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0453  Cont intraop neuro monitor                        A   0.50   0.24NA   0.24    0.03   0.77  0.770XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0454  MD document visit by NPP                          A   0.18   0.07     0.07    0.01   0.26  0.260XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0455  Fecal microbiota prep instil                      A   0.97   2.48     2.48NA  0.10   3.55  3.551000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0456  Neg pre wound <=50 sq cm                          C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0457  Neg pres wound >50 sq cm                          C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
G0458  LDR prostate brachy comp rat                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0908  HgB > 12 g/dL                                     M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0909  HbG not doc                                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0910  HgB <= 12 g/dL                                    M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0913  Improve visual funct                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0914  Survey not complete                               M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0915  No improve visual funct                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0916  Satisfy with care                                 M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0917  Satisfy survey not complete                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0918  No satisfy with care                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0919  Flu immunize not avail                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0920  Type loc act doc                                  M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0921  Doc pt reas no assess                             M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G0922  Type loc act not doc                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G3001  Admin + supply, tositumomab                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8126  Pt treat w/antidepress12wks                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8396  LVEF not performed                                M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8410  Eval on foot documented                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8416  Pt inelig footwear evaluatio                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8420  Calc BMI norm parameters                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8421  BMI not calculated                                M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8422  Pt inelig BMI calculation                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8428  Cur meds not document                             M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8430  Pt inelig med check                               M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8442  Pt inelig pain assessment                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8473  ACE/ARB thxpy rxd                                M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8474  ACE/ARB not rxd; doc reas                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8475  ACE/ARB thxpy not rxd                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8478  BP not performed/doc                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8482  Flu immunize order/admin                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8485  Report, Diabetes measures                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8486  Report, Prev Care Measures                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8487  Report CKD Measures                               M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8489  CAD measures grp                                  M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8490  RA measures grp                                   M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8491  HIV/AIDS measures grp                             M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8492  Periop Care measures grp                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8493  Back pain measures grp                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8506  Pt rec ACE/ARB                                    M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8509  Pos pain assess no f/u doc                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8530  Auto AV fistula recd                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8539  Doc funct and care plan                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8540  Pt inelig funct assess                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8542  Doc funct no deficiencies                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8544  CABG measures grp                                 M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8545  HepC measures grp                                 M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8547  IVD measures grp                                  M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8548  HF measures grp                                   M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8553  Prescrip transmit via ERx sy                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8564  Pt ref oto eval                                   M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8565  Ver doc hear loss                                 M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8569  Prol intubation req                               M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8570  No prol intub req                                 M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8572  No ster wd ifx                                    M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8573  Stk CABG                                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8574  No strk CABG                                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8575  Postop ren fail                                   M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8576  No postop ren fail                                M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8579  Antplt med disch                                  M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8580  Antplt med contraind                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8581  no antplt med disch                               M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8582  Bblock disch                                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8583  Bblock contraind                                  M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8584  No bblock disch                                   M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8585  Antilipid treat disch                             M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8586  Antlip disch contra                               M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8587  No antlipid treat disch                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8588  Sys BP <140                                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8589  Sys BP >= 140                                     M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8590  Dia BP < 90                                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8591  Dia BP >= 90                                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8592  No BP measure                                     M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8593  Lipid pn results                                  M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8594  No lipid prof perf                                M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8595  Ldl < 100                                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8596  No LDL perf                                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8597  Ldl >= 100                                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8598  Asp therp used                                    M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8599  No asp therp used                                 M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8603  Spok lang comp score                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8606  Attention score                                   M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8607  No high score attention                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8608  No attention score                                M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8609  Memory score                                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8610  No high score memory                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8611  No memory score                                   M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8612  Moto speech score                                 M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8614  No moto speech score                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8615  Reading score                                     M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8616  No high score reading                             M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8617  No reading score                                  M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8618  Spok lang exp score                               M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8621  Writing score                                     M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8622  No high score writing                             M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8623  No writing score                                  M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8624  Swallowing score                                  M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8625  No high score swallowing                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8626  No swallowing score                               M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8633  Pharm ther osteo rx                               M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8644  EP no prescribe priv                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8645  Asthma measures grp                               M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8682  LVG test perf                                     M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8685  LVF test not perf                                 M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8694  Lvef <40%                                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8696  Antithromb thx presc                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8697  Antithromb no presc doc reas                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8698  Antithromb no presc no reas                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8699  Rehab ordered disch                               M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8700  Rehab not indicated disch                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8701  Rehab not ordered                                 M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8702  Antiobiotics 4 hr prior surg                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8703  Antibiotics not prior surg                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8704  ECG performed                                     M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8705  Med reas no ECG                                   M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8706  Pt reas no ECG                                    M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8707  ECG not performed                                 M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8708  Antibiotic not pres                               M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8709  Med reas antibiotic pres                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8710  Pt pres antibiotic                                M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8711  Pres antibiotic                                   M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8712  Not pres antibiotic                               M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8713  SpKt/V great 1.2 Kt/V                             M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8714  Hemodialysis 3 times week                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8717  Less 1.2 Kt/V                                     M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8718  Great 1.7 Kt/V per week                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8720  Less 1.7 Kt/V per week                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8721  Pt, pn, hist grade doc                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8722  Med reas pt, pn, not doc                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8723  Spec sit not prim tumor                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8724  Pt, pn, hist grade not doc                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8725  Lipid profile perf doc                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8726  Doc reas no lipid profile                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8728  Lipid profile not perf                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8730  Pain doc pos and plan                             M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8731  Pain neg no plan                                  M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8732  No doc of pain                                    M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8733  Doc pos elder mal scrn plan                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8734  Doc neg elder mal no plan                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8735  Eld mal scrn pos no plan                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8736  LDL-C <100mg/dL                                   M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8737  LDL-C >=100mg/dL                                  M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8738  Lvef < 40%                                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8739  Lvef >= 40%                                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8740  LVEF not perfrmd                                  M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8741  Not tx spoken lang                                M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8742  Not tx attention                                  M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8743  Not tx memory                                     M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8744  Not tx motor speech                               M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8745  Not tx reading                                    M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8746  Not tx spoken lang express                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8747  Not tx writing                                    M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8748  Not tx swallowing                                 M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8749  Signs of melanoma absent                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8751  Smkg status not assess                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8752  Sys BP less 140                                   M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8753  Sys BP > or = 140                                 M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8754  Dias BP less 90                                   M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8755  Dias BP > or = 90                                 M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8756  No BP measure doc                                 M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8757  COPD MG qual act perform                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8758  IBD MG qual act perform                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8759  OSA MG qual act perform                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8761  Dementia MG qual act perform                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8762  PD MG qual act perform                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8763  Hyperten MG qual act perform                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8764  Car Prev MG qual act perform                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8765  Cataract MG qual act perform                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8767  Lipid panel res doc rev                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8768  Doc med reas no lipid profle                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8769  Lipid profile not perform                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8770  Urine protein test doc rev                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8771  Doc dx CKD                                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8772  Doc med reas no urine protn                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8773  No urine protein test                             M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8774  Serum creatinine doc rev                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8775  Doc med reas no serum crtn                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8776  No serum creatinine test                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8777  Diabetes screen                                   M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8778  Doc med reas no diabete scrn                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8779  No diabetes screen                                M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8780  Counsel diet phys activity                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8781  Doc med reas no counsel diet                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8782  No counsel diet phys act                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8783  BP scrn perf rec interval                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8784  Pt no elig for BP assess                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8785  BP scrn no perf at interval                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8790  Systolic <130mmHg                                 M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8791  Systolic 130-139mmHg                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8792  Systolic >=140mmHg                                M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8793  Diastolic <80mmHg                                 M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8794  Diastolic 80-89mmHg                               M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8795  Diastolic >=90mmHg                                M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8796  BP not doc                                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8797  Specimen site not esophagus                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8798  Specimen site not prostate                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8799  Anticoag ordered                                  M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8800  Doc reas anticoag not order                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8801  Anticoag not ordered                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8806  Transab or transvag US                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8807  Doc reas no US                                    M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8808  No transab or transvag US                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8809  Rh-immunoglobulin order                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8810  Doc reas no Rh-immuno                             M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8811  No Rh-immunoglobulin order                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8812  Pt not elig CTA, duplex, MRA                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8813  CTA, duplex, MRA performed                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8814  No CTA, duplex, MRA                               M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8815  Doc reas no statin therapy                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8816  Statin med pres at disch                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8817  Doc reas no statin med disch                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8818  Pt disch to home by day#7                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8825  Pt not disch to home day#7                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8826  Pt disch home day #2 EVAR                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8827  Aneurysm <= 5.5cm for women                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8833  Pt not disch home day#2 EVAR                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8834  Pt disch home day #2 CEA                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8835  Asymptom no trans                                 M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8838  Not disch home by day #2                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8839  Sleep apnea assess                                M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8840  Doc reas no sleep apnea                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8841  No sleep apnea assess                             M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8842  AHI or RDI initial dx                             M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8843  Doc reas no AHI or RDI                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8844  No AHI or RDI initial dx                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8845  Pos Airway Press prescribed                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8846  Mod or severe OSA                                 M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8848  Mild OSA                                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8849  Doc reas no Pos Air Press                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8850  No PAP prescribed                                 M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8851  Adhere Pos Air Press therapy                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8852  Pos Air Press prescribe                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8853  Pos Air Press not prescribe                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8854  Reas no adhere Pos Air Pres                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8855  Pos Air Press adhere no perf                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8856  Ref for oto eval                                  M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8857  No elig ref for oto eval                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8858  Not ref for oto eval                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8859  Corticosteroids 10mg 60 days                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8860  Corticosteroid 10 mg 60 days                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8861  DXA ordered for osteo                             M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8862  No corticostrd 10mg 60 days                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8863  No assess bone loss                               M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8864  Pneumococcal vaccine admin                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8865  Doc med reas no pneumococcal                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8866  Doc pt reas no pneumococcal                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8867  No pneumococcal admin                             M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8868  1st course antiTNF                                M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8869  Doc immun hep B 1st antiTNF                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8870  HepB admin 1st antiTNF                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8871  No 1st antiTNF                                    M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8872  Intraop image confirm excise                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8873  Specimen not intraop image                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8874  Tissue not image intraop                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8875  Breast cancer dx min invsive                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8876  Doc reas no min inv dx                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8877  No brst cncr dx min invasive                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8878  Sent lymph node biopsy                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8879  Node neg inv brst cncr                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8880  Doc reas no lymph node biop                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8881  Brst cncr stage > T1N0M0                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8882  No sent lymph node biopsy                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8883  Rev, comm, track, doc biopsy                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8884  Doc reas biopsy not review                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8885  No rev, comm, track biopsy                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8886  BP under control                                  M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8887  Doc med reas BP not control                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8888  BP not under control                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8889  No doc BP                                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8890  LDL-C under control                               M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8891  Doc med reas no LDL-C contrl                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8892  Doc med reas no LDL-C test                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8893  LDL-C not under control                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8894  LDL-C not performed                               M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8895  Antrom prescribe                                  M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8896  Doc med reas no antihtrom                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8897  Antithrom not prescribe                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8898  COPD Measures Group                               M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8899  Inflammatory Bowel Dis MG                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8900  Obstructive Sleep Apnea MG                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8902  Dementia Measures Group                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8903  Parkinsons Disease MG                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8904  Hypertension MG                                   M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8905  Cardiovascular Prevention MG                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8906  Cataract Measures Group                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8907  Pt doc no events on discharg                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8908  Pt doc w burn prior to D/C                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8909  Pt doc no burn prior to D/C                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8910  Pt doc to have fall in ASC                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8911  Pt doc no fall in ASC                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8912  Pt doc with wrong event                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8913  Pt doc no wrong event                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8914  Pt trans to hosp post D/C                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8915  Pt not trans to hosp at D/C                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8916  Pt w IV AB given on time                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8917  Pt w IV AB not given on time                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8918  Pt w/o preop order IV AB pro                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8919  Mst rcnt sys bp <140mmg                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8920  Mst rcnt sys bp >=140mmhg                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8921  Mst rcnt dia bp <90mmhg                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8922  Mst rcnt dia bp >=90mmhg                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8923  LVEF < 40% or lvsd                                M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8924  Spiro EV1/FVC <60% COPD sym                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8925  Spiro>=60% or pt no COPD sym                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8926  Spiro no perf or doc                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8927  Adj chem pres AJCC III                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8928  Adj chem not pres rsn spec                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8929  Adj cmo not pres rsn not gvn                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8930  Assess of dep @ initial eval                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8931  Asses of dep not documented                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8932  Suicd rsk assessed init eval                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8933  Suicide risk not assessed                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8934  LVEF <40% or dep lv sys fcn                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8935  Rx ACE or ARB therapy                             M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8936  Pt not eligible ACE/ARB                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8937  No rx ACE/ARB therapy                             M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8938  BMI calc, pt no f/u plan elg                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8939  Pain assess doc, f/u no doc                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8940  Srn clin dep doc no f/u pln                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8941  No doc elder scrn, pt no el                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8942  Doc fcn/care plan w/30 days                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8943  LDLC not pres w/i 12 mo prir                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8944  AJCC Mel cnr stg 0 - IIC                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8945  Aneurysm <=6 cm for men                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8946  MIBM but no dx of breast CA                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8947  1 or more neuropsych                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8948  No neuropsych symptoms                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8949  Doc pt reas on counsel diet                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8950  Pre-htn or htn doc, f/u indc                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8951  Pre-htn/htn doc, no pt f/u                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8952  Pre-htn/htn, no f/u, not gvn                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8953  Oncology MG qual act perform                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8954  Pt data rpt qual clin db reg                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8955  Most recent assess vol mgmt                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8956  Pt rcv HeDia outpt dyls fac                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8957  Pt no HeDia in outpt fac                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8958  Assess vol mgmt not doc                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8959  Clin tx MDD comm to tx clin                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8960  Clin tx MDD not comm                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8961  CSIT lowrisk surg pts preop                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8962  CSIT on pt any reas 30 days                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8963  CSI per asx pt w/PCI 2 yrs                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8964  CSI any other than PCI 2 yr                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8965  CSIT perf on low CHD rsk                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8966  CSIT perf sx or high CHD rsk                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8967  Wrfrn or oral antigoag pres                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8968  Md rsn no pres Wrfrn or othr                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8969  Pt rsn no pres Wrfrn or othr                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8970  No rsk fac or 1 mod risk TE                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8971  Warfrn or othr antcog no rx                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8972  1>=risk or>= mod risk for TE                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8973  Mst rcnt Hbb < 10g/dL                             M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8974  Hgb not doc rns not gvn                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8975  Hgb <10g/dL, med rsn                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8976  Hgb >= 10 g/dL                                    M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8977  Oncology measures grp                             M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8978  Mobility current status                           Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8979  Mobility goal status                              Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8980  Mobility D/C status                               Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8981  Body pos current status                           Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8982  Body pos goal status                              Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8983  Body pos D/C status                               Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8984  Carry current status                              Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8985  Carry goal status                                 Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8986  Carry D/C status                                  Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8987  Self care current status                          Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8988  Self care goal status                             Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8989  Self care D/C status                              Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8990  Other PT/OT current status                        Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8991  Other PT/OT goal status                           Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8992  Other PT/OT  D/C status                           Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8993  Sub PT/OT current status                          Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8994  Sub PT/OT goal status                             Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8995  Sub PT/OT D/C status                              Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8996  Swallow current status                            Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8997  Swallow goal status                               Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8998  Swallow D/C status                                Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G8999  Motor speech current status                       Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9001  MCCD, initial rate                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9002  MCCD,maintenance rate                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9005  MCCD, risk adj, maintenance                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9006  MCCD, Home monitoring                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9007  MCCD, sch team conf                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9012  Other Specified Case Mgmt                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9016  Demo-smoking cessation coun                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9017  Amantadine HCL 100mg oral                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9018  Zanamivir,inhalation pwd 10m                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9019  Oseltamivir phosphate 75mg                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9020  Rimantadine HCL 100mg oral                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9033  Amantadine HCL oral brand                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9034  Zanamivir, inh pwdr, brand                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9035  Oseltamivir phosp, brand                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9036  Rimantadine HCL, brand                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9050  Oncology work-up evaluation                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9051  Oncology tx decision-mgmt                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9052  Onc surveillance for disease                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9053  Onc expectant management pt                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9054  Onc supervision palliative                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9055  Onc visit unspecified NOS                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9099  Onc dx esophageal unknown                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9102  Onc dx gastric unresectable                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9103  Onc dx gastric recurrent                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9107  Onc dx pancreatic unresectab                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9116  Onc dx ovarian recurrence                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9126  Onc dx CML remission                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9140  Frontier extended stay demo                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9143  Warfarin respon genetic test                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9148  Medical Home Level I                              R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9149  Medical Home Level II                             R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9150  Medical Home Level III                            R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9151  MAPCP demo state                                  R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9152  MAPCP demo community                              R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9153  MAPCP demo physician                              R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9156  Evaluation for wheelchair                         R   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9157  Transesoph doppl cardiac mon                      B   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9158  Motor speech D/C status                           Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9159  Lang comp current status                          Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9160  Lang comp goal status                             Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9161  Lang comp D/C status                              Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9162  Lang express current status                       Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9163  Lang express goal status                          Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9164  Lang express D/C status                           Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9165  Atten current status                              Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9166  Atten goal status                                 Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9167  Atten D/C status                                  Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9168  Memory current status                             Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9169  Memory goal status                                Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9170  Memory D/C status                                 Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9171  Voice current status                              Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9172  Voice goal status                                 Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9173  Voice D/C status                                  Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9174  Speech lang current status                        Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9175  Speech lang goal status                           Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9176  Speech lang D/C status                            Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
G9186  Motor speech goal status                          Q   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
H0043  Supported housing, per diem                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
H0044  Supported housing, per month                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
H0046  Mental health service, nos                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
H0049  Alcohol/drug screening                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
H1000  Prenatal care atrisk assessm                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
H1001  Antepartum management                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
H1002  Carecoordination prenatal                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
H1003  Prenatal at risk education                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
H1005  Prenatalcare enhanced srv pk                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
H1010  Nonmed family planning ed                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
H1011  Family assessment                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
H2000  Comp multidisipln evaluation                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
H2024  Supported employ, per diem                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
H2033  Multisys ther/juvenile 15min                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0120  Tetracyclin injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0129  Abatacept injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0130  Abciximab injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0131  Acetaminophen injection                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0132  Acetylcysteine injection                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0133  Acyclovir injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0135  Adalimumab injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0150  Injection adenosine 6 MG                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0152  Adenosine injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0171  Adrenalin epinephrine inject                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0178  Aflibercept injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0180  Agalsidase beta injection                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0200  Alatrofloxacin mesylate                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0205  Alglucerase injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0207  Amifostine                                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0210  Methyldopate hcl injection                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0215  Alefacept                                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0220  Alglucosidase alfa injection                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0221  Lumizyme injection                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0256  Alpha 1 proteinase inhibitor                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0257  Glassia injection                                 E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0270  Alprostadil for injection                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0275  Alprostadil urethral suppos                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0278  Amikacin sulfate injection                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0280  Aminophyllin 250 MG inj                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0282  Amiodarone HCl                                    E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0285  Amphotericin B                                    E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0287  Amphotericin b lipid complex                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0288  Ampho b cholesteryl sulfate                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0289  Amphotericin b liposome inj                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0290  Ampicillin 500 MG inj                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0300  Amobarbital 125 MG inj                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0330  Succinycholine chloride inj                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0348  Anidulafungin injection                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0350  Injection anistreplase 30 u                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0360  Hydralazine hcl injection                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0364  Apomorphine hydrochloride                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0365  Aprotonin, 10,000 kiu                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0380  Inj metaraminol bitartrate                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0390  Chloroquine injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0395  Arbutamine hcl injection                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0400  Aripiprazole injection                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0456  Azithromycin                                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0461  Atropine sulfate injection                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0470  Dimecaprol injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0475  Baclofen 10 MG injection                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0476  Baclofen intrathecal trial                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0480  Basiliximab                                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0485  Belatacept injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0490  Belimumab injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0500  Dicyclomine injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0515  Inj benztropine mesylate                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0520  Bethanechol chloride inject                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0558  PenG benzathine/procaine inj                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0561  Penicillin g benzathine inj                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0583  Bivalirudin                                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0585  Injection,onabotulinumtoxinA                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0586  AbobotulinumtoxinA                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0587  Inj, rimabotulinumtoxinB                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0588  Incobotulinumtoxin a                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0592  Buprenorphine hydrochloride                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0594  Busulfan injection                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0595  Butorphanol tartrate 1 mg                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0597  C-1 esterase, berinert                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0598  C-1 esterase, cinryze                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0600  Edetate calcium disodium inj                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0610  Calcium gluconate injection                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0630  Calcitonin salmon injection                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0637  Caspofungin acetate                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0638  Canakinumab injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0640  Leucovorin calcium injection                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0641  Levoleucovorin injection                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0690  Cefazolin sodium injection                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0692  Cefepime HCl for injection                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0694  Cefoxitin sodium injection                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0696  Ceftriaxone sodium injection                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0697  Sterile cefuroxime injection                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0698  Cefotaxime sodium injection                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0702  Betamethasone acet&sod phosp                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0706  Caffeine citrate injection                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0710  Cephapirin sodium injection                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0712  Ceftaroline fosamil inj                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0715  Ceftizoxime sodium / 500 MG                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0716  Centruroides immune f(ab)                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0718  Certolizumab pegol inj                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0720  Chloramphenicol sodium injec                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0725  Chorionic gonadotropin/1000u                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0735  Clonidine hydrochloride                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0740  Cidofovir injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0743  Cilastatin sodium injection                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0744  Ciprofloxacin iv                                  E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0760  Colchicine injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0770  Colistimethate sodium inj                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0775  Collagenase, clost hist inj                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0780  Prochlorperazine injection                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0795  Corticorelin ovine triflutal                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0800  Corticotropin injection                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0833  Cosyntropin injection NOS                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0834  Cosyntropin cortrosyn inj                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0840  Crotalidae poly immune fab                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0850  Cytomegalovirus imm IV /vial                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0878  Daptomycin injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0881  Darbepoetin alfa, non-esrd                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0882  Darbepoetin alfa, esrd use                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0885  Epoetin alfa, non-esrd                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0890  Peginesatide injection                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0894  Decitabine injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0895  Deferoxamine mesylate inj                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0897  Denosumab injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0900  Testosterone enanthate inj                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J0945  Brompheniramine maleate inj                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1000  Depo-estradiol cypionate inj                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1020  Methylprednisolone 20 MG inj                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1030  Methylprednisolone 40 MG inj                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1040  Methylprednisolone 80 MG inj                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1050  Medroxyprogesterone acetate                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1060  Testosterone cypionate 1 ML                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1070  Testosterone cypionat 100 MG                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1080  Testosterone cypionat 200 MG                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1094  Inj dexamethasone acetate                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1100  Dexamethasone sodium phos                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1110  Inj dihydroergotamine mesylt                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1120  Acetazolamid sodium injectio                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1160  Digoxin injection                                 E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1162  Digoxin immune fab (ovine)                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1165  Phenytoin sodium injection                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1170  Hydromorphone injection                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1180  Dyphylline injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1190  Dexrazoxane HCl injection                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1200  Diphenhydramine hcl injectio                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1205  Chlorothiazide sodium inj                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1230  Methadone injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1240  Dimenhydrinate injection                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1245  Dipyridamole injection                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1260  Dolasetron mesylate                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1265  Dopamine injection                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1267  Doripenem injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1270  Injection, doxercalciferol                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1290  Ecallantide injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1300  Eculizumab injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1320  Amitriptyline injection                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1324  Enfuvirtide injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1325  Epoprostenol injection                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1327  Eptifibatide injection                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1330  Ergonovine maleate injection                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1335  Ertapenem injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1364  Erythro lactobionate /500 MG                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1430  Ethanolamine oleate 100 mg                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1436  Etidronate disodium inj                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1438  Etanercept injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1440  Filgrastim 300 mcg injection                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1441  Filgrastim 480 mcg injection                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1450  Fluconazole                                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1451  Fomepizole, 15 mg                                 E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1452  Intraocular Fomivirsen na                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1453  Fosaprepitant injection                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1455  Foscarnet sodium injection                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1457  Gallium nitrate injection                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1458  Galsulfase injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1557  Gammaplex injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1559  Hizentra injection                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1561  Gamunex-C/Gammaked                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1562  Vivaglobin, inj                                   E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1566  Immune globulin, powder                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1568  Octagam injection                                 E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1569  Gammagard liquid injection                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1570  Ganciclovir sodium injection                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1571  Hepagam b im injection                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1572  Flebogamma injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1573  Hepagam b intravenous, inj                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1580  Garamycin gentamicin inj                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1590  Gatifloxacin injection                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1595  Injection glatiramer acetate                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1599  Ivig non-lyophilized, NOS                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1600  Gold sodium thiomaleate inj                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1610  Glucagon hydrochloride/1 MG                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1620  Gonadorelin hydroch/ 100 mcg                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1626  Granisetron hcl injection                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1630  Haloperidol injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1631  Haloperidol decanoate inj                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1640  Hemin, 1 mg                                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1645  Dalteparin sodium                                 E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1650  Inj enoxaparin sodium                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1652  Fondaparinux sodium                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1655  Tinzaparin sodium injection                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1670  Tetanus immune globulin inj                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1675  Histrelin acetate                                 E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1700  Hydrocortisone acetate inj                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1710  Hydrocortisone sodium ph inj                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1720  Hydrocortisone sodium succ i                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1725  Hydroxyprogesterone caproate                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1730  Diazoxide injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1740  Ibandronate sodium injection                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1741  Ibuprofen injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1742  Ibutilide fumarate injection                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1743  Idursulfase injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1744  Icatibant injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1745  Infliximab injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1750  Inj iron dextran                                  E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1756  Iron sucrose injection                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1786  Imuglucerase injection                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1790  Droperidol injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1800  Propranolol injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1810  Droperidol/fentanyl inj                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1815  Insulin injection                                 E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1826  Interferon Beta-1A inj                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1835  Itraconazole injection                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1885  Ketorolac tromethamine inj                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1890  Cephalothin sodium injection                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1930  Lanreotide injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1931  Laronidase injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1940  Furosemide injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1945  Lepirudin                                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1953  Levetiracetam injection                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1956  Levofloxacin injection                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1960  Levorphanol tartrate inj                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1980  Hyoscyamine sulfate inj                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J1990  Chlordiazepoxide injection                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2001  Lidocaine injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2010  Lincomycin injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2020  Linezolid injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2060  Lorazepam injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2150  Mannitol injection                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2170  Mecasermin injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2175  Meperidine hydrochl /100 MG                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2180  Meperidine/promethazine inj                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2185  Meropenem                                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2210  Methylergonovin maleate inj                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2212  Methylnaltrexone injection                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2248  Micafungin sodium injection                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2250  Inj midazolam hydrochloride                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2265  Minocycline hydrochloride                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2270  Morphine sulfate injection                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2271  Morphine so4 injection 100mg                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2275  Morphine sulfate injection                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2278  Ziconotide injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2280  Inj, moxifloxacin 100 mg                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2300  Inj nalbuphine hydrochloride                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2310  Inj naloxone hydrochloride                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2315  Naltrexone, depot form                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2320  Nandrolone decanoate 50 MG                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2323  Natalizumab injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2325  Nesiritide injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2353  Octreotide injection, depot                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2354  Octreotide inj, non-depot                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2355  Oprelvekin injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2357  Omalizumab injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2358  Olanzapine long-acting inj                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2360  Orphenadrine injection                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2370  Phenylephrine hcl injection                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2400  Chloroprocaine hcl injection                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2405  Ondansetron hcl injection                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2410  Oxymorphone hcl injection                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2425  Palifermin injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2426  Paliperidone palmitate inj                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2430  Pamidronate disodium /30 MG                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2440  Papaverin hcl injection                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2460  Oxytetracycline injection                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2469  Palonosetron hcl                                  E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2501  Paricalcitol                                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2503  Pegaptanib sodium injection                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2504  Pegademase bovine, 25 iu                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2505  Injection, pegfilgrastim 6mg                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2507  Pegloticase injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2510  Penicillin g procaine inj                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2513  Pentastarch 10% solution                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2515  Pentobarbital sodium inj                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2540  Penicillin g potassium inj                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2543  Piperacillin/tazobactam                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2545  Pentamidine non-comp unit                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2550  Promethazine hcl injection                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2560  Phenobarbital sodium inj                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2562  Plerixafor injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2590  Oxytocin injection                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2597  Inj desmopressin acetate                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2650  Prednisolone acetate inj                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2670  Totazoline hcl injection                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2680  Fluphenazine decanoate 25 MG                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2690  Procainamide hcl injection                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2700  Oxacillin sodium injeciton                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2710  Neostigmine methylslfte inj                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2724  Protein c concentrate                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2730  Pralidoxime chloride inj                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2760  Phentolaine mesylate inj                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2765  Metoclopramide hcl injection                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2770  Quinupristin/dalfopristin                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2778  Ranibizumab injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2780  Ranitidine hydrochloride inj                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2783  Rasburicase                                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2785  Regadenoson injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2791  Rhophylac injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2793  Rilonacept injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2794  Risperidone, long acting                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2795  Ropivacaine HCl injection                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2796  Romiplostim injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2800  Methocarbamol injection                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2805  Sincalide injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2820  Sargramostim injection                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2850  Inj secretin synthetic human                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2910  Aurothioglucose injeciton                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2916  Na ferric gluconate complex                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2920  Methylprednisolone injection                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2930  Methylprednisolone injection                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2940  Somatrem injection                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2941  Somatropin injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2950  Promazine hcl injection                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2993  Reteplase injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2995  Inj streptokinase /250000 IU                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J2997  Alteplase recombinant                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3000  Streptomycin injection                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3010  Fentanyl citrate injeciton                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3030  Sumatriptan succinate / 6 MG                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3070  Pentazocine injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3095  Telavancin injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3101  Tenecteplase injection                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3105  Terbutaline sulfate inj                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3110  Teriparatide injection                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3120  Testosterone enanthate inj                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3130  Testosterone enanthate inj                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3140  Testosterone suspension inj                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3150  Testosteron propionate inj                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3230  Chlorpromazine hcl injection                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3240  Thyrotropin injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3243  Tigecycline injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3246  Tirofiban HCl                                     E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3250  Trimethobenzamide hcl inj                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3260  Tobramycin sulfate injection                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3262  Tocilizumab injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3280  Thiethylperazine maleate inj                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3285  Treprostinil injection                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3301  Triamcinolone acet inj NOS                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3302  Triamcinolone diacetate inj                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3303  Triamcinolone hexacetonl inj                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3305  Inj trimetrexate glucoronate                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3310  Perphenazine injeciton                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3315  Triptorelin pamoate                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3320  Spectinomycn di-hcl inj                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3350  Urea injection                                    E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3355  Urofollitropin, 75 iu                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3357  Ustekinumab injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3360  Diazepam injection                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3364  Urokinase 5000 IU injection                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3370  Vancomycin hcl injection                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3385  Velaglucerase alfa                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3396  Verteporfin injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3400  Triflupromazine hcl inj                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3410  Hydroxyzine hcl injection                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3411  Thiamine hcl 100 mg                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3415  Pyridoxine hcl 100 mg                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3420  Vitamin b12 injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3430  Vitamin k phytonadione inj                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3465  Injection, voriconazole                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3470  Hyaluronidase injection                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3472  Ovine, 1000 USP units                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3473  Hyaluronidase recombinant                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3475  Inj magnesium sulfate                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3480  Inj potassium chloride                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3485  Zidovudine                                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3486  Ziprasidone mesylate                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3487  Zoledronic acid                                   E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3488  Reclast injection                                 E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3490  Drugs unclassified injection                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3530  Nasal vaccine inhalation                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3535  Metered dose inhaler drug                         N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3570  Laetrile amygdalin vit B17                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J3590  Unclassified biologics                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7030  Normal saline solution infus                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7040  Normal saline solution infus                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7042  5% dextrose/normal saline                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7050  Normal saline solution infus                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7060  5% dextrose/water                                 E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7070  D5w infusion                                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7100  Dextran 40 infusion                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7110  Dextran 75 infusion                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7120  Ringers lactate infusion                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7131  Hypertonic saline sol                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7178  Human fibrinogen conc inj                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7180  Factor XIII anti-hem factor                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7183  Wilate injection                                  E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7185  Xyntha inj                                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7186  Antihemophilic viii/vwf comp                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7187  Humate-P, inj                                     E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7189  Factor viia                                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7190  Factor viii                                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7191  Factor VIII (porcine)                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7192  Factor viii recombinant NOS                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7193  Factor IX non-recombinant                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7194  Factor ix complex                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7195  Factor IX recombinant                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7196  Antithrombin recombinant                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7197  Antithrombin iii injection                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7198  Anti-inhibitor                                    X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7199  Hemophilia clot factor noc                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7300  Intraut copper contraceptive                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7302  Levonorgestrel iu contracept                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7303  Contraceptive vaginal ring                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7304  Contraceptive hormone patch                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7306  Levonorgestrel implant sys                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7307  Etonogestrel implant system                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7308  Aminolevulinic acid hcl top                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7309  Methyl aminolevulinate, top                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7310  Ganciclovir long act implant                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7311  Fluocinolone acetonide implt                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7312  Dexamethasone intra implant                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7315  Opthalmic mitomycin                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7323  Euflexxa inj per dose                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7324  Orthovisc inj per dose                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7325  Synvisc or Synvisc-One                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7326  Gel-one                                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7330  Cultured chondrocytes implnt                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7335  Capsaicin 8% patch                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7500  Azathioprine oral 50mg                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7501  Azathioprine parenteral                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7502  Cyclosporine oral 100 mg                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7504  Lymphocyte immune globulin                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7505  Monoclonal antibodies                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7506  Prednisone oral                                   X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7509  Methylprednisolone oral                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7511  Antithymocyte globuln rabbit                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7513  Daclizumab, parenteral                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7515  Cyclosporine oral 25 mg                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7516  Cyclosporin parenteral 250mg                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7517  Mycophenolate mofetil oral                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7518  Mycophenolic acid                                 E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7520  Sirolimus, oral                                   E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7525  Tacrolimus injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7527  Oral everolimus                                   E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7599  Immunosuppressive drug noc                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7604  Acetylcysteine comp unit                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7605  Arformoterol non-comp unit                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7606  Formoterol fumarate, inh                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7607  Levalbuterol comp con                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7608  Acetylcysteine non-comp unit                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7609  Albuterol comp unit                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7610  Albuterol comp con                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7611  Albuterol non-comp con                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7612  Levalbuterol non-comp con                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7613  Albuterol non-comp unit                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7614  Levalbuterol non-comp unit                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7615  Levalbuterol comp unit                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7620  Albuterol ipratrop non-comp                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7622  Beclomethasone comp unit                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7624  Betamethasone comp unit                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7626  Budesonide non-comp unit                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7627  Budesonide comp unit                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7628  Bitolterol mesylate comp con                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7629  Bitolterol mesylate comp unt                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7631  Cromolyn sodium noncomp unit                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7632  Cromolyn sodium comp unit                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7633  Budesonide non-comp con                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7634  Budesonide comp con                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7635  Atropine comp con                                 E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7636  Atropine comp unit                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7637  Dexamethasone comp con                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7638  Dexamethasone comp unit                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7640  Formoterol comp unit                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7641  Flunisolide comp unit                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7642  Glycopyrrolate comp con                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7643  Glycopyrrolate comp unit                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7644  Ipratropium bromide non-comp                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7645  Ipratropium bromide comp                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7647  Isoetharine comp con                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7648  Isoetharine non-comp con                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7649  Isoetharine non-comp unit                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7650  Isoetharine comp unit                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7657  Isoproterenol comp con                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7658  Isoproterenol non-comp con                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7659  Isoproterenol non-comp unit                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7660  Isoproterenol comp unit                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7665  Mannitol for inhaler                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7667  Metaproterenol comp con                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7668  Metaproterenol non-comp con                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7669  Metaproterenol non-comp unit                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7670  Metaproterenol comp unit                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7674  Methacholine chloride, neb                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7676  Pentamidine comp unit dose                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7680  Terbutaline sulf comp con                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7681  Terbutaline sulf comp unit                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7682  Tobramycin non-comp unit                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7683  Triamcinolone comp con                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7684  Triamcinolone comp unit                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7685  Tobramycin comp unit                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7686  Treprostinil, non-comp unit                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J7699  Inhalation solution for DME                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J8498  Antiemetic rectal/supp NOS                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J8501  Oral aprepitant                                   E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J8510  Oral busulfan                                     E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J8515  Cabergoline, oral 0.25mg                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J8520  Capecitabine, oral, 150 mg                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J8521  Capecitabine, oral, 500 mg                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J8530  Cyclophosphamide oral 25 MG                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J8540  Oral dexamethasone                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J8560  Etoposide oral 50 MG                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J8562  Oral fludarabine phosphate                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J8565  Gefitinib oral                                    I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J8597  Antiemetic drug oral NOS                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J8600  Melphalan oral 2 MG                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J8650  Nabilone oral                                     E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J8700  Temozolomide                                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J8705  Topotecan oral                                    E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J8999  Oral prescription drug chemo                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9000  Doxorubicin hcl injection                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9002  Doxil injection                                   E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9010  Alemtuzumab injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9015  Aldesleukin injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9017  Arsenic trioxide injection                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9019  Erwinaze injection                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9020  Asparaginase, NOS                                 E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9025  Azacitidine injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9027  Clofarabine injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9031  Bcg live intravesical vac                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9033  Bendamustine injection                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9035  Bevacizumab injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9040  Bleomycin sulfate injection                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9041  Bortezomib injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9042  Brentuximab vedotin inj                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9043  Cabazitaxel injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9045  Carboplatin injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9050  Carmustine injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9055  Cetuximab injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9060  Cisplatin 10 MG injection                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9070  Cyclophosphamide 100 MG inj                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9098  Cytarabine liposome inj                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9120  Dactinomycin injection                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9130  Dacarbazine 100 mg inj                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9150  Daunorubicin injection                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9151  Daunorubicin citrate inj                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9155  Degarelix injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9160  Denileukin diftitox inj                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9165  Diethylstilbestrol injection                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9171  Docetaxel injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9179  Eribulin mesylate injection                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9181  Etoposide injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9185  Fludarabine phosphate inj                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9190  Fluorouracil injection                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9200  Floxuridine injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9201  Gemcitabine hcl injection                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9202  Goserelin acetate implant                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9206  Irinotecan injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9207  Ixabepilone injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9208  Ifosfamide injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9209  Mesna injection                                   E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9211  Idarubicin hcl injection                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9212  Interferon alfacon-1 inj                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9213  Interferon alfa-2a inj                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9214  Interferon alfa-2b inj                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9215  Interferon alfa-n3 inj                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9217  Leuprolide acetate suspnsion                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9218  Leuprolide acetate injeciton                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9219  Leuprolide acetate implant                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9225  Vantas implant                                    E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9226  Supprelin LA implant                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9228  Ipilimumab injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9230  Mechlorethamine hcl inj                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9250  Methotrexate sodium inj                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9260  Methotrexate sodium inj                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9261  Nelarabine injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9263  Oxaliplatin                                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9264  Paclitaxel protein bound                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9265  Paclitaxel injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9266  Pegaspargase injection                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9268  Pentostatin injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9270  Plicamycin (mithramycin) inj                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9280  Mitomycin injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9293  Mitoxantrone hydrochl / 5 MG                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9300  Gemtuzumab ozogamicin inj                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9302  Ofatumumab injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9303  Panitumumab injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9305  Pemetrexed injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9307  Pralatrexate injection                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9310  Rituximab injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9315  Romidepsin injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9320  Streptozocin injection                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9328  Temozolomide injection                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9330  Temsirolimus injection                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9340  Thiotepa injection                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9351  Topotecan injection                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9355  Trastuzumab injection                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9357  Valrubicin injection                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9360  Vinblastine sulfate inj                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9390  Vinorelbine tartrate inj                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9395  Injection, Fulvestrant                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9600  Porfimer sodium injection                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
J9999  Chemotherapy drug                                 E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
M0064  Visit for drug monitoring                         A   0.37   1.29     0.07    0.01   1.67  0.450XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
M0075  Cellular therapy                                  N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
M0076  Prolotherapy                                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
M0100  Intragastric hypothermia                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
M0300  IV chelationtherapy                               N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
M0301  Fabric wrapping of aneurysm                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P2028  Cephalin floculation test                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P2029  Congo red blood test                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P2031  Hair analysis                                     N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P2033  Blood thymol turbidity                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P2038  Blood mucoprotein                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P3001  Screening pap smear by phys                       A   0.42   0.48     0.48    0.03   0.93  0.930XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
P7001  Culture bacterial urine                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P9010  Whole blood for transfusion                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P9011  Blood split unit                                  E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P9012  Cryoprecipitate each unit                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P9016  RBC leukocytes reduced                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P9019  Platelets, each unit                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P9020  Plaelet rich plasma unit                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P9021  Red blood cells unit                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P9023  Frozen plasma, pooled, sd                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P9031  Platelets leukocytes reduced                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P9032  Platelets, irradiated                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P9033  Platelets leukoreduced irrad                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P9034  Platelets, pheresis                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P9035  Platelet pheres leukoreduced                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P9036  Platelet pheresis irradiated                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P9037  Plate pheres leukoredu irrad                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P9038  RBC irradiated                                    X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P9039  RBC deglycerolized                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P9040  RBC leukoreduced irradiated                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P9041  Albumin (human),5%, 50ml                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P9044  Cryoprecipitatereducedplasma                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P9047  Albumin (human), 25%, 50ml                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P9048  Plasmaprotein fract,5%,250ml                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P9050  Granulocytes, pheresis unit                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P9056  Blood, l/r, irradiated                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P9612  Catheterize for urine spec                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
P9615  Urine specimen collect mult                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0035  Cardiokymography                                  A   0.17   0.44     0.44NA  0.02   0.63  0.631XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
Q0035TCCardiokymography                                  A   0.00   0.36     0.36NA  0.01   0.37  0.371XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
Q003526Cardiokymography                                  A   0.17   0.08     0.08    0.01   0.26  0.261XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
Q0091  Obtaining screen pap smear                        A   0.37   0.95     0.16    0.03   1.35  0.560XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
Q0092  Set up port xray equipment                        A   0.00   0.73     0.73    0.01   0.74  0.743XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
Q0111  Wet mounts/ w preparations                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0112  Potassium hydroxide preps                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0113  Pinworm examinations                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0114  Fern test                                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0115  Post-coital mucous exam                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0138  Ferumoxytol, non-esrd                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0139  Ferumoxytol, esrd use                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0144  Azithromycin dihydrate, oral                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0162  Ondansetron oral                                  E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0163  Diphenhydramine HCl 50mg                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0164  Prochlorperazine maleate 5mg                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0165  Prochlorperazine maleate10mg                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0167  Dronabinol 2.5mg oral                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0168  Dronabinol 5mg oral                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0171  Chlorpromazine HCl 10mg oral                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0172  Chlorpromazine HCl 25mg oral                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0173  Trimethobenzamide HCl 250mg                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0174  Thiethylperazine maleate10mg                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0175  Perphenazine 4mg oral                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0176  Perphenazine 8mg oral                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0177  Hydroxyzine pamoate 25mg                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0178  Hydroxyzine pamoate 50mg                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0180  Dolasetron mesylate oral                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0181  Unspecified oral anti-emetic                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0478  Power adapter, combo vad                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0480  Driver pneumatic vad, rep                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0483  Monitor elec vad, rep                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0503  Battery pneum vad replacemnt                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0505  Miscl supply/accessory vad                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0510  Dispens fee immunosupressive                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q0515  Sermorelin acetate injection                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q1004  Ntiol category 4                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q1005  Ntiol category 5                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q2004  Bladder calculi irrig sol                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q2009  Fosphenytoin inj PE                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q2017  Teniposide, 50 mg                                 E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q2026  Radiesse injection                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q2027  Sculptra injection                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q2034  Agriflu vaccine                                   X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q2036  Flulaval vacc, 3 yrs & >, im                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q2037  Fluvirin vacc, 3 yrs & >, im                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q2038  Fluzone vacc, 3 yrs & >, im                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q2043  Sipuleucel-T auto CD54+                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q2049  Imported lipodox inj                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q3001  Brachytherapy Radioelements                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
Q3014  Telehealth facility fee                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q3031  Collagen skin test                                B   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4013  Cast sup gauntlet plaster                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4014  Cast sup gauntlet fiberglass                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4049  Finger splint, static                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4050  Cast supplies unlisted                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4051  Splint supplies misc                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4100  Skin substitute, NOS                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4101  Apligraf                                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4102  Oasis wound matrix                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4103  Oasis burn matrix                                 E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4104  Integra BMWD                                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4105  Integra DRT                                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4106  Dermagraft                                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4107  Graftjacket                                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4108  Integra matrix                                    E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4110  Primatrix                                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4111  Gammagraft                                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4112  Cymetra injectable                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4113  Graftjacket xpress                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4114  Integra flowable wound matri                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4115  Alloskin                                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4116  Alloderm                                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4117  Hyalomatrix                                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4118  Matristem micromatrix                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4119  Matristem wound matrix                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4120  Matristem burn matrix                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4121  Theraskin                                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4122  Dermacell                                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4123  Alloskin                                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4124  Oasis tri-layer wound matrix                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4125  Arthroflex                                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4126  Memoderm/derma/tranz/integup                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4127  Talymed                                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4128  Flexhd/Allopatchhd/matrixhd                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4129  Unite biomatrix                                   E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4130  Strattice TM                                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4131  Epifix                                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4132  Grafix core                                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4133  Grafix prime                                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4134  hMatrix                                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4135  Mediskin                                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q4136  EZderm                                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q5001  Hospice in patient home                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q5002  Hospice in assisted living                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q5004  Hospice in SNF                                    E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q5005  Hospice, inpatient hospital                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q5006  Hospice in hospice facility                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q5007  Hospice in LTCH                                   E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q5008  Hospice in inpatient psych                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q5009  Hospice care, NOS                                 E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q9956  Inj octafluoropropane mic,ml                      E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q9968  Visualization adjunct                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
Q9969  Non-HEU TC-99M add-on/dose                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
R0070  Transport portable x-ray                          C   0.00   0.00     0.00    0.00   0.00  0.003XXX.00.00.0000000             25.0008 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  0.003XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
R0076  Transport portable EKG                            B   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0012  Butorphanol tartrate, nasal                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0014  Tacrine hydrochloride, 10 mg                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0017  Injection, aminocaproic acid                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0020  Injection, bupivicaine hydro                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0021  Injection, cefoperazone sod                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0023  Injection, cimetidine hydroc                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0028  Injection, famotidine, 20 mg                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0030  Injection, metronidazole                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0032  Injection, nafcillin sodium                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0034  Injection, ofloxacin, 400 mg                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0039  Injection, sulfamethoxazole                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0040  Injection, ticarcillin disod                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0073  Injection, aztreonam, 500 mg                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0074  Injection, cefotetan disodiu                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0077  Injection, clindamycin phosp                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0078  Injection, fosphenytoin sodi                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0080  Injection, pentamidine iseth                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0081  Injection, piperacillin sodi                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0088  Imatinib 100 mg                                   I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0090  Sildenafil citrate, 25 mg                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0091  Granisetron 1mg                                   I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0092  Hydromorphone 250 mg                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0093  Morphine 500 mg                                   I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0104  Zidovudine, oral, 100 mg                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0108  Mercaptopurine 50 mg                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0109  Methadone oral 5mg                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0117  Tretinoin topical 5 g                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0119  Ondansetron 4 mg                                  I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0122  Inj menotropins 75 iu                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0136  Clozapine, 25 mg                                  I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0137  Didanosine, 25 mg                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0138  Finasteride, 5 mg                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0139  Minoxidil, 10 mg                                  I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0140  Saquinavir, 200 mg                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0142  Colistimethate inh sol mg                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0155  Epoprostenol dilutant                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0156  Exemestane, 25 mg                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0160  Dextroamphetamine                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0164  Injection pantroprazole                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0166  Inj olanzapine 2.5mg                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0169  Calcitrol                                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0170  Anastrozole 1 mg                                  I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0171  Bumetanide 0.5 mg                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0172  Chlorambucil 2 mg                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0174  Dolasetron 50 mg                                  I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0175  Flutamide 125 mg                                  I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0176  Hydroxyurea 500 mg                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0177  Levamisole 50 mg                                  I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0178  Lomustine 10 mg                                   I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0179  Megestrol 20 mg                                   I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0182  Procarbazine 5 mg                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0183  Prochlorperazine 5 mg                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0187  Tamoxifen 10 mg                                   I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0189  Testosterone pellet 75 mg                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0190  Mifepristone, oral, 200 mg                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0191  Misoprostol, oral, 200 mcg                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0194  Vitamin suppl 100 caps                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0197  Prenatal vitamins 30 day                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0201  Partial hospitalization serv                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0207  Paramedicintercep nonhospals                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0208  Paramed intrcept nonvol                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0215  Nonemerg transp mileage                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0220  Medical conference by physic                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0221  Medical conference, 60 min                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0250  Comp geriatr assmt team                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0255  Hospice refer visit nonmd                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0257  End of life counseling                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0260  H&P for surgery                                   I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0265  Genetic counsel 15 mins                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0280  Medical home, initial plan                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0281  Medical home, maintenance                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0302  Completed EPSDT                                   I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0310  Hospitalist visit                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0315  Disease management program                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0316  Follow-up/reassessment                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0317  Disease mgmt per diem                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0340  Lifestyle mod 1st stage                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0342  Lifestyle mod 4th stage                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0353  Cancer treatmentplan initial                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0354  Cancer treatment plan change                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0395  Impression casting ft                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0400  Global eswl kidney                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0500  Dispos cont lens                                  I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0504  Singl prscrp lens                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0506  Bifoc prscp lens                                  I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0508  Trifoc prscrp lens                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0510  Non-prscrp lens                                   I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0512  Daily cont lens                                   I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0514  Color cont lens                                   I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0515  Scleral lens liquid bandage                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0516  Safety frames                                     I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0518  Sunglass frames                                   I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0580  Polycarb lens                                     I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0581  Nonstnd lens                                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0590  Misc integral lens serv                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0592  Comp cont lens eval                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0596  Phakic iol refractive error                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0601  Screening proctoscopy                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0610  Annual gynecological examina                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0612  Annual gynecological examina                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0613  Ann breast exam                                   I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0618  Audiometry for hearing aid                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0620  Routine ophthalmological exa                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0621  Routine ophthalmological exa                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0622  Phys exam for college                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0630  Removal of sutures                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0800  Laser in situ keratomileusis                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0810  Photorefractive keratectomy                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S0812  Phototherap keratect                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S1001  Deluxe item                                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S1002  Custom item                                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S1015  IV tubing extension set                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S1016  Non-pvc intravenous administ                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S1030  Gluc monitor purchase                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S1031  Gluc monitor rental                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S1040  Cranial remolding orthosis                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S1090  Mometasone sinus implant                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2053  Transplantation of small int                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2054  Transplantation of multivisc                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2055  Harvesting of donor multivis                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2060  Lobar lung transplantation                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2061  Donor lobectomy (lung)                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2065  Simult panc kidn trans                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2066  Breast GAP flap reconst                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2067  Breast "stacked" DIEP/GAP                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2079  Lap esophagomyotomy                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2080  Laup                                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2083  Adjustment gastric band                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2095  Transcath emboliz microspher                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2102  Islet cell tissue transplant                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2103  Adrenal tissue transplant                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2107  Adoptive immunotherapy                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2112  Knee arthroscp harv                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2115  Periacetabular osteotomy                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2117  Arthroereisis, subtalar                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2118  Total hip resurfacing                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2120  Low density lipoprotein(LDL)                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2140  Cord blood harvesting                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2152  Solid organ transpl pkg                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2202  Echosclerotherapy                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2205  Minimally invasive direct co                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2206  Minimally invasive direct co                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2207  Minimally invasive direct co                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2208  Minimally invasive direct co                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2209  Minimally invasive direct co                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2225  Myringotomy laser-assist                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2230  Implant semi-imp hear                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2235  Implant auditory brain imp                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2300  Arthroscopy, shoulder, surgi                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2325  Hip core decompression                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2340  Chemodenervation of abductor                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2341  Chemodenerv adduct vocal                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2342  Nasal endoscop po debrid                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2348  Decompress disc RF lumbar                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2350  Diskectomy, anterior, with d                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2351  Diskectomy, anterior, with d                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2360  Vertebroplast cerv 1st                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2361  Vertebroplast cerv addl                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2400  Fetal surg congen hernia                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2403  Fetal surg pulmon sequest                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2404  Fetal surg myelomeningo                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2405  Fetal surg sacrococ teratoma                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2409  Fetal surg noc                                    I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2411  Fetoscop laser ther TTTS                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S2900  Robotic surgical system                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3000  Bilat dil retinal exam                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3005  Eval self-assess depression                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3600  Stat lab                                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3601  Stat lab home/nf                                  I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3620  Newborn metabolic screening                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3625  Maternal triple screen test                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3626  Maternal serum quad screen                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3630  Eosinophil blood count                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3650  Saliva test, hormone level;                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3652  Saliva test, hormone level;                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3655  Antisperm antibodies test                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3708  Gastrointestinal fat absorpt                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3721  Pca3 testing                                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3722  Dose optimization AUC - 5FU                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3800  Genetic testing ALS                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3833  Comp APC sequence                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3834  Sing mutation APC                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3840  DNA analysis RET-oncogene                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3841  Gene test retinoblastoma                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3842  Gene test Hippel-Lindau                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3844  DNA analysis deafness                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3845  Gene test alpha-thalassemia                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3846  Gene test beta-thalassemia                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3849  Gene test Niemann-Pick                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3850  Gene test sickle cell                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3852  DNA analysis APOE alzheimer                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3854  Gene profile panel breast                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3861  Genetic test brugada                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3870  CGH test developmental delay                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3890  Fecal DNA analysis                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3900  Surface EMG                                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3902  Ballistocardiogram                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S3904  Masters two step                                  I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S4005  Interim labor facility globa                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S4011  IVF package                                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S4013  Compl GIFT case rate                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S4014  Compl ZIFT case rate                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S4016  Frozen IVF case rate                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S4026  Procure donor sperm                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S4027  Store prev froz embryos                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S4028  Microsurg epi sperm asp                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S4030  Sperm procure init visit                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S4031  Sperm procure subs visit                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S4035  Stimulated IUI case rate                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S4042  Ovulation mgmt per cycle                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S4981  Insert levonorgestrel ius                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S4989  Contracept IUD                                    I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S4990  Nicotine patch legend                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S4991  Nicotine patch nonlegend                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S4993  Contraceptive pills for bc                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S4995  Smoking cessation gum                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5000  Prescription drug, generic                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5001  Prescription drug,brand name                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5012  5% dextrose with potassium                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5035  HIT routine device maint                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5036  HIT device repair                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5100  Adult daycare services 15min                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5105  Centerbased day care perdiem                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5109  Homecare train pt session                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5110  Family homecare training 15m                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5111  Family homecare train/sessio                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5115  Nonfamily homecare train/15m                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5116  Nonfamily HC train/session                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5121  Chore services per diem                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5125  Attendant care service /15m                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5126  Attendant care service /diem                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5131  Homemaker service nos /diem                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5135  Adult companioncare per 15m                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5136  Adult companioncare per diem                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5146  Ther fostercare child /month                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5150  Unskilled respite care /15m                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5151  Unskilled respitecare /diem                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5162  Emer rspns system purchase                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5165  Home modifications per serv                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5170  Homedelivered prepared meal                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5190  Wellness assessment by nonph                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5497  HIT cath care noc                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5498  HIT simple cath care                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5501  HIT complex cath care                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5502  HIT interim cath care                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5517  HIT declotting kit                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5518  HIT cath repair kit                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5520  HIT picc insert kit                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5550  Insulin rapid 5 u                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5552  Insulin intermed 5 u                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5565  Insulin cartridge 150 u                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S5566  Insulin cartridge 300 u                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8030  Tantalum ring application                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8035  Magnetic source imaging                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8037  mrcp                                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8040  Topographic brain mapping                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8042  MRI low field                                     I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8055  Us guidance fetal reduct                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8080  Scintimammography                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8085  Fluorine-18 fluorodeoxygluco                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8092  Electron beam computed tomog                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8096  Portable peak flow meter                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8097  Asthma kit                                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8100  Spacer without mask                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8101  Spacer with mask                                  I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8121  O2 contents liquid lb                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8130  Interferential stim 2 chan                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8131  Interferential stim 4 chan                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8185  Flutter device                                    I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8186  Swivel adaptor                                    I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8189  Trach supply noc                                  I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8210  Mucus trap                                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8262  Mandib ortho repos device                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8265  Haberman feeder                                   I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8270  Enuresis alarm                                    I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8301  Infect control supplies NOS                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8415  Supplies for home delivery                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8420  Custom gradient sleev/glov                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8421  Ready gradient sleev/glov                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8422  Custom grad sleeve med                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8423  Custom grad sleeve heavy                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8424  Ready gradient sleeve                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8425  Custom grad glove med                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8426  Custom grad glove heavy                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8427  Ready gradient glove                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8428  Ready gradient gauntlet                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8429  Gradient pressure wrap                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8430  Padding for comprssn bdg                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8431  Compression bandage                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8450  Splint digit                                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8451  Splint wrist or ankle                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8452  Splint elbow                                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8460  Camisole post-mast                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8490  100 insulin syringes                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8930  Auricular electrostimulation                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8940  Hippotherapy per session                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8950  Complex lymphedema therapy,                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S8999  Resuscitation bag                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9007  Ultrafiltration monitor                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9015  Automated EEG monitoring                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9024  Paranasal sinus ultrasound                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9025  Omnicardiogram/cardiointegra                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9034  ESWL for gallstones                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9056  Coma stimulation per diem                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9061  Medical supplies and equipme                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9083  Urgent care center global                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9088  Services provided in urgent                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9090  Vertebral axial decompressio                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9097  Home visit wound care                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9098  Home phototherapy visit                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9110  Telemonitoring/home per mnth                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9117  Back school visit                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9129  Occupational therapy, in the                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9140  Diabetic Management Program,                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9141  Diabetic Management Program,                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9145  Insulin pump initiation                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9150  Evaluation by ocularist                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9152  Speech therapy, re-eval                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9208  Home mgmt preterm labor                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9209  Home mgmt PPROM                                   I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9211  Home mgmt gest hypertension                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9213  Hm preeclamp per diem                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9329  HIT chemo per diem                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9330  HIT cont chem diem                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9331  HIT intermit chemo diem                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9335  HT hemodialysis diem                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9336  HIT cont anticoag diem                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9338  HIT immunotherapy diem                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9339  HIT periton dialysis diem                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9340  HIT enteral per diem                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9341  HIT enteral grav diem                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9342  HIT enteral pump diem                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9343  HIT enteral bolus nurs                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9345  HIT anti-hemophil diem                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9347  HIT longterm infusion diem                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9348  HIT sympathomim diem                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9349  HIT tocolysis diem                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9351  HIT cont antiemetic diem                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9353  HIT cont insulin diem                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9355  HIT chelation diem                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9357  HIT enzyme replace diem                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9361  HIT diuretic infus diem                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9363  HIT anti-spasmotic diem                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9364  HIT tpn total diem                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9370  HT inj antiemetic diem                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9372  HT inj anticoag diem                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9373  HIT hydra total diem                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9379  HIT noc per diem                                  I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9381  HIT high risk/escort                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9401  Anticoag clinic per session                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9430  Pharmacy comp/disp serv                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9434  Mod solid food suppl                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9436  Lamaze class                                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9437  Childbirth refresher class                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9438  Cesarean birth class                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9439  VBAC class                                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9441  Asthma education                                  I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9442  Birthing class                                    I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9443  Lactation class                                   I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9444  Parenting class                                   I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9445  PT education noc individ                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9446  PT education noc group                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9447  Infant safety class                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9449  Weight mgmt class                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9451  Exercise class                                    I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9452  Nutrition class                                   I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9453  Smoking cessation class                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9454  Stress mgmt class                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9455  Diabetic Management Program,                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9460  Diabetic Management Program,                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9465  Diabetic Management Program,                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9470  Nutritional counseling, diet                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9472  Cardiac rehabilitation progr                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9473  Pulmonary rehabilitation pro                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9475  Ambulatory setting substance                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9476  Vestibular rehab per diem                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9480  Intensive outpatient psychia                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9482  Family stabilization 15 min                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9484  Crisis intervention per hour                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9485  Crisis intervention mental h                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9490  HIT corticosteroid/diem                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9494  HIT antibiotic total diem                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9497  HIT antibiotic q3h diem                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9500  HIT antibiotic q24h diem                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9501  HIT antibiotic q12h diem                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9502  HIT antibiotic q8h diem                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9503  HIT antibiotic q6h diem                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9504  HIT antibiotic q4h diem                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9529  Venipuncture home/snf                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9538  HIT blood products diem                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9559  HIT inj interferon diem                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9560  HT inj hormone diem                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9562  HT inj palivizumab diem                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9590  HT irrigation diem                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9810  HT pharm per hour                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9900  Christian Sci Pract visit                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9970  Health club membership yr                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9975  Transplant related per diem                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9976  Lodging per diem                                  I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9977  Meals per diem                                    I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9981  Med record copy admin                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9986  Not medically necessary svc                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9989  Services outside US                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9992  Transportation costs to and                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
S9999  Sales tax                                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T1000  Private duty/independent nsg                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T1001  Nursing assessment/evaluatn                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T1006  Family/Couple Counseling                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T1007  Treatment Plan Development                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T1009  Child Sitting Services                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T1010  Meals when Receive Services                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T1012  Alcohol/Substance Abuse Skil                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T1013  Sign Lang/Oral Interpreter                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T1014  Telehealth transmit, per min                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T1015  Clinic service                                    I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T1016  Case management                                   I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T1017  Targeted case management                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T1022  Contracted services per day                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T1023  Program intake assessment                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T1024  Team evaluation & management                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T1027  Family training & counseling                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T1028  Home environment assessment                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T1029  Dwelling lead investigation                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T1502  Medication admin visit                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T1999  NOC retail items andsupplies                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T2002  N-et; per diem                                    I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T2003  N-et; encounter/trip                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T2005  N-et; stretcher van                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T2010  PASRR Level I                                     I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T2011  PASRR Level II                                    I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T2022  Case management, per month                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T2025  Waiver service, nos                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T2026  Special childcare waiver/d                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T2028  Special supply, nos waiver                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T2029  Special med equip, noswaiver                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T2030  Assist living waiver/month                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T2031  Assist living waiver/diem                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T2034  Crisis interven waiver/diem                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T2035  Utility services waiver                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T2036  Camp overnite waiver/session                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T2037  Camp day waiver/session                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T2038  Comm trans waiver/service                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T2039  Vehicle mod waiver/service                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T2040  Financial mgt waiver/15min                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T2042  Hospice routine home care                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T2043  Hospice continuous home care                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T2044  Hospice respite care                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T2045  Hospice general care                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T4533  Youth size brief/diaper                           N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T4534  Youth size pull-on                                N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T4535  Disposable liner/shield/pad                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T4537  Reusable underpad bed size                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T4538  Diaper serv reusable diaper                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T4540  Reusable underpad chair size                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T4541  Large disposable underpad                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T4542  Small disposable underpad                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T4543  Disp bariatric brief/diaper                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
T5999  Supply, nos                                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2020  Vision svcs frames purchases                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2025  Eyeglasses delux frames                           N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2114  Spherocylinder over 12.00d                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2115  Lens lenticular bifocal                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2118  Lens aniseikonic single                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2121  Lenticular lens, single                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2215  Lens lenticular bifocal                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2218  Lens aniseikonic bifocal                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2221  Lenticular lens, bifocal                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2299  Lens bifocal speciality                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2315  Lens lenticular trifocal                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2318  Lens aniseikonic trifocal                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2321  Lenticular lens, trifocal                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2399  Lens trifocal speciality                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2410  Lens variab asphericity sing                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2430  Lens variable asphericity bi                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2499  Variable asphericity lens                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2500  Contact lens pmma spherical                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2502  Contact lens pmma bifocal                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2510  Cntct gas permeable sphericl                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2511  Cntct toric prism ballast                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2513  Contact lens extended wear                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2520  Contact lens hydrophilic                          P   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2521  Cntct lens hydrophilic toric                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2522  Cntct lens hydrophil bifocl                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2523  Cntct lens hydrophil extend                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2530  Contact lens gas impermeable                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2531  Contact lens gas permeable                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2610  Single lens spectacle mount                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2615  Telescop/othr compound lens                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2623  Plastic eye prosth custom                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2624  Polishing artifical eye                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2625  Enlargemnt of eye prosthesis                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2626  Reduction of eye prosthesis                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2627  Scleral cover shell                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2628  Fabrication & fitting                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2629  Prosthetic eye other type                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2630  Anter chamber intraocul lens                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2631  Iris support intraoclr lens                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2632  Post chmbr intraocular lens                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2700  Balance lens                                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2702  Deluxe lens feature                               N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2715  Prism lens/es                                     X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2730  Special base curve                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2744  Tint photochromatic lens/es                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2750  Anti-reflective coating                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2755  UV lens/es                                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2756  Eye glass case                                    X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2760  Scratch resistant coating                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2761  Mirror coating                                    X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2762  Polarization, any lens                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2770  Occluder lens/es                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2780  Oversize lens/es                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2781  Progressive lens per lens                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2784  Lens polycarb or equal                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2785  Corneal tissue processing                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2786  Occupational multifocal lens                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2787  Astigmatism-correct function                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2788  Presbyopia-correct function                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2790  Amniotic membrane                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V2799  Miscellaneous vision service                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5008  Hearing screening                                 N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5010  Assessment for hearing aid                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5011  Hearing aid fitting/checking                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5014  Hearing aid repair/modifying                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5020  Conformity evaluation                             N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5060  Behind ear hearing aid                            N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5070  Glasses air conduction                            N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5080  Glasses bone conduction                           N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5090  Hearing aid dispensing fee                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5110  Hearing aid dispensing fee                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5150  Glasses binaural hearing aid                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5160  Dispensing fee binaural                           N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5190  Glasses cros hearing aid                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5230  Glasses bicros hearing aid                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5240  Dispensing fee bicros                             N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5241  Dispensing fee, monaural                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5242  Hearing aid, monaural, cic                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5243  Hearing aid, monaural, itc                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5248  Hearing aid, binaural, cic                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5249  Hearing aid, binaural, itc                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5262  Hearing aid, disp, monaural                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5263  Hearing aid, disp, binaural                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5264  Ear mold/insert                                   N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5265  Ear mold/insert, disp                             N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5266  Battery for hearing device                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5267  Hearing aid sup/access/dev                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5268  ALD Telephone Amplifier                           N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5269  Alerting device, any type                         N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5271  ALD, TV caption decoder                           N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5272  Tdd                                               N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5273  ALD for cochlear implant                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5274  ALD unspecified                                   N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5275  Ear impression                                    N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5281  Ald fm/dm system, monaural                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5282  Ald fm/dm system binaural                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5283  Ald neck, loop ind receiver                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5284  Ald FM/DM ear level receiver                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5285  Ald fm/dm aud input receiver                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5286  Ald blu tooth fm/dm receiver                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5287  Ald fm/dm receiver, NOS                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5288  Ald fm/dm transmitter ald                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5289  Ald fm/dm adapt/boot couplin                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5290  Ald transmitter microphone                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5298  Hearing aid noc                                   N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5299  Hearing service                                   R   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
V5336  Repair communication device                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
V5362  Speech screening                                  N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 010 99      0.00   0.00   0.00
V5363  Language screening                                N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 010 99      0.00   0.00   0.00
V5364  Dysphagia screening                               N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 010 99      0.00   0.00   0.00
0001F  Heart failure composite                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0005F  Osteoarthritis composite                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00100  Anesth salivary gland                             J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00103  Anesth blepharoplasty                             J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00104  Anesth electroshock                               J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0012F  Cap bacterial assess                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00120  Anesth ear surgery                                J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00124  Anesth ear exam                                   J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00126  Anesth tympanotomy                                J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00140  Anesth procedures on eye                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00142  Anesth lens surgery                               J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00144  Anesth corneal transplant                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00145  Anesth vitreoretinal surg                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00147  Anesth iridectomy                                 J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00148  Anesth eye exam                                   J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0015F  Melan follow-up complete                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00160  Anesth nose/sinus surgery                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00162  Anesth nose/sinus surgery                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00164  Anesth biopsy of nose                             J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00170  Anesth procedure on mouth                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00172  Anesth cleft palate repair                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00174  Anesth pharyngeal surgery                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00176  Anesth pharyngeal surgery                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.000XXX.00.00.0000000             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00192  Anesth facial bone surgery                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00210  Anesth cranial surg nos                           J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00211  Anesth cran surg hemotoma                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00212  Anesth skull drainage                             J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00214  Anesth skull drainage                             J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00215  Anesth skull repair/fract                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00216  Anesth head vessel surgery                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00218  Anesth special head surgery                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00220  Anesth intrcrn nerve                              J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00222  Anesth head nerve surgery                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00300  Anesth head/neck/ptrunk                           J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00320  Anesth neck organ 1yr/>                           J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00322  Anesth biopsy of thyroid                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00350  Anesth neck vessel surgery                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00352  Anesth neck vessel surgery                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00402  Anesth surgery of breast                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00404  Anesth surgery of breast                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00406  Anesth surgery of breast                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00410  Anesth correct heart rhythm                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
00450  Anesth surgery of shoulder                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00452  Anesth surgery of shoulder                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00454  Anesth collar bone biopsy                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00470  Anesth removal of rib                             J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00472  Anesth chest wall repair                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00474  Anesth surgery of rib                             J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00500  Anesth esophageal surgery                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0051T  Implant total heart system                        C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0052T  Replace component heart syst                      C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
00520  Anesth chest procedure                            J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00522  Anesth chest lining biopsy                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00524  Anesth chest drainage                             J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00528  Anes mediascpy & dx thorscpy                      J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00529  Anes medscpy&thorscpy 1 lung                      J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0053T  Replace component heart syst                      C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
00530  Anesth pacemaker insertion                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00532  Anesth vascular access                            J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00534  Anesth cardioverter/defib                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00537  Anesth cardiac electrophys                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00539  Anesth trach-bronch reconst                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0054T  Bone surgery using computer                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
00540  Anesth chest surgery                              J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00541  Anesth one lung ventilation                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00542  Anesthesia removal pleura                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00548  Anesth trachea bronchi surg                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0055T  Bone surgery using computer                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
00550  Anesth sternal debridement                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00567  Anesth cabg w/pump                                J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0058T  Cryopreservation ovary tiss                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
00580  Anesth heart/lung transplnt                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0059T  Cryopreservation oocyte                           C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
00600  Anesth spine cord surgery                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00604  Anesth sitting procedure                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00620  Anesth spine cord surgery                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00622  Anesth removal of nerves                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00630  Anesth spine cord surgery                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00632  Anesth removal of nerves                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00634  Anesth for chemonucleolysis                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00635  Anesth lumbar puncture                            J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00640  Anesth spine manipulation                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00670  Anesth spine cord surgery                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00700  Anesth abdominal wall surg                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00702  Anesth for liver biopsy                           J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.000XXX.00.00.0000000             25.0008 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  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0073T  Delivery comp imrt                                A   0.00  11.91    11.91NA  0.01  11.92 11.923XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
00730  Anesth abdominal wall surg                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00740  Anesth upper gi visualize                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0075T  Perq stent/chest vert art                         C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0075TTCPerq stent/chest vert art                         C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0075T26Perq stent/chest vert art                         C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
00750  Anesth repair of hernia                           J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00752  Anesth repair of hernia                           J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00754  Anesth repair of hernia                           J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00756  Anesth repair of hernia                           J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0076T  S&i stent/chest vert art                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0076TTCS&i stent/chest vert art                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 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  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
00770  Anesth blood vessel repair                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0079T  Endovasc visc extnsn repr                         C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
00790  Anesth surg upper abdomen                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00792  Anesth hemorr/excise liver                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00794  Anesth pancreas removal                           J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00796  Anesth for liver transplant                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00797  Anesth surgery for obesity                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
00800  Anesth abdominal wall surg                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00802  Anesth fat layer removal                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
00810  Anesth low intestine scope                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00820  Anesth abdominal wall surg                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00830  Anesth repair of hernia                           J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00832  Anesth repair of hernia                           J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00836  Anesth hernia repair preemie                      J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00840  Anesth surg lower abdomen                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00842  Anesth amniocentesis                              J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00844  Anesth pelvis surgery                             J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00846  Anesth hysterectomy                               J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00848  Anesth pelvic organ surg                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0085T  Breath test heart reject                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00851  Anesth tubal ligation                             J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00860  Anesth surgery of abdomen                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00862  Anesth kidney/ureter surg                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00864  Anesth removal of bladder                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00865  Anesth removal of prostate                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00866  Anesth removal of adrenal                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00868  Anesth kidney transplant                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00870  Anesth bladder stone surg                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00872  Anesth kidney stone destruct                      J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00873  Anesth kidney stone destruct                      J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00880  Anesth abdomen vessel surg                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00882  Anesth major vein ligation                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00902  Anesth anorectal surgery                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00904  Anesth perineal surgery                           J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00906  Anesth removal of vulva                           J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00908  Anesth removal of prostate                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00910  Anesth bladder surgery                            J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00912  Anesth bladder tumor surg                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00914  Anesth removal of prostate                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00916  Anesth bleeding control                           J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00918  Anesth stone removal                              J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0092T  Artific disc addl                                 C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
00920  Anesth genitalia surgery                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00921  Anesth vasectomy                                  J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00922  Anesth sperm duct surgery                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00924  Anesth testis exploration                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00926  Anesth removal of testis                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00928  Anesth removal of testis                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00930  Anesth testis suspension                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00932  Anesth amputation of penis                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00934  Anesth penis nodes removal                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00936  Anesth penis nodes removal                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00938  Anesth insert penis device                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00940  Anesth vaginal procedures                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00944  Anesth vaginal hysterectomy                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00948  Anesth repair of cervix                           J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0095T  Artific diskectomy addl                           C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
00950  Anesth vaginal endoscopy                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
00952  Anesth hysteroscope/graph                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0098T  Rev artific disc addl                             C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0099T  Implant corneal ring                              C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0100T  Prosth retina receive&gen                         C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 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  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0102T  Extracorp shockwv tx anesth                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0103T  Holotranscobalamin                                C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0106T  Touch quant sensory test                          C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0107T  Vibrate quant sensory test                        C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0108T  Cool quant sensory test                           C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0109T  Heat quant sensory test                           C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0110T  Nos quant sensory test                            C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0111T  Rbc membranes fatty acids                         C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
01112  Anesth bone aspirate/bx                           J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01120  Anesth pelvis surgery                             J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01130  Anesth body cast procedure                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01140  Anesth amputation at pelvis                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01150  Anesth pelvic tumor surgery                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01160  Anesth pelvis procedure                           J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01170  Anesth pelvis surgery                             J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01173  Anesth fx repair pelvis                           J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01180  Anesth pelvis nerve removal                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01190  Anesth pelvis nerve removal                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01200  Anesth hip joint procedure                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01202  Anesth arthroscopy of hip                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01210  Anesth hip joint surgery                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01212  Anesth hip disarticulation                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01214  Anesth hip arthroplasty                           J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01215  Anesth revise hip repair                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01220  Anesth procedure on femur                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0123T  Scleral fistulization                             C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
01230  Anesth surgery of femur                           J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01232  Anesth amputation of femur                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01234  Anesth radical femur surg                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0124T  Conjunctival drug placement                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
01250  Anesth upper leg surgery                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0126T  Chd risk imt study                                C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01270  Anesth thigh arteries surg                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01272  Anesth femoral artery surg                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01274  Anesth femoral embolectomy                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01320  Anesth knee area surgery                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01340  Anesth knee area procedure                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01360  Anesth knee area surgery                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01380  Anesth knee joint procedure                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01382  Anesth dx knee arthroscopy                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01390  Anesth knee area procedure                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01392  Anesth knee area surgery                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01400  Anesth knee joint surgery                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01402  Anesth knee arthroplasty                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01404  Anesth amputation at knee                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01420  Anesth knee joint casting                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01430  Anesth knee veins surgery                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01432  Anesth knee vessel surg                           J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01440  Anesth knee arteries surg                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01442  Anesth knee artery surg                           J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01444  Anesth knee artery repair                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01462  Anesth lower leg procedure                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01464  Anesth ankle/ft arthroscopy                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01470  Anesth lower leg surgery                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01472  Anesth achilles tendon surg                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01474  Anesth lower leg surgery                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01482  Anesth radical leg surgery                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01484  Anesth lower leg revision                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01486  Anesth ankle replacement                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01490  Anesth lower leg casting                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01500  Anesth leg arteries surg                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01502  Anesth lwr leg embolectomy                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0159T  Cad breast mri                                    C   0.00   0.00     0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0159TTCCad breast mri                                    C   0.00   0.00     0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0159T26Cad breast mri                                    C   0.00   0.00     0.00    0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
01610  Anesth surgery of shoulder                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01620  Anesth shoulder procedure                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01622  Anes dx shoulder arthroscopy                      J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0163T  Lumb artif diskectomy addl                        C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
01630  Anesth surgery of shoulder                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01634  Anesth shoulder joint amput                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01636  Anesth forequarter amput                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01638  Anesth shoulder replacement                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.000YYY.00.00.0000000             25.0008 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  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
01650  Anesth shoulder artery surg                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01652  Anesth shoulder vessel surg                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01654  Anesth shoulder vessel surg                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01670  Anesth shoulder vein surg                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01680  Anesth shoulder casting                           J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01682  Anesth airplane cast                              J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0169T  Place stereo cath brain                           C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0171T  Lumbar spine proces distract                      C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
01710  Anesth elbow area surgery                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01716  Anesth biceps tendon repair                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0172T  Lumbar spine process addl                         C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
01730  Anesth uppr arm procedure                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01732  Anesth dx elbow arthroscopy                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0174T  Cad cxr with interp                               C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
01740  Anesth upper arm surgery                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01742  Anesth humerus surgery                            J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01744  Anesth humerus repair                             J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0175T  Cad cxr remote                                    C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
01756  Anesth radical humerus surg                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01758  Anesth humeral lesion surg                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01760  Anesth elbow replacement                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01772  Anesth uppr arm embolectomy                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.004XXX.00.00.0000000             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.003XXX.00.00.0000000             25.0008 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  0.002XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0181T  Corneal hysteresis                                C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
01810  Anesth lower arm surgery                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0182T  Hdr elect brachytherapy                           C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0182TTCHdr elect brachytherapy                           C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0182T26Hdr elect brachytherapy                           C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
01820  Anesth lower arm procedure                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01829  Anesth dx wrist arthroscopy                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0183T  Wound ultrasound                                  C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
01830  Anesth lower arm surgery                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01832  Anesth wrist replacement                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0184T  Exc rectal tumor endoscopic                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01842  Anesth lwr arm embolectomy                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01844  Anesth vascular shunt surg                        J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0185T  Comptr probability analysis                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0186T  Suprachoroidal drug delivery                      C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
01860  Anesth lower arm casting                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0190T  Place intraoc radiation src                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 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  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
01916  Anesth dx arteriography                           J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
01920  Anesth catheterize heart                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01924  Anes ther interven rad artrl                      J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01925  Anes ther interven rad card                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01930  Anes ther interven rad vein                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01931  Anes ther interven rad tips                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01933  Anes tx interv rad cran vein                      J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0195T  Arthrod presac interbody                          C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01958  Anesth antepartum manipul                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0196T  Arthrod presac interbody eac                      C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
01960  Anesth vaginal delivery                           J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01961  Anesth cs delivery                                J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01962  Anesth emer hysterectomy                          J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01963  Anesth cs hysterectomy                            J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01966  Anesth induced ab procedure                       J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01967  Anesth/analg vag delivery                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0197T  Intrafraction track motion                        C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0198T  Ocular blood flow measure                         C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0199T  Physiologic tremor record                         C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
01990  Support for organ donor                           J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01991  Anesth nerve block/inj                            J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
01999  Unlisted anesth procedure                         J   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.000XXX.00.00.0001000             25.0008 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  0.000XXX.00.00.0002000             25.0008 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  0.000XXX.00.00.0000000             25.0008 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  0.000ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0206T  Remote algorithm analys ecg                       C   0.00   0.00     0.00    0.00   0.00  0.003XXX.00.00.0000000             25.0008 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  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0208T  Audiometry air only                               C   0.00   0.00     0.00    0.00   0.00  0.003XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0209T  Audiometry air & bone                             C   0.00   0.00     0.00    0.00   0.00  0.003XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0210T  Speech audiometry threshold                       C   0.00   0.00     0.00    0.00   0.00  0.003XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0211T  Speech audiom thresh & recog                      C   0.00   0.00     0.00    0.00   0.00  0.003XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0212T  Compre audiometry evaluation                      C   0.00   0.00     0.00    0.00   0.00  0.003XXX.00.00.0000000             25.0008 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  0.000XXX.00.00.0001000             25.0008 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  0.000ZZZ.00.00.0001000             25.0008 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  0.000ZZZ.00.00.0001000             25.0008 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  0.000XXX.00.00.0001000             25.0008 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  0.000ZZZ.00.00.0001000             25.0008 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  0.000ZZZ.00.00.0001000             25.0008 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  0.000XXX.00.00.0000000             25.0008 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  0.000XXX.00.00.0000000             25.0008 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  0.000XXX.00.00.0000000             25.0008 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  0.000ZZZ.00.00.0000000             25.0008 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  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0224T  Acoustic ecg 1+ analysis                          C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0225T  Acoustic ecg analy & reprog                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 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  0.000XXX.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
0227T  Anoscopy hra w/biopsy                             C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000100             25.0008 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  0.000XXX.00.00.0001100             25.0008 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  0.000XXX.00.00.0001100             25.0008 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  0.000XXX.00.00.0001100             25.0008 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  0.000XXX.00.00.0001100             25.0008 090 99      0.00   0.00   0.00
0232T  Njx platelet plasma                               C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
0233T  Skin glycation spectroscopy                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 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  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0235T  Trluml perip athrc visceral                       C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 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  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0237T  Trluml perip athrc brchiocph                      C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 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  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0239T  Bioimpedance spectroscopy                         C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0240T  Esoph motility 3d topography                      C   0.00   0.00     0.00NA  0.00   0.00  0.001YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0240TTCEsoph motility 3d topography                      C   0.00   0.00     0.00NA  0.00   0.00  0.001YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0240T26Esoph motility 3d topography                      C   0.00   0.00     0.00    0.00   0.00  0.001YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0241T  Esoph motility w/stim/perf                        C   0.00   0.00     0.00NA  0.00   0.00  0.001YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0241TTCEsoph motility w/stim/perf                        C   0.00   0.00     0.00NA  0.00   0.00  0.001YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0241T26Esoph motility w/stim/perf                        C   0.00   0.00     0.00    0.00   0.00  0.001YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0243T  Intm msr bronchodil wheeze                        C   0.00   0.00     0.00NA  0.00   0.00  0.001YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0243TTCIntm msr bronchodil wheeze                        C   0.00   0.00     0.00NA  0.00   0.00  0.001YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0243T26Intm msr bronchodil wheeze                        C   0.00   0.00     0.00    0.00   0.00  0.001YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0244T  Cont msr bronchodil wheeze                        C   0.00   0.00     0.00NA  0.00   0.00  0.001YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0244TTCCont msr bronchodil wheeze                        C   0.00   0.00     0.00NA  0.00   0.00  0.001YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0244T26Cont msr bronchodil wheeze                        C   0.00   0.00     0.00    0.00   0.00  0.001YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0245T  Open tx rib fx 1-2 ribs                           C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0001000             25.0008 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  0.000YYY.00.00.0001000             25.0008 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  0.000YYY.00.00.0001000             25.0008 090 99      0.00   0.00   0.00
0248T  Open tx rib fx 7/> ribs                           C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0001000             25.0008 090 99      0.00   0.00   0.00
0249T  Ligation hemorrhoid w/us                          C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0253T  Insert aqueous drain device                       C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 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  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0255T  Evasc rpr iliac art bifr s&i                      C   0.00   0.00     0.00NA  0.00   0.00  0.001YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0255TTCEvasc rpr iliac art bifr s&i                      C   0.00   0.00     0.00NA  0.00   0.00  0.001YYY.00.00.0000000             25.0008 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  0.001YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0260T  Hypthrm bdy neonate 28d/<                         C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0261T  Hypthrm head neonate 28d/<                        C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0262T  Impltj pulm vlv evasc appr                        C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0263T  Im B1 mrw cel ther cmpl                           C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0264T  Im B1 mrw cel ther xcl hrvst                      C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0265T  Im B1 mrw cel ther hrvst onl                      C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0266T  Implt/rpl crtd sns dev total                      C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0267T  Implt/rpl crtd sns dev lead                       C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0268T  Implt/rpl crtd sns dev gen                        C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0269T  Rev/remvl crtd sns dev total                      C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0270T  Rev/remvl crtd sns dev lead                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0271T  Rev/remvl crtd sns dev gen                        C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0272T  Interrogate crtd sns dev                          C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0273T  Interrogate crtd sns w/pgrmg                      C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0274T  Perq lamot/lam crv/thrc                           C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0275T  Perq lamot/lam lumbar                             C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0278T  Tempr                                             C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0281T  Laa closure w/implant                             C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0282T  Periph field stimul trial                         C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0001000             25.0008 090 99      0.00   0.00   0.00
0283T  Periph field stimul perm                          C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0001000             25.0008 090 99      0.00   0.00   0.00
0284T  Periph field stimul revise                        C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0285T  Periph field stimul analys                        C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0286T  Near ifr spectrsc of wounds                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0287T  Near ifr guide of vasc site                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0288T  Anoscopy w/rf delivery                            C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0289T  Laser inc for pkp/lkp donor                       C   0.00   0.00     0.00    0.00   0.00  0.000ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0290T  Laser inc for pkp/lkp recip                       C   0.00   0.00     0.00    0.00   0.00  0.000ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0291T  Iv oct for proc init vessel                       C   0.00   0.00     0.00    0.00   0.00  0.000ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0292T  Iv oct for proc addl vessel                       C   0.00   0.00     0.00    0.00   0.00  0.000ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0293T  Ins lt atrl press monitor                         C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0294T  Ins lt atrl mont pres lead                        C   0.00   0.00     0.00    0.00   0.00  0.000ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0295T  Ext ecg complete                                  C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0296T  Ext ecg recording                                 C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0297T  Ext ecg scan w/report                             C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0298T  Ext ecg review and interp                         C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0299T  Esw wound healing init wound                      C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0300T  Esw wound healing addl wound                      C   0.00   0.00     0.00    0.00   0.00  0.000ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0301T  Mw therapy for breast tumor                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0302T  Icar ischm mntrng sys compl                       C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020120             25.0008 090 99      0.00   0.00   0.00
0303T  Icar ischm mntrng sys eltrd                       C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
0304T  Icar ischm mntrng sys device                      C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
0305T  Icar ischm mntrng prgrm eval                      C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0306T  icar ischm mntr interr eval                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0307T  Rmvl icar ischm mntrng dvce                       C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
0308T  Insj ocular telescope prosth                      C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
0309T  Prescrl fuse w/ instr l4/l5                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0310T  Motor function mapping ntms                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0311T  Cal & alys cntrl artl press                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0312T  Laps impltj nstim vagus                           C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0313T  Laps rmvl nstim array vagus                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0314T  Laps rmvl vgl arry & pls gen                      C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0315T  Rmvl vagus nerve pls gen                          C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0316T  Replc vagus nerve pls gen                         C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0317T  Elec alys vagus nrv pls gen                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0318T  Replace aortic valve tthorac                      C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020021             25.0008 090 99      0.00   0.00   0.00
0319T  Insert subq defib w/eltrd                         C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0320T  Insert subq defib electrode                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0321T  Insert subq defib pls gen                         C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0322T  Rmvl subq defib pls gen                           C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0323T  Rmvl & replc subq pls gen                         C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0324T  Rmvl subq defib electrode                         C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0325T  Repos subq defib eltrd &/gen                      C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0326T  Ephys eval subq implt defib                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0327T  Implt subq defib interogat                        C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0328T  Implt subq defib sys dev evl                      C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
0500F  Initial prenatal care visit                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0501F  Prenatal flow sheet                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0502F  Subsequent prenatal care                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0503F  Postpartum care visit                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0505F  Hemodialysis plan docd                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0507F  Periton dialysis plan docd                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0509F  Urine incon plan docd                             M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0514F  Care plan hgb docd esa pt                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0525F  Initial visit for episode                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0526F  Subs visit for episode                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0528F  Rcmnd flw-up 10 yrs docd                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0529F  Intrvl 3/>yr pts clnscp docd                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0535F  Dyspnea mngmnt plan docd                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0540F  Gluco mngmnt plan docd                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0550F  Cytopath report nongyn spcmn                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0551F  Cytopath report non routine                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0555F  Symptom mgmnt plan care docd                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0556F  Plan care lipid control docd                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0557F  Plan caremng angnl symptdocd                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0580F  Multidisciplinary care plan                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0581F  Pt trnsfrd from anesth to cc                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0582F  No trnsfr from anesth to cc                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0583F  Transfer care checklist used                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
0584F  No transfercare chklist used                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1000F  Tobacco use assessed                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1002F  Assess anginal symptom/level                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
10021  Fna w/o image                                     A   1.27   3.04     0.59    0.22   4.53  2.080XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
10022  Fna w/image                                       A   1.27   2.76     0.49    0.14   4.17  1.900XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
1003F  Level of activity assess                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
10040  Acne surgery                                      A   1.21   1.64     1.24    0.18   3.03  2.630010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
1005F  Asthma symptoms evaluate                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1006F  Osteoarthritis assess                             M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
10060  Drainage of skin abscess                          A   1.22   2.13     1.52    0.12   3.47  2.860010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
10061  Drainage of skin abscess                          A   2.45   3.37     2.58    0.30   6.12  5.330010.10.80.1020100             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1008F  Gi/renal risk assess                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
10080  Drainage of pilonidal cyst                        A   1.22   4.03     1.68    0.20   5.45  3.100010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
10081  Drainage of pilonidal cyst                        A   2.50   5.29     2.20    0.45   8.24  5.150010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
1010F  Severity angina by actvty                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1011F  Angina present                                    M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1012F  Angina absent                                     M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
10120  Remove foreign body                               A   1.22   3.21     1.72    0.16   4.59  3.100010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
10121  Remove foreign body                               A   2.74   5.14     2.40    0.41   8.29  5.550010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
10140  Drainage of hematoma/fluid                        A   1.58   3.11     1.75    0.20   4.89  3.530010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
1015F  Copd symptoms assess                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
10160  Puncture drainage of lesion                       A   1.25   2.50     1.45    0.16   3.91  2.860010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
1018F  Assess dyspnea not present                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
10180  Complex drainage wound                            A   2.30   4.66     2.56    0.48   7.44  5.340010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
1019F  Assess dyspnea present                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1022F  Pneumo imm status assess                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1026F  Co-morbid condition assess                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1030F  Influenza imm status assess                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1031F  Smoking & 2nd hand assessed                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1032F  Smoker/exposed 2nd hnd smoke                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1033F  Tobacco nonsmoker nor 2ndhnd                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1034F  Current tobacco smoker                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1035F  Smokeless tobacco user                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1036F  Tobacco non-user                                  M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1038F  Persistent asthma                                 M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1039F  Intermittent asthma                               M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1050F  History of mole changes                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1052F  Type location activityasses                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1055F  Visual funct status assess                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1070F  Alarm symp assessed-absent                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1091F  Urine incon characterized                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
11000  Debride infected skin                             A   0.60   0.97     0.18    0.05   1.62  0.830000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
11001  Debride infected skin add-on                      A   0.30   0.30     0.09    0.03   0.63  0.420ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
11004  Debride genitalia & perineum                      A  10.80   4.26NA   4.26    1.89  16.95 16.950000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
11005  Debride abdom wall                                A  14.24   5.75NA   5.75    2.97  22.96 22.960000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
11006  Debride genit/per/abdom wall                      A  13.10   5.23NA   5.23    2.34  20.67 20.670000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
11008  Remove mesh from abd wall                         A   5.00   2.02NA   2.02    1.05   8.07  8.070ZZZ.00.00.0000000             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
11010  Debride skin at fx site                           A   4.19   9.96     3.35    0.76  14.91  8.300010.10.80.1022100             25.0008 090 99      0.00   0.00   0.00
11011  Debride skin musc at fx site                      A   4.94  10.23     2.91    0.98  16.15  8.830000.00.00.0022100             25.0008 090 99      0.00   0.00   0.00
11012  Deb skin bone at fx site                          A   6.87  13.14     4.30    1.31  21.32 12.480000.00.00.0022100             25.0008 090 99      0.00   0.00   0.00
11042  Deb subq tissue 20 sq cm/<                        A   1.01   2.39     0.69    0.13   3.53  1.830000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
11043  Deb musc/fascia 20 sq cm/<                        A   2.70   3.74     1.49    0.45   6.89  4.640000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
11044  Deb bone 20 sq cm/<                               A   4.10   4.66     2.08    0.72   9.48  6.900000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
11045  Deb subq tissue add-on                            A   0.50   0.65     0.20    0.11   1.26  0.810ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
11046  Deb musc/fascia add-on                            A   1.03   0.97     0.44    0.18   2.18  1.650ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
11047  Deb bone add-on                                   A   1.80   1.55     0.79    0.33   3.68  2.920ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
11055  Trim skin lesion                                  R   0.35   1.05     0.09    0.02   1.42  0.460000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
11056  Trim skin lesions 2 to 4                          R   0.50   1.20     0.13    0.03   1.73  0.660000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
11057  Trim skin lesions over 4                          R   0.65   1.25     0.17    0.04   1.94  0.860000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
1110F  Pt lft inpt fac w/in 60 days                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
11100  Biopsy skin lesion                                A   0.81   2.21     0.52    0.11   3.13  1.440000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
11101  Biopsy skin add-on                                A   0.41   0.50     0.27    0.05   0.96  0.730ZZZ.00.00.0000100             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1116F  Auric/peri pain assessed                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1119F  Init eval for condition                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
11200  Removal of skin tags <w/15                        A   0.82   1.70     1.26    0.11   2.63  2.190010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11201  Remove skin tags add-on                           A   0.29   0.22     0.16    0.04   0.55  0.490ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
1121F  Subs eval for condition                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1127F  New episode for condition                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1128F  Subs episode for condition                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1130F  Bk pain + fxn assessed                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
11300  Shave skin lesion 0.5 cm/<                        A   0.60   2.27     0.35    0.08   2.95  1.030000.00.00.0029000             25.0008 090 99      0.00   0.00   0.00
11301  Shave skin lesion 0.6-1.0 cm                      A   0.90   2.60     0.56    0.12   3.62  1.580000.00.00.0029000             25.0008 090 99      0.00   0.00   0.00
11302  Shave skin lesion 1.1-2.0 cm                      A   1.05   3.07     0.66    0.14   4.26  1.850000.00.00.0029000             25.0008 090 99      0.00   0.00   0.00
11303  Shave skin lesion >2.0 cm                         A   1.25   3.27     0.76    0.18   4.70  2.190000.00.00.0029000             25.0008 090 99      0.00   0.00   0.00
11305  Shave skin lesion 0.5 cm/<                        A   0.80   2.09     0.27    0.06   2.95  1.130000.00.00.0029000             25.0008 090 99      0.00   0.00   0.00
11306  Shave skin lesion 0.6-1.0 cm                      A   0.96   2.58     0.44    0.11   3.65  1.510000.00.00.0029000             25.0008 090 99      0.00   0.00   0.00
11307  Shave skin lesion 1.1-2.0 cm                      A   1.20   2.98     0.61    0.15   4.33  1.960000.00.00.0029000             25.0008 090 99      0.00   0.00   0.00
11308  Shave skin lesion >2.0 cm                         A   1.46   2.96     0.58    0.14   4.56  2.180000.00.00.0029000             25.0008 090 99      0.00   0.00   0.00
11310  Shave skin lesion 0.5 cm/<                        A   0.80   2.52     0.48    0.11   3.43  1.390000.00.00.0029000             25.0008 090 99      0.00   0.00   0.00
11311  Shave skin lesion 0.6-1.0 cm                      A   1.10   2.08     0.69    0.15   3.33  1.940000.00.00.0029000             25.0008 090 99      0.00   0.00   0.00
11312  Shave skin lesion 1.1-2.0 cm                      A   1.30   3.36     0.82    0.20   4.86  2.320000.00.00.0029000             25.0008 090 99      0.00   0.00   0.00
11313  Shave skin lesion >2.0 cm                         A   1.68   3.66     1.03    0.25   5.59  2.960000.00.00.0029000             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
11400  Exc tr-ext b9+marg 0.5 cm<                        A   0.90   2.70     1.37    0.12   3.72  2.390010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11401  Exc tr-ext b9+marg 0.6-1 cm                       A   1.28   3.01     1.63    0.20   4.49  3.110010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11402  Exc tr-ext b9+marg 1.1-2 cm                       A   1.45   3.30     1.72    0.24   4.99  3.410010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11403  Exc tr-ext b9+marg 2.1-3cm/<                      A   1.84   3.59     2.25    0.31   5.74  4.400010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11404  Exc tr-ext b9+marg 3.1-4 cm                       A   2.11   4.04     2.35    0.37   6.52  4.830010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11406  Exc tr-ext b9+marg >4.0 cm                        A   3.52   5.14     3.10    0.67   9.33  7.290010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11420  Exc h-f-nk-sp b9+marg 0.5/<                       A   1.03   2.55     1.29    0.12   3.70  2.440010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11421  Exc h-f-nk-sp b9+marg 0.6-1                       A   1.47   3.05     1.62    0.22   4.74  3.310010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11422  Exc h-f-nk-sp b9+marg 1.1-2                       A   1.68   3.33     2.12    0.26   5.27  4.060010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11423  Exc h-f-nk-sp b9+marg 2.1-3                       A   2.06   3.68     2.32    0.33   6.07  4.710010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11424  Exc h-f-nk-sp b9+marg 3.1-4                       A   2.48   4.08     2.46    0.41   6.97  5.350010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11426  Exc h-f-nk-sp b9+marg >4 cm                       A   4.09   5.08     3.32    0.71   9.88  8.120010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11440  Exc face-mm b9+marg 0.5 cm/<                      A   1.05   2.88     1.92    0.16   4.09  3.130010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11441  Exc face-mm b9+marg 0.6-1 cm                      A   1.53   3.28     2.18    0.24   5.05  3.950010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11442  Exc face-mm b9+marg 1.1-2 cm                      A   1.77   3.59     2.30    0.29   5.65  4.360010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11443  Exc face-mm b9+marg 2.1-3 cm                      A   2.34   3.99     2.60    0.38   6.71  5.320010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11444  Exc face-mm b9+marg 3.1-4 cm                      A   3.19   4.67     3.03    0.52   8.38  6.740010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11446  Exc face-mm b9+marg >4 cm                         A   4.80   5.96     4.01    0.80  11.56  9.610010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11450  Removal sweat gland lesion                        A   3.22   7.61     3.65    0.65  11.48  7.520090.10.71.1921100             25.0008 090 99      0.00   0.00   0.00
11451  Removal sweat gland lesion                        A   4.43   9.29     4.30    0.90  14.62  9.630090.10.71.1921000             25.0008 090 99      0.00   0.00   0.00
11462  Removal sweat gland lesion                        A   3.00   7.65     3.60    0.60  11.25  7.200090.10.71.1921000             25.0008 090 99      0.00   0.00   0.00
11463  Removal sweat gland lesion                        A   4.43   9.28     4.31    0.88  14.59  9.620090.10.71.1921000             25.0008 090 99      0.00   0.00   0.00
11470  Removal sweat gland lesion                        A   3.74   8.03     3.96    0.71  12.48  8.410090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
11471  Removal sweat gland lesion                        A   4.89   9.72     4.62    0.91  15.52 10.420090.10.71.1920000             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
11600  Exc tr-ext mal+marg 0.5 cm/<                      A   1.63   3.91     1.68    0.26   5.80  3.570010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11601  Exc tr-ext mal+marg 0.6-1 cm                      A   2.07   4.49     2.06    0.31   6.87  4.440010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11602  Exc tr-ext mal+marg 1.1-2 cm                      A   2.27   4.85     2.26    0.34   7.46  4.870010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11603  Exc tr-ext mal+marg 2.1-3 cm                      A   2.82   5.23     2.56    0.42   8.47  5.800010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11604  Exc tr-ext mal+marg 3.1-4 cm                      A   3.17   5.75     2.71    0.52   9.44  6.400010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11606  Exc tr-ext mal+marg >4 cm                         A   5.02   7.55     3.56    0.88  13.45  9.460010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11620  Exc h-f-nk-sp mal+marg 0.5/<                      A   1.64   3.98     1.73    0.26   5.88  3.630010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11621  Exc s/n/h/f/g mal+mrg 0.6-1                       A   2.08   4.52     2.08    0.31   6.91  4.470010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11622  Exc s/n/h/f/g mal+mrg 1.1-2                       A   2.41   4.93     2.34    0.37   7.71  5.120010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11623  Exc s/n/h/f/g mal+mrg 2.1-3                       A   3.11   5.41     2.71    0.49   9.01  6.310010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11624  Exc s/n/h/f/g mal+mrg 3.1-4                       A   3.62   5.91     2.91    0.60  10.13  7.130010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11626  Exc s/n/h/f/g mal+mrg >4 cm                       A   4.61   6.79     3.32    0.80  12.20  8.730010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11640  Exc f/e/e/n/l mal+mrg 0.5cm<                      A   1.67   4.13     1.82    0.26   6.06  3.750010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11641  Exc f/e/e/n/l mal+mrg 0.6-1                       A   2.17   4.66     2.17    0.33   7.16  4.670010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11642  Exc f/e/e/n/l mal+mrg 1.1-2                       A   2.62   5.13     2.47    0.39   8.14  5.480010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11643  Exc f/e/e/n/l mal+mrg 2.1-3                       A   3.42   5.62     2.90    0.54   9.58  6.860010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11644  Exc f/e/e/n/l mal+mrg 3.1-4                       A   4.34   6.75     3.43    0.71  11.80  8.480010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11646  Exc f/e/e/n/l mal+mrg >4 cm                       A   6.26   8.02     4.42    1.05  15.33 11.730010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
1170F  Fxnl status assessed                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
11719  Trim nail(s) any number                           R   0.17   0.16     0.04    0.01   0.34  0.220000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
11720  Debride nail 1-5                                  A   0.32   0.61     0.08    0.03   0.96  0.430000.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
11721  Debride nail 6 or more                            A   0.54   0.74     0.14    0.04   1.32  0.720000.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
11730  Removal of nail plate                             A   1.10   1.74     0.29    0.08   2.92  1.470000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
11732  Remove nail plate add-on                          A   0.44   0.58     0.11    0.03   1.05  0.580ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
11740  Drain blood from under nail                       A   0.37   1.08     0.57    0.03   1.48  0.970000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
1175F  Function stat assessed rvwd                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
11750  Removal of nail bed                               A   2.50   3.93     2.43    0.22   6.65  5.150010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11752  Remove nail bed/finger tip                        A   3.63   5.58     3.73    0.39   9.60  7.750010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11755  Biopsy nail unit                                  A   1.31   2.61     0.90    0.11   4.03  2.320000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
11760  Repair of nail bed                                A   1.63   5.18     2.12    0.26   7.07  4.010010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11762  Reconstruction of nail bed                        A   2.94   5.27     2.28    0.31   8.52  5.530010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11765  Excision of nail fold toe                         A   1.22   3.70     1.47    0.08   5.00  2.770010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11770  Remove pilonidal cyst simple                      A   2.66   5.19     2.30    0.52   8.37  5.480010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
11771  Remove pilonidal cyst exten                       A   6.09   9.80     5.53    1.24  17.13 12.860090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
11772  Remove pilonidal cyst compl                       A   7.35  12.03     8.39    1.47  20.85 17.210090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
1180F  Thromboemb risk assessed                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1181F  Neuropsychia sympts assessed                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1182F  Neuropsychi sympt 1+present                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1183F  Neuropsychiatric symp absent                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
11900  Inject skin lesions </w 7                         A   0.52   1.07     0.33    0.07   1.66  0.920000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
11901  Inject skin lesions >7                            A   0.80   1.17     0.52    0.11   2.08  1.430000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
11920  Correct skin color 6.0 cm/<                       R   1.61   3.27     1.53    0.31   5.19  3.450000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
11921  Corect skin color 6.1-20.0cm                      R   1.93   3.69     1.74    0.37   5.99  4.040000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
11922  Correct skin color ea 20.0cm                      R   0.49   1.29     0.31    0.08   1.86  0.880ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
11950  Tx contour defects 1 cc/<                         R   0.84   1.20     0.52    0.10   2.14  1.460000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
11951  Tx contour defects 1.1-5.0cc                      R   1.19   1.74     0.80    0.24   3.17  2.230000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
11952  Tx contour defects 5.1-10cc                       R   1.69   2.22     1.17    0.24   4.15  3.100000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
11954  Tx contour defects >10.0 cc                       R   1.85   2.53     1.22    0.35   4.73  3.420000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
11960  Insert tissue expander(s)                         A  11.49  14.43NA  14.43    1.84  27.76 27.760090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
11970  Replace tissue expander                           A   8.01   8.72NA   8.72    1.57  18.30 18.300090.10.71.1921100             25.0008 090 99      0.00   0.00   0.00
11971  Remove tissue expander(s)                         A   3.41  10.29     5.63    0.64  14.34  9.680090.10.71.1921000             25.0008 090 99      0.00   0.00   0.00
11976  Remove contraceptive capsule                      R   1.78   2.24     0.76    0.30   4.32  2.840000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
11980  Implant hormone pellet(s)                         A   1.48   1.35     0.65    0.23   3.06  2.360000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
11981  Insert drug implant device                        A   1.48   2.36     0.65    0.24   4.08  2.370XXX.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
11982  Remove drug implant device                        A   1.78   2.57     0.81    0.24   4.59  2.830XXX.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
11983  Remove/insert drug implant                        A   3.30   2.63     1.26    0.35   6.28  4.910XXX.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
1200F  Seizure type& frequ docd                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
12001  Rpr s/n/ax/gen/trnk 2.5cm/<                       A   0.84   1.74     0.34    0.14   2.72  1.320000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
12002  Rpr s/n/ax/gen/trnk2.6-7.5cm                      A   1.14   1.96     0.42    0.19   3.29  1.750000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
12004  Rpr s/n/ax/gen/trk7.6-12.5cm                      A   1.44   2.18     0.50    0.24   3.86  2.180000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
12005  Rpr s/n/a/gen/trk12.6-20.0cm                      A   1.97   2.69     0.64    0.33   4.99  2.940000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
12006  Rpr s/n/a/gen/trk20.1-30.0cm                      A   2.39   3.23     0.78    0.41   6.03  3.580000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
12007  Rpr s/n/ax/gen/trnk >30.0 cm                      A   2.90   3.46     1.09    0.50   6.86  4.490000.00.00.0020110             25.0008 090 99      0.00   0.00   0.00
12011  Rpr f/e/e/n/l/m 2.5 cm/<                          A   1.07   2.06     0.40    0.19   3.32  1.660000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
12013  Rpr f/e/e/n/l/m 2.6-5.0 cm                        A   1.22   2.21     0.42    0.20   3.63  1.840000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
12014  Rpr f/e/e/n/l/m 5.1-7.5 cm                        A   1.57   2.41     0.51    0.26   4.24  2.340000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
12015  Rpr f/e/e/n/l/m 7.6-12.5 cm                       A   1.98   2.86     0.61    0.33   5.17  2.920000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
12016  Rpr fe/e/en/l/m 12.6-20.0 cm                      A   2.68   3.28     0.80    0.46   6.42  3.940000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
12017  Rpr fe/e/en/l/m 20.1-30.0 cm                      A   3.18   0.78NA   0.78    0.56   4.52  4.520000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
12018  Rpr f/e/e/n/l/m >30.0 cm                          A   3.61   1.74NA   1.74    0.64   5.99  5.990000.00.00.0020200             25.0008 090 99      0.00   0.00   0.00
12020  Closure of split wound                            A   2.67   5.38     2.54    0.42   8.47  5.630010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
12021  Closure of split wound                            A   1.89   2.92     2.11    0.31   5.12  4.310010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
12031  Intmd rpr s/a/t/ext 2.5 cm/<                      A   2.00   4.85     2.28    0.32   7.17  4.600010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
12032  Intmd rpr s/a/t/ext 2.6-7.5                       A   2.52   6.26     2.94    0.38   9.16  5.840010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
12034  Intmd rpr s/tr/ext 7.6-12.5                       A   2.97   5.92     2.69    0.50   9.39  6.160010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
12035  Intmd rpr s/a/t/ext 12.6-20                       A   3.50   7.54     3.08    0.65  11.69  7.230010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
12036  Intmd rpr s/a/t/ext 20.1-30                       A   4.23   7.70     3.30    0.81  12.74  8.340010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
12037  Intmd rpr s/tr/ext >30.0 cm                       A   5.00   8.05     3.67    0.96  14.01  9.630010.10.80.1020010             25.0008 090 99      0.00   0.00   0.00
12041  Intmd rpr n-hf/genit 2.5cm/<                      A   2.10   4.86     2.26    0.32   7.28  4.680010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
12042  Intmd rpr n-hf/genit2.6-7.5                       A   2.79   5.46     2.78    0.41   8.66  5.980010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
12044  Intmd rpr n-hf/genit7.6-12.5                      A   3.19   7.12     2.68    0.52  10.83  6.390010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
12045  Intmd rpr n-hf/genit12.6-20                       A   3.75   7.72     3.73    0.64  12.11  8.120010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
12046  Intmd rpr n-hf/genit20.1-30                       A   4.30  10.99     4.99    0.84  16.13 10.130010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
12047  Intmd rpr n-hf/genit >30.0cm                      A   4.95  11.78     5.34    0.96  17.69 11.250010.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
1205F  EPI etiol synd rvwd and docd                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
12051  Intmd rpr face/mm 2.5 cm/<                        A   2.33   5.09     2.44    0.36   7.78  5.130010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
12052  Intmd rpr face/mm 2.6-5.0 cm                      A   2.87   5.54     2.78    0.42   8.83  6.070010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
12053  Intmd rpr face/mm 5.1-7.5 cm                      A   3.17   6.76     2.81    0.50  10.43  6.480010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
12054  Intmd rpr face/mm 7.6-12.5cm                      A   3.50   7.03     2.74    0.59  11.12  6.830010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
12055  Intmd rpr face/mm 12.6-20 cm                      A   4.50   8.99     3.73    0.73  14.22  8.960010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
12056  Intmd rpr face/mm 20.1-30.0                       A   5.30  10.45     5.24    0.67  16.42 11.210010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
12057  Intmd rpr face/mm >30.0 cm                        A   6.00   9.82     4.40    0.76  16.58 11.160010.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
1220F  Pt screened for depression                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
13100  Cmplx rpr trunk 1.1-2.5 cm                        A   3.00   6.55     2.65    0.47  10.02  6.120010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
13101  Cmplx rpr trunk 2.6-7.5 cm                        A   3.50   7.88     3.55    0.54  11.92  7.590010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
13102  Cmplx rpr trunk addl 5cm/<                        A   1.24   2.17     0.73    0.23   3.64  2.200ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
13120  Cmplx rpr s/a/l 1.1-2.5 cm                        A   3.23   6.78     3.34    0.50  10.51  7.070010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
13121  Cmplx rpr s/a/l 2.6-7.5 cm                        A   4.00   8.21     3.35    0.61  12.82  7.960010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
13122  Cmplx rpr s/a/l addl 5 cm/>                       A   1.44   2.31     0.84    0.26   4.01  2.540ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
13131  Cmplx rpr f/c/c/m/n/ax/g/h/f                      A   3.73   7.25     3.15    0.57  11.55  7.450010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
13132  Cmplx rpr f/c/c/m/n/ax/g/h/f                      A   4.78   8.77     3.87    0.71  14.26  9.360010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
13133  Cmplx rpr f/c/c/m/n/ax/g/h/f                      A   2.19   2.78     1.34    0.34   5.31  3.870ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
13150  Cmplx rpr e/n/e/l 1.0 cm/<                        A   3.58   6.89     2.47    0.57  11.04  6.620010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
13151  Cmplx rpr e/n/e/l 1.1-2.5 cm                      A   4.34   7.64     3.57    0.65  12.63  8.560010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
13152  Cmplx rpr e/n/e/l 2.6-7.5 cm                      A   4.90   8.70     3.92    0.73  14.33  9.550010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
13153  Cmplx rpr e/n/e/l addl 5cm/<                      A   2.38   3.00     1.41    0.38   5.76  4.170ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
13160  Late closure of wound                             A  12.04   9.78NA   9.78    2.23  24.05 24.050090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
1400F  Prkns diag rviewed                                M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
14000  Tis trnfr trunk 10 sq cm/<                        A   6.37  11.25     7.63    1.13  18.75 15.130090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
14001  Tis trnfr trunk 10.1-30sqcm                       A   8.78  13.67     9.29    1.54  23.99 19.610090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
14020  Tis trnfr s/a/l 10 sq cm/<                        A   7.22  12.53     8.68    1.21  20.96 17.110090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
14021  Tis trnfr s/a/l 10.1-30 sqcm                      A   9.72  14.83    10.29    1.55  26.10 21.560090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
14040  Tis trnfr f/c/c/m/n/a/g/h/f                       A   8.60  12.95     9.09    1.32  22.87 19.010090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
14041  Tis trnfr f/c/c/m/n/a/g/h/f                       A  10.83  15.75    10.82    1.62  28.20 23.270090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
14060  Tis trnfr e/n/e/l 10 sq cm/<                      A   9.23  12.59     9.56    1.42  23.24 20.210090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
14061  Tis trnfr e/n/e/l10.1-30sqcm                      A  11.48  17.11    11.68    1.71  30.30 24.870090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
14301  Tis trnfr any 30.1-60 sq cm                       A  12.65  17.47    11.62    2.14  32.26 26.410090.10.71.1920200             25.0008 090 99      0.00   0.00   0.00
14302  Tis trnfr addl 30 sq cm/<                         A   3.73   2.11     2.11    0.63   6.47  6.470ZZZ.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
14350  Filleted finger/toe flap                          A  11.05   8.44NA   8.44    1.55  21.04 21.040090.10.71.1920000             25.0008 090 99      0.00   0.00   0.00
1450F  Symptoms improved/consist                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1451F  Sympt show clin import drop                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1460F  Qual card diag prior 12 mons                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1461F  No qual card diag prior12mon                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1490F  Dem severity classified mild                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1491F  Dem severity classified mod                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1493F  Dem severity class severe                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1494F  Cognit assessed and reviewed                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1500F  Symptom+sign symm polyneuro                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
15002  Wound prep trk/arm/leg                            A   3.65   6.17     2.48    0.65  10.47  6.780000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
15003  Wound prep addl 100 cm                            A   0.80   1.32     0.39    0.16   2.28  1.350ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
15004  Wound prep f/n/hf/g                               A   4.58   6.77     2.80    0.67  12.02  8.050000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
15005  Wnd prep f/n/hf/g addl cm                         A   1.60   1.81     0.78    0.31   3.72  2.690ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
1501F  Not initial eval for cond                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1502F  Pt queried pain fxn w/ instr                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1503F  Pt queried symp resp insuff                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
1504F  Pt has resp insufficiency                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
15040  Harvest cultured skin graft                       A   2.00   5.43     1.43    0.37   7.80  3.800000.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
1505F  Pt has no resp insufficiency                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
15050  Skin pinch graft                                  A   5.57  10.70     6.95    0.90  17.17 13.420090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15100  Skin splt grft trnk/arm/leg                       A   9.90  13.92     9.61    1.95  25.77 21.460090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15101  Skin splt grft t/a/l add-on                       A   1.72   3.57     1.23    0.34   5.63  3.290ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
15110  Epidrm autogrft trnk/arm/leg                      A  10.97  12.87     9.47    2.15  25.99 22.590090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15111  Epidrm autogrft t/a/l add-on                      A   1.85   1.16     0.80    0.38   3.39  3.030ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
15115  Epidrm a-grft face/nck/hf/g                       A  11.28  12.74     9.39    1.85  25.87 22.520090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15116  Epidrm a-grft f/n/hf/g addl                       A   2.50   1.47     0.99    0.49   4.46  3.980ZZZ.00.00.0000110             25.0008 090 99      0.00   0.00   0.00
15120  Skn splt a-grft fac/nck/hf/g                      A  10.15  13.56     8.91    1.76  25.47 20.820090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15121  Skn splt a-grft f/n/hf/g add                      A   2.00   3.89     1.56    0.37   6.26  3.930ZZZ.00.00.0000110             25.0008 090 99      0.00   0.00   0.00
15130  Derm autograft trnk/arm/leg                       A   7.53  11.24     7.89    1.48  20.25 16.900090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15131  Derm autograft t/a/l add-on                       A   1.50   0.85     0.59    0.31   2.66  2.400ZZZ.00.00.0000110             25.0008 090 99      0.00   0.00   0.00
15135  Derm autograft face/nck/hf/g                      A  11.03  13.29     9.98    1.88  26.20 22.890090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15136  Derm autograft f/n/hf/g add                       A   1.50   1.10     0.90    0.10   2.70  2.500ZZZ.00.00.0000110             25.0008 090 99      0.00   0.00   0.00
15150  Cult skin grft t/arm/leg                          A   9.39   9.26     7.38    1.99  20.64 18.760090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15151  Cult skin grft t/a/l addl                         A   2.00   1.08     0.79    0.42   3.50  3.210ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
15152  Cult skin graft t/a/l +%                          A   2.50   1.60     1.30    0.49   4.59  4.290ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
15155  Cult skin graft f/n/hf/g                          A  10.14  11.87     9.96    0.76  22.77 20.860090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15156  Cult skin grft f/n/hfg add                        A   2.75   1.37     1.09    0.59   4.71  4.430ZZZ.00.00.0000110             25.0008 090 99      0.00   0.00   0.00
15157  Cult epiderm grft f/n/hfg +%                      A   3.00   2.22     1.80    0.22   5.44  5.020ZZZ.00.00.0000110             25.0008 090 99      0.00   0.00   0.00
15200  Skin full graft trunk                             A   9.15  14.11     9.32    1.65  24.91 20.120090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15201  Skin full graft trunk add-on                      A   1.32   2.91     0.77    0.26   4.49  2.350ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
15220  Skin full graft sclp/arm/leg                      A   8.09  13.72     9.01    1.39  23.20 18.490090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15221  Skin full graft add-on                            A   1.19   2.73     0.70    0.23   4.15  2.120ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
15240  Skin full grft face/genit/hf                      A  10.41  15.90    11.98    1.70  28.01 24.090090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15241  Skin full graft add-on                            A   1.86   3.38     1.12    0.33   5.57  3.310ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
15260  Skin full graft een & lips                        A  11.64  16.95    12.41    1.77  30.36 25.820090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15261  Skin full graft add-on                            A   2.23   3.90     1.59    0.37   6.50  4.190ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
15271  Skin sub graft trnk/arm/leg                       A   1.50   2.27     0.80    0.25   4.02  2.550000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
15272  Skin sub graft t/a/l add-on                       A   0.33   0.38     0.13    0.04   0.75  0.500ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
15273  Skin sub grft t/arm/lg child                      A   3.50   3.94     1.61    0.62   8.06  5.730000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
15274  Skn sub grft t/a/l child add                      A   0.80   0.92     0.32    0.10   1.82  1.220ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
15275  Skin sub graft face/nk/hf/g                       A   1.83   2.41     0.93    0.31   4.55  3.070000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
15276  Skin sub graft f/n/hf/g addl                      A   0.50   0.45     0.20    0.06   1.01  0.760ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
15277  Skn sub grft f/n/hf/g child                       A   4.00   4.22     1.81    0.59   8.81  6.400000.00.00.0020110             25.0008 090 99      0.00   0.00   0.00
15278  Skn sub grft f/n/hf/g ch add                      A   1.00   1.06     0.40    0.13   2.19  1.530ZZZ.00.00.0000110             25.0008 090 99      0.00   0.00   0.00
15570  Skin pedicle flap trunk                           A  10.21  15.19     9.83    2.07  27.47 22.110090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15572  Skin pedicle flap arms/legs                       A  10.12  14.38    10.17    1.82  26.32 22.110090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15574  Pedcle fh/ch/ch/m/n/ax/g/h/f                      A  10.70  14.82    10.40    1.82  27.34 22.920090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15576  Pedicle e/n/e/l/ntroral                           A   9.37  13.40     9.32    1.54  24.31 20.230090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15600  Delay flap trunk                                  A   2.01   7.47     3.90    0.38   9.86  6.290090.10.71.1920000             25.0008 090 99      0.00   0.00   0.00
15610  Delay flap arms/legs                              A   2.52   7.80     4.31    0.45  10.77  7.280090.10.71.1920000             25.0008 090 99      0.00   0.00   0.00
15620  Delay flap f/c/c/n/ax/g/h/f                       A   3.75   8.93     5.47    0.61  13.29  9.830090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15630  Delay flap eye/nos/ear/lip                        A   4.08   9.20     5.75    0.65  13.93 10.480090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15650  Transfer skin pedicle flap                        A   4.77   9.69     5.98    0.78  15.24 11.530090.10.71.1920000             25.0008 090 99      0.00   0.00   0.00
15731  Forehead flap w/vasc pedicle                      A  14.38  17.04    13.51    2.41  33.83 30.300090.10.71.1920000             25.0008 090 99      0.00   0.00   0.00
15732  Muscle-skin graft head/neck                       A  16.38  19.50    14.62    2.91  38.79 33.910090.10.71.1920110             25.0008 090 99      0.00   0.00   0.00
15734  Muscle-skin graft trunk                           A  19.86  20.94    15.56    3.99  44.79 39.410090.10.71.1920210             25.0008 090 99      0.00   0.00   0.00
15736  Muscle-skin graft arm                             A  17.04  19.17    13.88    3.36  39.57 34.280090.10.71.1920110             25.0008 090 99      0.00   0.00   0.00
15738  Muscle-skin graft leg                             A  19.04  19.18    14.17    3.81  42.03 37.020090.10.71.1920210             25.0008 090 99      0.00   0.00   0.00
15740  Island pedicle flap graft                         A  11.80  16.81    11.92    1.77  30.38 25.490090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15750  Neurovascular pedicle flap                        A  12.96  11.99NA  11.99    2.29  27.24 27.240090.10.71.1920200             25.0008 090 99      0.00   0.00   0.00
15756  Free myo/skin flap microvasc                      A  36.94  26.14NA  26.14    6.36  69.44 69.440090.10.71.1920220             25.0008 090 99      0.00   0.00   0.00
15757  Free skin flap microvasc                          A  37.15  25.47NA  25.47    5.92  68.54 68.540090.10.71.1920220             25.0008 090 99      0.00   0.00   0.00
15758  Free fascial flap microvasc                       A  36.90  25.64NA  25.64    5.92  68.46 68.460090.10.71.1920220             25.0008 090 99      0.00   0.00   0.00
15760  Composite skin graft                              A   9.86  14.26     9.91    1.58  25.70 21.350090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15770  Derma-fat-fascia graft                            A   8.96   9.67NA   9.67    1.63  20.26 20.260090.10.71.1920210             25.0008 090 99      0.00   0.00   0.00
15775  Hair trnspl 1-15 punch grfts                      R   3.95   4.39     2.05    0.29   8.63  6.290000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
15776  Hair trnspl >15 punch grafts                      R   5.53   8.23     4.25    0.38  14.14 10.160000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
15777  Acellular derm matrix implt                       A   3.65   1.47     1.47    0.77   5.89  5.890ZZZ.00.00.0001100             25.0008 090 99      0.00   0.00   0.00
15780  Dermabrasion total face                           A   8.73  17.64     9.83    1.20  27.57 19.760090.10.71.1920000             25.0008 090 99      0.00   0.00   0.00
15781  Dermabrasion segmental face                       A   5.02  10.93     7.28    0.76  16.71 13.060090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15782  Dermabrasion other than face                      A   4.44  12.04     6.92    0.63  17.11 11.990090.10.71.1920000             25.0008 090 99      0.00   0.00   0.00
15783  Dermabrasion suprfl any site                      A   4.41   9.60     6.23    0.63  14.64 11.270090.10.71.1920000             25.0008 090 99      0.00   0.00   0.00
15786  Abrasion lesion single                            A   2.08   5.07     1.69    0.33   7.48  4.100010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
15787  Abrasion lesions add-on                           A   0.33   1.14     0.15    0.04   1.51  0.520ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
15788  Chemical peel face epiderm                        R   2.09  11.93     5.31    0.35  14.37  7.750090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15789  Chemical peel face dermal                         R   4.91  10.98     6.94    0.68  16.57 12.530090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15792  Chemical peel nonfacial                           R   1.86  11.34     5.91    0.30  13.50  8.070090.10.71.1920000             25.0008 090 99      0.00   0.00   0.00
15793  Chemical peel nonfacial                           A   3.96  10.42     6.56    0.56  14.94 11.080090.10.71.1920000             25.0008 090 99      0.00   0.00   0.00
15819  Plastic surgery neck                              A  10.65   9.11NA   9.11    2.10  21.86 21.860090.10.71.1920000             25.0008 090 99      0.00   0.00   0.00
15820  Revision of lower eyelid                          A   6.27  10.07     8.36    1.24  17.58 15.870090.10.71.1921000             25.0008 090 99      0.00   0.00   0.00
15821  Revision of lower eyelid                          A   6.84  10.44     8.54    1.33  18.61 16.710090.10.71.1921000             25.0008 090 99      0.00   0.00   0.00
15822  Revision of upper eyelid                          A   4.62   8.22     6.54    0.82  13.66 11.980090.10.71.1921100             25.0008 090 99      0.00   0.00   0.00
15823  Revision of upper eyelid                          A   6.81  10.69     8.76    1.27  18.77 16.840090.10.71.1921100             25.0008 090 99      0.00   0.00   0.00
15824  Removal of forehead wrinkles                      R   0.00   0.00     0.00    0.00   0.00  0.000000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
15825  Removal of neck wrinkles                          R   0.00   0.00     0.00    0.00   0.00  0.000000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
15826  Removal of brow wrinkles                          R   0.00   0.00     0.00    0.00   0.00  0.000000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
15828  Removal of face wrinkles                          R   0.00   0.00     0.00    0.00   0.00  0.000000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
15829  Removal of skin wrinkles                          R   0.00   0.00     0.00    0.00   0.00  0.000000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
15830  Exc skin abd                                      R  17.11  14.39NA  14.39    3.39  34.89 34.890090.10.71.1920210             25.0008 090 99      0.00   0.00   0.00
15832  Excise excessive skin thigh                       A  12.85  12.55NA  12.55    2.57  27.97 27.970090.10.71.1921210             25.0008 090 99      0.00   0.00   0.00
15833  Excise excessive skin leg                         A  11.90  11.95NA  11.95    2.33  26.18 26.180090.10.71.1921000             25.0008 090 99      0.00   0.00   0.00
15834  Excise excessive skin hip                         A  12.17  12.12NA  12.12    2.40  26.69 26.690090.10.71.1921000             25.0008 090 99      0.00   0.00   0.00
15835  Excise excessive skin buttck                      A  12.99  12.60NA  12.60    2.56  28.15 28.150090.10.71.1920000             25.0008 090 99      0.00   0.00   0.00
15836  Excise excessive skin arm                         A  10.61  11.03NA  11.03    2.08  23.72 23.720090.10.71.1921000             25.0008 090 99      0.00   0.00   0.00
15837  Excise excess skin arm/hand                       A   9.55  15.09    10.03    2.01  26.65 21.590090.10.71.1920000             25.0008 090 99      0.00   0.00   0.00
15838  Excise excess skin fat pad                        A   8.25   7.73NA   7.73    1.06  17.04 17.040090.10.71.1920000             25.0008 090 99      0.00   0.00   0.00
15839  Excise excess skin & tissue                       A  10.50  13.68     9.38    1.93  26.11 21.810090.10.71.1920000             25.0008 090 99      0.00   0.00   0.00
15840  Nerve palsy fascial graft                         A  14.99  12.97NA  12.97    2.40  30.36 30.360090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15841  Nerve palsy muscle graft                          A  25.99  18.15NA  18.15    3.36  47.50 47.500090.10.71.1920210             25.0008 090 99      0.00   0.00   0.00
15842  Nerve palsy microsurg graft                       A  41.01  32.28NA  32.28    5.28  78.57 78.570090.10.71.1920210             25.0008 090 99      0.00   0.00   0.00
15845  Skin and muscle repair face                       A  14.32  14.22NA  14.22    1.84  30.38 30.380090.10.71.1920200             25.0008 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  0.000YYY.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
15850  Remove sutures same surgeon                       B+  0.78   1.76     0.31    0.05   2.59  1.149XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
15851  Remove sutures diff surgeon                       A   0.86   2.02     0.39    0.12   3.00  1.370000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
15852  Dressing change not for burn                      A   0.86   0.37NA   0.37    0.14   1.37  1.370000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
15860  Test for blood flow in graft                      A   1.95   0.97NA   0.97    0.38   3.30  3.300000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
15876  Suction lipectomy head&neck                       R   0.00   0.00     0.00    0.00   0.00  0.000000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
15877  Suction lipectomy trunk                           R   0.00   0.00     0.00    0.00   0.00  0.000000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
15878  Suction lipectomy upr extrem                      R   0.00   0.00     0.00    0.00   0.00  0.000000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
15879  Suction lipectomy lwr extrem                      R   0.00   0.00     0.00    0.00   0.00  0.000000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
15920  Removal of tail bone ulcer                        A   8.29   8.21NA   8.21    1.71  18.21 18.210090.10.71.1920000             25.0008 090 99      0.00   0.00   0.00
15922  Removal of tail bone ulcer                        A  10.38  11.07NA  11.07    2.03  23.48 23.480090.10.71.1920210             25.0008 090 99      0.00   0.00   0.00
15931  Remove sacrum pressure sore                       A  10.07   8.16NA   8.16    2.07  20.30 20.300090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15933  Remove sacrum pressure sore                       A  11.77  11.18NA  11.18    2.41  25.36 25.360090.10.71.1920000             25.0008 090 99      0.00   0.00   0.00
15934  Remove sacrum pressure sore                       A  13.68  11.05NA  11.05    2.78  27.51 27.510090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15935  Remove sacrum pressure sore                       A  15.78  14.00NA  14.00    3.18  32.96 32.960090.10.71.1920210             25.0008 090 99      0.00   0.00   0.00
15936  Remove sacrum pressure sore                       A  13.16  10.84NA  10.84    2.67  26.67 26.670090.10.71.1920110             25.0008 090 99      0.00   0.00   0.00
15937  Remove sacrum pressure sore                       A  15.14  12.80NA  12.80    3.06  31.00 31.000090.10.71.1920110             25.0008 090 99      0.00   0.00   0.00
15940  Remove hip pressure sore                          A  10.20   8.47NA   8.47    2.07  20.74 20.740090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15941  Remove hip pressure sore                          A  12.41  12.29NA  12.29    2.48  27.18 27.180090.10.71.1920000             25.0008 090 99      0.00   0.00   0.00
15944  Remove hip pressure sore                          A  12.44  12.07NA  12.07    2.50  27.01 27.010090.10.71.1920000             25.0008 090 99      0.00   0.00   0.00
15945  Remove hip pressure sore                          A  13.75  13.12NA  13.12    2.74  29.61 29.610090.10.71.1920000             25.0008 090 99      0.00   0.00   0.00
15946  Remove hip pressure sore                          A  24.12  19.89NA  19.89    4.82  48.83 48.830090.10.71.1920110             25.0008 090 99      0.00   0.00   0.00
15950  Remove thigh pressure sore                        A   8.03   7.83NA   7.83    1.59  17.45 17.450090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
15951  Remove thigh pressure sore                        A  11.58   9.99NA   9.99    2.27  23.84 23.840090.10.71.1920010             25.0008 090 99      0.00   0.00   0.00
15952  Remove thigh pressure sore                        A  12.31  12.41NA  12.41    2.63  27.35 27.350090.10.71.1920210             25.0008 090 99      0.00   0.00   0.00
15953  Remove thigh pressure sore                        A  13.57  13.63NA  13.63    2.67  29.87 29.870090.10.71.1920110             25.0008 090 99      0.00   0.00   0.00
15956  Remove thigh pressure sore                        A  16.79  14.27NA  14.27    3.42  34.48 34.480090.10.71.1920110             25.0008 090 99      0.00   0.00   0.00
15958  Remove thigh pressure sore                        A  16.75  15.00NA  15.00    3.39  35.14 35.140090.10.71.1920110             25.0008 090 99      0.00   0.00   0.00
15999  Removal of pressure sore                          C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 090 99      0.00   0.00   0.00
16000  Initial treatment of burn(s)                      A   0.89   1.04     0.35    0.12   2.05  1.360000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
16020  Dress/debrid p-thick burn s                       A   0.71   1.64     0.81    0.10   2.45  1.620000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
16025  Dress/debrid p-thick burn m                       A   1.74   2.38     1.29    0.29   4.41  3.320000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
16030  Dress/debrid p-thick burn l                       A   2.08   3.05     1.51    0.37   5.50  3.960000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
16035  Incision of burn scab initi                       A   3.74   1.49NA   1.49    0.63   5.86  5.860000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
16036  Escharotomy addl incision                         A   1.50   0.61NA   0.61    0.27   2.38  2.380ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
17000  Destruct premalg lesion                           A   0.65   1.72     0.95    0.08   2.45  1.680010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
17003  Destruct premalg les 2-14                         A   0.07   0.12     0.05    0.01   0.20  0.130ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
17004  Destroy premal lesions 15/>                       A   1.85   2.95     1.76    0.27   5.07  3.880010.10.80.1000100             25.0008 090 99      0.00   0.00   0.00
17106  Destruction of skin lesions                       A   3.69   5.86     3.90    0.53  10.08  8.120090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
17107  Destruction of skin lesions                       A   4.79   7.60     4.97    0.73  13.12 10.490090.10.71.1920100             25.0008 090 99      0.00   0.00   0.00
17108  Destruction of skin lesions                       A   7.49  10.34     6.87    1.31  19.14 15.670090.10.71.1920000             25.0008 090 99      0.00   0.00   0.00
17110  Destruct b9 lesion 1-14                           A   0.70   2.58     1.32    0.08   3.36  2.100010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
17111  Destruct lesion 15 or more                        A   0.97   2.88     1.48    0.12   3.97  2.570010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
17250  Chemical cautery tissue                           A   0.50   1.85     0.53    0.07   2.42  1.100000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
17260  Destruction of skin lesions                       A   0.96   1.73     0.99    0.12   2.81  2.070010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
17261  Destruction of skin lesions                       A   1.22   2.93     1.34    0.18   4.33  2.740010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
17262  Destruction of skin lesions                       A   1.63   3.40     1.61    0.23   5.26  3.470010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
17263  Destruction of skin lesions                       A   1.84   3.63     1.74    0.26   5.73  3.840010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
17264  Destruction of skin lesions                       A   1.99   3.88     1.83    0.29   6.16  4.110010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
17266  Destruction of skin lesions                       A   2.39   4.22     2.06    0.34   6.95  4.790010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
17270  Destruction of skin lesions                       A   1.37   2.96     1.41    0.20   4.53  2.980010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
17271  Destruction of skin lesions                       A   1.54   3.14     1.55    0.23   4.91  3.320010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
17272  Destruction of skin lesions                       A   1.82   3.50     1.73    0.26   5.58  3.810010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
17273  Destruction of skin lesions                       A   2.10   3.83     1.90    0.30   6.23  4.300010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
17274  Destruction of skin lesions                       A   2.64   4.32     2.24    0.37   7.33  5.250010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
17276  Destruction of skin lesions                       A   3.25   4.77     2.58    0.48   8.50  6.310010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
17280  Destruction of skin lesions                       A   1.22   2.85     1.32    0.18   4.25  2.720010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
17281  Destruction of skin lesions                       A   1.77   3.31     1.69    0.26   5.34  3.720010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
17282  Destruction of skin lesions                       A   2.09   3.73     1.90    0.30   6.12  4.290010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
17283  Destruction of skin lesions                       A   2.69   4.23     2.28    0.38   7.30  5.350010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
17284  Destruction of skin lesions                       A   3.20   4.66     2.57    0.44   8.30  6.210010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
17286  Destruction of skin lesions                       A   4.48   5.59     3.32    0.67  10.74  8.470010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
17311  Mohs 1 stage h/n/hf/g                             A   6.20  12.44     4.07    0.87  19.51 11.140000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
17312  Mohs addl stage                                   A   3.30   7.93     2.16    0.45  11.68  5.910ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
17313  Mohs 1 stage t/a/l                                A   5.56  11.47     3.65    0.78  17.81  9.990000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
17314  Mohs addl stage t/a/l                             A   3.06   7.35     2.01    0.42  10.83  5.490ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
17315  Mohs surg addl block                              A   0.87   1.34     0.57    0.11   2.32  1.550ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
17340  Cryotherapy of skin                               A   0.77   0.64     0.57    0.10   1.51  1.440010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
17360  Skin peel therapy                                 A   1.46   2.18     1.26    0.22   3.86  2.940010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
17380  Hair removal by electrolysis                      R   0.00   0.00     0.00    0.00   0.00  0.000000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
17999  Skin tissue procedure                             C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 090 99      0.00   0.00   0.00
19000  Drainage of breast lesion                         A   0.84   2.41     0.32    0.11   3.36  1.270000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
19001  Drain breast lesion add-on                        A   0.42   0.31     0.16    0.05   0.78  0.630ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
19020  Incision of breast lesion                         A   3.83   9.77     4.54    0.78  14.38  9.150090.10.71.1921100             25.0008 090 99      0.00   0.00   0.00
19030  Injection for breast x-ray                        A   1.53   3.13     0.56    0.14   4.80  2.230000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
19100  Bx breast percut w/o image                        A   1.27   3.04     0.50    0.26   4.57  2.030000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
19101  Biopsy of breast open                             A   3.23   6.43     2.66    0.67  10.33  6.560010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
19102  Bx breast percut w/image                          A   2.00   4.20     0.74    0.22   6.42  2.960000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
19103  Bx breast percut w/device                         A   3.69  12.54     1.38    0.48  16.71  5.550000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
19105  Cryosurg ablate fa each                           A   3.69  55.43     1.50    0.39  59.51  5.580000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
19110  Nipple exploration                                A   4.44   9.44     4.87    0.93  14.81 10.240090.10.71.1921100             25.0008 090 99      0.00   0.00   0.00
19112  Excise breast duct fistula                        A   3.81   9.48     4.78    0.80  14.09  9.390090.10.71.1921000             25.0008 090 99      0.00   0.00   0.00
19120  Removal of breast lesion                          A   5.92   7.57     5.08    1.25  14.74 12.250090.10.71.1921100             25.0008 090 99      0.00   0.00   0.00
19125  Excision breast lesion                            A   6.69   8.25     5.49    1.42  16.36 13.600090.10.71.1921110             25.0008 090 99      0.00   0.00   0.00
19126  Excision addl breast lesion                       A   2.93   1.15NA   1.15    0.63   4.71  4.710ZZZ.00.00.0000110             25.0008 090 99      0.00   0.00   0.00
19260  Removal of chest wall lesion                      A  17.78  14.48NA  14.48    3.96  36.22 36.220090.10.71.1920210             25.0008 090 99      0.00   0.00   0.00
19271  Revision of chest wall                            A  22.19  21.65NA  21.65    5.05  48.89 48.890090.10.71.1920210             25.0008 090 99      0.00   0.00   0.00
19272  Extensive chest wall surgery                      A  25.17  22.96NA  22.96    5.96  54.09 54.090090.10.71.1920210             25.0008 090 99      0.00   0.00   0.00
19290  Place needle wire breast                          A   1.27   3.34     0.47    0.12   4.73  1.860000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
19291  Place needle wire breast                          A   0.63   1.35     0.23    0.05   2.03  0.910ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
19295  Place breast clip percut                          A   0.00   2.82     2.82NA  0.01   2.83  2.833ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
19296  Place po breast cath for rad                      A   3.63 122.58     1.79    0.73 126.94  6.150000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
19297  Place breast cath for rad                         A   1.72   0.68NA   0.68    0.35   2.75  2.750ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
19298  Place breast rad tube/caths                       A   6.00  27.61     2.66    0.76  34.37  9.420000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
19300  Removal of breast tissue                          A   5.31   9.24     5.82    1.13  15.68 12.260090.10.71.1921100             25.0008 090 99      0.00   0.00   0.00
19301  Partical mastectomy                               A  10.13   6.98NA   6.98    2.15  19.26 19.260090.10.71.1921000             25.0008 090 99      0.00   0.00   0.00
19302  P-mastectomy w/ln removal                         A  13.99   9.55NA   9.55    2.98  26.52 26.520090.10.71.1921210             25.0008 090 99      0.00   0.00   0.00
19303  Mast simple complete                              A  15.85  10.58NA  10.58    3.38  29.81 29.810090.10.71.1921210             25.0008 090 99      0.00   0.00   0.00
19304  Mast subq                                         A   7.95   7.49NA   7.49    1.67  17.11 17.110090.10.71.1921210             25.0008 090 99      0.00   0.00   0.00
19305  Mast radical                                      A  17.46  12.19NA  12.19    3.73  33.38 33.380090.10.71.1921210             25.0008 090 99      0.00   0.00   0.00
19306  Mast rad urban type                               A  18.13  13.50NA  13.50    3.87  35.50 35.500090.10.71.1921210             25.0008 090 99      0.00   0.00   0.00
19307  Mast mod rad                                      A  18.23  13.26NA  13.26    3.87  35.36 35.360090.10.71.1921210             25.0008 090 99      0.00   0.00   0.00
19316  Suspension of breast                              A  11.09   9.66NA   9.66    2.19  22.94 22.940090.10.71.1921210             25.0008 090 99      0.00   0.00   0.00
19318  Reduction of large breast                         A  16.03  13.90NA  13.90    3.16  33.09 33.090090.10.71.1921210             25.0008 090 99      0.00   0.00   0.00
19324  Enlarge breast                                    A   6.80   6.35NA   6.35    1.46  14.61 14.610090.10.71.1921000             25.0008 090 99      0.00   0.00   0.00
19325  Enlarge breast with implant                       A   8.64   9.05NA   9.05    1.69  19.38 19.380090.10.71.1921000             25.0008 090 99      0.00   0.00   0.00
19328  Removal of breast implant                         A   6.48   7.13NA   7.13    1.28  14.89 14.890090.10.71.1921100             25.0008 090 99      0.00   0.00   0.00
19330  Removal of implant material                       A   8.54   8.79NA   8.79    1.66  18.99 18.990090.10.71.1921100             25.0008 090 99      0.00   0.00   0.00
19340  Immediate breast prosthesis                       A  13.99  13.40NA  13.40    2.75  30.14 30.140090.10.71.1921110             25.0008 090 99      0.00   0.00   0.00
19342  Delayed breast prosthesis                         A  12.63  12.64NA  12.64    2.44  27.71 27.710090.10.71.1921010             25.0008 090 99      0.00   0.00   0.00
19350  Breast reconstruction                             A   9.11  13.94     9.34    1.78  24.83 20.230090.10.71.1921100             25.0008 090 99      0.00   0.00   0.00
19355  Correct inverted nipple(s)                        A   8.52  10.68     6.56    1.82  21.02 16.900090.10.71.1921000             25.0008 090 99      0.00   0.00   0.00
19357  Breast reconstruction                             A  18.50  23.34NA  23.34    3.62  45.46 45.460090.10.71.1921210             25.0008 090 99      0.00   0.00   0.00
19361  Breast reconstr w/lat flap                        A  23.36  19.32NA  19.32    4.60  47.28 47.280090.10.71.1921210             25.0008 090 99      0.00   0.00   0.00
19364  Breast reconstruction                             A  42.58  31.60NA  31.60    8.25  82.43 82.430090.10.71.1921210             25.0008 090 99      0.00   0.00   0.00
19366  Breast reconstruction                             A  21.84  15.14NA  15.14    4.46  41.44 41.440090.10.71.1921210             25.0008 090 99      0.00   0.00   0.00
19367  Breast reconstruction                             A  26.80  21.56NA  21.56    5.27  53.63 53.630090.10.71.1921210             25.0008 090 99      0.00   0.00   0.00
19368  Breast reconstruction                             A  33.90  25.38NA  25.38    6.67  65.95 65.950090.10.71.1921210             25.0008 090 99      0.00   0.00   0.00
19369  Breast reconstruction                             A  31.31  23.75NA  23.75    6.15  61.21 61.210090.10.71.1921210             25.0008 090 99      0.00   0.00   0.00
19370  Surgery of breast capsule                         A   9.17   9.63NA   9.63    1.80  20.60 20.600090.10.71.1921100             25.0008 090 99      0.00   0.00   0.00
19371  Removal of breast capsule                         A  10.62  10.88NA  10.88    2.07  23.57 23.570090.10.71.1921100             25.0008 090 99      0.00   0.00   0.00
19380  Revise breast reconstruction                      A  10.41  10.79NA  10.79    2.03  23.23 23.230090.10.71.1921100             25.0008 090 99      0.00   0.00   0.00
19396  Design custom breast implant                      A   2.17   6.31     1.78    0.45   8.93  4.400000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
19499  Breast surgery procedure                          C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021011             25.0008 090 99      0.00   0.00   0.00
2000F  Blood pressure measure                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
20005  I&d abscess subfascial                            A   3.58   5.14     2.81    0.59   9.31  6.980010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
2001F  Weight record                                     I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
2004F  Initial exam involved joints                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
2010F  Vital signs recorded                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
20100  Explore wound neck                                A  10.38   5.40NA   5.40    1.96  17.74 17.740010.10.80.1021200             25.0008 090 99      0.00   0.00   0.00
20101  Explore wound chest                               A   3.23  10.00     2.26    0.69  13.92  6.180010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
20102  Explore wound abdomen                             A   3.98  10.16     2.75    0.80  14.94  7.530010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
20103  Explore wound extremity                           A   5.34  11.29     4.01    0.99  17.62 10.340010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
2014F  Mental status assess                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
2015F  Asthma impairment assessed                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
20150  Excise epiphyseal bar                             A  14.75  12.16NA  12.16    2.93  29.84 29.840090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
2016F  Asthma risk assessed                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
2018F  Hydration status assess                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
2019F  Dilated macul exam done                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
2020F  Dilated fundus eval done                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
20200  Muscle biopsy                                     A   1.46   4.50     1.02    0.33   6.29  2.810000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
20205  Deep muscle biopsy                                A   2.35   5.87     1.67    0.56   8.78  4.580000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
20206  Needle biopsy muscle                              A   0.99   6.03     0.65    0.10   7.12  1.740000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
2021F  Dilat macul+ exam done                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
20220  Bone biopsy trocar/needle                         A   1.27   3.65     0.74    0.11   5.03  2.120000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
20225  Bone biopsy trocar/needle                         A   1.87  14.06     1.15    0.23  16.16  3.250000.00.00.0020100             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
20240  Bone biopsy excisional                            A   3.28   2.79NA   2.79    0.52   6.59  6.590010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
20245  Bone biopsy excisional                            A   8.95   7.96NA   7.96    1.65  18.56 18.560010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
20250  Open bone biopsy                                  A   5.19   5.15NA   5.15    1.22  11.56 11.560010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
20251  Open bone biopsy                                  A   5.72   5.41NA   5.41    1.32  12.45 12.450010.10.80.1020200             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
2028F  Foot exam performed                               M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
2030F  H2o stat docd normal                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
2031F  H2o stat docd dehydrated                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
2035F  Tymp memb motion examd                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
20500  Injection of sinus tract                          A   1.28   1.75     1.13    0.12   3.15  2.530010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
20501  Inject sinus tract for x-ray                      A   0.76   2.67     0.27    0.07   3.50  1.100000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
20520  Removal of foreign body                           A   1.90   3.92     2.17    0.30   6.12  4.370010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
20525  Removal of foreign body                           A   3.54  10.48     3.23    0.64  14.66  7.410010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
20526  Ther injection carp tunnel                        A   0.94   1.17     0.58    0.14   2.25  1.660000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
20527  Inj dupuytren cord w/enzyme                       A   1.00   1.10     0.63    0.15   2.25  1.780000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
20550  Inj tendon sheath/ligament                        A   0.75   0.89     0.38    0.08   1.72  1.210000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
20551  Inj tendon origin/insertion                       A   0.75   0.95     0.42    0.08   1.78  1.250000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
20552  Inj trigger point 1/2 muscl                       A   0.66   0.91     0.38    0.07   1.64  1.110000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
20553  Inject trigger points 3/>                         A   0.75   1.08     0.44    0.07   1.90  1.260000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
20555  Place ndl musc/tis for rt                         A   6.00   2.88NA   2.88    0.86   9.74  9.740000.00.00.0020000             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
20600  Drain/inject joint/bursa                          A   0.66   0.66     0.30    0.07   1.39  1.030000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
20605  Drain/inject joint/bursa                          A   0.98   0.83     0.45    0.12   1.93  1.550000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
20610  Drain/inject joint/bursa                          A   0.79   0.86     0.44    0.12   1.77  1.350000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
20612  Aspirate/inj ganglion cyst                        A   0.70   1.00     0.44    0.08   1.78  1.220000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
20615  Treatment of bone cyst                            A   2.33   4.64     2.19    0.29   7.26  4.810010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
20650  Insert and remove bone pin                        A   2.28   3.59     2.04    0.29   6.16  4.610010.10.80.1020110             25.0008 090 99      0.00   0.00   0.00
20660  Apply rem fixation device                         A   4.00   2.04NA   2.04    1.10   7.14  7.140000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
20661  Application of head brace                         A   5.26   8.29NA   8.29    1.65  15.20 15.200090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
20662  Application of pelvis brace                       A   6.38   5.60NA   5.60    0.61  12.59 12.590090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
20663  Application of thigh brace                        A   5.74   7.10NA   7.10    1.14  13.98 13.980090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
20664  Application of halo                               A  10.06  12.40NA  12.40    3.61  26.07 26.070090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
20665  Removal of fixation device                        A   1.36   1.59     1.15    0.11   3.06  2.620010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
20670  Removal of support implant                        A   1.79   9.63     2.35    0.30  11.72  4.440010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
20680  Removal of support implant                        A   5.96  11.76     5.67    1.06  18.78 12.690090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
20690  Apply bone fixation device                        A   8.78   7.09NA   7.09    1.62  17.49 17.490090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
20692  Apply bone fixation device                        A  16.27  14.07NA  14.07    2.80  33.14 33.140090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
20693  Adjust bone fixation device                       A   6.06   6.40NA   6.40    1.08  13.54 13.540090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
20694  Remove bone fixation device                       A   4.28   7.71     5.03    0.76  12.75 10.070090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
20696  Comp multiplane ext fixation                      A  17.56  15.21NA  15.21    1.25  34.02 34.020090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
20697  Comp ext fixate strut change                      A   0.00  64.53    64.53NA  0.01  64.54 64.543000.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
20802  Replantation arm complete                         A  42.62  22.14NA  22.14    3.05  67.81 67.810090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
20805  Replant forearm complete                          A  51.46  29.15NA  29.15   10.14  90.75 90.750090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
20808  Replantation hand complete                        A  63.09  31.64NA  31.64   12.43 107.16107.160090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
20816  Replantation digit complete                       A  31.95  22.65NA  22.65    3.99  58.59 58.590090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
20822  Replantation digit complete                       A  26.66  22.16NA  22.16    5.27  54.09 54.090090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
20824  Replantation thumb complete                       A  31.95  25.03NA  25.03    6.29  63.27 63.270090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
20827  Replantation thumb complete                       A  27.48  22.67NA  22.67    5.42  55.57 55.570090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
20838  Replantation foot complete                        A  42.88  30.91NA  30.91    3.06  76.85 76.850090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
20900  Removal of bone for graft                         A   3.00   9.26     2.70    0.56  12.82  6.260000.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
20902  Removal of bone for graft                         A   4.58   3.63NA   3.63    0.87   9.08  9.080000.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
20910  Remove cartilage for graft                        A   5.53   7.23NA   7.23    0.71  13.47 13.470090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
20912  Remove cartilage for graft                        A   6.54   6.89NA   6.89    0.99  14.42 14.420090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
20920  Removal of fascia for graft                       A   5.51   5.61NA   5.61    0.69  11.81 11.810090.10.69.2120110             25.0008 090 99      0.00   0.00   0.00
20922  Removal of fascia for graft                       A   6.93  10.17     6.67    1.28  18.38 14.880090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
20924  Removal of tendon for graft                       A   6.68   7.16NA   7.16    1.20  15.04 15.040090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
20926  Removal of tissue for graft                       A   5.79   6.19NA   6.19    1.17  13.15 13.150090.10.69.2120100             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
20931  Sp bone algrft struct add-on                      A   1.81   0.93NA   0.93    0.56   3.30  3.300ZZZ.00.00.0000110             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
20937  Sp bone agrft morsel add-on                       A   2.79   1.45NA   1.45    0.68   4.92  4.920ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
20938  Sp bone agrft struct add-on                       A   3.02   1.57NA   1.57    0.83   5.42  5.420ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
20950  Fluid pressure muscle                             A   1.26   6.31     1.25    0.23   7.80  2.740000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
20955  Fibula bone graft microvasc                       A  40.26  27.47NA  27.47    6.67  74.40 74.400090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
20956  Iliac bone graft microvasc                        A  41.18  28.83NA  28.83    8.13  78.14 78.140090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
20957  Mt bone graft microvasc                           A  42.61  15.89NA  15.89    8.41  66.91 66.910090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
20962  Other bone graft microvasc                        A  39.21  17.40NA  17.40    7.73  64.34 64.340090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
20969  Bone/skin graft microvasc                         A  45.43  30.67NA  30.67    6.67  82.77 82.770090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
20970  Bone/skin graft iliac crest                       A  44.58  27.65NA  27.65    8.81  81.04 81.040090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
20972  Bone/skin graft metatarsal                        A  44.51  16.23NA  16.23    3.43  64.17 64.170090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
20973  Bone/skin graft great toe                         A  47.27  32.45NA  32.45    3.38  83.10 83.100090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
20974  Electrical bone stimulation                       A   0.62   1.56     0.75    0.12   2.30  1.490000.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
20975  Electrical bone stimulation                       A   2.60   2.04NA   2.04    0.59   5.23  5.230000.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
20979  Us bone stimulation                               A   0.62   0.87     0.25    0.08   1.57  0.950000.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
20982  Ablate bone tumor(s) perq                         A   7.27  98.83     2.94    0.80 106.90 11.010000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
20985  Cptr-asst dir ms px                               A   2.50   1.33NA   1.33    0.49   4.32  4.320ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
20999  Musculoskeletal surgery                           C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 090 99      0.00   0.00   0.00
21010  Incision of jaw joint                             A  11.04  10.22NA  10.22    1.42  22.68 22.680090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
21011  Exc face les sc <2 cm                             A   2.99   7.08     4.30    0.45  10.52  7.740090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21012  Exc face les sbq 2 cm/<                           A   4.45   4.84NA   4.84    0.72  10.01 10.010090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21013  Exc face tum deep < 2 cm                          A   5.42   9.36     5.65    0.82  15.60 11.890090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21014  Exc face tum deep 2 cm/>                          A   7.13   7.17NA   7.17    1.16  15.46 15.460090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21015  Resect face tum < 2 cm                            A   9.89   9.37NA   9.37    1.86  21.12 21.120090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
21016  Resect face tum 2 cm/>                            A  15.26  12.55NA  12.55    2.91  30.72 30.720090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21025  Excision of bone lower jaw                        A  10.03  15.20    10.90    1.44  26.67 22.370090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
21026  Excision of facial bone(s)                        A   5.70  12.20     8.49    0.83  18.73 15.020090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
21029  Contour of face bone lesion                       A   8.39  13.48     9.42    1.65  23.52 19.460090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21030  Excise max/zygoma b9 tumor                        A   4.91  10.02     6.88    0.76  15.69 12.550090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
21031  Remove exostosis mandible                         A   3.30   8.11     5.07    0.41  11.82  8.780090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
21032  Remove exostosis maxilla                          A   3.34   8.32     4.94    0.42  12.08  8.700090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
21034  Excise max/zygoma mal tumor                       A  17.38  19.79    14.87    2.44  39.61 34.690090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21040  Excise mandible lesion                            A   4.91  10.11     6.89    0.75  15.77 12.550090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
21044  Removal of jaw bone lesion                        A  12.80  11.78NA  11.78    1.78  26.36 26.360090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21045  Extensive jaw surgery                             A  18.37  15.56NA  15.56    2.52  36.45 36.450090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21046  Remove mandible cyst complex                      A  14.21  17.03NA  17.03    1.82  33.06 33.060090.10.69.2120010             25.0008 090 99      0.00   0.00   0.00
21047  Excise lwr jaw cyst w/repair                      A  20.07  15.91NA  15.91    2.59  38.57 38.570090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21048  Remove maxilla cyst complex                       A  14.71  17.31NA  17.31    1.89  33.91 33.910090.10.69.2120010             25.0008 090 99      0.00   0.00   0.00
21049  Excis uppr jaw cyst w/repair                      A  19.32  14.39NA  14.39    2.46  36.17 36.170090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21050  Removal of jaw joint                              A  11.76  11.84NA  11.84    2.30  25.90 25.900090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
21060  Remove jaw joint cartilage                        A  11.07  11.20NA  11.20    2.34  24.61 24.610090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
21070  Remove coronoid process                           A   8.62   9.40NA   9.40    1.10  19.12 19.120090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
21073  Mnpj of tmj w/anesth                              A   3.45   7.67     3.52    0.68  11.80  7.650090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
21076  Prepare face/oral prosthesis                      A  13.40  14.34     9.27    1.70  29.44 24.370010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
21077  Prepare face/oral prosthesis                      A  33.70  35.82    23.59    4.33  73.85 61.620090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
21079  Prepare face/oral prosthesis                      A  22.31  24.70    15.75    2.87  49.88 40.930090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
21080  Prepare face/oral prosthesis                      A  25.06  27.72    17.21    3.23  56.01 45.500090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
21081  Prepare face/oral prosthesis                      A  22.85  25.86    15.97    2.95  51.66 41.770090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21082  Prepare face/oral prosthesis                      A  20.84  25.56    15.90    2.67  49.07 39.410090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21083  Prepare face/oral prosthesis                      A  19.27  25.12    14.87    1.37  45.76 35.510090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21084  Prepare face/oral prosthesis                      A  22.48  28.04    16.97    2.90  53.42 42.350090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21085  Prepare face/oral prosthesis                      A   8.99  12.49     6.51    3.35  24.83 18.850010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
21086  Prepare face/oral prosthesis                      A  24.88  26.95    17.36    3.20  55.03 45.440090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
21087  Prepare face/oral prosthesis                      A  24.88  26.42    16.46    3.20  54.50 44.540090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21088  Prepare face/oral prosthesis                      C   0.00   0.00     0.00    0.00   0.00  0.000090.10.69.2100000             25.0008 090 99      0.00   0.00   0.00
21089  Prepare face/oral prosthesis                      C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000111             25.0008 090 99      0.00   0.00   0.00
21100  Maxillofacial fixation                            A   4.73  12.95     4.89    0.64  18.32 10.260090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21110  Interdental fixation                              A   5.99  17.62    13.58    0.76  24.37 20.330090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
21116  Injection jaw joint x-ray                         A   0.81   3.73     0.40    0.05   4.59  1.260000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
21120  Reconstruction of chin                            A   5.10  12.87     8.95    1.01  18.98 15.060090.10.69.2120110             25.0008 090 99      0.00   0.00   0.00
21121  Reconstruction of chin                            A   7.81  14.81    10.72    0.54  23.16 19.070090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21122  Reconstruction of chin                            A   8.71  11.57NA  11.57    0.61  20.89 20.890090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21123  Reconstruction of chin                            A  11.34  13.92NA  13.92    0.80  26.06 26.060090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21125  Augmentation lower jaw bone                       A  10.80  92.88    10.40    2.14 105.82 23.340090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21127  Augmentation lower jaw bone                       A  12.44 105.62    12.55    1.59 119.65 26.580090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21137  Reduction of forehead                             A  10.24   8.58NA   8.58    2.00  20.82 20.820090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21138  Reduction of forehead                             A  12.87  10.05NA  10.05    1.82  24.74 24.740090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21139  Reduction of forehead                             A  15.02  13.25NA  13.25    1.06  29.33 29.330090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21141  Lefort i-1 piece w/o graft                        A  19.57  17.11NA  17.11    3.85  40.53 40.530090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21142  Lefort i-2 piece w/o graft                        A  20.28  17.38NA  17.38    4.00  41.66 41.660090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21143  Lefort i-3/> piece w/o graft                      A  21.05  18.55NA  18.55    4.49  44.09 44.090090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21145  Lefort i-1 piece w/ graft                         A  23.94  18.84NA  18.84    1.69  44.47 44.470090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21146  Lefort i-2 piece w/ graft                         A  24.87  18.07NA  18.07    4.90  47.84 47.840090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21147  Lefort i-3/> piece w/ graft                       A  26.47  23.07NA  23.07    1.88  51.42 51.420090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21150  Lefort ii anterior intrusion                      A  25.96  17.54NA  17.54    1.84  45.34 45.340090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21151  Lefort ii w/bone grafts                           A  29.02  22.48NA  22.48    3.74  55.24 55.240090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21154  Lefort iii w/o lefort i                           A  31.29  24.07NA  24.07    4.01  59.37 59.370090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21155  Lefort iii w/ lefort i                            A  35.22  26.01NA  26.01    2.50  63.73 63.730090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21159  Lefort iii w/fhdw/o lefort i                      A  43.14  27.39NA  27.39    5.53  76.06 76.060090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21160  Lefort iii w/fhd w/ lefort i                      A  47.19  26.49NA  26.49    3.36  77.04 77.040090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21172  Reconstruct orbit/forehead                        A  28.20  23.65NA  23.65    3.62  55.47 55.470090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21175  Reconstruct orbit/forehead                        A  33.56  26.22NA  26.22   12.03  71.81 71.810090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21179  Reconstruct entire forehead                       A  22.65  14.97NA  14.97    4.46  42.08 42.080090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21180  Reconstruct entire forehead                       A  25.58  16.52NA  16.52    3.29  45.39 45.390090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21181  Contour cranial bone lesion                       A  10.28   8.20NA   8.20    1.31  19.79 19.790090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21182  Reconstruct cranial bone                          A  32.58  25.76NA  25.76    4.18  62.52 62.520090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21183  Reconstruct cranial bone                          A  35.70  27.84NA  27.84    7.02  70.56 70.560090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21184  Reconstruct cranial bone                          A  38.62  18.88NA  18.88    7.62  65.12 65.120090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21188  Reconstruction of midface                         A  23.15  20.81NA  20.81    2.98  46.94 46.940090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21193  Reconst lwr jaw w/o graft                         A  18.90  14.10NA  14.10    4.04  37.04 37.040090.10.69.2122210             25.0008 090 99      0.00   0.00   0.00
21194  Reconst lwr jaw w/graft                           A  21.82  15.95NA  15.95    2.80  40.57 40.570090.10.69.2122200             25.0008 090 99      0.00   0.00   0.00
21195  Reconst lwr jaw w/o fixation                      A  19.16  18.34NA  18.34    2.45  39.95 39.950090.10.69.2122200             25.0008 090 99      0.00   0.00   0.00
21196  Reconst lwr jaw w/fixation                        A  20.83  20.41NA  20.41    2.67  43.91 43.910090.10.69.2122210             25.0008 090 99      0.00   0.00   0.00
21198  Reconstr lwr jaw segment                          A  15.71  16.78NA  16.78    2.18  34.67 34.670090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21199  Reconstr lwr jaw w/advance                        A  16.73  10.97NA  10.97    2.15  29.85 29.850090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21206  Reconstruct upper jaw bone                        A  15.59  19.01NA  19.01    3.09  37.69 37.690090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21208  Augmentation of facial bones                      A  11.42  45.24    12.11    2.25  58.91 25.780090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21209  Reduction of facial bones                         A   7.82  16.05     9.87    1.54  25.41 19.230090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21210  Face bone graft                                   A  11.69  57.05    12.35    1.51  70.25 25.550090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
21215  Lower jaw bone graft                              A  12.23 111.33    12.73    2.40 125.96 27.360090.10.69.2120110             25.0008 090 99      0.00   0.00   0.00
21230  Rib cartilage graft                               A  11.17   8.57NA   8.57    2.19  21.93 21.930090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21235  Ear cartilage graft                               A   7.50  13.55     8.54    1.10  22.15 17.140090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
21240  Reconstruction of jaw joint                       A  16.07  14.63NA  14.63    2.04  32.74 32.740090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
21242  Reconstruction of jaw joint                       A  14.59  13.48NA  13.48    1.88  29.95 29.950090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
21243  Reconstruction of jaw joint                       A  24.53  21.88NA  21.88    3.16  49.57 49.570090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
21244  Reconstruction of lower jaw                       A  13.62  16.48NA  16.48    1.93  32.03 32.030090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21245  Reconstruction of jaw                             A  13.12  18.85    11.73    1.67  33.64 26.520090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21246  Reconstruction of jaw                             A  12.92   9.87NA   9.87    1.65  24.44 24.440090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21247  Reconstruct lower jaw bone                        A  24.37  17.94NA  17.94    4.82  47.13 47.130090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
21248  Reconstruction of jaw                             A  12.74  18.69    12.38    1.63  33.06 26.750090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
21249  Reconstruction of jaw                             A  18.77  23.87    15.41    2.40  45.04 36.580090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21255  Reconstruct lower jaw bone                        A  18.46  18.87NA  18.87    2.35  39.68 39.680090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
21256  Reconstruction of orbit                           A  17.66  16.63NA  16.63    2.26  36.55 36.550090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
21260  Revise eye sockets                                A  17.90  17.57NA  17.57    1.27  36.74 36.740090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21261  Revise eye sockets                                A  34.07  23.60NA  23.60    6.72  64.39 64.390090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21263  Revise eye sockets                                A  31.01  22.37NA  22.37    2.20  55.58 55.580090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21267  Revise eye sockets                                A  20.69  25.11NA  25.11    4.08  49.88 49.880090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
21268  Revise eye sockets                                A  27.07  20.78NA  20.78    5.34  53.19 53.190090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
21270  Augmentation cheek bone                           A  10.63  17.34     9.93    1.51  29.48 22.070090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
21275  Revision orbitofacial bones                       A  11.76  11.13NA  11.13    2.30  25.19 25.190090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21280  Revision of eyelid                                A   7.13   9.16NA   9.16    1.40  17.69 17.690090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
21282  Revision of eyelid                                A   4.27   6.66NA   6.66    0.78  11.71 11.710090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
21295  Revision of jaw muscle/bone                       A   1.90   3.65NA   3.65    0.37   5.92  5.920090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
21296  Revision of jaw muscle/bone                       A   4.78   7.95NA   7.95    0.61  13.34 13.340090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
21299  Cranio/maxillofacial surgery                      C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 090 99      0.00   0.00   0.00
21310  Closed tx nose fx w/o manj                        A   0.58   3.42     0.13    0.10   4.10  0.810000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
21315  Closed tx nose fx w/o stablj                      A   1.83   6.54     2.50    0.29   8.66  4.620010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
21320  Closed tx nose fx w/ stablj                       A   1.88   5.76     1.90    0.27   7.91  4.050010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
21325  Open tx nose fx uncomplicatd                      A   4.18   9.39NA   9.39    0.67  14.24 14.240090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21330  Open tx nose fx w/skele fixj                      A   5.79  10.59NA  10.59    0.73  17.11 17.110090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21335  Open tx nose & septal fx                          A   9.02  11.62NA  11.62    1.22  21.86 21.860090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
21336  Open tx septal fx w/wo stabj                      A   6.77  11.88NA  11.88    0.91  19.56 19.560090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21337  Closed tx septal&nose fx                          A   3.39   8.53     5.06    0.52  12.44  8.970090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21338  Open nasoethmoid fx w/o fixj                      A   6.87  14.63NA  14.63    1.36  22.86 22.860090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21339  Open nasoethmoid fx w/ fixj                       A   8.50  15.66NA  15.66    1.66  25.82 25.820090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21340  Perq tx nasoethmoid fx                            A  11.49  11.52NA  11.52    1.48  24.49 24.490090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21343  Open tx dprsd front sinus fx                      A  14.32  19.67NA  19.67    2.83  36.82 36.820090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21344  Open tx compl front sinus fx                      A  21.57  17.03NA  17.03    7.74  46.34 46.340090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
21345  Closed tx nose/jaw fx                             A   9.06  15.07     9.79    1.17  25.30 20.020090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21346  Opn tx nasomax fx w/fixj                          A  11.45  14.48NA  14.48    1.48  27.41 27.410090.10.69.2120110             25.0008 090 99      0.00   0.00   0.00
21347  Opn tx nasomax fx multple                         A  13.53  18.10NA  18.10    1.71  33.34 33.340090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21348  Opn tx nasomax fx w/graft                         A  17.52  15.38NA  15.38    2.25  35.15 35.150090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
21355  Perq tx malar fracture                            A   4.45   8.08     4.63    0.56  13.09  9.640010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
21356  Opn tx dprsd zygomatic arch                       A   4.83   9.68     5.82    0.71  15.22 11.360010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
21360  Opn tx dprsd malar fracture                       A   7.19   7.83NA   7.83    0.91  15.93 15.930090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
21365  Opn tx complx malar fx                            A  16.77  13.62NA  13.62    2.80  33.19 33.190090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
21366  Opn tx complx malar w/grft                        A  18.60  16.07NA  16.07    3.67  38.34 38.340090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
21385  Opn tx orbit fx transantral                       A   9.57   9.70NA   9.70    1.22  20.49 20.490090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
21386  Opn tx orbit fx periorbital                       A   9.57   9.53NA   9.53    1.88  20.98 20.980090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
21387  Opn tx orbit fx combined                          A  10.11   9.95NA   9.95    1.97  22.03 22.030090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
21390  Opn tx orbit periorbtl implt                      A  11.23  11.00NA  11.00    1.89  24.12 24.120090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
21395  Opn tx orbit periorbt w/grft                      A  14.70  12.73NA  12.73    1.88  29.31 29.310090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
21400  Closed tx orbit w/o manipulj                      A   1.50   4.16     3.03    0.27   5.93  4.800090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
21401  Closed tx orbit w/ manipulj                       A   3.68   9.89     4.49    0.72  14.29  8.890090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
21406  Opn tx orbit fx w/o implant                       A   7.42   8.42NA   8.42    0.95  16.79 16.790090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
21407  Opn tx orbit fx w/implant                         A   9.02   9.01NA   9.01    1.59  19.62 19.620090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
21408  Opn tx orbit fx w/bone grft                       A  12.78  11.35NA  11.35    2.52  26.65 26.650090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
21421  Treat mouth roof fracture                         A   6.02  17.41    13.11    1.18  24.61 20.310090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21422  Treat mouth roof fracture                         A   8.73  10.05NA  10.05    1.13  19.91 19.910090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21423  Treat mouth roof fracture                         A  10.85  11.91NA  11.91    2.14  24.90 24.900090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
21431  Treat craniofacial fracture                       A   7.90  12.95NA  12.95    1.55  22.40 22.400090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21432  Treat craniofacial fracture                       A   8.82  11.04NA  11.04    1.71  21.57 21.570090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21433  Treat craniofacial fracture                       A  26.29  20.81NA  20.81    5.19  52.29 52.290090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21435  Treat craniofacial fracture                       A  20.26  18.02NA  18.02    2.60  40.88 40.880090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21436  Treat craniofacial fracture                       A  30.30  16.89NA  16.89    5.97  53.16 53.160090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
21440  Treat dental ridge fracture                       A   3.44  13.75    10.35    0.67  17.86 14.460090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21445  Treat dental ridge fracture                       A   6.26  16.25    11.76    0.80  23.31 18.820090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21450  Treat lower jaw fracture                          A   3.71  14.54    10.74    0.65  18.90 15.100090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21451  Treat lower jaw fracture                          A   5.65  16.83    12.98    0.72  23.20 19.350090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21452  Treat lower jaw fracture                          A   2.40  14.47     7.57    0.48  17.35 10.450090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21453  Treat lower jaw fracture                          A   6.64  20.31    16.21    1.05  28.00 23.900090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21454  Treat lower jaw fracture                          A   7.36   7.88NA   7.88    0.93  16.17 16.170090.10.69.2120010             25.0008 090 99      0.00   0.00   0.00
21461  Treat lower jaw fracture                          A   9.31  55.56    17.91    1.40  66.27 28.620090.10.69.2120110             25.0008 090 99      0.00   0.00   0.00
21462  Treat lower jaw fracture                          A  11.01  57.23    19.03    1.42  69.66 31.460090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21465  Treat lower jaw fracture                          A  13.12  12.39NA  12.39    2.59  28.10 28.100090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
21470  Treat lower jaw fracture                          A  17.54  15.56NA  15.56    2.90  36.00 36.000090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21480  Reset dislocated jaw                              A   0.61   2.30     0.24    0.10   3.01  0.950000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
21485  Reset dislocated jaw                              A   4.77  16.02    12.42    0.61  21.40 17.800090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
21490  Repair dislocated jaw                             A  12.95  12.23NA  12.23    2.56  27.74 27.740090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
21495  Treat hyoid bone fracture                         A   6.79  14.08NA  14.08    0.86  21.73 21.730090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21497  Interdental wiring                                A   4.64  17.30    13.36    0.90  22.84 18.900090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21499  Head surgery procedure                            C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 090 99      0.00   0.00   0.00
21501  Drain neck/chest lesion                           A   3.98   9.17     4.98    0.75  13.90  9.710090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
21502  Drain chest lesion                                A   7.55   5.84NA   5.84    1.61  15.00 15.000090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21510  Drainage of bone lesion                           A   6.20   5.71NA   5.71    1.46  13.37 13.370090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21550  Biopsy of neck/chest                              A   2.11   5.55     2.30    0.30   7.96  4.710010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
21552  Exc neck les sc 3 cm/>                            A   6.49   5.49NA   5.49    1.28  13.26 13.260090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21554  Exc neck tum deep 5 cm/>                          A  11.13   8.41NA   8.41    2.08  21.62 21.620090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21555  Exc neck les sc < 3 cm                            A   3.96   7.92     4.48    0.78  12.66  9.220090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
21556  Exc neck tum deep < 5 cm                          A   7.66   6.81NA   6.81    1.44  15.91 15.910090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
21557  Resect neck tum < 5 cm                            A  14.75  10.99NA  10.99    2.79  28.53 28.530090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21558  Resect neck tum 5 cm/>                            A  21.58  14.06NA  14.06    4.08  39.72 39.720090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21600  Partial removal of rib                            A   7.26   8.10NA   8.10    1.57  16.93 16.930090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21610  Partial removal of rib                            A  15.91  12.08NA  12.08    5.72  33.71 33.710090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21615  Removal of rib                                    A  10.45   6.22NA   6.22    2.46  19.13 19.130090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
21616  Removal of rib and nerves                         A  12.69   9.28NA   9.28    3.04  25.01 25.010090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
21620  Partial removal of sternum                        A   7.28   6.43NA   6.43    1.62  15.33 15.330090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21627  Sternal debridement                               A   7.30   7.44NA   7.44    1.65  16.39 16.390090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21630  Extensive sternum surgery                         A  19.18  13.19NA  13.19    4.04  36.41 36.410090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21632  Extensive sternum surgery                         A  19.68  11.82NA  11.82    4.94  36.44 36.440090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21685  Hyoid myotomy & suspension                        A  15.26  12.52NA  12.52    1.96  29.74 29.740090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
21700  Revision of neck muscle                           A   6.31   3.32NA   3.32    1.50  11.13 11.130090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
21705  Revision of neck muscle/rib                       A   9.92   4.29NA   4.29    2.34  16.55 16.550090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
21720  Revision of neck muscle                           A   5.80   7.84NA   7.84    2.07  15.71 15.710090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21725  Revision of neck muscle                           A   7.19   6.02NA   6.02    1.42  14.63 14.630090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21740  Reconstruction of sternum                         A  17.57  15.03NA  15.03    3.47  36.07 36.070090.10.69.2120210             25.0008 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  0.000090.10.69.2120210             25.0008 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  0.000090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21750  Repair of sternum separation                      A  11.40   6.46NA   6.46    2.71  20.57 20.570090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21800  Treatment of rib fracture                         A   1.01   2.26     2.38    0.18   3.45  3.570090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
21805  Treatment of rib fracture                         A   2.88   4.53NA   4.53    0.67   8.08  8.080090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
21810  Treatment of rib fracture(s)                      A   7.03   6.93NA   6.93    1.63  15.59 15.590090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21820  Treat sternum fracture                            A   1.36   2.68     2.80    0.26   4.30  4.420090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
21825  Treat sternum fracture                            A   7.76   6.83NA   6.83    1.82  16.41 16.410090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
21899  Neck/chest surgery procedure                      C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 090 99      0.00   0.00   0.00
21920  Biopsy soft tissue of back                        A   2.11   5.46     2.42    0.34   7.91  4.870010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
21925  Biopsy soft tissue of back                        A   4.63   7.98     5.08    0.93  13.54 10.640090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
21930  Exc back les sc < 3 cm                            A   4.94   8.36     4.98    1.02  14.32 10.940090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
21931  Exc back les sc 3 cm/>                            A   6.88   5.68NA   5.68    1.42  13.98 13.980090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21932  Exc back tum deep < 5 cm                          A   9.82   7.73NA   7.73    2.08  19.63 19.630090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21933  Exc back tum deep 5 cm/>                          A  11.13   8.40NA   8.40    2.35  21.88 21.880090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
21935  Resect back tum < 5 cm                            A  15.72  11.67NA  11.67    3.21  30.60 30.600090.10.69.2120110             25.0008 090 99      0.00   0.00   0.00
21936  Resect back tum 5 cm/>                            A  22.55  14.55NA  14.55    4.60  41.70 41.700090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22010  I&d p-spine c/t/cerv-thor                         A  12.75  12.14NA  12.14    3.29  28.18 28.180090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
22015  I&d abscess p-spine l/s/ls                        A  12.64  11.10NA  11.10    3.08  26.82 26.820090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
22100  Remove part of neck vertebra                      A  11.00  12.74NA  12.74    3.96  27.70 27.700090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22101  Remove part thorax vertebra                       A  11.08  11.05NA  11.05    3.97  26.10 26.100090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22102  Remove part lumbar vertebra                       A  11.08  10.17NA  10.17    2.67  23.92 23.920090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22103  Remove extra spine segment                        A   2.34   1.18NA   1.18    0.64   4.16  4.160ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
22110  Remove part of neck vertebra                      A  14.00  13.05NA  13.05    5.04  32.09 32.090090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22112  Remove part thorax vertebra                       A  14.07  12.65NA  12.65    5.05  31.77 31.770090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22114  Remove part lumbar vertebra                       A  14.07  12.80NA  12.80    2.78  29.65 29.650090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22116  Remove extra spine segment                        A   2.32   1.17NA   1.17    0.60   4.09  4.090ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
22206  Incis spine 3 column thorac                       A  37.18  25.18NA  25.18    7.32  69.68 69.680090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22207  Incis spine 3 column lumbar                       A  36.68  24.76NA  24.76    9.20  70.64 70.640090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22208  Incis spine 3 column adl seg                      A   9.66   5.07NA   5.07    2.59  17.32 17.320ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
22210  Incis 1 vertebral seg cerv                        A  25.38  20.40NA  20.40    6.75  52.53 52.530090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22212  Incis 1 vertebral seg thorac                      A  20.99  17.78NA  17.78    4.97  43.74 43.740090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22214  Incis 1 vertebral seg lumbar                      A  21.02  17.82NA  17.82    5.12  43.96 43.960090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22216  Incis addl spine segment                          A   6.03   3.16NA   3.16    1.51  10.70 10.700ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
22220  Incis w/discectomy cervical                       A  22.94  18.89NA  18.89    6.42  48.25 48.250090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22222  Incis w/discectomy thoracic                       A  23.09  15.25NA  15.25    4.55  42.89 42.890090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22224  Incis w/discectomy lumbar                         A  23.09  18.59NA  18.59    5.38  47.06 47.060090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22226  Revise extra spine segment                        A   6.03   3.12NA   3.12    1.58  10.73 10.730ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
22305  Closed tx spine process fx                        A   2.13   3.22     2.67    0.41   5.76  5.210090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
22310  Closed tx vert fx w/o manj                        A   3.89   4.46     3.71    0.78   9.13  8.380090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
22315  Closed tx vert fx w/manj                          A  10.11  13.71    10.32    2.55  26.37 22.980090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
22318  Treat odontoid fx w/o graft                       A  22.72  18.11NA  18.11    7.68  48.51 48.510090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
22319  Treat odontoid fx w/graft                         A  25.33  19.73NA  19.73    9.11  54.17 54.170090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
22325  Treat spine fracture                              A  19.87  17.28NA  17.28    5.69  42.84 42.840090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22326  Treat neck spine fracture                         A  20.84  17.05NA  17.05    6.30  44.19 44.190090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22327  Treat thorax spine fracture                       A  20.77  17.78NA  17.78    5.62  44.17 44.170090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22328  Treat each add spine fx                           A   4.60   2.37NA   2.37    1.36   8.33  8.330ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
22505  Manipulation of spine                             A   1.87   1.48NA   1.48    0.29   3.64  3.640010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
22520  Percut vertebroplasty thor                        A   9.22  58.74     4.63    1.06  69.02 14.910010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
22521  Percut vertebroplasty lumb                        A   8.65  59.43     4.58    1.01  69.09 14.240010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
22522  Percut vertebroplasty addl                        A   4.30   1.74NA   1.74    0.54   6.58  6.580ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
22523  Percut kyphoplasty thor                           A   9.04 224.62     5.82    1.78 235.44 16.640010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
22524  Percut kyphoplasty lumbar                         A   8.54 223.81     5.60    1.68 234.03 15.820010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
22525  Percut kyphoplasty add-on                         A   4.47 139.45     2.12    0.95 144.87  7.540ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
22526  Idet single level                                 N+  6.10  66.33     3.38    0.54  72.97 10.029010.10.80.1099999             25.0008 090 99      0.00   0.00   0.00
22527  Idet 1 or more levels                             N+  3.03  57.62     1.22    0.24  60.89  4.499ZZZ.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
22532  Lat thorax spine fusion                           A  25.99  19.36NA  19.36    7.57  52.92 52.920090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
22533  Lat lumbar spine fusion                           A  24.79  18.53NA  18.53    6.38  49.70 49.700090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
22534  Lat thor/lumb addl seg                            A   5.99   3.11NA   3.11    1.59  10.69 10.690ZZZ.00.00.0000220             25.0008 090 99      0.00   0.00   0.00
22548  Neck spine fusion                                 A  27.06  21.44NA  21.44    9.72  58.22 58.220090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
22551  Neck spine fuse&remov bel c2                      A  25.00  18.34NA  18.34    7.57  50.91 50.910090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
22552  Addl neck spine fusion                            A   6.50   3.34NA   3.34    1.78  11.62 11.620ZZZ.00.00.0000220             25.0008 090 99      0.00   0.00   0.00
22554  Neck spine fusion                                 A  17.69  14.60NA  14.60    5.47  37.76 37.760090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
22556  Thorax spine fusion                               A  24.70  18.06NA  18.06    6.63  49.39 49.390090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
22558  Lumbar spine fusion                               A  23.53  16.53NA  16.53    5.66  45.72 45.720090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
22585  Additional spinal fusion                          A   5.52   2.76NA   2.76    1.59   9.87  9.870ZZZ.00.00.0000220             25.0008 090 99      0.00   0.00   0.00
22586  Prescrl fuse w/ instr l5/s1                       A  28.12  10.35NA  10.35    6.76  45.23 45.230090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
22590  Spine & skull spinal fusion                       A  21.76  18.14NA  18.14    7.05  46.95 46.950090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
22595  Neck spinal fusion                                A  20.64  17.52NA  17.52    6.57  44.73 44.730090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
22600  Neck spine fusion                                 A  17.40  15.68NA  15.68    5.32  38.40 38.400090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
22610  Thorax spine fusion                               A  17.28  15.41NA  15.41    4.86  37.55 37.550090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
22612  Lumbar spine fusion                               A  23.53  17.55NA  17.55    6.23  47.31 47.310090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
22614  Spine fusion extra segment                        A   6.43   3.33NA   3.33    1.77  11.53 11.530ZZZ.00.00.0000220             25.0008 090 99      0.00   0.00   0.00
22630  Lumbar spine fusion                               A  22.09  17.53NA  17.53    6.27  45.89 45.890090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
22632  Spine fusion extra segment                        A   5.22   2.70NA   2.70    1.50   9.42  9.420ZZZ.00.00.0000220             25.0008 090 99      0.00   0.00   0.00
22633  Lumbar spine fusion combined                      A  27.75  19.40NA  19.40    7.35  54.50 54.500090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
22634  Spine fusion extra segment                        A   8.16   4.22NA   4.22    2.25  14.63 14.630ZZZ.00.00.0000220             25.0008 090 99      0.00   0.00   0.00
22800  Post fusion </6 vert seg                          A  19.50  15.87NA  15.87    4.90  40.27 40.270090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22802  Post fusion 7-12 vert seg                         A  32.11  22.44NA  22.44    7.51  62.06 62.060090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22804  Post fusion 13/> vert seg                         A  37.50  25.34NA  25.34    8.53  71.37 71.370090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22808  Ant fusion 2-3 vert seg                           A  27.51  19.34NA  19.34    7.27  54.12 54.120090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22810  Ant fusion 4-7 vert seg                           A  31.50  20.74NA  20.74    7.93  60.17 60.170090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22812  Ant fusion 8/> vert seg                           A  34.25  24.38NA  24.38    6.75  65.38 65.380090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22818  Kyphectomy 1-2 segments                           A  34.33  23.93NA  23.93    6.76  65.02 65.020090.11.76.1320222             25.0008 090 99      0.00   0.00   0.00
22819  Kyphectomy 3 or more                              A  39.38  27.69NA  27.69   14.15  81.22 81.220090.11.76.1320222             25.0008 090 99      0.00   0.00   0.00
22830  Exploration of spinal fusion                      A  11.22  10.05NA  10.05    2.90  24.17 24.170090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22840  Insert spine fixation device                      A  12.52   6.48NA   6.48    3.48  22.48 22.480ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
22841  Insert spine fixation device                      B   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
22842  Insert spine fixation device                      A  12.56   6.51NA   6.51    3.44  22.51 22.510ZZZ.00.00.0000220             25.0008 090 99      0.00   0.00   0.00
22843  Insert spine fixation device                      A  13.44   6.99NA   6.99    3.50  23.93 23.930ZZZ.00.00.0000220             25.0008 090 99      0.00   0.00   0.00
22844  Insert spine fixation device                      A  16.42   8.67NA   8.67    3.69  28.78 28.780ZZZ.00.00.0000220             25.0008 090 99      0.00   0.00   0.00
22845  Insert spine fixation device                      A  11.94   6.12NA   6.12    3.66  21.72 21.720ZZZ.00.00.0000220             25.0008 090 99      0.00   0.00   0.00
22846  Insert spine fixation device                      A  12.40   6.37NA   6.37    3.77  22.54 22.540ZZZ.00.00.0000220             25.0008 090 99      0.00   0.00   0.00
22847  Insert spine fixation device                      A  13.78   6.99NA   6.99    4.95  25.72 25.720ZZZ.00.00.0000220             25.0008 090 99      0.00   0.00   0.00
22848  Insert pelv fixation device                       A   5.99   3.15NA   3.15    1.39  10.53 10.530ZZZ.00.00.0000220             25.0008 090 99      0.00   0.00   0.00
22849  Reinsert spinal fixation                          A  19.17  14.26NA  14.26    5.14  38.57 38.570090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22850  Remove spine fixation device                      A   9.82   9.12NA   9.12    2.61  21.55 21.550090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22851  Apply spine prosth device                         A   6.70   3.46NA   3.46    1.89  12.05 12.050ZZZ.00.00.0000220             25.0008 090 99      0.00   0.00   0.00
22852  Remove spine fixation device                      A   9.37   8.84NA   8.84    2.41  20.62 20.620090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22855  Remove spine fixation device                      A  15.86  12.68NA  12.68    4.75  33.29 33.290090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22856  Cerv artific diskectomy                           A  24.05  18.23NA  18.23    7.28  49.56 49.560090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
22857  Lumbar artif diskectomy                           R  27.13   9.39NA   9.39    5.78  42.30 42.300090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
22861  Revise cerv artific disc                          A  33.36  23.53NA  23.53    9.12  66.01 66.010090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
22862  Revise lumbar artif disc                          R  32.63  16.86NA  16.86    6.42  55.91 55.910090.10.71.1920222             25.0008 090 99      0.00   0.00   0.00
22864  Remove cerv artif disc                            A  29.40  21.52NA  21.52    8.04  58.96 58.960090.10.69.2120220             25.0008 090 99      0.00   0.00   0.00
22865  Remove lumb artif disc                            R  31.75  23.90NA  23.90    6.25  61.90 61.900090.10.71.1920222             25.0008 090 99      0.00   0.00   0.00
22899  Spine surgery procedure                           C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020211             25.0008 090 99      0.00   0.00   0.00
22900  Exc abdl tum deep < 5 cm                          A   8.32   6.68NA   6.68    1.71  16.71 16.710090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22901  Exc abdl tum deep 5 cm/>                          A  10.11   7.47NA   7.47    2.10  19.68 19.680090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22902  Exc abd les sc < 3 cm                             A   4.42   7.93     4.56    0.71  13.06  9.690090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22903  Exc abd les sc 3 cm/>                             A   6.39   5.32NA   5.32    1.21  12.92 12.920090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
22904  Resect abd tum < 5 cm                             A  16.69  10.93NA  10.93    3.55  31.17 31.170090.09.81.1020211             25.0008 090 99      0.00   0.00   0.00
22905  Resect abd tum 5 cm/>                             A  21.58  13.17NA  13.17    4.60  39.35 39.350090.09.81.1020211             25.0008 090 99      0.00   0.00   0.00
22999  Abdomen surgery procedure                         C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 090 99      0.00   0.00   0.00
23000  Removal of calcium deposits                       A   4.48  12.46     5.75    0.86  17.80 11.090090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
23020  Release shoulder joint                            A   9.36   9.30NA   9.30    1.80  20.46 20.460090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
23030  Drain shoulder lesion                             A   3.47   9.30     3.46    0.68  13.45  7.610010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
23031  Drain shoulder bursa                              A   2.79   9.57     3.19    0.53  12.89  6.510010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
23035  Drain shoulder bone lesion                        A   9.16   9.25NA   9.25    1.80  20.21 20.210090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
23040  Exploratory shoulder surgery                      A   9.75   9.70NA   9.70    1.91  21.36 21.360090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23044  Exploratory shoulder surgery                      A   7.59   7.80NA   7.80    1.50  16.89 16.890090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
23065  Biopsy shoulder tissues                           A   2.30   3.91     2.37    0.38   6.59  5.050010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
23066  Biopsy shoulder tissues                           A   4.30  11.52     5.38    0.84  16.66 10.520090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
23071  Exc shoulder les sc 3 cm/>                        A   5.91   5.35NA   5.35    1.21  12.47 12.470090.10.80.1021200             25.0008 090 99      0.00   0.00   0.00
23073  Exc shoulder tum deep 5 cm/>                      A  10.13   8.33NA   8.33    2.04  20.50 20.500090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
23075  Exc shoulder les sc < 3 cm                        A   4.21   9.17     4.70    0.86  14.24  9.770090.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
23076  Exc shoulder tum deep < 5 cm                      A   7.41   7.10NA   7.10    1.51  16.02 16.020090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
23077  Resect shoulder tum < 5 cm                        A  17.66  12.44NA  12.44    3.59  33.69 33.690090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23078  Resect shoulder tum 5 cm/>                        A  22.55  15.18NA  15.18    4.82  42.55 42.550090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23100  Biopsy of shoulder joint                          A   6.20   7.47NA   7.47    1.22  14.89 14.890090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23101  Shoulder joint surgery                            A   5.72   6.39NA   6.39    1.13  13.24 13.240090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
23105  Remove shoulder joint lining                      A   8.48   8.83NA   8.83    1.66  18.97 18.970090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23106  Incision of collarbone joint                      A   6.13   7.43NA   7.43    1.21  14.77 14.770090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
23107  Explore treat shoulder joint                      A   8.87   9.06NA   9.06    1.71  19.64 19.640090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23120  Partial removal collar bone                       A   7.39   8.61NA   8.61    1.46  17.46 17.460090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23125  Removal of collar bone                            A   9.64   9.47NA   9.47    1.89  21.00 21.000090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23130  Remove shoulder bone part                         A   7.77   8.82NA   8.82    1.52  18.11 18.110090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
23140  Removal of bone lesion                            A   7.12   7.25NA   7.25    1.42  15.79 15.790090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
23145  Removal of bone lesion                            A   9.40   9.34NA   9.34    1.85  20.59 20.590090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23146  Removal of bone lesion                            A   8.08   8.76NA   8.76    1.59  18.43 18.430090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
23150  Removal of humerus lesion                         A   8.91   8.99NA   8.99    1.71  19.61 19.610090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23155  Removal of humerus lesion                         A  10.86  10.50NA  10.50    2.14  23.50 23.500090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23156  Removal of humerus lesion                         A   9.11   9.19NA   9.19    1.80  20.10 20.100090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
23170  Remove collar bone lesion                         A   7.21   8.01NA   8.01    1.42  16.64 16.640090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
23172  Remove shoulder blade lesion                      A   7.31   8.07NA   8.07    1.46  16.84 16.840090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
23174  Remove humerus lesion                             A  10.05  10.48NA  10.48    1.97  22.50 22.500090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23180  Remove collar bone lesion                         A   8.99   9.07NA   9.07    1.81  19.87 19.870090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
23182  Remove shoulder blade lesion                      A   8.61   9.38NA   9.38    1.69  19.68 19.680090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
23184  Remove humerus lesion                             A   9.90   9.99NA   9.99    1.91  21.80 21.800090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23190  Partial removal of scapula                        A   7.47   7.98NA   7.98    1.48  16.93 16.930090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23195  Removal of head of humerus                        A  10.36   9.98NA   9.98    2.03  22.37 22.370090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23200  Resect clavicle tumor                             A  22.71  17.61NA  17.61    4.48  44.80 44.800090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23210  Resect scapula tumor                              A  27.21  20.01NA  20.01    5.36  52.58 52.580090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23220  Resect prox humerus tumor                         A  30.21  21.58NA  21.58    5.96  57.75 57.750090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23330  Remove shoulder foreign body                      A   1.90   5.99     2.71    0.35   8.24  4.960010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
23331  Remove shoulder foreign body                      A   7.63   8.47NA   8.47    1.50  17.60 17.600090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
23332  Remove shoulder foreign body                      A  12.37  11.40NA  11.40    2.40  26.17 26.170090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23350  Injection for shoulder x-ray                      A   1.00   2.76     0.38    0.10   3.86  1.480000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
23395  Muscle transfer shoulder/arm                      A  18.54  16.00NA  16.00    3.59  38.13 38.130090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
23397  Muscle transfers                                  A  16.76  13.65NA  13.65    3.31  33.72 33.720090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
23400  Fixation of shoulder blade                        A  13.87  12.11NA  12.11    2.74  28.72 28.720090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23405  Incision of tendon & muscle                       A   8.54   8.44NA   8.44    1.66  18.64 18.640090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
23406  Incise tendon(s) & muscle(s)                      A  11.01   9.69NA   9.69    2.16  22.86 22.860090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
23410  Repair rotator cuff acute                         A  11.39  10.79NA  10.79    2.22  24.40 24.400090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23412  Repair rotator cuff chronic                       A  11.93  11.06NA  11.06    2.31  25.30 25.300090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23415  Release of shoulder ligament                      A   9.23   9.64NA   9.64    1.81  20.68 20.680090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
23420  Repair of shoulder                                A  13.54  12.58NA  12.58    2.65  28.77 28.770090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23430  Repair biceps tendon                              A  10.17  10.12NA  10.12    1.97  22.26 22.260090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23440  Remove/transplant tendon                          A  10.64   9.70NA   9.70    2.07  22.41 22.410090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23450  Repair shoulder capsule                           A  13.70  11.65NA  11.65    2.71  28.06 28.060090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23455  Repair shoulder capsule                           A  14.67  12.15NA  12.15    2.86  29.68 29.680090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23460  Repair shoulder capsule                           A  15.82  13.28NA  13.28    3.13  32.23 32.230090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23462  Repair shoulder capsule                           A  15.72  12.74NA  12.74    3.12  31.58 31.580090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23465  Repair shoulder capsule                           A  16.30  13.57NA  13.57    3.21  33.08 33.080090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23466  Repair shoulder capsule                           A  15.80  14.40NA  14.40    3.12  33.32 33.320090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23470  Reconstruct shoulder joint                        A  17.89  14.31NA  14.31    3.51  35.71 35.710090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23472  Reconstruct shoulder joint                        A  22.13  16.84NA  16.84    4.32  43.29 43.290090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23473  Revis reconst shoulder joint                      A  25.00  18.34NA  18.34    4.88  48.22 48.220090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23474  Revis reconst shoulder joint                      A  27.21  19.52NA  19.52    5.36  52.09 52.090090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23480  Revision of collar bone                           A  11.54  10.49NA  10.49    2.26  24.29 24.290090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
23485  Revision of collar bone                           A  13.91  11.74NA  11.74    2.72  28.37 28.370090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23490  Reinforce clavicle                                A  12.16  10.96NA  10.96    2.40  25.52 25.520090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
23491  Reinforce shoulder bones                          A  14.54  12.60NA  12.60    2.87  30.01 30.010090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23500  Treat clavicle fracture                           A   2.21   3.97     4.09    0.41   6.59  6.710090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
23505  Treat clavicle fracture                           A   3.83   6.02     5.40    0.72  10.57  9.950090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
23515  Treat clavicle fracture                           A   9.69   9.86NA   9.86    1.89  21.44 21.440090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23520  Treat clavicle dislocation                        A   2.29   4.19     4.30    0.44   6.92  7.030090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
23525  Treat clavicle dislocation                        A   3.79   6.79     5.93    0.73  11.31 10.450090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
23530  Treat clavicle dislocation                        A   7.48   8.03NA   8.03    1.48  16.99 16.990090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
23532  Treat clavicle dislocation                        A   8.20   8.70NA   8.70    1.61  18.51 18.510090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
23540  Treat clavicle dislocation                        A   2.36   3.97     4.09    0.42   6.75  6.870090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
23545  Treat clavicle dislocation                        A   3.43   6.45     5.46    0.60  10.48  9.490090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
23550  Treat clavicle dislocation                        A   7.59   7.88NA   7.88    1.47  16.94 16.940090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23552  Treat clavicle dislocation                        A   8.82   9.00NA   9.00    1.70  19.52 19.520090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23570  Treat shoulder blade fx                           A   2.36   4.17     4.39    0.44   6.97  7.190090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
23575  Treat shoulder blade fx                           A   4.23   6.92     6.14    0.83  11.98 11.200090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
23585  Treat scapula fracture                            A  14.23  12.15NA  12.15    2.76  29.14 29.140090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23600  Treat humerus fracture                            A   3.00   6.29     5.70    0.58   9.87  9.280090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
23605  Treat humerus fracture                            A   5.06   7.89     6.68    0.98  13.93 12.720090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
23615  Treat humerus fracture                            A  12.30  11.59NA  11.59    2.40  26.29 26.290090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23616  Treat humerus fracture                            A  18.37  14.83NA  14.83    3.58  36.78 36.780090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
23620  Treat humerus fracture                            A   2.55   5.09     4.69    0.49   8.13  7.730090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
23625  Treat humerus fracture                            A   4.10   6.53     5.72    0.78  11.41 10.600090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
23630  Treat humerus fracture                            A  10.57  10.64NA  10.64    2.07  23.28 23.280090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23650  Treat shoulder dislocation                        A   3.53   5.34     4.54    0.61   9.48  8.680090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
23655  Treat shoulder dislocation                        A   4.76   6.30NA   6.30    0.88  11.94 11.940090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
23660  Treat shoulder dislocation                        A   7.66   8.20NA   8.20    1.50  17.36 17.360090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23665  Treat dislocation/fracture                        A   4.66   7.19     6.29    0.88  12.73 11.830090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
23670  Treat dislocation/fracture                        A  12.28  11.39NA  11.39    2.40  26.07 26.070090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23675  Treat dislocation/fracture                        A   6.27   8.93     7.42    1.20  16.40 14.890090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
23680  Treat dislocation/fracture                        A  13.15  11.84NA  11.84    2.57  27.56 27.560090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23700  Fixation of shoulder                              A   2.57   2.76NA   2.76    0.49   5.82  5.820010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
23800  Fusion of shoulder joint                          A  14.73  12.69NA  12.69    2.93  30.35 30.350090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23802  Fusion of shoulder joint                          A  18.42  15.95NA  15.95    3.62  37.99 37.990090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23900  Amputation of arm & girdle                        A  20.72  16.18NA  16.18    4.10  41.00 41.000090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
23920  Amputation at shoulder joint                      A  16.23  13.92NA  13.92    3.20  33.35 33.350090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
23921  Amputation follow-up surgery                      A   5.72   7.09NA   7.09    1.36  14.17 14.170090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
23929  Shoulder surgery procedure                        C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020211             25.0008 090 99      0.00   0.00   0.00
23930  Drainage of arm lesion                            A   2.99   7.17     2.84    0.61  10.77  6.440010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
23931  Drainage of arm bursa                             A   1.84   6.52     2.60    0.34   8.70  4.780010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
23935  Drain arm/elbow bone lesion                       A   6.38   7.50NA   7.50    1.24  15.12 15.120090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
24000  Exploratory elbow surgery                         A   6.08   6.92NA   6.92    1.17  14.17 14.170090.10.69.2121010             25.0008 090 99      0.00   0.00   0.00
24006  Release elbow joint                               A   9.74   9.55NA   9.55    1.82  21.11 21.110090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
24065  Biopsy arm/elbow soft tissue                      A   2.13   5.35     2.57    0.34   7.82  5.040010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
24066  Biopsy arm/elbow soft tissue                      A   5.35  12.43     5.90    1.08  18.86 12.330090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
24071  Exc arm/elbow les sc 3 cm/>                       A   5.70   5.21NA   5.21    1.16  12.07 12.070090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
24073  Ex arm/elbow tum deep 5 cm/>                      A  10.13   8.29NA   8.29    2.01  20.43 20.430090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
24075  Exc arm/elbow les sc < 3 cm                       A   4.24   9.85     4.79    0.84  14.93  9.870090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
24076  Ex arm/elbow tum deep < 5 cm                      A   7.41   7.26NA   7.26    1.48  16.15 16.150090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
24077  Resect arm/elbow tum < 5 cm                       A  15.72  11.85NA  11.85    3.18  30.75 30.750090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
24079  Resect arm/elbow tum 5 cm/>                       A  20.61  14.23NA  14.23    4.38  39.22 39.220090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24100  Biopsy elbow joint lining                         A   5.07   6.37NA   6.37    1.01  12.45 12.450090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24101  Explore/treat elbow joint                         A   6.30   7.36NA   7.36    1.21  14.87 14.870090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
24102  Remove elbow joint lining                         A   8.26   8.44NA   8.44    1.55  18.25 18.250090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24105  Removal of elbow bursa                            A   3.78   5.98NA   5.98    0.72  10.48 10.480090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
24110  Remove humerus lesion                             A   7.58   8.37NA   8.37    1.50  17.45 17.450090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
24115  Remove/graft bone lesion                          A  10.12   9.73NA   9.73    1.99  21.84 21.840090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24116  Remove/graft bone lesion                          A  12.23  10.86NA  10.86    2.41  25.50 25.500090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
24120  Remove elbow lesion                               A   6.82   7.61NA   7.61    1.29  15.72 15.720090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
24125  Remove/graft bone lesion                          A   8.14   8.67NA   8.67    1.59  18.40 18.400090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24126  Remove/graft bone lesion                          A   8.62   8.93NA   8.93    1.69  19.24 19.240090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
24130  Removal of head of radius                         A   6.42   7.45NA   7.45    1.20  15.07 15.070090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
24134  Removal of arm bone lesion                        A  10.22   9.91NA   9.91    2.00  22.13 22.130090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
24136  Remove radius bone lesion                         A   8.40   8.65NA   8.65    1.65  18.70 18.700090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
24138  Remove elbow bone lesion                          A   8.50   9.90NA   9.90    1.66  20.06 20.060090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
24140  Partial removal of arm bone                       A   9.55   9.46NA   9.46    1.78  20.79 20.790090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
24145  Partial removal of radius                         A   7.81   8.21NA   8.21    1.54  17.56 17.560090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
24147  Partial removal of elbow                          A   7.84   9.14NA   9.14    1.51  18.49 18.490090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
24149  Radical resection of elbow                        A  16.22  15.51NA  15.51    2.98  34.71 34.710090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24150  Resect distal humerus tumor                       A  23.46  17.88NA  17.88    4.63  45.97 45.970090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24152  Resect radius tumor                               A  19.99  16.03NA  16.03    3.93  39.95 39.950090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24155  Removal of elbow joint                            A  12.09  10.77NA  10.77    2.38  25.24 25.240090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24160  Remove elbow joint implant                        A   8.00   8.46NA   8.46    1.50  17.96 17.960090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
24164  Remove radius head implant                        A   6.43   7.08NA   7.08    1.27  14.78 14.780090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
24200  Removal of arm foreign body                       A   1.81   4.07     2.05    0.31   6.19  4.170010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
24201  Removal of arm foreign body                       A   4.70  11.29     5.27    0.93  16.92 10.900090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
24220  Injection for elbow x-ray                         A   1.31   3.38     0.56    0.12   4.81  1.990000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
24300  Manipulate elbow w/anesth                         A   4.04   7.67NA   7.67    0.72  12.43 12.430090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
24301  Muscle/tendon transfer                            A  10.38   9.72NA   9.72    2.03  22.13 22.130090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
24305  Arm tendon lengthening                            A   7.62   8.13NA   8.13    1.36  17.11 17.110090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
24310  Revision of arm tendon                            A   6.12   6.89NA   6.89    1.18  14.19 14.190090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
24320  Repair of arm tendon                              A  10.86  10.12NA  10.12    2.14  23.12 23.120090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
24330  Revision of arm muscles                           A   9.79   9.54NA   9.54    1.92  21.25 21.250090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
24331  Revision of arm muscles                           A  10.95  10.16NA  10.16    2.16  23.27 23.270090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
24332  Tenolysis triceps                                 A   7.91   8.73NA   8.73    1.55  18.19 18.190090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
24340  Repair of biceps tendon                           A   8.08   8.61NA   8.61    1.58  18.27 18.270090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24341  Repair arm tendon/muscle                          A   9.49  10.95NA  10.95    1.85  22.29 22.290090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24342  Repair of ruptured tendon                         A  10.86  10.10NA  10.10    2.07  23.03 23.030090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24343  Repr elbow lat ligmnt w/tiss                      A   9.16  10.11NA  10.11    1.67  20.94 20.940090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24344  Reconstruct elbow lat ligmnt                      A  15.21  14.30NA  14.30    3.01  32.52 32.520090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24345  Repr elbw med ligmnt w/tissu                      A   9.16  10.00NA  10.00    1.67  20.83 20.830090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24346  Reconstruct elbow med ligmnt                      A  15.21  14.34NA  14.34    3.01  32.56 32.560090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24357  Repair elbow perc                                 A   5.44   6.65NA   6.65    1.03  13.12 13.120090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
24358  Repair elbow w/deb open                           A   6.66   7.64NA   7.64    1.25  15.55 15.550090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
24359  Repair elbow deb/attch open                       A   8.98   8.89NA   8.89    1.67  19.54 19.540090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
24360  Reconstruct elbow joint                           A  12.67  11.44NA  11.44    2.48  26.59 26.590090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24361  Reconstruct elbow joint                           A  14.41  12.50NA  12.50    2.84  29.75 29.750090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24362  Reconstruct elbow joint                           A  15.32  12.99NA  12.99    3.04  31.35 31.350090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
24363  Replace elbow joint                               A  22.00  16.93NA  16.93    4.09  43.02 43.020090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
24365  Reconstruct head of radius                        A   8.62   8.62NA   8.62    1.69  18.93 18.930090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24366  Reconstruct head of radius                        A   9.36   9.00NA   9.00    1.77  20.13 20.130090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24370  Revise reconst elbow joint                        A  23.55  17.64NA  17.64    4.38  45.57 45.570090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
24371  Revise reconst elbow joint                        A  27.50  19.90NA  19.90    5.11  52.51 52.510090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
24400  Revision of humerus                               A  11.33  10.85NA  10.85    2.19  24.37 24.370090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24410  Revision of humerus                               A  15.11  13.91NA  13.91    2.99  32.01 32.010090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24420  Revision of humerus                               A  13.73  12.98NA  12.98    2.71  29.42 29.420090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24430  Repair of humerus                                 A  15.25  13.13NA  13.13    2.95  31.33 31.330090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24435  Repair humerus with graft                         A  14.99  14.02NA  14.02    2.93  31.94 31.940090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24470  Revision of elbow joint                           A   8.93   6.54NA   6.54    1.77  17.24 17.240090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
24495  Decompression of forearm                          A   8.41   8.96NA   8.96    1.80  19.17 19.170090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
24498  Reinforce humerus                                 A  12.28  11.00NA  11.00    2.41  25.69 25.690090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24500  Treat humerus fracture                            A   3.41   6.72     5.73    0.64  10.77  9.780090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
24505  Treat humerus fracture                            A   5.39   8.57     7.09    1.05  15.01 13.530090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
24515  Treat humerus fracture                            A  12.12  11.55NA  11.55    2.34  26.01 26.010090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24516  Treat humerus fracture                            A  12.19  10.93NA  10.93    2.38  25.50 25.500090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
24530  Treat humerus fracture                            A   3.69   7.04     5.93    0.69  11.42 10.310090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
24535  Treat humerus fracture                            A   7.11   9.89     8.45    1.37  18.37 16.930090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
24538  Treat humerus fracture                            A   9.77  10.41NA  10.41    1.92  22.10 22.100090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
24545  Treat humerus fracture                            A  13.15  11.84NA  11.84    2.56  27.55 27.550090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24546  Treat humerus fracture                            A  14.91  13.01NA  13.01    2.90  30.82 30.820090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
24560  Treat humerus fracture                            A   2.98   6.18     5.13    0.56   9.72  8.670090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
24565  Treat humerus fracture                            A   5.78   9.00     7.64    1.14  15.92 14.560090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
24566  Treat humerus fracture                            A   9.06  10.49NA  10.49    1.80  21.35 21.350090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
24575  Treat humerus fracture                            A   9.71  10.22NA  10.22    1.88  21.81 21.810090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24576  Treat humerus fracture                            A   3.06   6.63     5.55    0.59  10.28  9.200090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
24577  Treat humerus fracture                            A   6.01   9.19     7.76    1.18  16.38 14.950090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
24579  Treat humerus fracture                            A  11.44  11.16NA  11.16    2.20  24.80 24.800090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24582  Treat humerus fracture                            A  10.14  11.93NA  11.93    1.99  24.06 24.060090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
24586  Treat elbow fracture                              A  15.78  13.19NA  13.19    3.05  32.02 32.020090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24587  Treat elbow fracture                              A  15.79  13.34NA  13.34    2.93  32.06 32.060090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24600  Treat elbow dislocation                           A   4.37   5.86     4.91    0.76  10.99 10.040090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
24605  Treat elbow dislocation                           A   5.64   7.29NA   7.29    1.09  14.02 14.020090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
24615  Treat elbow dislocation                           A   9.83   9.43NA   9.43    1.84  21.10 21.100090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24620  Treat elbow fracture                              A   7.22   7.90NA   7.90    1.36  16.48 16.480090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
24635  Treat elbow fracture                              A   8.80   9.51NA   9.51    1.67  19.98 19.980090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24640  Treat elbow dislocation                           A   1.25   2.83     1.39    0.23   4.31  2.870010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
24650  Treat radius fracture                             A   2.31   5.17     4.51    0.42   7.90  7.240090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
24655  Treat radius fracture                             A   4.62   7.69     6.47    0.86  13.17 11.950090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
24665  Treat radius fracture                             A   8.36   9.42NA   9.42    1.59  19.37 19.370090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24666  Treat radius fracture                             A   9.86  10.03NA  10.03    1.86  21.75 21.750090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24670  Treat ulnar fracture                              A   2.69   5.59     4.71    0.50   8.78  7.900090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
24675  Treat ulnar fracture                              A   4.91   7.84     6.60    0.93  13.68 12.440090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
24685  Treat ulnar fracture                              A   8.37   9.49NA   9.49    1.62  19.48 19.480090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24800  Fusion of elbow joint                             A  11.41  10.91NA  10.91    2.25  24.57 24.570090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24802  Fusion/graft of elbow joint                       A  14.32  12.47NA  12.47    2.83  29.62 29.620090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
24900  Amputation of upper arm                           A  10.18   9.56NA   9.56    2.01  21.75 21.750090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24920  Amputation of upper arm                           A  10.13   7.67NA   7.67    1.99  19.79 19.790090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
24925  Amputation follow-up surgery                      A   7.30   8.05NA   8.05    1.44  16.79 16.790090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
24930  Amputation follow-up surgery                      A  10.83   9.94NA   9.94    2.14  22.91 22.910090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
24931  Amputate upper arm & implant                      A  13.44   8.28NA   8.28    0.95  22.67 22.670090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
24935  Revision of amputation                            A  16.45  11.44NA  11.44    3.24  31.13 31.130090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
24940  Revision of upper arm                             C   0.00   0.00     0.00    0.00   0.00  0.000090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
24999  Upper arm/elbow surgery                           C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021011             25.0008 090 99      0.00   0.00   0.00
25000  Incision of tendon sheath                         A   3.55   5.86NA   5.86    0.64  10.05 10.050090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25001  Incise flexor carpi radialis                      A   3.79   5.80NA   5.80    0.67  10.26 10.260090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25020  Decompress forearm 1 space                        A   6.06  10.07NA  10.07    1.06  17.19 17.190090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25023  Decompress forearm 1 space                        A  13.83  16.52NA  16.52    2.74  33.09 33.090090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
25024  Decompress forearm 2 spaces                       A  10.79  10.42NA  10.42    2.12  23.33 23.330090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25025  Decompress forearm 2 spaces                       A  17.94  14.76NA  14.76    3.54  36.24 36.240090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
25028  Drainage of forearm lesion                        A   5.39   9.32NA   9.32    1.03  15.74 15.740090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25031  Drainage of forearm bursa                         A   4.26   5.29NA   5.29    0.83  10.38 10.380090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
25035  Treat forearm bone lesion                         A   7.65   8.19NA   8.19    1.48  17.32 17.320090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
25040  Explore/treat wrist joint                         A   7.50   7.79NA   7.79    1.36  16.65 16.650090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
25065  Biopsy forearm soft tissues                       A   2.04   5.39     2.57    0.33   7.76  4.940010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
25066  Biopsy forearm soft tissues                       A   4.27   5.58NA   5.58    0.80  10.65 10.650090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25071  Exc forearm les sc 3 cm/>                         A   5.91   5.57NA   5.57    1.17  12.65 12.650090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25073  Exc forearm tum deep 3 cm/>                       A   7.13   7.28NA   7.28    1.36  15.77 15.770090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25075  Exc forearm les sc < 3 cm                         A   3.96   9.84     4.76    0.76  14.56  9.480090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25076  Exc forearm tum deep < 3 cm                       A   6.74   7.31NA   7.31    1.28  15.33 15.330090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25077  Resect forearm/wrist tum<3cm                      A  12.93  10.65NA  10.65    2.61  26.19 26.190090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25078  Resect forarm/wrist tum 3cm>                      A  17.69  13.16NA  13.16    3.78  34.63 34.630090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25085  Incision of wrist capsule                         A   5.64   6.65NA   6.65    1.10  13.39 13.390090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25100  Biopsy of wrist joint                             A   4.02   5.51NA   5.51    0.78  10.31 10.310090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
25101  Explore/treat wrist joint                         A   4.83   6.31NA   6.31    0.90  12.04 12.040090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
25105  Remove wrist joint lining                         A   6.02   7.22NA   7.22    1.10  14.34 14.340090.10.69.2121010             25.0008 090 99      0.00   0.00   0.00
25107  Remove wrist joint cartilage                      A   7.70   9.18NA   9.18    1.36  18.24 18.240090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25109  Excise tendon forearm/wrist                       A   6.94   7.74NA   7.74    1.24  15.92 15.920090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25110  Remove wrist tendon lesion                        A   4.04   5.33NA   5.33    0.75  10.12 10.120090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25111  Remove wrist tendon lesion                        A   3.53   5.36NA   5.36    0.67   9.56  9.560090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25112  Reremove wrist tendon lesion                      A   4.67   5.96NA   5.96    0.87  11.50 11.500090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25115  Remove wrist/forearm lesion                       A  10.09  10.54NA  10.54    1.80  22.43 22.430090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25116  Remove wrist/forearm lesion                       A   7.56   8.93NA   8.93    1.33  17.82 17.820090.10.69.2121010             25.0008 090 99      0.00   0.00   0.00
25118  Excise wrist tendon sheath                        A   4.51   6.01NA   6.01    0.80  11.32 11.320090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25119  Partial removal of ulna                           A   6.21   7.32NA   7.32    1.22  14.75 14.750090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25120  Removal of forearm lesion                         A   6.27   7.34NA   7.34    1.17  14.78 14.780090.10.69.2121010             25.0008 090 99      0.00   0.00   0.00
25125  Remove/graft forearm lesion                       A   7.67   8.49NA   8.49    1.51  17.67 17.670090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
25126  Remove/graft forearm lesion                       A   7.74   8.46NA   8.46    1.52  17.72 17.720090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25130  Removal of wrist lesion                           A   5.43   6.87NA   6.87    0.99  13.29 13.290090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
25135  Remove & graft wrist lesion                       A   7.08   8.10NA   8.10    1.39  16.57 16.570090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25136  Remove & graft wrist lesion                       A   6.14   7.31NA   7.31    1.21  14.66 14.660090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25145  Remove forearm bone lesion                        A   6.54   7.53NA   7.53    1.28  15.35 15.350090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25150  Partial removal of ulna                           A   7.38   7.99NA   7.99    1.36  16.73 16.730090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
25151  Partial removal of radius                         A   7.68   8.16NA   8.16    1.51  17.35 17.350090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25170  Resect radius/ulnar tumor                         A  22.21  17.09NA  17.09    4.37  43.67 43.670090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25210  Removal of wrist bone                             A   6.12   7.27NA   7.27    1.08  14.47 14.470090.10.69.2120010             25.0008 090 99      0.00   0.00   0.00
25215  Removal of wrist bones                            A   8.14   8.67NA   8.67    1.40  18.21 18.210090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25230  Partial removal of radius                         A   5.37   6.48NA   6.48    0.90  12.75 12.750090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
25240  Partial removal of ulna                           A   5.31   6.47NA   6.47    0.91  12.69 12.690090.10.69.2121010             25.0008 090 99      0.00   0.00   0.00
25246  Injection for wrist x-ray                         A   1.45   3.21     0.59    0.14   4.80  2.180000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
25248  Remove forearm foreign body                       A   5.31   5.91NA   5.91    1.05  12.27 12.270090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25250  Removal of wrist prosthesis                       A   6.77   7.63NA   7.63    1.32  15.72 15.720090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25251  Removal of wrist prosthesis                       A   9.82   9.55NA   9.55    1.93  21.30 21.300090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25259  Manipulate wrist w/anesthes                       A   4.04   7.68NA   7.68    0.72  12.44 12.440090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25260  Repair forearm tendon/muscle                      A   8.04   9.19NA   9.19    1.48  18.71 18.710090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
25263  Repair forearm tendon/muscle                      A   8.04   9.06NA   9.06    1.58  18.68 18.680090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
25265  Repair forearm tendon/muscle                      A  10.10  10.09NA  10.09    1.97  22.16 22.160090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
25270  Repair forearm tendon/muscle                      A   6.17   7.23NA   7.23    1.16  14.56 14.560090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
25272  Repair forearm tendon/muscle                      A   7.21   7.89NA   7.89    1.32  16.42 16.420090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
25274  Repair forearm tendon/muscle                      A   8.94   9.10NA   9.10    1.77  19.81 19.810090.10.69.2120010             25.0008 090 99      0.00   0.00   0.00
25275  Repair forearm tendon sheath                      A   8.96   9.29NA   9.29    1.77  20.02 20.020090.10.69.2121010             25.0008 090 99      0.00   0.00   0.00
25280  Revise wrist/forearm tendon                       A   7.39   8.03NA   8.03    1.28  16.70 16.700090.10.69.2120010             25.0008 090 99      0.00   0.00   0.00
25290  Incise wrist/forearm tendon                       A   5.43   6.53NA   6.53    0.98  12.94 12.940090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
25295  Release wrist/forearm tendon                      A   6.72   7.56NA   7.56    1.18  15.46 15.460090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
25300  Fusion of tendons at wrist                        A   9.02   9.63NA   9.63    1.78  20.43 20.430090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25301  Fusion of tendons at wrist                        A   8.59   8.88NA   8.88    1.57  19.04 19.040090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25310  Transplant forearm tendon                         A   8.08   8.82NA   8.82    1.39  18.29 18.290090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
25312  Transplant forearm tendon                         A   9.82   9.66NA   9.66    1.78  21.26 21.260090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
25315  Revise palsy hand tendon(s)                       A  10.68  10.02NA  10.02    2.10  22.80 22.800090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25316  Revise palsy hand tendon(s)                       A  12.90  11.91NA  11.91    1.61  26.42 26.420090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25320  Repair/revise wrist joint                         A  12.75  14.26NA  14.26    2.26  29.27 29.270090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25332  Revise wrist joint                                A  11.74  11.05NA  11.05    2.18  24.97 24.970090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25335  Realignment of hand                               A  13.39  12.47NA  12.47    0.95  26.81 26.810090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25337  Reconstruct ulna/radioulnar                       A  11.73  12.56NA  12.56    2.01  26.30 26.300090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25350  Revision of radius                                A   9.09   9.21NA   9.21    1.61  19.91 19.910090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25355  Revision of radius                                A  10.53  10.07NA  10.07    2.07  22.67 22.670090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25360  Revision of ulna                                  A   8.74   9.00NA   9.00    1.65  19.39 19.390090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25365  Revise radius & ulna                              A  12.91  11.59NA  11.59    2.55  27.05 27.050090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25370  Revise radius or ulna                             A  14.10  12.89NA  12.89    2.78  29.77 29.770090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25375  Revise radius & ulna                              A  13.55  12.30NA  12.30    0.95  26.80 26.800090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25390  Shorten radius or ulna                            A  10.70  10.11NA  10.11    1.88  22.69 22.690090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25391  Lengthen radius or ulna                           A  14.28  12.33NA  12.33    2.83  29.44 29.440090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25392  Shorten radius & ulna                             A  14.58  12.49NA  12.49    2.90  29.97 29.970090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25393  Lengthen radius & ulna                            A  16.56  13.54NA  13.54    3.28  33.38 33.380090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25394  Repair carpal bone shorten                        A  10.85  10.21NA  10.21    2.14  23.20 23.200090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25400  Repair radius or ulna                             A  11.28  10.37NA  10.37    2.07  23.72 23.720090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25405  Repair/graft radius or ulna                       A  15.01  12.82NA  12.82    2.74  30.57 30.570090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25415  Repair radius & ulna                              A  13.80  12.07NA  12.07    2.72  28.59 28.590090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25420  Repair/graft radius & ulna                        A  17.04  14.09NA  14.09    3.38  34.51 34.510090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25425  Repair/graft radius or ulna                       A  13.72  12.03NA  12.03    2.71  28.46 28.460090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25426  Repair/graft radius & ulna                        A  16.45  13.49NA  13.49    3.24  33.18 33.180090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25430  Vasc graft into carpal bone                       A   9.71  10.07NA  10.07    1.21  20.99 20.990090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25431  Repair nonunion carpal bone                       A  10.89  10.32NA  10.32    2.15  23.36 23.360090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25440  Repair/graft wrist bone                           A  10.68  10.12NA  10.12    1.89  22.69 22.690090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25441  Reconstruct wrist joint                           A  13.29  12.12NA  12.12    1.65  27.06 27.060090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25442  Reconstruct wrist joint                           A  11.12  10.70NA  10.70    1.39  23.21 23.210090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25443  Reconstruct wrist joint                           A  10.66  10.37NA  10.37    2.10  23.13 23.130090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25444  Reconstruct wrist joint                           A  11.42  11.02NA  11.02    0.80  23.24 23.240090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25445  Reconstruct wrist joint                           A   9.88   9.62NA   9.62    1.80  21.30 21.300090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
25446  Wrist replacement                                 A  17.30  14.10NA  14.10    2.95  34.35 34.350090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25447  Repair wrist joints                               A  11.14  11.34NA  11.34    1.96  24.44 24.440090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25449  Remove wrist joint implant                        A  14.94  12.85NA  12.85    2.95  30.74 30.740090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25450  Revision of wrist joint                           A   8.06   8.62NA   8.62    1.58  18.26 18.260090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25455  Revision of wrist joint                           A   9.71   7.02NA   7.02    0.68  17.41 17.410090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25490  Reinforce radius                                  A   9.73   9.65NA   9.65    1.25  20.63 20.630090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25491  Reinforce ulna                                    A  10.15   9.74NA   9.74    1.99  21.88 21.880090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25492  Reinforce radius and ulna                         A  12.66   8.30NA   8.30    2.48  23.44 23.440090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25500  Treat fracture of radius                          A   2.60   5.14     4.45    0.45   8.19  7.500090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25505  Treat fracture of radius                          A   5.45   8.60     7.29    1.03  15.08 13.770090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25515  Treat fracture of radius                          A   8.80   9.41NA   9.41    1.67  19.88 19.880090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25520  Treat fracture of radius                          A   6.50   9.12     8.22    1.28  16.90 16.000090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25525  Treat fracture of radius                          A  10.55  10.62NA  10.62    2.01  23.18 23.180090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
25526  Treat fracture of radius                          A  13.15  12.54NA  12.54    2.60  28.29 28.290090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
25530  Treat fracture of ulna                            A   2.24   5.26     4.49    0.41   7.91  7.140090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25535  Treat fracture of ulna                            A   5.36   8.28     7.16    1.02  14.66 13.540090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25545  Treat fracture of ulna                            A   7.94   9.06NA   9.06    1.51  18.51 18.510090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25560  Treat fracture radius & ulna                      A   2.59   5.33     4.50    0.48   8.40  7.570090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25565  Treat fracture radius & ulna                      A   5.85   8.68     7.16    1.10  15.63 14.110090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25574  Treat fracture radius & ulna                      A   8.80   9.53NA   9.53    1.70  20.03 20.030090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
25575  Treat fracture radius/ulna                        A  12.29  12.05NA  12.05    2.34  26.68 26.680090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25600  Treat fracture radius/ulna                        A   2.78   6.61     6.07    0.52   9.91  9.370090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25605  Treat fracture radius/ulna                        A   6.25   8.99     7.98    1.20  16.44 15.430090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25606  Treat fx distal radial                            A   8.31   9.77NA   9.77    1.61  19.69 19.690090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25607  Treat fx rad extra-articul                        A   9.56  10.45NA  10.45    1.82  21.83 21.830090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25608  Treat fx rad intra-articul                        A  11.07  11.27NA  11.27    2.07  24.41 24.410090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25609  Treat fx radial 3+ frag                           A  14.38  13.93NA  13.93    2.69  31.00 31.000090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25622  Treat wrist bone fracture                         A   2.79   5.89     5.04    0.52   9.20  8.350090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25624  Treat wrist bone fracture                         A   4.77   8.62     7.30    0.88  14.27 12.950090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
25628  Treat wrist bone fracture                         A   9.67   9.86NA   9.86    1.74  21.27 21.270090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25630  Treat wrist bone fracture                         A   3.03   5.59     4.82    0.56   9.18  8.410090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25635  Treat wrist bone fracture                         A   4.61   8.11     6.54    0.90  13.62 12.050090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
25645  Treat wrist bone fracture                         A   7.42   7.99NA   7.99    1.47  16.88 16.880090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25650  Treat wrist bone fracture                         A   3.23   5.82     5.20    0.60   9.65  9.030090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25651  Pin ulnar styloid fracture                        A   5.82   7.50NA   7.50    1.10  14.42 14.420090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
25652  Treat fracture ulnar styloid                      A   8.06   8.90NA   8.90    1.47  18.43 18.430090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
25660  Treat wrist dislocation                           A   4.98   6.37NA   6.37    0.90  12.25 12.250090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
25670  Treat wrist dislocation                           A   8.09   8.28NA   8.28    1.50  17.87 17.870090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25671  Pin radioulnar dislocation                        A   6.46   8.08NA   8.08    1.27  15.81 15.810090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25675  Treat wrist dislocation                           A   4.89   7.53     6.35    0.87  13.29 12.110090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
25676  Treat wrist dislocation                           A   8.29   8.84NA   8.84    1.54  18.67 18.670090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25680  Treat wrist fracture                              A   6.23   6.96NA   6.96    1.08  14.27 14.270090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
25685  Treat wrist fracture                              A  10.09   9.70NA   9.70    1.97  21.76 21.760090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25690  Treat wrist dislocation                           A   5.72   7.46NA   7.46    1.14  14.32 14.320090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
25695  Treat wrist dislocation                           A   8.51   8.57NA   8.57    1.66  18.74 18.740090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25800  Fusion of wrist joint                             A  10.07   9.75NA   9.75    1.81  21.63 21.630090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25805  Fusion/graft of wrist joint                       A  11.73  10.95NA  10.95    2.30  24.98 24.980090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25810  Fusion/graft of wrist joint                       A  11.95  11.56NA  11.56    2.12  25.63 25.630090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25820  Fusion of hand bones                              A   7.64   9.27NA   9.27    1.37  18.28 18.280090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25825  Fuse hand bones with graft                        A   9.69  11.04NA  11.04    1.69  22.42 22.420090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25830  Fusion radioulnar jnt/ulna                        A  10.88  15.48NA  15.48    2.15  28.51 28.510090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
25900  Amputation of forearm                             A   9.61   9.61NA   9.61    1.82  21.04 21.040090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
25905  Amputation of forearm                             A   9.59   9.28NA   9.28    1.89  20.76 20.760090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25907  Amputation follow-up surgery                      A   8.09   8.48NA   8.48    1.59  18.16 18.160090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25909  Amputation follow-up surgery                      A   9.31   9.13NA   9.13    1.84  20.28 20.280090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25915  Amputation of forearm                             A  17.52   9.87NA   9.87    3.10  30.49 30.490090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25920  Amputate hand at wrist                            A   9.03   9.87NA   9.87    1.78  20.68 20.680090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
25922  Amputate hand at wrist                            A   7.65   9.01NA   9.01    0.53  17.19 17.190090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25924  Amputation follow-up surgery                      A   8.81   9.79NA   9.79    1.71  20.31 20.310090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25927  Amputation of hand                                A   9.09  13.37NA  13.37    1.80  24.26 24.260090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
25929  Amputation follow-up surgery                      A   7.82   8.33NA   8.33    1.54  17.69 17.690090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
25931  Amputation follow-up surgery                      A   8.04  12.29NA  12.29    1.70  22.03 22.030090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
25999  Forearm or wrist surgery                          C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021011             25.0008 090 99      0.00   0.00   0.00
26010  Drainage of finger abscess                        A   1.59   6.21     2.30    0.27   8.07  4.160010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
26011  Drainage of finger abscess                        A   2.24   9.23     2.88    0.39  11.86  5.510010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
26020  Drain hand tendon sheath                          A   5.08   6.92NA   6.92    0.93  12.93 12.930090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26025  Drainage of palm bursa                            A   5.08   6.57NA   6.57    0.91  12.56 12.560090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
26030  Drainage of palm bursas                           A   6.25   7.20NA   7.20    1.16  14.61 14.610090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
26034  Treat hand bone lesion                            A   6.63   8.17NA   8.17    1.22  16.02 16.020090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26035  Decompress fingers/hand                           A  11.37  11.83NA  11.83    2.23  25.43 25.430090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26037  Decompress fingers/hand                           A   7.57   7.91NA   7.91    1.44  16.92 16.920090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
26040  Release palm contracture                          A   3.46   5.21NA   5.21    0.56   9.23  9.230090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
26045  Release palm contracture                          A   5.73   7.09NA   7.09    1.09  13.91 13.910090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
26055  Incise finger tendon sheath                       A   3.11  13.33     5.61    0.56  17.00  9.280090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26060  Incision of finger tendon                         A   2.91   4.48NA   4.48    0.54   7.93  7.930090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26070  Explore/treat hand joint                          A   3.81   4.73NA   4.73    0.65   9.19  9.190090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
26075  Explore/treat finger joint                        A   3.91   5.15NA   5.15    0.67   9.73  9.730090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
26080  Explore/treat finger joint                        A   4.47   6.35NA   6.35    0.78  11.60 11.600090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26100  Biopsy hand joint lining                          A   3.79   5.46NA   5.46    0.73   9.98  9.980090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
26105  Biopsy finger joint lining                        A   3.83   5.49NA   5.49    0.75  10.07 10.070090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
26110  Biopsy finger joint lining                        A   3.65   5.27NA   5.27    0.64   9.56  9.560090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26111  Exc hand les sc 1.5 cm/>                          A   5.42   5.96NA   5.96    0.99  12.37 12.370090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
26113  Exc hand tum deep 1.5 cm/>                        A   7.13   7.82NA   7.82    1.25  16.20 16.200090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
26115  Exc hand les sc < 1.5 cm                          A   3.96  10.53     5.21    0.71  15.20  9.880090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26116  Exc hand tum deep < 1.5 cm                        A   6.74   7.66NA   7.66    1.20  15.60 15.600090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26117  Exc hand tum ra < 3 cm                            A  10.13  10.21NA  10.21    1.85  22.19 22.190090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26118  Exc hand tum ra 3 cm/>                            A  14.81  13.70NA  13.70    2.94  31.45 31.450090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
26121  Release palm contracture                          A   7.73   8.54NA   8.54    1.40  17.67 17.670090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
26123  Release palm contracture                          A  10.88  11.85NA  11.85    1.92  24.65 24.650090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
26125  Release palm contracture                          A   4.60   2.60NA   2.60    0.82   8.02  8.020ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
26130  Remove wrist joint lining                         A   5.59   6.93NA   6.93    1.06  13.58 13.580090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
26135  Revise finger joint each                          A   7.13   7.88NA   7.88    1.27  16.28 16.280090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26140  Revise finger joint each                          A   6.34   7.47NA   7.47    1.14  14.95 14.950090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26145  Tendon excision palm/finger                       A   6.49   7.48NA   7.48    1.18  15.15 15.150090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26160  Remove tendon sheath lesion                       A   3.57  13.20     5.74    0.65  17.42  9.960090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26170  Removal of palm tendon each                       A   4.91   6.26NA   6.26    0.86  12.03 12.030090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26180  Removal of finger tendon                          A   5.35   6.88NA   6.88    0.90  13.13 13.130090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26185  Remove finger bone                                A   6.52   8.57NA   8.57    1.28  16.37 16.370090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
26200  Remove hand bone lesion                           A   5.65   6.65NA   6.65    1.03  13.33 13.330090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26205  Remove/graft bone lesion                          A   7.93   8.35NA   8.35    1.57  17.85 17.850090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26210  Removal of finger lesion                          A   5.32   6.84NA   6.84    0.95  13.11 13.110090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26215  Remove/graft finger lesion                        A   7.27   8.07NA   8.07    1.44  16.78 16.780090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26230  Partial removal of hand bone                      A   6.47   7.17NA   7.17    1.13  14.77 14.770090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26235  Partial removal finger bone                       A   6.33   7.13NA   7.13    1.10  14.56 14.560090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26236  Partial removal finger bone                       A   5.46   6.63NA   6.63    0.98  13.07 13.070090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26250  Extensive hand surgery                            A  15.21  13.47NA  13.47    3.01  31.69 31.690090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26260  Resect prox finger tumor                          A  11.16  10.43NA  10.43    2.19  23.78 23.780090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
26262  Resect distal finger tumor                        A   8.29   8.90NA   8.90    1.62  18.81 18.810090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
26320  Removal of implant from hand                      A   4.10   5.46NA   5.46    0.71  10.27 10.270090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26340  Manipulate finger w/anesth                        A   2.80   6.77NA   6.77    0.52  10.09 10.090090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
26341  Manipulat palm cord post inj                      A   0.91   1.89     1.15    0.14   2.94  2.200010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
26350  Repair finger/hand tendon                         A   6.21  13.85NA  13.85    1.13  21.19 21.190090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26352  Repair/graft hand tendon                          A   7.87  14.87NA  14.87    1.55  24.29 24.290090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
26356  Repair finger/hand tendon                         A  10.62  19.93NA  19.93    1.92  32.47 32.470090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26357  Repair finger/hand tendon                         A   8.77  15.35NA  15.35    1.71  25.83 25.830090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
26358  Repair/graft hand tendon                          A   9.36  16.04NA  16.04    1.85  27.25 27.250090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
26370  Repair finger/hand tendon                         A   7.28  13.83NA  13.83    1.36  22.47 22.470090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26372  Repair/graft hand tendon                          A   9.01  15.48NA  15.48    1.78  26.27 26.270090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
26373  Repair finger/hand tendon                         A   8.41  15.16NA  15.16    1.65  25.22 25.220090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
26390  Revise hand/finger tendon                         A   9.43  13.28NA  13.28    1.86  24.57 24.570090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
26392  Repair/graft hand tendon                          A  10.50  16.01NA  16.01    2.07  28.58 28.580090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
26410  Repair hand tendon                                A   4.77  11.17NA  11.17    0.87  16.81 16.810090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26412  Repair/graft hand tendon                          A   6.48  12.84NA  12.84    1.16  20.48 20.480090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26415  Excision hand/finger tendon                       A   8.51  13.93NA  13.93    1.17  23.61 23.610090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26416  Graft hand or finger tendon                       A   9.56  10.89NA  10.89    1.88  22.33 22.330090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26418  Repair finger tendon                              A   4.47  11.99NA  11.99    0.82  17.28 17.280090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26420  Repair/graft finger tendon                        A   6.94  12.71NA  12.71    1.37  21.02 21.020090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
26426  Repair finger/hand tendon                         A   6.32   7.38NA   7.38    1.14  14.84 14.840090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26428  Repair/graft finger tendon                        A   7.40  13.27NA  13.27    1.47  22.14 22.140090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26432  Repair finger tendon                              A   4.16   9.96NA   9.96    0.73  14.85 14.850090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26433  Repair finger tendon                              A   4.70  10.22NA  10.22    0.86  15.78 15.780090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26434  Repair/graft finger tendon                        A   6.26  11.73NA  11.73    1.24  19.23 19.230090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
26437  Realignment of tendons                            A   5.99  11.38NA  11.38    1.03  18.40 18.400090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26440  Release palm/finger tendon                        A   5.16  12.30NA  12.30    0.90  18.36 18.360090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26442  Release palm & finger tendon                      A   9.75  17.04NA  17.04    1.74  28.53 28.530090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26445  Release hand/finger tendon                        A   4.45  11.93NA  11.93    0.78  17.16 17.160090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26449  Release forearm/hand tendon                       A   8.59  10.52NA  10.52    1.51  20.62 20.620090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26450  Incision of palm tendon                           A   3.79   7.43NA   7.43    0.68  11.90 11.900090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26455  Incision of finger tendon                         A   3.76   7.59NA   7.59    0.69  12.04 12.040090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26460  Incise hand/finger tendon                         A   3.58   7.48NA   7.48    0.63  11.69 11.690090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26471  Fusion of finger tendons                          A   5.90  11.26NA  11.26    1.03  18.19 18.190090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26474  Fusion of finger tendons                          A   5.49  10.96NA  10.96    1.08  17.53 17.530090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
26476  Tendon lengthening                                A   5.35  10.88NA  10.88    1.06  17.29 17.290090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26477  Tendon shortening                                 A   5.32  10.87NA  10.87    1.02  17.21 17.210090.10.69.2120110             25.0008 090 99      0.00   0.00   0.00
26478  Lengthening of hand tendon                        A   5.97  11.35NA  11.35    1.09  18.41 18.410090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26479  Shortening of hand tendon                         A   5.91  11.21NA  11.21    1.17  18.29 18.290090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
26480  Transplant hand tendon                            A   6.90  14.22NA  14.22    1.21  22.33 22.330090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26483  Transplant/graft hand tendon                      A   8.48  14.88NA  14.88    1.57  24.93 24.930090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
26485  Transplant palm tendon                            A   7.89  14.61NA  14.61    1.40  23.90 23.900090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
26489  Transplant/graft palm tendon                      A   9.86  15.93NA  15.93    1.93  27.72 27.720090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26490  Revise thumb tendon                               A   8.60  13.11NA  13.11    1.69  23.40 23.400090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26492  Tendon transfer with graft                        A   9.84  14.30NA  14.30    1.93  26.07 26.070090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
26494  Hand tendon/muscle transfer                       A   8.66  13.30NA  13.30    1.69  23.65 23.650090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
26496  Revise thumb tendon                               A   9.78  13.75NA  13.75    1.65  25.18 25.180090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26497  Finger tendon transfer                            A   9.76  13.73NA  13.73    1.92  25.41 25.410090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
26498  Finger tendon transfer                            A  14.21  16.64NA  16.64    2.80  33.65 33.650090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
26499  Revision of finger                                A   9.17  13.39NA  13.39    1.81  24.37 24.370090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
26500  Hand tendon reconstruction                        A   6.13  11.22NA  11.22    1.14  18.49 18.490090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26502  Hand tendon reconstruction                        A   7.31  12.29NA  12.29    1.46  21.06 21.060090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
26508  Release thumb contracture                         A   6.18  11.69NA  11.69    1.10  18.97 18.970090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
26510  Thumb tendon transfer                             A   5.60  11.08NA  11.08    0.98  17.66 17.660090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26516  Fusion of knuckle joint                           A   7.32  12.07NA  12.07    1.29  20.68 20.680090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
26517  Fusion of knuckle joints                          A   9.08  13.33NA  13.33    1.80  24.21 24.210090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
26518  Fusion of knuckle joints                          A   9.27  13.62NA  13.62    1.82  24.71 24.710090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
26520  Release knuckle contracture                       A   5.47  12.88NA  12.88    0.99  19.34 19.340090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26525  Release finger contracture                        A   5.50  12.91NA  12.91    0.95  19.36 19.360090.10.69.2120110             25.0008 090 99      0.00   0.00   0.00
26530  Revise knuckle joint                              A   6.88   7.77NA   7.77    1.22  15.87 15.870090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
26531  Revise knuckle with implant                       A   8.13   8.88NA   8.88    1.39  18.40 18.400090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
26535  Revise finger joint                               A   5.41   6.14NA   6.14    0.83  12.38 12.380090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26536  Revise/implant finger joint                       A   6.56  13.43NA  13.43    1.13  21.12 21.120090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26540  Repair hand joint                                 A   6.60  11.67NA  11.67    1.18  19.45 19.450090.10.69.2120010             25.0008 090 99      0.00   0.00   0.00
26541  Repair hand joint with graft                      A   8.81  13.22NA  13.22    1.52  23.55 23.550090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
26542  Repair hand joint with graft                      A   6.95  11.87NA  11.87    1.25  20.07 20.070090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26545  Reconstruct finger joint                          A   7.11  12.47NA  12.47    1.27  20.85 20.850090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26546  Repair nonunion hand                              A  10.83  16.65NA  16.65    1.85  29.33 29.330090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
26548  Reconstruct finger joint                          A   8.22  12.78NA  12.78    1.50  22.50 22.500090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26550  Construct thumb replacement                       A  21.68  22.76NA  22.76    4.26  48.70 48.700090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
26551  Great toe-hand transfer                           A  48.48  28.17NA  28.17    9.55  86.20 86.200090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
26553  Single transfer toe-hand                          A  48.17  27.97NA  27.97    3.43  79.57 79.570090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
26554  Double transfer toe-hand                          A  57.01  31.97NA  31.97    4.06  93.04 93.040090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
26555  Positional change of finger                       A  17.08  19.99NA  19.99    3.38  40.45 40.450090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
26556  Toe joint transfer                                A  49.75  31.99NA  31.99    3.96  85.70 85.700090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
26560  Repair of web finger                              A   5.52  10.96NA  10.96    1.09  17.57 17.570090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
26561  Repair of web finger                              A  11.10  14.46NA  14.46    2.35  27.91 27.910090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
26562  Repair of web finger                              A  16.68  19.62NA  19.62    1.18  37.48 37.480090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
26565  Correct metacarpal flaw                           A   6.91  11.86NA  11.86    1.36  20.13 20.130090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
26567  Correct finger deformity                          A   6.99  11.85NA  11.85    1.24  20.08 20.080090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26568  Lengthen metacarpal/finger                        A   9.27  15.62NA  15.62    1.82  26.71 26.710090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
26580  Repair hand deformity                             A  19.75  20.88NA  20.88    3.89  44.52 44.520090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
26587  Reconstruct extra finger                          A  14.50  13.36NA  13.36    3.10  30.96 30.960090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
26590  Repair finger deformity                           A  18.67  15.40NA  15.40    3.70  37.77 37.770090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
26591  Repair muscles of hand                            A   3.38   9.07NA   9.07    0.61  13.06 13.060090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26593  Release muscles of hand                           A   5.50  11.28NA  11.28    0.93  17.71 17.710090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26596  Excision constricting tissue                      A   9.14  11.53NA  11.53    1.81  22.48 22.480090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
26600  Treat metacarpal fracture                         A   2.60   5.80     5.27    0.48   8.88  8.350090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26605  Treat metacarpal fracture                         A   3.03   6.09     5.21    0.56   9.68  8.800090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26607  Treat metacarpal fracture                         A   5.48   7.04NA   7.04    1.06  13.58 13.580090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26608  Treat metacarpal fracture                         A   5.55   7.62NA   7.62    1.03  14.20 14.200090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26615  Treat metacarpal fracture                         A   7.07   8.76NA   8.76    1.29  17.12 17.120090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26641  Treat thumb dislocation                           A   4.13   6.17     5.19    0.72  11.02 10.040090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
26645  Treat thumb fracture                              A   4.58   7.28     6.20    0.88  12.74 11.660090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
26650  Treat thumb fracture                              A   5.35   7.85NA   7.85    1.02  14.22 14.220090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
26665  Treat thumb fracture                              A   7.94   9.27NA   9.27    1.47  18.68 18.680090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
26670  Treat hand dislocation                            A   3.83   5.41     4.48    0.67   9.91  8.980090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26675  Treat hand dislocation                            A   4.83   7.79     6.66    0.95  13.57 12.440090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26676  Pin hand dislocation                              A   5.74   8.12NA   8.12    1.06  14.92 14.920090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26685  Treat hand dislocation                            A   7.07   8.77NA   8.77    1.39  17.23 17.230090.10.69.2120110             25.0008 090 99      0.00   0.00   0.00
26686  Treat hand dislocation                            A   8.17   8.71NA   8.71    1.61  18.49 18.490090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
26700  Treat knuckle dislocation                         A   3.83   5.25     4.63    0.65   9.73  9.110090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26705  Treat knuckle dislocation                         A   4.38   7.20     6.13    0.82  12.40 11.330090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26706  Pin knuckle dislocation                           A   5.31   6.84NA   6.84    0.95  13.10 13.100090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26715  Treat knuckle dislocation                         A   7.03   8.74NA   8.74    1.31  17.08 17.080090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26720  Treat finger fracture each                        A   1.76   3.91     3.48    0.33   6.00  5.570090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26725  Treat finger fracture each                        A   3.48   6.01     4.99    0.64  10.13  9.110090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26727  Treat finger fracture each                        A   5.42   7.54NA   7.54    0.99  13.95 13.950090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26735  Treat finger fracture each                        A   7.42   8.93NA   8.93    1.37  17.72 17.720090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26740  Treat finger fracture each                        A   2.07   4.45     4.02    0.35   6.87  6.440090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26742  Treat finger fracture each                        A   3.99   6.27     5.21    0.72  10.98  9.920090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26746  Treat finger fracture each                        A   9.80  10.35NA  10.35    1.78  21.93 21.930090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26750  Treat finger fracture each                        A   1.80   3.43     3.45    0.33   5.56  5.580090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26755  Treat finger fracture each                        A   3.23   5.64     4.39    0.59   9.46  8.210090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26756  Pin finger fracture each                          A   4.58   7.07NA   7.07    0.83  12.48 12.480090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26765  Treat finger fracture each                        A   5.86   7.99NA   7.99    1.09  14.94 14.940090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26770  Treat finger dislocation                          A   3.15   4.64     4.01    0.54   8.33  7.700090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26775  Treat finger dislocation                          A   3.90   6.96     5.83    0.69  11.55 10.420090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26776  Pin finger dislocation                            A   4.99   7.27NA   7.27    0.91  13.17 13.170090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26785  Treat finger dislocation                          A   6.60   8.45NA   8.45    1.21  16.26 16.260090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26820  Thumb fusion with graft                           A   8.45  13.19NA  13.19    1.66  23.30 23.300090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
26841  Fusion of thumb                                   A   7.35  12.84NA  12.84    1.39  21.58 21.580090.10.69.2121010             25.0008 090 99      0.00   0.00   0.00
26842  Thumb fusion with graft                           A   8.49  13.08NA  13.08    1.66  23.23 23.230090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
26843  Fusion of hand joint                              A   7.78  12.54NA  12.54    1.54  21.86 21.860090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
26844  Fusion/graft of hand joint                        A   8.98  13.28NA  13.28    1.78  24.04 24.040090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
26850  Fusion of knuckle                                 A   7.14  12.02NA  12.02    1.24  20.40 20.400090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26852  Fusion of knuckle with graft                      A   8.71  13.16NA  13.16    1.47  23.34 23.340090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
26860  Fusion of finger joint                            A   4.88  10.99NA  10.99    0.84  16.71 16.710090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26861  Fusion of finger jnt add-on                       A   1.74   0.97NA   0.97    0.31   3.02  3.020ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
26862  Fusion/graft of finger joint                      A   7.56  12.49NA  12.49    1.31  21.36 21.360090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
26863  Fuse/graft added joint                            A   3.89   2.29NA   2.29    0.75   6.93  6.930ZZZ.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
26910  Amputate metacarpal bone                          A   7.79  11.84NA  11.84    1.50  21.13 21.130090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26951  Amputation of finger/thumb                        A   6.04  12.21NA  12.21    1.14  19.39 19.390090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26952  Amputation of finger/thumb                        A   6.48  11.39NA  11.39    1.21  19.08 19.080090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26989  Hand/finger surgery                               C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020111             25.0008 090 99      0.00   0.00   0.00
26990  Drainage of pelvis lesion                         A   7.95   9.10NA   9.10    1.58  18.63 18.630090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
26991  Drainage of pelvis bursa                          A   7.06  12.82     7.14    1.39  21.27 15.590090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
26992  Drainage of bone lesion                           A  13.48  12.36NA  12.36    2.67  28.51 28.510090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
27000  Incision of hip tendon                            A   5.74   5.77NA   5.77    1.08  12.59 12.590090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27001  Incision of hip tendon                            A   7.14   7.60NA   7.60    1.40  16.14 16.140090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27003  Incision of hip tendon                            A   7.81   8.33NA   8.33    1.54  17.68 17.680090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27005  Incision of hip tendon                            A  10.07   9.50NA   9.50    1.97  21.54 21.540090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27006  Incision of hip tendons                           A  10.11   9.82NA   9.82    1.96  21.89 21.890090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27025  Incision of hip/thigh fascia                      A  12.89  11.88NA  11.88    2.57  27.34 27.340090.10.69.2121010             25.0008 090 99      0.00   0.00   0.00
27027  Buttock fasciotomy                                A  13.04  11.11NA  11.11    0.91  25.06 25.060090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
27030  Drainage of hip joint                             A  13.65  10.45NA  10.45    2.67  26.77 26.770090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27033  Exploration of hip joint                          A  14.11  11.92NA  11.92    2.78  28.81 28.810090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27035  Denervation of hip joint                          A  17.37   9.06NA   9.06    3.43  29.86 29.860090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27036  Excision of hip joint/muscle                      A  14.38  12.74NA  12.74    2.79  29.91 29.910090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27040  Biopsy of soft tissues                            A   2.92   6.85     2.46    0.48  10.25  5.860010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
27041  Biopsy of soft tissues                            A  10.18   8.27NA   8.27    1.81  20.26 20.260090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27043  Exc hip pelvis les sc 3 cm/>                      A   6.88   5.69NA   5.69    1.42  13.99 13.990090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27045  Exc hip/pelv tum deep 5 cm/>                      A  11.13   8.69NA   8.69    2.26  22.08 22.080090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27047  Exc hip/pelvis les sc < 3 cm                      A   4.94   8.15     4.86    1.02  14.11 10.820090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27048  Exc hip/pelv tum deep < 5 cm                      A   8.85   7.45NA   7.45    1.81  18.11 18.110090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27049  Resect hip/pelv tum < 5 cm                        A  21.55  14.22NA  14.22    4.33  40.10 40.100090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27050  Biopsy of sacroiliac joint                        A   4.74   6.32NA   6.32    0.93  11.99 11.990090.10.69.2121010             25.0008 090 99      0.00   0.00   0.00
27052  Biopsy of hip joint                               A   7.42   8.35NA   8.35    1.47  17.24 17.240090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27054  Removal of hip joint lining                       A   9.21   9.35NA   9.35    1.81  20.37 20.370090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27057  Buttock fasciotomy w/dbrdmt                       A  14.91  12.11NA  12.11    1.06  28.08 28.080090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
27059  Resect hip/pelv tum 5 cm/>                        A  29.35  18.12NA  18.12    5.78  53.25 53.250090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27060  Removal of ischial bursa                          A   5.87   6.80NA   6.80    1.17  13.84 13.840090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27062  Remove femur lesion/bursa                         A   5.75   6.70NA   6.70    1.13  13.58 13.580090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27065  Remove hip bone les super                         A   6.55   7.54NA   7.54    1.28  15.37 15.370090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27066  Remove hip bone les deep                          A  11.20  10.69NA  10.69    2.20  24.09 24.090090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27067  Remove/graft hip bone lesion                      A  14.72  12.97NA  12.97    2.91  30.60 30.600090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
27070  Part remove hip bone super                        A  11.56  11.35NA  11.35    2.27  25.18 25.180090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27071  Part removal hip bone deep                        A  12.39  12.42NA  12.42    2.44  27.25 27.250090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27075  Resect hip tumor                                  A  32.71  22.83NA  22.83    6.44  61.98 61.980090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
27076  Resect hip tum incl acetabul                      A  40.21  26.84NA  26.84    7.93  74.98 74.980090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
27077  Resect hip tum w/innom bone                       A  45.21  29.51NA  29.51    8.91  83.63 83.630090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
27078  Rsect hip tum incl femur                          A  32.21  22.56NA  22.56    6.34  61.11 61.110090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27080  Removal of tail bone                              A   6.89   6.99NA   6.99    1.42  15.30 15.300090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
27086  Remove hip foreign body                           A   1.92   5.58     2.30    0.31   7.81  4.530010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
27087  Remove hip foreign body                           A   8.83   8.15NA   8.15    1.70  18.68 18.680090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27090  Removal of hip prosthesis                         A  11.69  10.64NA  10.64    2.29  24.62 24.620090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27091  Removal of hip prosthesis                         A  24.35  18.16NA  18.16    4.80  47.31 47.310090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27093  Injection for hip x-ray                           A   1.30   4.32     0.62    0.14   5.76  2.060000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
27095  Injection for hip x-ray                           A   1.50   5.53     0.73    0.18   7.21  2.410000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
27096  Inject sacroiliac joint                           A   1.48   3.39     0.91    0.13   5.00  2.520000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
27097  Revision of hip tendon                            A   9.27   9.01NA   9.01    1.82  20.10 20.100090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
27098  Transfer tendon to pelvis                         A   9.32   9.42NA   9.42    1.84  20.58 20.580090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
27100  Transfer of abdominal muscle                      A  11.35  10.88NA  10.88    2.23  24.46 24.460090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27105  Transfer of spinal muscle                         A  12.04  11.25NA  11.25    2.35  25.64 25.640090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
27110  Transfer of iliopsoas muscle                      A  13.77  12.17NA  12.17    2.72  28.66 28.660090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27111  Transfer of iliopsoas muscle                      A  12.60  11.55NA  11.55    2.46  26.61 26.610090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27120  Reconstruction of hip socket                      A  19.25  15.13NA  15.13    3.80  38.18 38.180090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27122  Reconstruction of hip socket                      A  16.09  13.33NA  13.33    3.16  32.58 32.580090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27125  Partial hip replacement                           A  16.64  13.66NA  13.66    3.28  33.58 33.580090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27130  Total hip arthroplasty                            A  21.79  16.62NA  16.62    4.29  42.70 42.700090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27132  Total hip arthroplasty                            A  25.69  18.90NA  18.90    5.06  49.65 49.650090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27134  Revise hip joint replacement                      A  30.28  20.47NA  20.47    5.96  56.71 56.710090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27137  Revise hip joint replacement                      A  22.70  16.47NA  16.47    4.46  43.63 43.630090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27138  Revise hip joint replacement                      A  23.70  16.99NA  16.99    4.67  45.36 45.360090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27140  Transplant femur ridge                            A  12.78  11.27NA  11.27    2.52  26.57 26.570090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27146  Incision of hip bone                              A  18.92  15.35NA  15.35    3.74  38.01 38.010090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27147  Revision of hip bone                              A  22.07  17.03NA  17.03    4.34  43.44 43.440090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27151  Incision of hip bones                             A  24.12  18.12NA  18.12    4.76  47.00 47.000090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27156  Revision of hip bones                             A  26.23  19.25NA  19.25    5.16  50.64 50.640090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27158  Revision of pelvis                                A  21.04  12.36NA  12.36    4.15  37.55 37.550090.10.69.2122200             25.0008 090 99      0.00   0.00   0.00
27161  Incision of neck of femur                         A  17.89  14.57NA  14.57    3.51  35.97 35.970090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27165  Incision/fixation of femur                        A  20.29  16.45NA  16.45    3.99  40.73 40.730090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27170  Repair/graft femur head/neck                      A  17.61  13.76NA  13.76    3.47  34.84 34.840090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27175  Treat slipped epiphysis                           A   9.38   8.51NA   8.51    1.85  19.74 19.740090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
27176  Treat slipped epiphysis                           A  12.92  11.72NA  11.72    2.56  27.20 27.200090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27177  Treat slipped epiphysis                           A  16.09  13.70NA  13.70    3.17  32.96 32.960090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27178  Treat slipped epiphysis                           A  12.92  11.72NA  11.72    2.56  27.20 27.200090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27179  Revise head/neck of femur                         A  13.97  12.15NA  12.15    2.75  28.87 28.870090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
27181  Treat slipped epiphysis                           A  16.18  13.88NA  13.88    3.20  33.26 33.260090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
27185  Revision of femur epiphysis                       A   9.79   9.54NA   9.54    0.69  20.02 20.020090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27187  Reinforce hip bones                               A  14.23  12.38NA  12.38    2.80  29.41 29.410090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27193  Treat pelvic ring fracture                        A   6.09   6.73     6.94    1.20  14.02 14.230090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
27194  Treat pelvic ring fracture                        A  10.20   9.12NA   9.12    1.66  20.98 20.980090.10.69.2120020             25.0008 090 99      0.00   0.00   0.00
27200  Treat tail bone fracture                          A   1.92   3.12     3.36    0.35   5.39  5.630090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
27202  Treat tail bone fracture                          A   7.31   7.03NA   7.03    1.46  15.80 15.800090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
27215  Treat pelvic fracture(s)                          I+ 10.45   6.48NA   6.48    0.73  17.66 17.669090.10.69.2199999             25.0008 090 99      0.00   0.00   0.00
27216  Treat pelvic ring fracture                        I+ 15.73   9.31NA   9.31    1.13  26.17 26.179090.10.69.2199999             25.0008 090 99      0.00   0.00   0.00
27217  Treat pelvic ring fracture                        I+ 14.65   8.87NA   8.87    1.05  24.57 24.579090.10.69.2199999             25.0008 090 99      0.00   0.00   0.00
27218  Treat pelvic ring fracture                        I+ 20.93  11.41NA  11.41    1.50  33.84 33.849090.10.69.2199999             25.0008 090 99      0.00   0.00   0.00
27220  Treat hip socket fracture                         A   6.83   7.62     7.47    1.33  15.78 15.630090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27222  Treat hip socket fracture                         A  14.11  11.77NA  11.77    2.76  28.64 28.640090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27226  Treat hip wall fracture                           A  15.57  12.63NA  12.63    3.08  31.28 31.280090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
27227  Treat hip fracture(s)                             A  25.41  18.69NA  18.69    5.01  49.11 49.110090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
27228  Treat hip fracture(s)                             A  29.33  20.75NA  20.75    5.78  55.86 55.860090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
27230  Treat thigh fracture                              A   5.81   7.25     7.15    1.14  14.20 14.100090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27232  Treat thigh fracture                              A  11.72   8.59NA   8.59    2.25  22.56 22.560090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27235  Treat thigh fracture                              A  13.00  11.38NA  11.38    2.56  26.94 26.940090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27236  Treat thigh fracture                              A  17.61  14.40NA  14.40    3.47  35.48 35.480090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27238  Treat thigh fracture                              A   5.75   6.88NA   6.88    1.13  13.76 13.760090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27240  Treat thigh fracture                              A  13.81  11.99NA  11.99    2.69  28.49 28.490090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27244  Treat thigh fracture                              A  18.18  14.72NA  14.72    3.57  36.47 36.470090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27245  Treat thigh fracture                              A  18.18  14.73NA  14.73    3.57  36.48 36.480090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
27246  Treat thigh fracture                              A   4.83   5.70     5.76    0.93  11.46 11.520090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27248  Treat thigh fracture                              A  10.78   9.12NA   9.12    2.12  22.02 22.020090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27250  Treat hip dislocation                             A   3.82   0.88NA   0.88    0.67   5.37  5.370000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
27252  Treat hip dislocation                             A  11.03   9.35NA   9.35    2.14  22.52 22.520090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27253  Treat hip dislocation                             A  13.58  11.66NA  11.66    2.67  27.91 27.910090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27254  Treat hip dislocation                             A  18.94  14.65NA  14.65    3.73  37.32 37.320090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27256  Treat hip dislocation                             A   4.28   4.12     1.98    0.75   9.15  7.010010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
27257  Treat hip dislocation                             A   5.38   3.54NA   3.54    0.98   9.90  9.900010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
27258  Treat hip dislocation                             A  16.18  13.40NA  13.40    3.20  32.78 32.780090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27259  Treat hip dislocation                             A  23.26  18.04NA  18.04    4.57  45.87 45.870090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
27265  Treat hip dislocation                             A   5.24   5.89NA   5.89    0.93  12.06 12.060090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27266  Treat hip dislocation                             A   7.78   7.96NA   7.96    1.52  17.26 17.260090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27267  Cltx thigh fx                                     A   5.50   6.45NA   6.45    1.09  13.04 13.040090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27268  Cltx thigh fx w/mnpj                              A   7.12   7.45NA   7.45    1.40  15.97 15.970090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27269  Optx thigh fx                                     A  18.89  14.16NA  14.16    3.70  36.75 36.750090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27275  Manipulation of hip joint                         A   2.32   2.75NA   2.75    0.39   5.46  5.460010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
27280  Fusion of sacroiliac joint                        A  14.64  13.24NA  13.24    3.04  30.92 30.920090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27282  Fusion of pubic bones                             A  11.85  11.15NA  11.15    2.31  25.31 25.310090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
27284  Fusion of hip joint                               A  25.06  17.77NA  17.77    4.95  47.78 47.780090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27286  Fusion of hip joint                               A  25.17  18.69NA  18.69    4.97  48.83 48.830090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27290  Amputation of leg at hip                          A  24.55  18.59NA  18.59    4.85  47.99 47.990090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
27295  Amputation of leg at hip                          A  19.66  13.68NA  13.68    4.01  37.35 37.350090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27299  Pelvis/hip joint surgery                          C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021211             25.0008 090 99      0.00   0.00   0.00
27301  Drain thigh/knee lesion                           A   6.78  12.10     6.78    1.37  20.25 14.930090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27303  Drainage of bone lesion                           A   8.63   8.64NA   8.64    1.69  18.96 18.960090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27305  Incise thigh tendon & fascia                      A   6.18   6.99NA   6.99    1.22  14.39 14.390090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27306  Incision of thigh tendon                          A   4.74   5.15NA   5.15    0.93  10.82 10.820090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
27307  Incision of thigh tendons                         A   6.06   7.01NA   7.01    1.20  14.27 14.270090.10.69.2121010             25.0008 090 99      0.00   0.00   0.00
27310  Exploration of knee joint                         A  10.00   9.75NA   9.75    1.96  21.71 21.710090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27323  Biopsy thigh soft tissues                         A   2.33   5.53     2.62    0.41   8.27  5.360010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
27324  Biopsy thigh soft tissues                         A   5.04   5.67NA   5.67    1.05  11.76 11.760090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27325  Neurectomy hamstring                              A   7.20   7.92NA   7.92    1.42  16.54 16.540090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
27326  Neurectomy popliteal                              A   6.47   7.53NA   7.53    1.27  15.27 15.270090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27327  Exc thigh/knee les sc < 3 cm                      A   3.96   9.19     4.61    0.80  13.95  9.370090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27328  Exc thigh/knee tum deep <5cm                      A   8.85   7.85NA   7.85    1.81  18.51 18.510090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27329  Resect thigh/knee tum < 5 cm                      A  15.72  11.73NA  11.73    3.18  30.63 30.630090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27330  Biopsy knee joint lining                          A   5.11   6.26NA   6.26    0.95  12.32 12.320090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27331  Explore/treat knee joint                          A   6.02   6.98NA   6.98    1.18  14.18 14.180090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27332  Removal of knee cartilage                         A   8.46   8.93NA   8.93    1.65  19.04 19.040090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27333  Removal of knee cartilage                         A   7.55   8.35NA   8.35    1.50  17.40 17.400090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27334  Remove knee joint lining                          A   9.19   9.34NA   9.34    1.81  20.34 20.340090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27335  Remove knee joint lining                          A  10.55  10.06NA  10.06    2.07  22.68 22.680090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27337  Exc thigh/knee les sc 3 cm/>                      A   5.91   5.36NA   5.36    1.21  12.48 12.480090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
27339  Exc thigh/knee tum dep 5cm/>                      A  11.13   8.89NA   8.89    2.26  22.28 22.280090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
27340  Removal of kneecap bursa                          A   4.32   5.94NA   5.94    0.84  11.10 11.100090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27345  Removal of knee cyst                              A   6.09   7.01NA   7.01    1.20  14.30 14.300090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27347  Remove knee cyst                                  A   6.73   7.69NA   7.69    1.32  15.74 15.740090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27350  Removal of kneecap                                A   8.66   9.05NA   9.05    1.69  19.40 19.400090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27355  Remove femur lesion                               A   8.00   8.33NA   8.33    1.58  17.91 17.910090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27356  Remove femur lesion/graft                         A  10.09   9.84NA   9.84    1.97  21.90 21.900090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27357  Remove femur lesion/graft                         A  11.16  10.78NA  10.78    2.20  24.14 24.140090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27358  Remove femur lesion/fixation                      A   4.73   2.53NA   2.53    0.91   8.17  8.170ZZZ.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
27360  Partial removal leg bone(s)                       A  11.46  11.64NA  11.64    2.26  25.36 25.360090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27364  Resect thigh/knee tum 5 cm/>                      A  24.49  16.56NA  16.56    4.97  46.02 46.020090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27365  Resect femur/knee tumor                           A  32.21  22.57NA  22.57    6.36  61.14 61.140090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27370  Injection for knee x-ray                          A   0.96   3.90     0.45    0.12   4.98  1.530000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
27372  Removal of foreign body                           A   5.21  12.13     5.81    1.03  18.37 12.050090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
27380  Repair of kneecap tendon                          A   7.45   8.81NA   8.81    1.47  17.73 17.730090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27381  Repair/graft kneecap tendon                       A  10.76  10.84NA  10.84    2.12  23.72 23.720090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27385  Repair of thigh muscle                            A   6.93   8.93NA   8.93    1.36  17.22 17.220090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27386  Repair/graft of thigh muscle                      A  11.13  11.45NA  11.45    2.19  24.77 24.770090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27390  Incision of thigh tendon                          A   5.53   6.73NA   6.73    1.09  13.35 13.350090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
27391  Incision of thigh tendons                         A   7.49   8.15NA   8.15    1.48  17.12 17.120090.10.69.2120010             25.0008 090 99      0.00   0.00   0.00
27392  Incision of thigh tendons                         A   9.63   9.58NA   9.58    1.89  21.10 21.100090.10.69.2122210             25.0008 090 99      0.00   0.00   0.00
27393  Lengthening of thigh tendon                       A   6.59   7.28NA   7.28    1.29  15.16 15.160090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27394  Lengthening of thigh tendons                      A   8.79   8.85NA   8.85    1.70  19.34 19.340090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
27395  Lengthening of thigh tendons                      A  12.24  11.35NA  11.35    2.41  26.00 26.000090.10.69.2122210             25.0008 090 99      0.00   0.00   0.00
27396  Transplant of thigh tendon                        A   8.15   8.51NA   8.51    1.61  18.27 18.270090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27397  Transplants of thigh tendons                      A  12.66  12.00NA  12.00    2.48  27.14 27.140090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
27400  Revise thigh muscles/tendons                      A   9.33   9.42NA   9.42    1.84  20.59 20.590090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27403  Repair of knee cartilage                          A   8.62   8.73NA   8.73    1.67  19.02 19.020090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27405  Repair of knee ligament                           A   9.08   9.27NA   9.27    1.80  20.15 20.150090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27407  Repair of knee ligament                           A  10.85  10.48NA  10.48    2.14  23.47 23.470090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27409  Repair of knee ligaments                          A  13.71  12.14NA  12.14    2.71  28.56 28.560090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27412  Autochondrocyte implant knee                      A  24.74  19.27NA  19.27    4.89  48.90 48.900090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27415  Osteochondral knee allograft                      A  20.00  16.74NA  16.74    3.93  40.67 40.670090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27416  Osteochondral knee autograft                      A  14.16  12.05NA  12.05    2.79  29.00 29.000090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
27418  Repair degenerated kneecap                        A  11.60  10.83NA  10.83    2.26  24.69 24.690090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27420  Revision of unstable kneecap                      A  10.26   9.34NA   9.34    2.00  21.60 21.600090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27422  Revision of unstable kneecap                      A  10.21   9.88NA   9.88    1.99  22.08 22.080090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27424  Revision/removal of kneecap                       A  10.24   9.91NA   9.91    2.00  22.15 22.150090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27425  Lat retinacular release open                      A   5.39   6.91NA   6.91    1.06  13.36 13.360090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27427  Reconstruction knee                               A   9.79   9.57NA   9.57    1.92  21.28 21.280090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27428  Reconstruction knee                               A  15.58  14.36NA  14.36    3.09  33.03 33.030090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27429  Reconstruction knee                               A  17.54  16.02NA  16.02    3.47  37.03 37.030090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27430  Revision of thigh muscles                         A  10.16   9.85NA   9.85    1.99  22.00 22.000090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27435  Incision of knee joint                            A  10.88  11.05NA  11.05    2.15  24.08 24.080090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27437  Revise kneecap                                    A   8.93   8.89NA   8.89    1.77  19.59 19.590090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27438  Revise kneecap with implant                       A  11.89  10.75NA  10.75    2.33  24.97 24.970090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27440  Revision of knee joint                            A  11.09  10.35NA  10.35    2.18  23.62 23.620090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27441  Revision of knee joint                            A  11.54  10.59NA  10.59    2.26  24.39 24.390090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27442  Revision of knee joint                            A  12.37  10.99NA  10.99    2.42  25.78 25.780090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27443  Revision of knee joint                            A  11.41  10.53NA  10.53    2.25  24.19 24.190090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27445  Revision of knee joint                            A  18.66  14.75NA  14.75    3.70  37.11 37.110090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27446  Revision of knee joint                            A  16.38  13.14NA  13.14    3.23  32.75 32.750090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27447  Total knee arthroplasty                           A  23.25  17.77NA  17.77    4.57  45.59 45.590090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27448  Incision of thigh                                 A  11.60  10.50NA  10.50    2.29  24.39 24.390090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27450  Incision of thigh                                 A  14.61  12.62NA  12.62    2.90  30.13 30.130090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27454  Realignment of thigh bone                         A  19.17  15.48NA  15.48    3.78  38.43 38.430090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27455  Realignment of knee                               A  13.36  11.89NA  11.89    2.63  27.88 27.880090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27457  Realignment of knee                               A  14.03  11.65NA  11.65    2.76  28.44 28.440090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27465  Shortening of thigh bone                          A  18.60  14.71NA  14.71    3.69  37.00 37.000090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27466  Lengthening of thigh bone                         A  17.28  14.25NA  14.25    3.42  34.95 34.950090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27468  Shorten/lengthen thighs                           A  19.97  15.77NA  15.77    3.93  39.67 39.670090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27470  Repair of thigh                                   A  17.14  14.38NA  14.38    3.39  34.91 34.910090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27472  Repair/graft of thigh                             A  18.72  15.07NA  15.07    3.70  37.49 37.490090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27475  Surgery to stop leg growth                        A   8.93   8.92NA   8.92    1.77  19.62 19.620090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27477  Surgery to stop leg growth                        A  10.14   9.57NA   9.57    1.99  21.70 21.700090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27479  Surgery to stop leg growth                        A  13.16  11.47NA  11.47    0.93  25.56 25.560090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
27485  Surgery to stop leg growth                        A   9.13   8.94NA   8.94    1.81  19.88 19.880090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27486  Revise/replace knee joint                         A  21.12  16.45NA  16.45    4.15  41.72 41.720090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27487  Revise/replace knee joint                         A  27.11  19.64NA  19.64    5.34  52.09 52.090090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27488  Removal of knee prosthesis                        A  17.60  14.58NA  14.58    3.47  35.65 35.650090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27495  Reinforce thigh                                   A  16.54  13.65NA  13.65    3.25  33.44 33.440090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27496  Decompression of thigh/knee                       A   6.78   8.06NA   8.06    1.33  16.17 16.170090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27497  Decompression of thigh/knee                       A   7.79   7.94NA   7.94    1.54  17.27 17.270090.10.69.2121020             25.0008 090 99      0.00   0.00   0.00
27498  Decompression of thigh/knee                       A   8.66   9.07NA   9.07    1.69  19.42 19.420090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
27499  Decompression of thigh/knee                       A   9.43   9.48NA   9.48    1.86  20.77 20.770090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
27500  Treatment of thigh fracture                       A   6.30   7.88     6.70    1.22  15.40 14.220090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27501  Treatment of thigh fracture                       A   6.45   7.27     7.14    1.27  14.99 14.860090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
27502  Treatment of thigh fracture                       A  11.36   9.32NA   9.32    2.19  22.87 22.870090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27503  Treatment of thigh fracture                       A  11.27  10.36NA  10.36    2.20  23.83 23.830090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
27506  Treatment of thigh fracture                       A  19.65  16.16NA  16.16    3.87  39.68 39.680090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27507  Treatment of thigh fracture                       A  14.48  11.48NA  11.48    2.86  28.82 28.820090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
27508  Treatment of thigh fracture                       A   6.20   8.33     7.37    1.20  15.73 14.770090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27509  Treatment of thigh fracture                       A   8.14   9.51NA   9.51    1.59  19.24 19.240090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
27510  Treatment of thigh fracture                       A   9.80   8.70NA   8.70    1.88  20.38 20.380090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27511  Treatment of thigh fracture                       A  15.11  11.42NA  11.42    2.98  29.51 29.510090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
27513  Treatment of thigh fracture                       A  19.25  13.64NA  13.64    3.80  36.69 36.690090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
27514  Treatment of thigh fracture                       A  14.60  11.16NA  11.16    2.87  28.63 28.630090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27516  Treat thigh fx growth plate                       A   5.59   8.50     7.54    1.10  15.19 14.230090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27517  Treat thigh fx growth plate                       A   9.12   9.42NA   9.42    1.80  20.34 20.340090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
27519  Treat thigh fx growth plate                       A  13.25  10.47NA  10.47    2.61  26.33 26.330090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27520  Treat kneecap fracture                            A   3.04   6.15     5.27    0.59   9.78  8.900090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27524  Treat kneecap fracture                            A  10.37   9.96NA   9.96    2.03  22.36 22.360090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27530  Treat knee fracture                               A   2.65   5.97     5.30    0.51   9.13  8.460090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27532  Treat knee fracture                               A   7.55   9.32     8.14    1.48  18.35 17.170090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27535  Treat knee fracture                               A  13.41  10.52NA  10.52    2.63  26.56 26.560090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
27536  Treat knee fracture                               A  17.39  14.48NA  14.48    3.43  35.30 35.300090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27538  Treat knee fracture(s)                            A   5.09   8.13     7.19    0.99  14.21 13.270090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
27540  Treat knee fracture                               A  11.30  10.56NA  10.56    2.22  24.08 24.080090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27550  Treat knee dislocation                            A   5.98   7.86     6.71    1.10  14.94 13.790090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
27552  Treat knee dislocation                            A   8.18   8.85NA   8.85    1.61  18.64 18.640090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
27556  Treat knee dislocation                            A  13.00  10.33NA  10.33    2.57  25.90 25.900090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27557  Treat knee dislocation                            A  15.90  11.88NA  11.88    3.14  30.92 30.920090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27558  Treat knee dislocation                            A  18.39  13.21NA  13.21    3.62  35.22 35.220090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
27560  Treat kneecap dislocation                         A   3.99   6.24     5.39    0.76  10.99 10.140090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27562  Treat kneecap dislocation                         A   5.98   7.23NA   7.23    1.18  14.39 14.390090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
27566  Treat kneecap dislocation                         A  12.71  11.24NA  11.24    2.50  26.45 26.450090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27570  Fixation of knee joint                            A   1.79   2.37NA   2.37    0.34   4.50  4.500010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
27580  Fusion of knee                                    A  21.10  17.42NA  17.42    4.15  42.67 42.670090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27590  Amputate leg at thigh                             A  13.47   7.87NA   7.87    2.95  24.29 24.290090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27591  Amputate leg at thigh                             A  13.94  11.90NA  11.90    2.91  28.75 28.750090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27592  Amputate leg at thigh                             A  10.98   7.44NA   7.44    2.34  20.76 20.760090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27594  Amputation follow-up surgery                      A   7.29   6.41NA   6.41    1.55  15.25 15.250090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27596  Amputation follow-up surgery                      A  11.29   8.21NA   8.21    2.40  21.90 21.900090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27598  Amputate lower leg at knee                        A  11.22   8.39NA   8.39    2.33  21.94 21.940090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27599  Leg surgery procedure                             C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021211             25.0008 090 99      0.00   0.00   0.00
27600  Decompression of lower leg                        A   6.03   5.15NA   5.15    1.27  12.45 12.450090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27601  Decompression of lower leg                        A   6.05   5.94NA   5.94    1.27  13.26 13.260090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27602  Decompression of lower leg                        A   7.82   5.42NA   5.42    1.74  14.98 14.980090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27603  Drain lower leg lesion                            A   5.23  10.05     5.49    1.01  16.29 11.730090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27604  Drain lower leg bursa                             A   4.59   9.27     4.76    0.78  14.64 10.130090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
27605  Incision of achilles tendon                       A   2.92   7.15     2.25    0.34  10.41  5.510010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
27606  Incision of achilles tendon                       A   4.18   3.61NA   3.61    0.72   8.51  8.510010.10.80.1021110             25.0008 090 99      0.00   0.00   0.00
27607  Treat lower leg bone lesion                       A   8.62   7.89NA   7.89    1.58  18.09 18.090090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27610  Explore/treat ankle joint                         A   9.13   8.57NA   8.57    1.63  19.33 19.330090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27612  Exploration of ankle joint                        A   8.15   7.29NA   7.29    1.16  16.60 16.600090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27613  Biopsy lower leg soft tissue                      A   2.22   5.21     2.40    0.31   7.74  4.930010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
27614  Biopsy lower leg soft tissue                      A   5.80  10.84     5.38    1.03  17.67 12.210090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27615  Resect leg/ankle tum < 5 cm                       A  15.72  11.53NA  11.53    3.14  30.39 30.390090.10.69.2121010             25.0008 090 99      0.00   0.00   0.00
27616  Resect leg/ankle tum 5 cm/>                       A  19.63  13.71NA  13.71    3.91  37.25 37.250090.10.69.2121010             25.0008 090 99      0.00   0.00   0.00
27618  Exc leg/ankle tum < 3 cm                          A   3.96   8.82     4.43    0.73  13.51  9.120090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27619  Exc leg/ankle tum deep <5 cm                      A   6.91   6.10NA   6.10    1.22  14.23 14.230090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27620  Explore/treat ankle joint                         A   6.15   6.30NA   6.30    1.05  13.50 13.500090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27625  Remove ankle joint lining                         A   8.49   7.43NA   7.43    1.27  17.19 17.190090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27626  Remove ankle joint lining                         A   9.10   7.88NA   7.88    1.52  18.50 18.500090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
27630  Removal of tendon lesion                          A   4.94  11.28     5.20    0.78  17.00 10.920090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27632  Exc leg/ankle les sc 3 cm/>                       A   5.91   5.36NA   5.36    1.13  12.40 12.400090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
27634  Exc leg/ankle tum dep 5 cm/>                      A  10.13   8.34NA   8.34    1.80  20.27 20.270090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
27635  Remove lower leg bone lesion                      A   8.03   8.02NA   8.02    1.50  17.55 17.550090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27637  Remove/graft leg bone lesion                      A  10.31  10.24NA  10.24    2.01  22.56 22.560090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27638  Remove/graft leg bone lesion                      A  10.99   9.91NA   9.91    2.16  23.06 23.060090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27640  Partial removal of tibia                          A  12.24  10.35NA  10.35    2.20  24.79 24.790090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27641  Partial removal of fibula                         A   9.84   8.21NA   8.21    1.67  19.72 19.720090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27645  Resect tibia tumor                                A  27.21  20.01NA  20.01    5.36  52.58 52.580090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27646  Resect fibula tumor                               A  23.21  17.87NA  17.87    4.57  45.65 45.650090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27647  Resect talus/calcaneus tum                        A  20.26   8.25NA   8.25    2.03  30.54 30.540090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
27648  Injection for ankle x-ray                         A   0.96   3.89     0.46    0.12   4.97  1.540000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
27650  Repair achilles tendon                            A   9.21   9.13NA   9.13    1.51  19.85 19.850090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27652  Repair/graft achilles tendon                      A  10.78   7.95NA   7.95    1.51  20.24 20.240090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27654  Repair of achilles tendon                         A  10.53   8.94NA   8.94    1.51  20.98 20.980090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27656  Repair leg fascia defect                          A   4.71  13.70     6.20    0.91  19.32 11.820090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
27658  Repair of leg tendon each                         A   5.12   5.38NA   5.38    0.78  11.28 11.280090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
27659  Repair of leg tendon each                         A   7.10   6.41NA   6.41    0.99  14.50 14.500090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
27664  Repair of leg tendon each                         A   4.73   5.40NA   5.40    0.75  10.88 10.880090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
27665  Repair of leg tendon each                         A   5.57   5.96NA   5.96    0.88  12.41 12.410090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
27675  Repair lower leg tendons                          A   7.35   6.23NA   6.23    1.02  14.60 14.600090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27676  Repair lower leg tendons                          A   8.73   8.14NA   8.14    1.70  18.57 18.570090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
27680  Release of lower leg tendon                       A   5.88   6.06NA   6.06    0.98  12.92 12.920090.10.69.2120110             25.0008 090 99      0.00   0.00   0.00
27681  Release of lower leg tendons                      A   7.05   7.80NA   7.80    1.39  16.24 16.240090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27685  Revision of lower leg tendon                      A   6.69  12.47     6.21    0.91  20.07 13.810090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27686  Revise lower leg tendons                          A   7.75   7.38NA   7.38    1.29  16.42 16.420090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27687  Revision of calf tendon                           A   6.41   6.25NA   6.25    0.99  13.65 13.650090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27690  Revise lower leg tendon                           A   9.17   8.34NA   8.34    1.32  18.83 18.830090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27691  Revise lower leg tendon                           A  10.49  10.11NA  10.11    1.82  22.42 22.420090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27692  Revise additional leg tendon                      A   1.87   0.93NA   0.93    0.34   3.14  3.140ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
27695  Repair of ankle ligament                          A   6.70   6.58NA   6.58    1.08  14.36 14.360090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27696  Repair of ankle ligaments                         A   8.58   6.93NA   6.93    1.16  16.67 16.670090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27698  Repair of ankle ligament                          A   9.61   8.02NA   8.02    1.51  19.14 19.140090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27700  Revision of ankle joint                           A   9.66   6.69NA   6.69    1.20  17.55 17.550090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27702  Reconstruct ankle joint                           A  14.42  11.81NA  11.81    2.65  28.88 28.880090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27703  Reconstruction ankle joint                        A  16.94  13.45NA  13.45    3.18  33.57 33.570090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
27704  Removal of ankle implant                          A   7.81   8.22NA   8.22    1.42  17.45 17.450090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27705  Incision of tibia                                 A  10.86   9.69NA   9.69    2.01  22.56 22.560090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27707  Incision of fibula                                A   4.78   6.43NA   6.43    0.90  12.11 12.110090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27709  Incision of tibia & fibula                        A  17.48  13.81NA  13.81    3.38  34.67 34.670090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27712  Realignment of lower leg                          A  15.87  13.72NA  13.72    3.14  32.73 32.730090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27715  Revision of lower leg                             A  15.50  12.93NA  12.93    3.08  31.51 31.510090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27720  Repair of tibia                                   A  12.36  11.33NA  11.33    2.40  26.09 26.090090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27722  Repair/graft of tibia                             A  12.45  11.47NA  11.47    2.44  26.36 26.360090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27724  Repair/graft of tibia                             A  19.31  14.43NA  14.43    3.80  37.54 37.540090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27725  Repair of lower leg                               A  17.41  15.30NA  15.30    3.44  36.15 36.150090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27726  Repair fibula nonunion                            A  14.34  11.81NA  11.81    2.78  28.93 28.930090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27727  Repair of lower leg                               A  14.84  12.91NA  12.91    2.94  30.69 30.690090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27730  Repair of tibia epiphysis                         A   7.70   8.18NA   8.18    1.52  17.40 17.400090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27732  Repair of fibula epiphysis                        A   5.46   6.79NA   6.79    1.08  13.33 13.330090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27734  Repair lower leg epiphyses                        A   8.83   8.88NA   8.88    0.63  18.34 18.340090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27740  Repair of leg epiphyses                           A   9.61   6.76NA   6.76    1.89  18.26 18.260090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
27742  Repair of leg epiphyses                           A  10.63   7.38NA   7.38    2.08  20.09 20.090090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27745  Reinforce tibia                                   A  10.49   9.99NA   9.99    2.04  22.52 22.520090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27750  Treatment of tibia fracture                       A   3.37   6.43     5.55    0.64  10.44  9.560090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27752  Treatment of tibia fracture                       A   6.27   8.62     7.33    1.21  16.10 14.810090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27756  Treatment of tibia fracture                       A   7.45   8.33NA   8.33    1.46  17.24 17.240090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27758  Treatment of tibia fracture                       A  12.54  11.47NA  11.47    2.45  26.46 26.460090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27759  Treatment of tibia fracture                       A  14.45  12.32NA  12.32    2.84  29.61 29.610090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
27760  Cltx medial ankle fx                              A   3.21   6.32     5.40    0.59  10.12  9.200090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27762  Cltx med ankle fx w/mnpj                          A   5.47   7.83     6.54    1.01  14.31 13.020090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27766  Optx medial ankle fx                              A   7.89   8.79NA   8.79    1.51  18.19 18.190090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27767  Cltx post ankle fx                                A   2.64   5.37     5.43    0.50   8.51  8.570090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27768  Cltx post ankle fx w/mnpj                         A   5.14   6.99NA   6.99    1.02  13.15 13.150090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27769  Optx post ankle fx                                A  10.14   9.67NA   9.67    1.99  21.80 21.800090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27780  Treatment of fibula fracture                      A   2.83   5.92     5.06    0.53   9.28  8.420090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27781  Treatment of fibula fracture                      A   4.59   7.08     6.15    0.87  12.54 11.610090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27784  Treatment of fibula fracture                      A   9.67   9.76NA   9.76    1.88  21.31 21.310090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27786  Treatment of ankle fracture                       A   3.02   6.02     5.08    0.54   9.58  8.640090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27788  Treatment of ankle fracture                       A   4.64   7.22     6.09    0.84  12.70 11.570090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27792  Treatment of ankle fracture                       A   8.75   9.11NA   9.11    1.66  19.52 19.520090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27808  Treatment of ankle fracture                       A   3.03   6.55     5.49    0.56  10.14  9.080090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27810  Treatment of ankle fracture                       A   5.32   7.82     6.48    1.01  14.15 12.810090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27814  Treatment of ankle fracture                       A  10.62  10.34NA  10.34    2.04  23.00 23.000090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27816  Treatment of ankle fracture                       A   3.07   6.01     4.99    0.54   9.62  8.600090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27818  Treatment of ankle fracture                       A   5.69   7.83     6.30    1.05  14.57 13.040090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27822  Treatment of ankle fracture                       A  11.21  11.73NA  11.73    2.16  25.10 25.100090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27823  Treatment of ankle fracture                       A  13.16  12.71NA  12.71    2.55  28.42 28.420090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27824  Treat lower leg fracture                          A   3.31   5.47     5.20    0.61   9.39  9.120090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27825  Treat lower leg fracture                          A   6.69   8.27     6.70    1.28  16.24 14.670090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
27826  Treat lower leg fracture                          A  11.10  11.74NA  11.74    2.14  24.98 24.980090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
27827  Treat lower leg fracture                          A  14.79  14.61NA  14.61    2.90  32.30 32.300090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
27828  Treat lower leg fracture                          A  18.43  16.47NA  16.47    3.59  38.49 38.490090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
27829  Treat lower leg joint                             A   8.80   9.98NA   9.98    1.69  20.47 20.470090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
27830  Treat lower leg dislocation                       A   3.96   6.68     5.87    0.76  11.40 10.590090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
27831  Treat lower leg dislocation                       A   4.73   6.27NA   6.27    0.91  11.91 11.910090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
27832  Treat lower leg dislocation                       A  10.17  10.28NA  10.28    1.99  22.44 22.440090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27840  Treat ankle dislocation                           A   4.77   5.62NA   5.62    0.83  11.22 11.220090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27842  Treat ankle dislocation                           A   6.46   7.12NA   7.12    1.21  14.79 14.790090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27846  Treat ankle dislocation                           A  10.28   9.55NA   9.55    1.95  21.78 21.780090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27848  Treat ankle dislocation                           A  11.68  10.11NA  10.11    2.25  24.04 24.040090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27860  Fixation of ankle joint                           A   2.39   2.55NA   2.55    0.39   5.33  5.330010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
27870  Fusion of ankle joint open                        A  15.41  12.56NA  12.56    2.80  30.77 30.770090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27871  Fusion of tibiofibular joint                      A   9.54   9.09NA   9.09    1.85  20.48 20.480090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27880  Amputation of lower leg                           A  15.37   8.89NA   8.89    3.32  27.58 27.580090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27881  Amputation of lower leg                           A  13.47  10.27NA  10.27    2.80  26.54 26.540090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27882  Amputation of lower leg                           A   9.79   6.46NA   6.46    2.15  18.40 18.400090.10.69.2121010             25.0008 090 99      0.00   0.00   0.00
27884  Amputation follow-up surgery                      A   8.76   6.85NA   6.85    1.86  17.47 17.470090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
27886  Amputation follow-up surgery                      A  10.02   7.80NA   7.80    2.14  19.96 19.960090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27888  Amputation of foot at ankle                       A  10.37   7.97NA   7.97    1.93  20.27 20.270090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
27889  Amputation of foot at ankle                       A  10.86   6.32NA   6.32    2.41  19.59 19.590090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
27892  Decompression of leg                              A   7.94   6.88NA   6.88    1.63  16.45 16.450090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
27893  Decompression of leg                              A   7.90   8.66NA   8.66    1.67  18.23 18.230090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
27894  Decompression of leg                              A  12.67  10.66NA  10.66    2.67  26.00 26.000090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
27899  Leg/ankle surgery procedure                       C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021011             25.0008 090 99      0.00   0.00   0.00
28001  Drainage of bursa of foot                         A   2.78   5.30     1.97    0.23   8.31  4.980010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
28002  Treatment of foot infection                       A   5.34   7.57     3.62    0.60  13.51  9.560010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
28003  Treatment of foot infection                       A   9.06  11.89     7.19    1.06  22.01 17.310090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28005  Treat foot bone lesion                            A   9.44   6.75NA   6.75    1.02  17.21 17.210090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28008  Incision of foot fascia                           A   4.59   8.05     3.69    0.41  13.05  8.690090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
28010  Incision of toe tendon                            A   2.97   3.74     3.02    0.27   6.98  6.260090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28011  Incision of toe tendons                           A   4.28   5.00     3.92    0.49   9.77  8.690090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28020  Exploration of foot joint                         A   5.15  10.66     4.98    0.67  16.48 10.800090.10.69.2120110             25.0008 090 99      0.00   0.00   0.00
28022  Exploration of foot joint                         A   4.81   9.63     4.41    0.49  14.93  9.710090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28024  Exploration of toe joint                          A   4.52   9.07     4.13    0.42  14.01  9.070090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28035  Decompression of tibia nerve                      A   5.23  10.14     4.70    0.65  16.02 10.580090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
28039  Exc foot/toe tum sc 1.5 cm/>                      A   5.42   9.80     4.58    0.54  15.76 10.540090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
28041  Exc foot/toe tum dep 1.5cm/>                      A   7.13   5.90NA   5.90    0.73  13.76 13.760090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
28043  Exc foot/toe tum sc < 1.5 cm                      A   3.96   7.87     3.51    0.39  12.22  7.860090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
28045  Exc foot/toe tum deep <1.5cm                      A   5.45   9.08     4.39    0.56  15.09 10.400090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
28046  Resect foot/toe tumor < 3 cm                      A  12.38   7.75NA   7.75    1.66  21.79 21.790090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
28047  Resect foot/toe tumor 3 cm/>                      A  17.45  11.29NA  11.29    1.33  30.07 30.070090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28050  Biopsy of foot joint lining                       A   4.39   8.15     3.59    0.39  12.93  8.370090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
28052  Biopsy of foot joint lining                       A   4.06   8.96     3.90    0.49  13.51  8.450090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
28054  Biopsy of toe joint lining                        A   3.57   7.57     3.17    0.27  11.41  7.010090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
28055  Neurectomy foot                                   A   6.29   4.32NA   4.32    0.53  11.14 11.140090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
28060  Partial removal foot fascia                       A   5.40   9.80     4.67    0.54  15.74 10.610090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
28062  Removal of foot fascia                            A   6.69  10.42     4.77    0.60  17.71 12.060090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
28070  Removal of foot joint lining                      A   5.24  10.43     4.77    0.56  16.23 10.570090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28072  Removal of foot joint lining                      A   4.72  10.19     4.61    0.64  15.55  9.970090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28080  Removal of foot lesion                            A   4.86  10.72     5.69    0.48  16.06 11.030090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
28086  Excise foot tendon sheath                         A   4.92  11.08     5.15    0.72  16.72 10.790090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28088  Excise foot tendon sheath                         A   3.98  10.35     4.57    0.54  14.87  9.090090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
28090  Removal of foot lesion                            A   4.55   9.34     4.17    0.48  14.37  9.200090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
28092  Removal of toe lesions                            A   3.78   8.87     3.93    0.39  13.04  8.100090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28100  Removal of ankle/heel lesion                      A   5.83  12.07     5.75    0.76  18.66 12.340090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28102  Remove/graft foot lesion                          A   7.92   8.54NA   8.54    0.61  17.07 17.070090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
28103  Remove/graft foot lesion                          A   6.67   4.41NA   4.41    0.50  11.58 11.580090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
28104  Removal of foot lesion                            A   5.26   9.99     4.54    0.54  15.79 10.340090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
28106  Remove/graft foot lesion                          A   7.35   5.56NA   5.56    0.56  13.47 13.470090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
28107  Remove/graft foot lesion                          A   5.73   9.45     4.17    0.42  15.60 10.320090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
28108  Removal of toe lesions                            A   4.30   8.68     3.88    0.38  13.36  8.560090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28110  Part removal of metatarsal                        A   4.22   9.52     4.00    0.41  14.15  8.630090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
28111  Part removal of metatarsal                        A   5.15   9.62     4.14    0.60  15.37  9.890090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
28112  Part removal of metatarsal                        A   4.63   9.92     4.26    0.52  15.07  9.410090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
28113  Part removal of metatarsal                        A   6.11  11.31     6.01    0.63  18.05 12.750090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
28114  Removal of metatarsal heads                       A  12.00  18.87    11.34    1.65  32.52 24.990090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28116  Revision of foot                                  A   9.14  13.11     7.06    0.95  23.20 17.150090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
28118  Removal of heel bone                              A   6.13  11.23     5.45    0.75  18.11 12.330090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28119  Removal of heel spur                              A   5.56   9.89     4.65    0.53  15.98 10.740090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
28120  Part removal of ankle/heel                        A   7.31  12.33     6.58    1.01  20.65 14.900090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
28122  Partial removal of foot bone                      A   6.76  10.74     5.66    0.72  18.22 13.140090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28124  Partial removal of toe                            A   5.00   9.03     4.39    0.42  14.45  9.810090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
28126  Partial removal of toe                            A   3.64   8.11     3.44    0.34  12.09  7.420090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28130  Removal of ankle bone                             A   9.50  10.31NA  10.31    1.86  21.67 21.670090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28140  Removal of metatarsal                             A   7.14  10.15     5.09    0.90  18.19 13.130090.10.69.2120110             25.0008 090 99      0.00   0.00   0.00
28150  Removal of toe                                    A   4.23   8.40     3.74    0.42  13.05  8.390090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28153  Partial removal of toe                            A   3.80   8.52     3.78    0.37  12.69  7.950090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28160  Partial removal of toe                            A   3.88   8.57     3.79    0.38  12.83  8.050090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28171  Resect tarsal tumor                               A  16.41   7.27NA   7.27    1.25  24.93 24.930090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
28173  Resect metatarsal tumor                           A  14.16   7.16NA   7.16    1.57  22.89 22.890090.10.69.2120110             25.0008 090 99      0.00   0.00   0.00
28175  Resect phalanx of toe tumor                       A   8.29   5.45NA   5.45    0.80  14.54 14.540090.10.69.2120110             25.0008 090 99      0.00   0.00   0.00
28190  Removal of foot foreign body                      A   2.01   5.66     1.79    0.20   7.87  4.000010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
28192  Removal of foot foreign body                      A   4.78   9.15     4.15    0.49  14.42  9.420090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
28193  Removal of foot foreign body                      A   5.90   9.78     4.59    0.56  16.24 11.050090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
28200  Repair of foot tendon                             A   4.74   9.57     4.27    0.45  14.76  9.460090.10.69.2120110             25.0008 090 99      0.00   0.00   0.00
28202  Repair/graft of foot tendon                       A   7.07  10.24     4.86    0.64  17.95 12.570090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
28208  Repair of foot tendon                             A   4.51   9.27     4.20    0.49  14.27  9.200090.10.69.2120110             25.0008 090 99      0.00   0.00   0.00
28210  Repair/graft of foot tendon                       A   6.52  10.39     5.07    0.64  17.55 12.230090.10.69.2120200             25.0008 090 99      0.00   0.00   0.00
28220  Release of foot tendon                            A   4.67   8.53     3.86    0.41  13.61  8.940090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
28222  Release of foot tendons                           A   5.76   9.21     4.17    0.50  15.47 10.430090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
28225  Release of foot tendon                            A   3.78   8.43     3.63    0.35  12.56  7.760090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
28226  Release of foot tendons                           A   4.67  13.13     6.18    0.35  18.15 11.200090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
28230  Incision of foot tendon(s)                        A   4.36   8.36     3.61    0.39  13.11  8.360090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
28232  Incision of toe tendon                            A   3.51   8.07     3.46    0.34  11.92  7.310090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28234  Incision of foot tendon                           A   3.54   8.68     4.05    0.35  12.57  7.940090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28238  Revision of foot tendon                           A   7.96  11.34     5.55    0.86  20.16 14.370090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28240  Release of big toe                                A   4.48   8.34     3.64    0.44  13.26  8.560090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
28250  Revision of foot fascia                           A   6.06  10.76     5.18    0.76  17.58 12.000090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28260  Release of midfoot joint                          A   8.19  11.20     5.75    1.03  20.42 14.970090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28261  Revision of foot tendon                           A  13.11  14.53     8.15    1.28  28.92 22.540090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
28262  Revision of foot and ankle                        A  17.21  23.59    14.43    3.01  43.81 34.650090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28264  Release of midfoot joint                          A  10.65  17.73    10.05    0.82  29.20 21.520090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
28270  Release of foot contracture                       A   4.93   9.58     4.55    0.50  15.01  9.980090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
28272  Release of toe joint each                         A   3.92   7.73     3.31    0.31  11.96  7.540090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
28280  Fusion of toes                                    A   5.33   9.96     4.57    0.60  15.89 10.500090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
28285  Repair of hammertoe                               A   5.62  10.03     5.05    0.53  16.18 11.200090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
28286  Repair of hammertoe                               A   4.70   8.67     3.83    0.39  13.76  8.920090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
28288  Partial removal of foot bone                      A   6.02  11.71     6.15    0.67  18.40 12.840090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28289  Repair hallux rigidus                             A   8.31  13.04     7.07    1.01  22.36 16.390090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28290  Correction of bunion                              A   5.83  11.39     5.24    0.69  17.91 11.760090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
28292  Correction of bunion                              A   9.05  13.96     7.99    0.87  23.88 17.910090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28293  Correction of bunion                              A  11.48  19.14     8.60    0.95  31.57 21.030090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28294  Correction of bunion                              A   8.75  12.90     6.12    0.93  22.58 15.800090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28296  Correction of bunion                              A   8.35  12.40     6.33    0.76  21.51 15.440090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28297  Correction of bunion                              A   9.43  14.17     6.79    1.18  24.78 17.400090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28298  Correction of bunion                              A   8.13  12.86     6.00    0.87  21.86 15.000090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28299  Correction of bunion                              A  11.57  14.15     7.22    1.14  26.86 19.930090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28300  Incision of heel bone                             A   9.73   8.24NA   8.24    1.61  19.58 19.580090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28302  Incision of ankle bone                            A   9.74   9.56NA   9.56    1.92  21.22 21.220090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28304  Incision of midfoot bones                         A   9.41  13.92     7.07    1.21  24.54 17.690090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28305  Incise/graft midfoot bones                        A  10.77   7.72NA   7.72    0.82  19.31 19.310090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28306  Incision of metatarsal                            A   6.00  11.98     5.27    0.83  18.81 12.100090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28307  Incision of metatarsal                            A   6.50  13.70     6.14    1.28  21.48 13.920090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
28308  Incision of metatarsal                            A   5.48  11.05     5.10    0.61  17.14 11.190090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28309  Incision of metatarsals                           A  14.16  10.23NA  10.23    2.10  26.49 26.490090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
28310  Revision of big toe                               A   5.57  10.44     4.47    0.54  16.55 10.580090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
28312  Revision of toe                                   A   4.69  10.40     4.34    0.50  15.59  9.530090.10.69.2120110             25.0008 090 99      0.00   0.00   0.00
28313  Repair deformity of toe                           A   5.15  10.15     4.80    0.69  15.99 10.640090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28315  Removal of sesamoid bone                          A   5.00   9.14     4.18    0.49  14.63  9.670090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
28320  Repair of foot bones                              A   9.37   7.50NA   7.50    1.39  18.26 18.260090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28322  Repair of metatarsals                             A   8.53  14.09     7.37    1.31  23.93 17.210090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
28340  Resect enlarged toe tissue                        A   7.15   9.77     4.53    0.54  17.46 12.220090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28341  Resect enlarged toe                               A   8.72  10.83     5.15    0.67  20.22 14.540090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28344  Repair extra toe(s)                               A   4.40   8.24     3.60    0.34  12.98  8.340090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
28345  Repair webbed toe(s)                              A   6.09   9.25     4.26    0.45  15.79 10.800090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
28360  Reconstruct cleft foot                            A  14.92  14.33NA  14.33    3.18  32.43 32.430090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
28400  Treatment of heel fracture                        A   2.31   4.93     4.26    0.37   7.61  6.940090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
28405  Treatment of heel fracture                        A   4.74   5.99     4.91    0.65  11.38 10.300090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
28406  Treatment of heel fracture                        A   6.56   8.02NA   8.02    1.17  15.75 15.750090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
28415  Treat heel fracture                               A  16.19  14.03NA  14.03    2.83  33.05 33.050090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28420  Treat/graft heel fracture                         A  17.52  16.23NA  16.23    3.46  37.21 37.210090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28430  Treatment of ankle fracture                       A   2.22   4.59     3.76    0.35   7.16  6.330090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
28435  Treatment of ankle fracture                       A   3.54   6.61     5.42    0.69  10.84  9.650090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
28436  Treatment of ankle fracture                       A   4.90   7.62NA   7.62    0.98  13.50 13.500090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
28445  Treat ankle fracture                              A  15.76  13.12NA  13.12    2.78  31.66 31.660090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28446  Osteochondral talus autogrft                      A  17.71  15.05NA  15.05    3.50  36.26 36.260090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28450  Treat midfoot fracture each                       A   2.03   4.23     3.49    0.30   6.56  5.820090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28455  Treat midfoot fracture each                       A   3.24   4.16     3.39    0.44   7.84  7.070090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
28456  Treat midfoot fracture                            A   2.86   6.24NA   6.24    0.56   9.66  9.660090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28465  Treat midfoot fracture each                       A   8.80   8.02NA   8.02    1.27  18.09 18.090090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28470  Treat metatarsal fracture                         A   2.03   4.35     3.89    0.33   6.71  6.250090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28475  Treat metatarsal fracture                         A   3.01   4.27     3.37    0.38   7.66  6.760090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28476  Treat metatarsal fracture                         A   3.60   6.29NA   6.29    0.53  10.42 10.420090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
28485  Treat metatarsal fracture                         A   7.44   7.32NA   7.32    0.95  15.71 15.710090.10.69.2120110             25.0008 090 99      0.00   0.00   0.00
28490  Treat big toe fracture                            A   1.17   3.13     2.49    0.16   4.46  3.820090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
28495  Treat big toe fracture                            A   1.68   3.53     2.65    0.20   5.41  4.530090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
28496  Treat big toe fracture                            A   2.48  11.04     4.35    0.35  13.87  7.180090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
28505  Treat big toe fracture                            A   7.44  11.84     6.50    0.93  20.21 14.870090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
28510  Treatment of toe fracture                         A   1.17   2.44     2.34    0.14   3.75  3.650090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28515  Treatment of toe fracture                         A   1.56   3.16     2.57    0.18   4.90  4.310090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28525  Treat toe fracture                                A   5.62  10.98     5.64    0.71  17.31 11.970090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
28530  Treat sesamoid bone fracture                      A   1.11   2.25     1.85    0.11   3.47  3.070090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
28531  Treat sesamoid bone fracture                      A   2.57   7.73     2.68    0.50  10.80  5.750090.10.69.2121120             25.0008 090 99      0.00   0.00   0.00
28540  Treat foot dislocation                            A   2.19   3.42     2.85    0.22   5.83  5.260090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
28545  Treat foot dislocation                            A   2.60   5.85     4.79    0.50   8.95  7.890090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
28546  Treat foot dislocation                            A   3.40  13.52     6.07    0.67  17.59 10.140090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
28555  Repair foot dislocation                           A   9.65  15.44     8.69    1.61  26.70 19.950090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28570  Treat foot dislocation                            A   1.76   3.00     2.28    0.12   4.88  4.160090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
28575  Treat foot dislocation                            A   3.49   6.84     5.74    0.68  11.01  9.910090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
28576  Treat foot dislocation                            A   4.60   6.34NA   6.34    0.90  11.84 11.840090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
28585  Repair foot dislocation                           A  11.13  13.67     7.74    1.65  26.45 20.520090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28600  Treat foot dislocation                            A   2.02   3.35     2.58    0.29   5.66  4.890090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
28605  Treat foot dislocation                            A   2.89   6.45     5.42    0.56   9.90  8.870090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
28606  Treat foot dislocation                            A   5.09   5.92NA   5.92    0.84  11.85 11.850090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28615  Repair foot dislocation                           A  10.70  11.09NA  11.09    1.77  23.56 23.560090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
28630  Treat toe dislocation                             A   1.75   2.78     1.29    0.23   4.76  3.270010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
28635  Treat toe dislocation                             A   1.96   3.05     1.71    0.22   5.23  3.890010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
28636  Treat toe dislocation                             A   2.77   6.00     2.65    0.39   9.16  5.810010.10.80.1020120             25.0008 090 99      0.00   0.00   0.00
28645  Repair toe dislocation                            A   7.44  11.69     6.20    0.80  19.93 14.440090.10.69.2120110             25.0008 090 99      0.00   0.00   0.00
28660  Treat toe dislocation                             A   1.28   2.06     1.19    0.20   3.54  2.670010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
28665  Treat toe dislocation                             A   1.97   2.47     1.74    0.24   4.68  3.950010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
28666  Treat toe dislocation                             A   2.66   2.61NA   2.61    0.52   5.79  5.790010.10.80.1020120             25.0008 090 99      0.00   0.00   0.00
28675  Repair of toe dislocation                         A   5.62  11.24     5.84    0.75  17.61 12.210090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28705  Fusion of foot bones                              A  20.33  14.38NA  14.38    3.46  38.17 38.170090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28715  Fusion of foot bones                              A  13.42  12.14NA  12.14    2.28  27.84 27.840090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28725  Fusion of foot bones                              A  11.22  10.14NA  10.14    1.73  23.09 23.090090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28730  Fusion of foot bones                              A  10.70   9.53NA   9.53    1.65  21.88 21.880090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28735  Fusion of foot bones                              A  12.23   9.26NA   9.26    1.78  23.27 23.270090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28737  Revision of foot bones                            A  11.03   8.22NA   8.22    1.28  20.53 20.530090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28740  Fusion of foot bones                              A   9.29  15.11     7.99    1.36  25.76 18.640090.10.69.2120210             25.0008 090 99      0.00   0.00   0.00
28750  Fusion of big toe joint                           A   8.57  15.12     7.95    1.31  25.00 17.830090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
28755  Fusion of big toe joint                           A   4.88  10.09     4.43    0.52  15.49  9.830090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
28760  Fusion of big toe joint                           A   9.14  13.46     6.83    1.05  23.65 17.020090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28800  Amputation of midfoot                             A   8.79   6.31NA   6.31    1.31  16.41 16.410090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
28805  Amputation thru metatarsal                        A  12.71   7.32NA   7.32    2.14  22.17 22.170090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
28810  Amputation toe & metatarsal                       A   6.64   5.32NA   5.32    1.18  13.14 13.140090.10.69.2120000             25.0008 090 99      0.00   0.00   0.00
28820  Amputation of toe                                 A   5.82  10.82     5.35    0.85  17.49 12.020090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28825  Partial amputation of toe                         A   5.37  10.51     5.10    0.75  16.63 11.220090.10.69.2120100             25.0008 090 99      0.00   0.00   0.00
28890  Hi enrgy eswt plantar fascia                      A   3.45   6.10     2.96    0.35   9.90  6.760090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
28899  Foot/toes surgery procedure                       C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 090 99      0.00   0.00   0.00
29000  Application of body cast                          A   2.25   5.96     2.45    0.18   8.39  4.880000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
29010  Application of body cast                          A   2.06   4.78     1.97    0.39   7.23  4.420000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
29015  Application of body cast                          A   2.41   6.04     2.54    0.41   8.86  5.360000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
29020  Application of body cast                          A   2.11   3.99     1.68    0.08   6.18  3.870000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
29025  Application of body cast                          A   2.40   6.02     2.53    0.48   8.90  5.410000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
29035  Application of body cast                          A   1.77   4.65     1.83    0.34   6.76  3.940000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
29040  Application of body cast                          A   2.22   4.26     1.80    0.42   6.90  4.440000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
29044  Application of body cast                          A   2.12   6.22     2.49    0.41   8.75  5.020000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
29046  Application of body cast                          A   2.41   5.15     2.18    0.48   8.04  5.070000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
29049  Application of figure eight                       A   0.89   1.93     1.03    0.18   3.00  2.100000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
29055  Application of shoulder cast                      A   1.78   4.64     2.01    0.35   6.77  4.140000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
29058  Application of shoulder cast                      A   1.31   2.16     1.25    0.23   3.70  2.790000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
29065  Application of long arm cast                      A   0.87   1.89     1.02    0.16   2.92  2.050000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29075  Application of forearm cast                       A   0.77   1.72     0.96    0.14   2.63  1.870000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29085  Apply hand/wrist cast                             A   0.87   1.86     1.00    0.14   2.87  2.010000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29086  Apply finger cast                                 A   0.62   1.69     0.84    0.08   2.39  1.540000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29105  Apply long arm splint                             A   0.87   1.65     0.77    0.14   2.66  1.780000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29125  Apply forearm splint                              A   0.50   1.40     0.61    0.08   1.98  1.190000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29126  Apply forearm splint                              A   0.68   1.56     0.68    0.10   2.34  1.460000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29130  Application of finger splint                      A   0.50   0.66     0.27    0.07   1.23  0.840000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29131  Application of finger splint                      A   0.55   0.94     0.37    0.08   1.57  1.000000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29200  Strapping of chest                                A   0.65   0.89     0.48    0.05   1.59  1.180000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
29240  Strapping of shoulder                             A   0.71   0.96     0.54    0.05   1.72  1.300000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29260  Strapping of elbow or wrist                       A   0.55   0.96     0.52    0.05   1.56  1.120000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29280  Strapping of hand or finger                       A   0.51   0.98     0.53    0.04   1.53  1.080000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29305  Application of hip cast                           A   2.03   5.08     2.33    0.39   7.50  4.750000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
29325  Application of hip casts                          A   2.32   5.52     2.56    0.45   8.29  5.330000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
29345  Application of long leg cast                      A   1.40   2.46     1.35    0.27   4.13  3.020000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29355  Application of long leg cast                      A   1.53   2.46     1.38    0.29   4.28  3.200000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29358  Apply long leg cast brace                         A   1.43   3.15     1.38    0.29   4.87  3.100000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29365  Application of long leg cast                      A   1.18   2.32     1.22    0.23   3.73  2.630000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29405  Apply short leg cast                              A   0.80   1.56     0.88    0.11   2.47  1.790000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29425  Apply short leg cast                              A   0.80   1.47     0.79    0.10   2.37  1.690000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29435  Apply short leg cast                              A   1.18   2.22     1.13    0.23   3.63  2.540000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29440  Addition of walker to cast                        A   0.57   0.69     0.23    0.08   1.34  0.880000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29445  Apply rigid leg cast                              A   1.78   2.08     1.11    0.24   4.10  3.130000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29450  Application of leg cast                           A   2.08   2.01     1.05    0.22   4.31  3.350000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29505  Application long leg splint                       A   0.69   1.74     0.70    0.11   2.54  1.500000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29515  Application lower leg splint                      A   0.73   1.35     0.66    0.10   2.18  1.490000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29520  Strapping of hip                                  A   0.54   0.88     0.47    0.04   1.46  1.050000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
29530  Strapping of knee                                 A   0.57   0.96     0.51    0.05   1.58  1.130000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29540  Strapping of ankle and/or ft                      A   0.39   0.69     0.35    0.03   1.11  0.770000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29550  Strapping of toes                                 A   0.25   0.69     0.32    0.01   0.95  0.580000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29580  Application of paste boot                         A   0.55   0.97     0.44    0.07   1.59  1.060000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29581  Apply multlay comprs lwr leg                      A   0.25   1.63     0.11    0.01   1.89  0.370000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
29582  Apply multlay comprs upr leg                      A   0.35   1.78     0.09    0.01   2.14  0.450000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
29583  Apply multlay comprs upr arm                      A   0.25   1.07     0.07    0.01   1.33  0.330000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
29584  Appl multlay comprs arm/hand                      A   0.35   1.78     0.09    0.01   2.14  0.450000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
29700  Removal/revision of cast                          A   0.57   1.33     0.33    0.10   2.00  1.000000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
29705  Removal/revision of cast                          A   0.76   1.12     0.50    0.12   2.00  1.380000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
29710  Removal/revision of cast                          A   1.34   2.10     0.86    0.27   3.71  2.470000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
29715  Removal/revision of cast                          A   0.94   1.35     0.49    0.12   2.41  1.550000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
29720  Repair of body cast                               A   0.68   1.73     0.48    0.12   2.53  1.280000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
29730  Windowing of cast                                 A   0.75   1.10     0.47    0.11   1.96  1.330000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
29740  Wedging of cast                                   A   1.12   1.51     0.65    0.18   2.81  1.950000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
29750  Wedging of clubfoot cast                          A   1.26   1.70     0.80    0.26   3.22  2.320000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
29799  Casting/strapping procedure                       C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 090 99      0.00   0.00   0.00
29800  Jaw arthroscopy/surgery                           A   6.84   7.12NA   7.12    1.33  15.29 15.290090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
29804  Jaw arthroscopy/surgery                           A   8.87   8.76NA   8.76    1.74  19.37 19.370090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
29805  Shoulder arthroscopy dx                           A   6.03   6.86NA   6.86    1.18  14.07 14.070090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
29806  Shoulder arthroscopy/surgery                      A  15.14  13.39NA  13.39    2.98  31.51 31.510090.10.69.2131110       29805 25.0008 090 99      0.00   0.00   0.00
29807  Shoulder arthroscopy/surgery                      A  14.67  13.18NA  13.18    2.87  30.72 30.720090.10.69.2131110       29805 25.0008 090 99      0.00   0.00   0.00
29819  Shoulder arthroscopy/surgery                      A   7.79   8.16NA   8.16    1.52  17.47 17.470090.10.69.2131110       29805 25.0008 090 99      0.00   0.00   0.00
29820  Shoulder arthroscopy/surgery                      A   7.21   7.47NA   7.47    1.40  16.08 16.080090.10.69.2131210       29805 25.0008 090 99      0.00   0.00   0.00
29821  Shoulder arthroscopy/surgery                      A   7.89   8.11NA   8.11    1.55  17.55 17.550090.10.69.2131210       29805 25.0008 090 99      0.00   0.00   0.00
29822  Shoulder arthroscopy/surgery                      A   7.60   8.04NA   8.04    1.50  17.14 17.140090.10.69.2131200       29805 25.0008 090 99      0.00   0.00   0.00
29823  Shoulder arthroscopy/surgery                      A   8.36   8.71NA   8.71    1.63  18.70 18.700090.10.69.2131210       29805 25.0008 090 99      0.00   0.00   0.00
29824  Shoulder arthroscopy/surgery                      A   8.98   9.45NA   9.45    1.77  20.20 20.200090.10.69.2131210       29805 25.0008 090 99      0.00   0.00   0.00
29825  Shoulder arthroscopy/surgery                      A   7.79   8.14NA   8.14    1.52  17.45 17.450090.10.69.2131210       29805 25.0008 090 99      0.00   0.00   0.00
29826  Shoulder arthroscopy/surgery                      A   3.00   1.60NA   1.60    0.59   5.19  5.190ZZZ.00.00.0001210             25.0008 090 99      0.00   0.00   0.00
29827  Arthroscop rotator cuff repr                      A  15.59  13.23NA  13.23    3.08  31.90 31.900090.10.69.2131210       29805 25.0008 090 99      0.00   0.00   0.00
29828  Arthroscopy biceps tenodesis                      A  13.16  11.71NA  11.71    2.59  27.46 27.460090.10.69.2131210       29805 25.0008 090 99      0.00   0.00   0.00
29830  Elbow arthroscopy                                 A   5.88   6.48NA   6.48    1.17  13.53 13.530090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
29834  Elbow arthroscopy/surgery                         A   6.42   6.97NA   6.97    1.22  14.61 14.610090.10.69.2131210       29830 25.0008 090 99      0.00   0.00   0.00
29835  Elbow arthroscopy/surgery                         A   6.62   7.18NA   7.18    1.29  15.09 15.090090.10.69.2131210       29830 25.0008 090 99      0.00   0.00   0.00
29836  Elbow arthroscopy/surgery                         A   7.72   7.90NA   7.90    1.52  17.14 17.140090.10.69.2131210       29830 25.0008 090 99      0.00   0.00   0.00
29837  Elbow arthroscopy/surgery                         A   7.01   7.40NA   7.40    1.36  15.77 15.770090.10.69.2131210       29830 25.0008 090 99      0.00   0.00   0.00
29838  Elbow arthroscopy/surgery                         A   7.88   8.18NA   8.18    1.50  17.56 17.560090.10.69.2131000       29830 25.0008 090 99      0.00   0.00   0.00
29840  Wrist arthroscopy                                 A   5.68   6.68NA   6.68    1.13  13.49 13.490090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
29843  Wrist arthroscopy/surgery                         A   6.15   7.06NA   7.06    1.21  14.42 14.420090.10.69.2131210       29840 25.0008 090 99      0.00   0.00   0.00
29844  Wrist arthroscopy/surgery                         A   6.51   7.11NA   7.11    1.18  14.80 14.800090.10.69.2131200       29840 25.0008 090 99      0.00   0.00   0.00
29845  Wrist arthroscopy/surgery                         A   7.69   8.13NA   8.13    1.37  17.19 17.190090.10.69.2131210       29840 25.0008 090 99      0.00   0.00   0.00
29846  Wrist arthroscopy/surgery                         A   6.89   7.34NA   7.34    1.22  15.45 15.450090.10.69.2131000       29840 25.0008 090 99      0.00   0.00   0.00
29847  Wrist arthroscopy/surgery                         A   7.22   7.51NA   7.51    1.42  16.15 16.150090.10.69.2131200       29840 25.0008 090 99      0.00   0.00   0.00
29848  Wrist endoscopy/surgery                           A   6.39   7.63NA   7.63    1.17  15.19 15.190090.10.69.2121100             25.0008 090 99      0.00   0.00   0.00
29850  Knee arthroscopy/surgery                          A   8.27   8.66NA   8.66    1.62  18.55 18.550090.10.69.2121020             25.0008 090 99      0.00   0.00   0.00
29851  Knee arthroscopy/surgery                          A  13.26  11.75NA  11.75    2.61  27.62 27.620090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
29855  Tibial arthroscopy/surgery                        A  10.76  10.50NA  10.50    2.12  23.38 23.380090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
29856  Tibial arthroscopy/surgery                        A  14.28  12.42NA  12.42    2.83  29.53 29.530090.10.69.2121220             25.0008 090 99      0.00   0.00   0.00
29860  Hip arthroscopy dx                                A   9.00   9.05NA   9.05    1.78  19.83 19.830090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
29861  Hip arthro w/fb removal                           A  10.10   9.54NA   9.54    1.97  21.61 21.610090.10.69.2131210       29860 25.0008 090 99      0.00   0.00   0.00
29862  Hip arthr0 w/debridement                          A  11.17  11.00NA  11.00    2.19  24.36 24.360090.10.69.2131210       29860 25.0008 090 99      0.00   0.00   0.00
29863  Hip arthr0 w/synovectomy                          A  11.17  11.00NA  11.00    2.20  24.37 24.370090.10.69.2131210       29860 25.0008 090 99      0.00   0.00   0.00
29866  Autgrft implnt knee w/scope                       A  14.67  13.57NA  13.57    2.91  31.15 31.150090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
29867  Allgrft implnt knee w/scope                       A  18.39  15.88NA  15.88    3.62  37.89 37.890090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
29868  Meniscal trnspl knee w/scpe                       A  25.10  19.47NA  19.47    4.95  49.52 49.520090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
29870  Knee arthroscopy dx                               A   5.19  11.50     6.11    1.02  17.71 12.320090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
29871  Knee arthroscopy/drainage                         A   6.69   7.33NA   7.33    1.31  15.33 15.330090.10.69.2131100       29870 25.0008 090 99      0.00   0.00   0.00
29873  Knee arthroscopy/surgery                          A   6.24   8.23NA   8.23    1.22  15.69 15.690090.10.69.2131110       29870 25.0008 090 99      0.00   0.00   0.00
29874  Knee arthroscopy/surgery                          A   7.19   7.45NA   7.45    1.40  16.04 16.040090.10.69.2131000       29870 25.0008 090 99      0.00   0.00   0.00
29875  Knee arthroscopy/surgery                          A   6.45   7.07NA   7.07    1.27  14.79 14.790090.10.69.2131000       29870 25.0008 090 99      0.00   0.00   0.00
29876  Knee arthroscopy/surgery                          A   8.87   8.94NA   8.94    1.74  19.55 19.550090.10.69.2131100       29870 25.0008 090 99      0.00   0.00   0.00
29877  Knee arthroscopy/surgery                          A   8.30   8.65NA   8.65    1.62  18.57 18.570090.10.69.2131000       29870 25.0008 090 99      0.00   0.00   0.00
29879  Knee arthroscopy/surgery                          A   8.99   9.01NA   9.01    1.77  19.77 19.770090.10.69.2131000       29870 25.0008 090 99      0.00   0.00   0.00
29880  Knee arthroscopy/surgery                          A   7.39   7.98NA   7.98    1.45  16.82 16.820090.10.69.2131010       29870 25.0008 090 99      0.00   0.00   0.00
29881  Knee arthroscopy/surgery                          A   7.03   7.79NA   7.79    1.37  16.19 16.190090.10.69.2131000       29870 25.0008 090 99      0.00   0.00   0.00
29882  Knee arthroscopy/surgery                          A   9.60   9.35NA   9.35    1.89  20.84 20.840090.10.69.2131100       29870 25.0008 090 99      0.00   0.00   0.00
29883  Knee arthroscopy/surgery                          A  11.77  10.91NA  10.91    2.30  24.98 24.980090.10.69.2131000       29870 25.0008 090 99      0.00   0.00   0.00
29884  Knee arthroscopy/surgery                          A   8.28   8.61NA   8.61    1.62  18.51 18.510090.10.69.2131210       29870 25.0008 090 99      0.00   0.00   0.00
29885  Knee arthroscopy/surgery                          A  10.21  10.15NA  10.15    2.00  22.36 22.360090.10.69.2131210       29870 25.0008 090 99      0.00   0.00   0.00
29886  Knee arthroscopy/surgery                          A   8.49   8.76NA   8.76    1.66  18.91 18.910090.10.69.2131100       29870 25.0008 090 99      0.00   0.00   0.00
29887  Knee arthroscopy/surgery                          A  10.16  10.13NA  10.13    1.99  22.28 22.280090.10.69.2131210       29870 25.0008 090 99      0.00   0.00   0.00
29888  Knee arthroscopy/surgery                          A  14.30  12.27NA  12.27    2.80  29.37 29.370090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
29889  Knee arthroscopy/surgery                          A  17.41  15.41NA  15.41    3.42  36.24 36.240090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
29891  Ankle arthroscopy/surgery                         A   9.67   8.93NA   8.93    1.65  20.25 20.250090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
29892  Ankle arthroscopy/surgery                         A  10.27   6.04NA   6.04    2.01  18.32 18.320090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
29893  Scope plantar fasciotomy                          A   6.32  11.71     5.92    0.50  18.53 12.740090.10.69.2121110             25.0008 090 99      0.00   0.00   0.00
29894  Ankle arthroscopy/surgery                         A   7.35   6.90NA   6.90    1.22  15.47 15.470090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
29895  Ankle arthroscopy/surgery                         A   7.13   6.09NA   6.09    1.13  14.35 14.350090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
29897  Ankle arthroscopy/surgery                         A   7.32   6.76NA   6.76    1.24  15.32 15.320090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
29898  Ankle arthroscopy/surgery                         A   8.49   7.07NA   7.07    1.29  16.85 16.850090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
29899  Ankle arthroscopy/surgery                         A  15.41  12.94NA  12.94    2.87  31.22 31.220090.10.69.2121210             25.0008 090 99      0.00   0.00   0.00
29900  Mcp joint arthroscopy dx                          A   5.88   7.10NA   7.10    0.41  13.39 13.390090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
29901  Mcp joint arthroscopy surg                        A   6.59   8.02NA   8.02    1.29  15.90 15.900090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
29902  Mcp joint arthroscopy surg                        A   7.16   8.32NA   8.32    2.57  18.05 18.050090.10.69.2121000             25.0008 090 99      0.00   0.00   0.00
29904  Subtalar arthro w/fb rmvl                         A   8.65   8.60NA   8.60    1.69  18.94 18.940090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
29905  Subtalar arthro w/exc                             A   9.18   9.55NA   9.55    1.81  20.54 20.540090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
29906  Subtalar arthro w/deb                             A   9.65   9.47NA   9.47    1.89  21.01 21.010090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
29907  Subtalar arthro w/fusion                          A  12.18  11.43NA  11.43    2.40  26.01 26.010090.10.69.2121200             25.0008 090 99      0.00   0.00   0.00
29914  Hip arthro w/femoroplasty                         A  14.67  12.42NA  12.42    2.91  30.00 30.000090.10.69.2131210       29860 25.0008 090 99      0.00   0.00   0.00
29915  Hip arthro acetabuloplasty                        A  15.00  12.65NA  12.65    2.95  30.60 30.600090.10.69.2131210       29860 25.0008 090 99      0.00   0.00   0.00
29916  Hip arthro w/labral repair                        A  15.00  12.68NA  12.68    2.95  30.63 30.630090.10.69.2131210       29860 25.0008 090 99      0.00   0.00   0.00
29999  Arthroscopy of joint                              C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021011             25.0008 090 99      0.00   0.00   0.00
30000  Drainage of nose lesion                           A   1.48   5.44     1.88    0.22   7.14  3.580010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
30020  Drainage of nose lesion                           A   1.48   5.56     1.92    0.20   7.24  3.600010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
3006F  Cxr doc rev                                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3008F  Body mass index docd                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
30100  Intranasal biopsy                                 A   0.94   3.33     1.02    0.11   4.38  2.070000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
3011F  Lipid panel doc rev                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
30110  Removal of nose polyp(s)                          A   1.68   5.20     2.02    0.23   7.11  3.930010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
30115  Removal of nose polyp(s)                          A   4.44   8.06NA   8.06    0.56  13.06 13.060090.10.76.1421100             25.0008 090 99      0.00   0.00   0.00
30117  Removal of intranasal lesion                      A   3.26  23.72     6.60    0.41  27.39 10.270090.10.76.1420100             25.0008 090 99      0.00   0.00   0.00
30118  Removal of intranasal lesion                      A   9.92  11.64NA  11.64    1.31  22.87 22.870090.10.76.1420110             25.0008 090 99      0.00   0.00   0.00
30120  Revision of nose                                  A   5.39   9.52     6.97    0.84  15.75 13.200090.10.76.1420100             25.0008 090 99      0.00   0.00   0.00
30124  Removal of nose lesion                            A   3.20   5.03NA   5.03    0.41   8.64  8.640090.10.76.1420100             25.0008 090 99      0.00   0.00   0.00
30125  Removal of nose lesion                            A   7.30  10.08NA  10.08    0.93  18.31 18.310090.10.76.1420200             25.0008 090 99      0.00   0.00   0.00
30130  Excise inferior turbinate                         A   3.47   7.63NA   7.63    0.44  11.54 11.540090.10.76.1421100             25.0008 090 99      0.00   0.00   0.00
3014F  Screen mammo doc rev                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
30140  Resect inferior turbinate                         A   3.57   9.47NA   9.47    0.45  13.49 13.490090.10.76.1421100             25.0008 090 99      0.00   0.00   0.00
3015F  Cerv cancer screen docd                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
30150  Partial removal of nose                           A   9.55  12.08NA  12.08    1.42  23.05 23.050090.10.76.1420110             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
30160  Removal of nose                                   A   9.99  11.92NA  11.92    1.28  23.19 23.190090.10.76.1420210             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3019F  Lvef assess planpost dschrge                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3020F  Lvf assess                                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
30200  Injection treatment of nose                       A   0.78   2.66     0.92    0.10   3.54  1.800000.00.00.0020100             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
30210  Nasal sinus therapy                               A   1.13   3.35     1.74    0.14   4.62  3.010010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
3022F  Lvef >/=40% systolic                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
30220  Insert nasal septal button                        A   1.59   7.68     1.97    0.22   9.49  3.780010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
3023F  Spirom doc rev                                    M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3025F  Spirom fev/fvc <70% w/copd                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3027F  Spirom fev/fvc>/=70%/w/ocopd                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3028F  O2 saturation doc rev                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
30300  Remove nasal foreign body                         A   1.09   6.00     2.66    0.14   7.23  3.890010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
30310  Remove nasal foreign body                         A   2.01   4.01NA   4.01    0.26   6.28  6.280010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
30320  Remove nasal foreign body                         A   4.64   8.45NA   8.45    0.60  13.69 13.690090.10.76.1420000             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3037F  O2 saturation >88%/pao>55 hg                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3040F  Fev <40% predicted value                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
30400  Reconstruction of nose                            R  10.86  18.26NA  18.26    1.39  30.51 30.510090.10.76.1420000             25.0008 090 99      0.00   0.00   0.00
30410  Reconstruction of nose                            R  14.00  19.82NA  19.82    1.80  35.62 35.620090.10.76.1420200             25.0008 090 99      0.00   0.00   0.00
3042F  Fev >/=40% predicted value                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
30420  Reconstruction of nose                            R  16.90  21.90NA  21.90    2.40  41.20 41.200090.10.76.1420100             25.0008 090 99      0.00   0.00   0.00
30430  Revision of nose                                  R   8.24  16.97NA  16.97    1.62  26.83 26.830090.10.76.1420200             25.0008 090 99      0.00   0.00   0.00
30435  Revision of nose                                  R  12.73  19.19NA  19.19    1.63  33.55 33.550090.10.76.1420200             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
30450  Revision of nose                                  R  19.66  22.62NA  22.62    2.52  44.80 44.800090.10.76.1420200             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
30460  Revision of nose                                  A  10.32  12.13NA  12.13    2.01  24.46 24.460090.10.76.1420220             25.0008 090 99      0.00   0.00   0.00
30462  Revision of nose                                  A  20.28  18.76NA  18.76    4.00  43.04 43.040090.10.76.1420220             25.0008 090 99      0.00   0.00   0.00
30465  Repair nasal stenosis                             A  12.36  15.39NA  15.39    1.74  29.49 29.490090.10.76.1420000             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
30520  Repair of nasal septum                            A   7.01  10.96NA  10.96    0.90  18.87 18.870090.10.76.1420100             25.0008 090 99      0.00   0.00   0.00
30540  Repair nasal defect                               A   7.92  11.79NA  11.79    1.02  20.73 20.730090.10.76.1420200             25.0008 090 99      0.00   0.00   0.00
30545  Repair nasal defect                               A  11.62  12.86NA  12.86    0.82  25.30 25.300090.10.76.1420200             25.0008 090 99      0.00   0.00   0.00
3055F  Lvef less than/equal to 35%                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3056F  Lvef greater than 35%                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
30560  Release of nasal adhesions                        A   1.31   6.91     2.71    0.18   8.40  4.200010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
30580  Repair upper jaw fistula                          A   6.88  11.60     7.22    0.87  19.35 14.970090.10.76.1420100             25.0008 090 99      0.00   0.00   0.00
3060F  Pos microalbuminuria rev                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
30600  Repair mouth/nose fistula                         A   6.16  10.38     5.83    0.78  17.32 12.770090.10.76.1420000             25.0008 090 99      0.00   0.00   0.00
3061F  Neg microalbuminuria rev                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3062F  Pos macroalbuminuria rev                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
30620  Intranasal reconstruction                         A   6.16  12.05NA  12.05    0.88  19.09 19.090090.10.76.1420100             25.0008 090 99      0.00   0.00   0.00
30630  Repair nasal septum defect                        A   7.29  10.62NA  10.62    0.99  18.90 18.900090.10.76.1420000             25.0008 090 99      0.00   0.00   0.00
3066F  Nephropathy doc tx                                M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3072F  Low risk for retinopathy                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3074F  Syst bp lt 130 mm hg                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3075F  Syst bp ge 130 - 139mm hg                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3077F  Syst bp >/= 140 mm hg                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3078F  Diast bp <80 mm hg                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3079F  Diast bp 80-89 mm hg                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3080F  Diast bp >/= 90 mm hg                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
30801  Ablate inf turbinate superf                       A   1.14   5.84     2.94    0.14   7.12  4.220010.10.80.1022100             25.0008 090 99      0.00   0.00   0.00
30802  Ablate inf turbinate submuc                       A   2.08   6.57     3.42    0.27   8.92  5.770010.10.80.1022100             25.0008 090 99      0.00   0.00   0.00
3082F  Kt/v >1.2                                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3083F  Kt/v =/> 1.2 & <1.7                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3084F  Kt/v ge 1.7                                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3085F  Suicide risk assessed                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3088F  Mdd mild                                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3089F  Mdd moderate                                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
30901  Control of nosebleed                              A   1.10   1.62     0.40    0.16   2.88  1.660000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
30903  Control of nosebleed                              A   1.54   4.58     0.58    0.23   6.35  2.350000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
30905  Control of nosebleed                              A   1.97   5.63     0.69    0.30   7.90  2.960000.00.00.0022100             25.0008 090 99      0.00   0.00   0.00
30906  Repeat control of nosebleed                       A   2.45   5.85     1.07    0.33   8.63  3.850000.00.00.0022100             25.0008 090 99      0.00   0.00   0.00
3091F  Mdd severe w/psych                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
30915  Ligation nasal sinus artery                       A   7.44   8.88NA   8.88    0.99  17.31 17.310090.10.76.1420100             25.0008 090 99      0.00   0.00   0.00
3092F  Mdd in remission                                  M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
30920  Ligation upper jaw artery                         A  11.14  12.42NA  12.42    1.46  25.02 25.020090.10.76.1420100             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
30930  Ther fx nasal inf turbinate                       A   1.31   2.27NA   2.27    0.18   3.76  3.760010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
3095F  Central dexa results docd                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3096F  Central dexa ordered                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
30999  Nasal surgery procedure                           C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
31000  Irrigation maxillary sinus                        A   1.20   4.24     1.82    0.14   5.58  3.160010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
31002  Irrigation sphenoid sinus                         A   1.96   3.88NA   3.88    0.26   6.10  6.100010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
31020  Exploration maxillary sinus                       A   3.07  11.41     7.48    0.39  14.87 10.940090.10.76.1421100             25.0008 090 99      0.00   0.00   0.00
31030  Exploration maxillary sinus                       A   6.01  14.11     8.98    0.75  20.87 15.740090.10.76.1421100             25.0008 090 99      0.00   0.00   0.00
31032  Explore sinus remove polyps                       A   6.69   9.65NA   9.65    0.87  17.21 17.210090.10.76.1421100             25.0008 090 99      0.00   0.00   0.00
31040  Exploration behind upper jaw                      A   9.77  11.59NA  11.59    1.39  22.75 22.750090.10.76.1421110             25.0008 090 99      0.00   0.00   0.00
31050  Exploration sphenoid sinus                        A   5.37   8.55NA   8.55    0.68  14.60 14.600090.10.76.1421100             25.0008 090 99      0.00   0.00   0.00
31051  Sphenoid sinus surgery                            A   7.25  11.28NA  11.28    0.91  19.44 19.440090.10.76.1421100             25.0008 090 99      0.00   0.00   0.00
31070  Exploration of frontal sinus                      A   4.40   8.35NA   8.35    0.59  13.34 13.340090.10.76.1421100             25.0008 090 99      0.00   0.00   0.00
31075  Exploration of frontal sinus                      A   9.51  12.73NA  12.73    1.22  23.46 23.460090.10.76.1421210             25.0008 090 99      0.00   0.00   0.00
31080  Removal of frontal sinus                          A  12.74  16.53NA  16.53    1.63  30.90 30.900090.10.76.1421200             25.0008 090 99      0.00   0.00   0.00
31081  Removal of frontal sinus                          A  14.19  25.94NA  25.94    5.09  45.22 45.220090.10.76.1421210             25.0008 090 99      0.00   0.00   0.00
31084  Removal of frontal sinus                          A  14.95  17.63NA  17.63    1.92  34.50 34.500090.10.76.1421210             25.0008 090 99      0.00   0.00   0.00
31085  Removal of frontal sinus                          A  15.64  26.67NA  26.67    5.62  47.93 47.930090.10.76.1421210             25.0008 090 99      0.00   0.00   0.00
31086  Removal of frontal sinus                          A  14.36  17.33NA  17.33    1.85  33.54 33.540090.10.76.1421200             25.0008 090 99      0.00   0.00   0.00
31087  Removal of frontal sinus                          A  14.57  15.82NA  15.82    1.86  32.25 32.250090.10.76.1421210             25.0008 090 99      0.00   0.00   0.00
31090  Exploration of sinuses                            A  11.17  18.23NA  18.23    1.47  30.87 30.870090.10.76.1421100             25.0008 090 99      0.00   0.00   0.00
3110F  Pres/absn hmrhg/lesion docd                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3111F  Ct/mri brain done w/in 24hrs                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3112F  Ct/mri brain done 24 hrs                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3115F  Quant results activity +symp                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3117F  Hf assessment tool completed                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3118F  Ny heart assoc class docd                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3119F  No eval activity clin symp                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3120F  12-lead ecg performed                             M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
31200  Removal of ethmoid sinus                          A   5.14  11.51NA  11.51    0.73  17.38 17.380090.10.76.1421100             25.0008 090 99      0.00   0.00   0.00
31201  Removal of ethmoid sinus                          A   8.60  12.65NA  12.65    1.14  22.39 22.390090.10.76.1421100             25.0008 090 99      0.00   0.00   0.00
31205  Removal of ethmoid sinus                          A  10.58  15.11NA  15.11    1.59  27.28 27.280090.10.76.1421210             25.0008 090 99      0.00   0.00   0.00
31225  Removal of upper jaw                              A  26.70  25.48NA  25.48    3.55  55.73 55.730090.10.76.1421210             25.0008 090 99      0.00   0.00   0.00
31230  Removal of upper jaw                              A  30.82  26.89NA  26.89    3.96  61.67 61.670090.10.76.1421210             25.0008 090 99      0.00   0.00   0.00
31231  Nasal endoscopy dx                                A   1.10   5.38     0.69    0.12   6.60  1.910000.00.00.0022100             25.0008 090 99      0.00   0.00   0.00
31233  Nasal/sinus endoscopy dx                          A   2.18   5.62     1.60    0.29   8.09  4.070000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
31235  Nasal/sinus endoscopy dx                          A   2.64   6.19     1.82    0.33   9.16  4.790000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
31237  Nasal/sinus endoscopy surg                        A   2.98   6.50     2.01    0.38   9.86  5.370000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
31238  Nasal/sinus endoscopy surg                        A   3.26   6.41     2.14    0.41  10.08  5.810000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
31239  Nasal/sinus endoscopy surg                        A   9.33  10.10NA  10.10    1.24  20.67 20.670010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
31240  Nasal/sinus endoscopy surg                        A   2.61   1.83NA   1.83    0.34   4.78  4.780000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
3125F  Esoph bx rprt w/dyspl info                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
31254  Revision of ethmoid sinus                         A   4.64   2.84NA   2.84    0.60   8.08  8.080000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
31255  Removal of ethmoid sinus                          A   6.95   3.97NA   3.97    0.88  11.80 11.800000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
31256  Exploration maxillary sinus                       A   3.29   2.16NA   2.16    0.41   5.86  5.860000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
31267  Endoscopy maxillary sinus                         A   5.45   3.23NA   3.23    0.69   9.37  9.370000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
31276  Sinus endoscopy surgical                          A   8.84   4.91NA   4.91    1.14  14.89 14.890000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
31287  Nasal/sinus endoscopy surg                        A   3.91   2.47NA   2.47    0.50   6.88  6.880000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
31288  Nasal/sinus endoscopy surg                        A   4.57   2.79NA   2.79    0.60   7.96  7.960000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
31290  Nasal/sinus endoscopy surg                        A  18.61  13.03NA  13.03    2.64  34.28 34.280010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
31291  Nasal/sinus endoscopy surg                        A  19.56  13.75NA  13.75    3.14  36.45 36.450010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
31292  Nasal/sinus endoscopy surg                        A  15.90  11.67NA  11.67    2.04  29.61 29.610010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
31293  Nasal/sinus endoscopy surg                        A  17.47  12.43NA  12.43    2.23  32.13 32.130010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
31294  Nasal/sinus endoscopy surg                        A  20.31  13.83NA  13.83    2.61  36.75 36.750010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
31295  Sinus endo w/balloon dil                          A   2.70  62.36     1.92    0.35  65.41  4.970000.00.00.0021200             25.0008 090 99      0.00   0.00   0.00
31296  Sinus endo w/balloon dil                          A   3.29  62.69     2.23    0.42  66.40  5.940000.00.00.0021200             25.0008 090 99      0.00   0.00   0.00
31297  Sinus endo w/balloon dil                          A   2.64  62.53     1.91    0.34  65.51  4.890000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
31299  Sinus surgery procedure                           C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 090 99      0.00   0.00   0.00
3130F  Upper gi endoscopy performed                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
31300  Removal of larynx lesion                          A  15.91  19.81NA  19.81    2.03  37.75 37.750090.10.76.1420210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
31320  Diagnostic incision larynx                        A   5.73  13.58NA  13.58    0.72  20.03 20.030090.10.76.1420000             25.0008 090 99      0.00   0.00   0.00
31360  Removal of larynx                                 A  29.91  28.12NA  28.12    3.92  61.95 61.950090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
31365  Removal of larynx                                 A  38.81  32.67NA  32.67    5.08  76.56 76.560090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
31367  Partial removal of larynx                         A  30.57  31.34NA  31.34    3.97  65.88 65.880090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
31368  Partial removal of larynx                         A  34.19  34.32NA  34.32    4.38  72.89 72.890090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
31370  Partial removal of larynx                         A  27.57  30.86NA  30.86    3.54  61.97 61.970090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
31375  Partial removal of larynx                         A  26.07  29.42NA  29.42    3.36  58.85 58.850090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
31380  Partial removal of larynx                         A  25.57  29.17NA  29.17    3.29  58.03 58.030090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
31382  Partial removal of larynx                         A  28.57  31.35NA  31.35    3.69  63.61 63.610090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
31390  Removal of larynx & pharynx                       A  42.51  36.81NA  36.81    5.84  85.16 85.160090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
31395  Reconstruct larynx & pharynx                      A  43.80  40.08NA  40.08    5.63  89.51 89.510090.10.76.1420210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
31400  Revision of larynx                                A  11.60  16.90NA  16.90    1.50  30.00 30.000090.10.76.1420200             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3142F  Barium swallow test ordered                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
31420  Removal of epiglottis                             A  11.43  12.06NA  12.06    1.47  24.96 24.960090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
3150F  Forceps esoph biopsy done                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
31500  Insert emergency airway                           A   2.33   0.58NA   0.58    0.31   3.22  3.220000.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
31502  Change of windpipe airway                         A   0.65   0.31NA   0.31    0.07   1.03  1.030000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
31505  Diagnostic laryngoscopy                           A   0.61   1.88     0.81    0.07   2.56  1.490000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
31510  Laryngoscopy with biopsy                          A   1.92   4.29     1.44    0.26   6.47  3.620000.00.00.0030000       31505 25.0008 090 99      0.00   0.00   0.00
31511  Remove foreign body larynx                        A   2.16   4.07     1.39    0.31   6.54  3.860000.00.00.0030100       31505 25.0008 090 99      0.00   0.00   0.00
31512  Removal of larynx lesion                          A   2.07   3.98     1.55    0.27   6.32  3.890000.00.00.0030000       31505 25.0008 090 99      0.00   0.00   0.00
31513  Injection into vocal cord                         A   2.10   1.57NA   1.57    0.27   3.94  3.940000.00.00.0030000       31505 25.0008 090 99      0.00   0.00   0.00
31515  Laryngoscopy for aspiration                       A   1.80   4.33     1.27    0.24   6.37  3.310000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
31520  Dx laryngoscopy newborn                           A   2.56   1.80NA   1.80    0.33   4.69  4.690000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
31525  Dx laryngoscopy excl nb                           A   2.63   4.67     1.78    0.34   7.64  4.750000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
31526  Dx laryngoscopy w/oper scope                      A   2.57   1.80NA   1.80    0.33   4.70  4.700000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
31527  Laryngoscopy for treatment                        A   3.27   2.15NA   2.15    0.41   5.83  5.830000.00.00.0030000       31525 25.0008 090 99      0.00   0.00   0.00
31528  Laryngoscopy and dilation                         A   2.37   1.64NA   1.64    0.31   4.32  4.320000.00.00.0030000       31525 25.0008 090 99      0.00   0.00   0.00
31529  Laryngoscopy and dilation                         A   2.68   1.80NA   1.80    0.34   4.82  4.820000.00.00.0030000       31525 25.0008 090 99      0.00   0.00   0.00
31530  Laryngoscopy w/fb removal                         A   3.38   2.05NA   2.05    0.44   5.87  5.870000.00.00.0030100       31525 25.0008 090 99      0.00   0.00   0.00
31531  Laryngoscopy w/fb & op scope                      A   3.58   2.29NA   2.29    0.45   6.32  6.320000.00.00.0030000       31526 25.0008 090 99      0.00   0.00   0.00
31535  Laryngoscopy w/biopsy                             A   3.16   2.09NA   2.09    0.41   5.66  5.660000.00.00.0030100       31525 25.0008 090 99      0.00   0.00   0.00
31536  Laryngoscopy w/bx & op scope                      A   3.55   2.29NA   2.29    0.45   6.29  6.290000.00.00.0030100       31526 25.0008 090 99      0.00   0.00   0.00
31540  Laryngoscopy w/exc of tumor                       A   4.12   2.57NA   2.57    0.53   7.22  7.220000.00.00.0030100       31525 25.0008 090 99      0.00   0.00   0.00
31541  Larynscop w/tumr exc + scope                      A   4.52   2.77NA   2.77    0.59   7.88  7.880000.00.00.0030100       31526 25.0008 090 99      0.00   0.00   0.00
31545  Remove vc lesion w/scope                          A   6.30   3.69NA   3.69    0.80  10.79 10.790000.00.00.0031100       31526 25.0008 090 99      0.00   0.00   0.00
31546  Remove vc lesion scope/graft                      A   9.73   5.40NA   5.40    1.25  16.38 16.380000.00.00.0031100       31526 25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
31560  Laryngoscop w/arytenoidectom                      A   5.45   3.18NA   3.18    0.69   9.32  9.320000.00.00.0030000       31525 25.0008 090 99      0.00   0.00   0.00
31561  Larynscop remve cart + scop                       A   5.99   3.44NA   3.44    0.76  10.19 10.190000.00.00.0030000       31526 25.0008 090 99      0.00   0.00   0.00
31570  Laryngoscope w/vc inj                             A   3.86   5.91     2.44    0.53  10.30  6.830000.00.00.0030100       31525 25.0008 090 99      0.00   0.00   0.00
31571  Laryngoscop w/vc inj + scope                      A   4.26   2.62NA   2.62    0.54   7.42  7.420000.00.00.0030100       31526 25.0008 090 99      0.00   0.00   0.00
31575  Diagnostic laryngoscopy                           A   1.10   2.24     1.06    0.12   3.46  2.280000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
31576  Laryngoscopy with biopsy                          A   1.97   4.62     1.47    0.24   6.83  3.680000.00.00.0030100       31575 25.0008 090 99      0.00   0.00   0.00
31577  Remove foreign body larynx                        A   2.47   4.63     1.66    0.33   7.43  4.460000.00.00.0030000       31575 25.0008 090 99      0.00   0.00   0.00
31578  Removal of larynx lesion                          A   2.84   5.33     1.94    0.35   8.52  5.130000.00.00.0030000       31575 25.0008 090 99      0.00   0.00   0.00
31579  Diagnostic laryngoscopy                           A   2.26   3.84     1.65    0.30   6.40  4.210000.00.00.0030100       31575 25.0008 090 99      0.00   0.00   0.00
31580  Revision of larynx                                A  14.66  20.17NA  20.17    1.88  36.71 36.710090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
31582  Revision of larynx                                A  23.22  30.66NA  30.66    2.99  56.87 56.870090.10.76.1420110             25.0008 090 99      0.00   0.00   0.00
31584  Treat larynx fracture                             A  20.47  21.98NA  21.98    2.63  45.08 45.080090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
31587  Revision of larynx                                A  15.27  12.58NA  12.58    1.95  29.80 29.800090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
31588  Revision of larynx                                A  14.99  17.31NA  17.31    1.93  34.23 34.230090.10.76.1420200             25.0008 090 99      0.00   0.00   0.00
31590  Reinnervate larynx                                A   7.85  18.22NA  18.22    1.02  27.09 27.090090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
31595  Larynx nerve surgery                              A   8.84  13.02NA  13.02    1.14  23.00 23.000090.10.76.1421210             25.0008 090 99      0.00   0.00   0.00
31599  Larynx surgery procedure                          C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
31600  Incision of windpipe                              A   7.17   3.29NA   3.29    1.27  11.73 11.730000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
31601  Incision of windpipe                              A   4.44   2.68NA   2.68    0.56   7.68  7.680000.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
31603  Incision of windpipe                              A   4.14   1.76NA   1.76    0.69   6.59  6.590000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
31605  Incision of windpipe                              A   3.57   1.22NA   1.22    0.63   5.42  5.420000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
31610  Incision of windpipe                              A   9.38  10.79NA  10.79    1.32  21.49 21.490090.10.76.1420100             25.0008 090 99      0.00   0.00   0.00
31611  Surgery/speech prosthesis                         A   6.00   9.59NA   9.59    0.76  16.35 16.350090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
31612  Puncture/clear windpipe                           A   0.91   1.53     0.39    0.11   2.55  1.410000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
31613  Repair windpipe opening                           A   4.71   8.41NA   8.41    0.72  13.84 13.840090.10.76.1420100             25.0008 090 99      0.00   0.00   0.00
31614  Repair windpipe opening                           A   8.63  13.13NA  13.13    1.18  22.94 22.940090.10.76.1420100             25.0008 090 99      0.00   0.00   0.00
31615  Visualization of windpipe                         A   2.09   3.15     1.48    0.26   5.50  3.830000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
31620  Endobronchial us add-on                           A   1.40   7.16     0.48    0.12   8.68  2.000ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
31622  Dx bronchoscope/wash                              A   2.78   6.47     1.24    0.34   9.59  4.360000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
31623  Dx bronchoscope/brush                             A   2.88   7.02     1.22    0.26  10.16  4.360000.00.00.0030100       31622 25.0008 090 99      0.00   0.00   0.00
31624  Dx bronchoscope/lavage                            A   2.88   6.42     1.25    0.26   9.56  4.390000.00.00.0030100       31622 25.0008 090 99      0.00   0.00   0.00
31625  Bronchoscopy w/biopsy(s)                          A   3.36   6.56     1.40    0.31  10.23  5.070000.00.00.0030100       31622 25.0008 090 99      0.00   0.00   0.00
31626  Bronchoscopy w/markers                            A   4.16   9.18     1.65    0.31  13.65  6.120000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
31627  Navigational bronchoscopy                         A   2.00  39.23     0.67    0.14  41.37  2.810ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
31628  Bronchoscopy/lung bx each                         A   3.80   7.43     1.54    0.30  11.53  5.640000.00.00.0030100       31622 25.0008 090 99      0.00   0.00   0.00
31629  Bronchoscopy/needle bx each                       A   4.09  14.20     1.64    0.34  18.63  6.070000.00.00.0030100       31622 25.0008 090 99      0.00   0.00   0.00
31630  Bronchoscopy dilate/fx repr                       A   3.81   1.67NA   1.67    0.49   5.97  5.970000.00.00.0030100       31622 25.0008 090 99      0.00   0.00   0.00
31631  Bronchoscopy dilate w/stent                       A   4.36   1.85NA   1.85    0.60   6.81  6.810000.00.00.0030100       31622 25.0008 090 99      0.00   0.00   0.00
31632  Bronchoscopy/lung bx addl                         A   1.03   1.05     0.35    0.07   2.15  1.450ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
31633  Bronchoscopy/needle bx addl                       A   1.32   1.21     0.45    0.10   2.63  1.870ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
31634  Bronch w/balloon occlusion                        A   4.00  56.27     1.61    0.33  60.60  5.940000.00.00.0030200       31622 25.0008 090 99      0.00   0.00   0.00
31635  Bronchoscopy w/fb removal                         A   3.67   6.50     1.53    0.39  10.56  5.590000.00.00.0030100       31622 25.0008 090 99      0.00   0.00   0.00
31636  Bronchoscopy bronch stents                        A   4.30   1.76NA   1.76    0.56   6.62  6.620000.00.00.0030100       31622 25.0008 090 99      0.00   0.00   0.00
31637  Bronchoscopy stent add-on                         A   1.58   0.50NA   0.50    0.11   2.19  2.190ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
31638  Bronchoscopy revise stent                         A   4.88   2.04NA   2.04    0.65   7.57  7.570000.00.00.0030100       31622 25.0008 090 99      0.00   0.00   0.00
31640  Bronchoscopy w/tumor excise                       A   4.93   2.07NA   2.07    0.64   7.64  7.640000.00.00.0030100       31622 25.0008 090 99      0.00   0.00   0.00
31641  Bronchoscopy treat blockage                       A   5.02   2.05NA   2.05    0.59   7.66  7.660000.00.00.0030100       31622 25.0008 090 99      0.00   0.00   0.00
31643  Diag bronchoscope/catheter                        A   3.49   1.46NA   1.46    0.29   5.24  5.240000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
31645  Bronchoscopy clear airways                        A   3.16   6.27     1.35    0.29   9.72  4.800000.00.00.0030100       31622 25.0008 090 99      0.00   0.00   0.00
31646  Bronchoscopy reclear airway                       A   2.72   5.84     1.20    0.26   8.82  4.180000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
31647  Bronchial valve init insert                       A   4.40   1.66NA   1.66    0.57   6.63  6.630000.00.00.0030100       31622 25.0008 090 99      0.00   0.00   0.00
31648  Bronchial valve addl insert                       A   4.20   2.17NA   2.17    0.56   6.93  6.930000.00.00.0030100       31622 25.0008 090 99      0.00   0.00   0.00
31649  Bronchial valve remov init                        A   1.44   0.64     0.64    0.10   2.18  2.180ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
31651  Bronchial valve remov addl                        A   1.58   0.62     0.62    0.11   2.31  2.310ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
31660  Bronch thermoplsty 1 lobe                         A   4.25   1.85NA   1.85    0.55   6.65  6.650000.00.00.0030100       31622 25.0008 090 99      0.00   0.00   0.00
31661  Bronch thermoplsty 2/> lobes                      A   4.50   1.93NA   1.93    0.60   7.03  7.030000.00.00.0030100       31622 25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
31717  Bronchial brush biopsy                            A   2.12   5.84     0.97    0.16   8.12  3.250000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
31720  Clearance of airways                              A   1.06   0.33NA   0.33    0.08   1.47  1.470000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
31725  Clearance of airways                              A   1.96   0.54NA   0.54    0.20   2.70  2.700000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
31730  Intro windpipe wire/tube                          A   2.85  34.70     1.02    0.45  38.00  4.320000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
31750  Repair of windpipe                                A  15.39  23.92NA  23.92    2.27  41.58 41.580090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
31755  Repair of windpipe                                A  17.54  32.53NA  32.53    2.25  52.32 52.320090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
31760  Repair of windpipe                                A  23.48  12.00NA  12.00    5.48  40.96 40.960090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
31766  Reconstruction of windpipe                        A  31.67  13.90NA  13.90    7.40  52.97 52.970090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
31770  Repair/graft of bronchus                          A  23.54  10.66NA  10.66    5.50  39.70 39.700090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
31775  Reconstruct bronchus                              A  24.59  10.44NA  10.44    5.76  40.79 40.790090.10.76.1420200             25.0008 090 99      0.00   0.00   0.00
31780  Reconstruct windpipe                              A  19.84  12.11NA  12.11    3.23  35.18 35.180090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
31781  Reconstruct windpipe                              A  24.85  14.92NA  14.92    5.81  45.58 45.580090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
31785  Remove windpipe lesion                            A  18.35  11.10NA  11.10    2.61  32.06 32.060090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
31786  Remove windpipe lesion                            A  25.42  11.63NA  11.63    5.96  43.01 43.010090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
31800  Repair of windpipe injury                         A   8.18  12.82NA  12.82    1.05  22.05 22.050090.10.76.1420000             25.0008 090 99      0.00   0.00   0.00
31805  Repair of windpipe injury                         A  13.42   7.85NA   7.85    3.16  24.43 24.430090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
31820  Closure of windpipe lesion                        A   4.64   7.99     4.58    0.67  13.30  9.890090.10.76.1420000             25.0008 090 99      0.00   0.00   0.00
31825  Repair of windpipe defect                         A   7.07  10.21     6.34    0.99  18.27 14.400090.10.76.1420000             25.0008 090 99      0.00   0.00   0.00
31830  Revise windpipe scar                              A   4.62   8.25     5.03    0.71  13.58 10.360090.10.76.1420000             25.0008 090 99      0.00   0.00   0.00
31899  Airways surgical procedure                        C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
32035  Thoracostomy w/rib resection                      A  11.29   7.87NA   7.87    2.57  21.73 21.730090.10.76.1421210             25.0008 090 99      0.00   0.00   0.00
32036  Thoracostomy w/flap drainage                      A  12.30   8.19NA   8.19    2.90  23.39 23.390090.10.76.1421210             25.0008 090 99      0.00   0.00   0.00
32096  Open wedge/bx lung infiltr                        A  13.75   7.29NA   7.29    3.22  24.26 24.260090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32097  Open wedge/bx lung nodule                         A  13.75   7.29NA   7.29    3.22  24.26 24.260090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32098  Open biopsy of lung pleura                        A  12.91   7.59NA   7.59    3.01  23.51 23.510090.10.76.1420210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
32100  Exploration of chest                              A  13.75   7.28NA   7.28    3.44  24.47 24.470090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32110  Explore/repair chest                              A  25.28  12.77NA  12.77    5.74  43.79 43.790090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32120  Re-exploration of chest                           A  14.39   8.38NA   8.38    3.40  26.17 26.170090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32124  Explore chest free adhesions                      A  15.45   8.76NA   8.76    3.67  27.88 27.880090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32140  Removal of lung lesion(s)                         A  16.66   9.15NA   9.15    3.89  29.70 29.700090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32141  Remove/treat lung lesions                         A  27.18  12.00NA  12.00    6.40  45.58 45.580090.10.76.1420210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
32150  Removal of lung lesion(s)                         A  16.82   9.34NA   9.34    3.93  30.09 30.090090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32151  Remove lung foreign body                          A  16.94   9.23NA   9.23    3.97  30.14 30.140090.10.76.1420210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
32160  Open chest heart massage                          A  13.10   7.57NA   7.57    2.99  23.66 23.660090.10.76.1420210             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
32200  Drain open lung lesion                            A  18.68  10.97NA  10.97    4.29  33.94 33.940090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32201  Drain percut lung lesion                          A   3.99  23.34     1.41    0.38  27.71  5.780000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
32215  Treat chest lining                                A  13.05   7.95NA   7.95    3.05  24.05 24.050090.10.76.1421210             25.0008 090 99      0.00   0.00   0.00
32220  Release of lung                                   A  26.65  14.69NA  14.69    6.30  47.64 47.640090.10.76.1421210             25.0008 090 99      0.00   0.00   0.00
32225  Partial release of lung                           A  16.75   9.17NA   9.17    3.92  29.84 29.840090.10.76.1421210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
32310  Removal of chest lining                           A  15.28   8.60NA   8.60    3.62  27.50 27.500090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32320  Free/remove chest lining                          A  27.25  14.30NA  14.30    6.33  47.88 47.880090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32400  Needle biopsy chest lining                        A   1.76   2.55     0.62    0.18   4.49  2.560000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
32405  Percut bx lung/mediastinum                        A   1.93  11.57     0.93    0.18  13.68  3.040000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
32440  Remove lung pneumonectomy                         A  27.28  13.16NA  13.16    6.36  46.80 46.800090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32442  Sleeve pneumonectomy                              A  56.47  21.46NA  21.46   13.21  91.14 91.140090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32445  Removal of lung extrapleural                      A  63.84  26.51NA  26.51   14.94 105.29105.290090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32480  Partial removal of lung                           A  25.82  12.40NA  12.40    6.06  44.28 44.280090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32482  Bilobectomy                                       A  27.44  13.54NA  13.54    6.42  47.40 47.400090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32484  Segmentectomy                                     A  25.38  11.65NA  11.65    5.91  42.94 42.940090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32486  Sleeve lobectomy                                  A  42.88  17.09NA  17.09   10.14  70.11 70.110090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32488  Completion pneumonectomy                          A  42.99  18.00NA  18.00   10.11  71.10 71.100090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32491  Lung volume reduction                             R  25.24  12.87NA  12.87    5.88  43.99 43.990090.10.76.1421210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
32501  Repair bronchus add-on                            A   4.68   1.50NA   1.50    1.09   7.27  7.270ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
32503  Resect apical lung tumor                          A  31.74  14.82NA  14.82    7.50  54.06 54.060090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32504  Resect apical lung tum/chest                      A  36.54  15.98NA  15.98    8.52  61.04 61.040090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32505  Wedge resect of lung initial                      A  15.75   9.32NA   9.32    3.61  28.68 28.680090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32506  Wedge resect of lung add-on                       A   3.00   1.21NA   1.21    0.71   4.92  4.920ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
32507  Wedge resect of lung diag                         A   3.00   1.21NA   1.21    0.71   4.92  4.920ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
32540  Removal of lung lesion                            A  30.35  14.13NA  14.13    7.10  51.58 51.580090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32550  Insert pleural cath                               A   4.17  19.54     1.77    0.69  24.40  6.630000.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
32551  Insertion of chest tube                           A   3.29   1.22NA   1.22    0.73   5.24  5.240000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
32552  Remove lung catheter                              A   2.53   2.66     1.87    0.60   5.79  5.000010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
32553  Ins mark thor for rt perq                         A   3.80  13.01     1.53    0.88  17.69  6.210000.00.00.0020200             25.0008 090 99      0.00   0.00   0.00
32554  Aspirate pleura w/o imaging                       A   1.82  24.32     0.65    0.17  26.31  2.640000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
32555  Aspirate pleura w/ imaging                        A   2.27  14.41     0.81    0.23  16.91  3.310000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
32556  Insert cath pleura w/o image                      A   2.50  15.06     0.88    0.25  17.81  3.630000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
32557  Insert cath pleura w/ image                       A   3.12  28.88     1.07    0.69  32.69  4.880000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
32560  Treat pleurodesis w/agent                         A   1.54   5.79     0.52    0.27   7.60  2.330000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
32561  Lyse chest fibrin init day                        A   1.39   1.21     0.47    0.24   2.84  2.100000.00.00.0020200             25.0008 090 99      0.00   0.00   0.00
32562  Lyse chest fibrin subq day                        A   1.24   1.10     0.41    0.23   2.57  1.880000.00.00.0020200             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
32601  Thoracoscopy diagnostic                           A   5.50   2.46NA   2.46    1.28   9.24  9.240000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
32604  Thoracoscopy wbx sac                              A   8.77   3.52NA   3.52    2.04  14.33 14.330000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
32606  Thoracoscopy w/bx med space                       A   8.39   3.49NA   3.49    1.93  13.81 13.810000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
32607  Thoracoscopy w/bx infiltrate                      A   5.50   2.79NA   2.79    1.28   9.57  9.570000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
32608  Thoracoscopy w/bx nodule                          A   6.84   3.33NA   3.33    1.60  11.77 11.770000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
32609  Thoracoscopy w/bx pleura                          A   4.58   2.42NA   2.42    1.11   8.11  8.110000.00.00.0020000             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
32650  Thoracoscopy w/pleurodesis                        A  10.83   6.71NA   6.71    2.48  20.02 20.020090.10.76.1421210             25.0008 090 99      0.00   0.00   0.00
32651  Thoracoscopy remove cortex                        A  18.78   9.67NA   9.67    4.31  32.76 32.760090.10.76.1421210             25.0008 090 99      0.00   0.00   0.00
32652  Thoracoscopy rem totl cortex                      A  29.13  13.77NA  13.77    6.72  49.62 49.620090.10.76.1421210             25.0008 090 99      0.00   0.00   0.00
32653  Thoracoscopy remov fb/fibrin                      A  18.17   9.30NA   9.30    4.12  31.59 31.590090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32654  Thoracoscopy contrl bleeding                      A  20.52  10.06NA  10.06    4.65  35.23 35.230090.10.76.1421210             25.0008 090 99      0.00   0.00   0.00
32655  Thoracoscopy resect bullae                        A  16.17   8.76NA   8.76    3.77  28.70 28.700090.10.76.1421210             25.0008 090 99      0.00   0.00   0.00
32656  Thoracoscopy w/pleurectomy                        A  13.26   7.64NA   7.64    3.01  23.91 23.910090.10.76.1421210             25.0008 090 99      0.00   0.00   0.00
32658  Thoracoscopy w/sac fb remove                      A  11.71   6.95NA   6.95    2.75  21.41 21.410090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
32659  Thoracoscopy w/sac drainage                       A  11.94   7.11NA   7.11    2.80  21.85 21.850090.09.84.0720210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
32661  Thoracoscopy w/pericard exc                       A  13.33   7.46NA   7.46    3.13  23.92 23.920090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
32662  Thoracoscopy w/mediast exc                        A  14.99   8.19NA   8.19    3.50  26.68 26.680090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
32663  Thoracoscopy w/lobectomy                          A  24.64  11.46NA  11.46    5.74  41.84 41.840090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
32664  Thoracoscopy w/ th nrv exc                        A  14.28   7.76NA   7.76    3.36  25.40 25.400090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
32665  Thoracoscop w/esoph musc exc                      A  21.53  10.25NA  10.25    4.60  36.38 36.380090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
32666  Thoracoscopy w/wedge resect                       A  14.50   8.82NA   8.82    3.39  26.71 26.710090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32667  Thoracoscopy w/w resect addl                      A   3.00   1.21NA   1.21    0.71   4.92  4.920ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
32668  Thoracoscopy w/w resect diag                      A   3.00   1.21NA   1.21    0.73   4.94  4.940ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
32669  Thoracoscopy remove segment                       A  23.53  11.16NA  11.16    5.48  40.17 40.170090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
3267F  path rprt w/ pt pn cat et al                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
32670  Thoracoscopy bilobectomy                          A  28.52  12.80NA  12.80    6.58  47.90 47.900090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32671  Thoracoscopy pneumonectomy                        A  31.92  13.62NA  13.62    7.54  53.08 53.080090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32672  Thoracoscopy for lvrs                             A  27.00  12.07NA  12.07    6.36  45.43 45.430090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32673  Thoracoscopy w/thymus resect                      A  21.13  10.16NA  10.16    4.51  35.80 35.800090.09.82.0920210             25.0008 090 99      0.00   0.00   0.00
32674  Thoracoscopy lymph node exc                       A   4.12   1.34NA   1.34    0.96   6.42  6.420ZZZ.00.00.0000210             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
32701  Thorax stereo rad targetw/tx                      A   4.18   1.32NA   1.32    1.05   6.55  6.552XXX.00.00.0000010             25.0008 090 99      0.00   0.00   0.00
3271F  Low risk prostate cancer                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3272F  Med risk prostate cancer                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3273F  High risk prostate cancer                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3278F  Serum lvls CA/iPTH/lpd ord                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3279F  Hgb lvl >/= 13 g/dl                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3280F  Hgb lvl 11-12.9 g/dL                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
32800  Repair lung hernia                                A  15.71   8.86NA   8.86    3.69  28.26 28.260090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
3281F  Hgb lvl <11 g/dl                                  I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
32810  Close chest after drainage                        A  14.95   8.56NA   8.56    3.51  27.02 27.020090.10.76.1420200             25.0008 090 99      0.00   0.00   0.00
32815  Close bronchial fistula                           A  50.03  21.90NA  21.90   11.90  83.83 83.830090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32820  Reconstruct injured chest                         A  22.51  14.38NA  14.38    5.28  42.17 42.170090.10.76.1420210             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
32850  Donor pneumonectomy                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
32851  Lung transplant single                            A  59.64  24.27NA  24.27   14.05  97.96 97.960090.10.76.1420212             25.0008 090 99      0.00   0.00   0.00
32852  Lung transplant with bypass                       A  65.50  26.15NA  26.15   15.35 107.00107.000090.10.76.1420212             25.0008 090 99      0.00   0.00   0.00
32853  Lung transplant double                            A  84.48  32.38NA  32.38   20.00 136.86136.860090.10.76.1422212             25.0008 090 99      0.00   0.00   0.00
32854  Lung transplant with bypass                       A  90.00  34.24NA  34.24   21.21 145.45145.450090.10.76.1422212             25.0008 090 99      0.00   0.00   0.00
32855  Prepare donor lung single                         C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
32856  Prepare donor lung double                         C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
3288F  Fall risk assessment docd                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
32900  Removal of rib(s)                                 A  23.81  12.27NA  12.27    5.48  41.56 41.560090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32905  Revise & repair chest wall                        A  23.29  11.19NA  11.19    5.44  39.92 39.920090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32906  Revise & repair chest wall                        A  29.30  13.08NA  13.08    6.87  49.25 49.250090.10.76.1420210             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
32940  Revision of lung                                  A  21.34  10.57NA  10.57    5.01  36.92 36.920090.10.76.1420210             25.0008 090 99      0.00   0.00   0.00
32960  Therapeutic pneumothorax                          A   1.84   2.28     0.81    0.42   4.54  3.070000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
32997  Total lung lavage                                 A   7.31   2.30NA   2.30    0.91  10.52 10.520000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
32998  Perq rf ablate tx pul tumor                       A   5.68  85.13     2.17    0.60  91.41  8.450000.00.00.0020200             25.0008 090 99      0.00   0.00   0.00
32999  Chest surgery procedure                           C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020111             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3301F  Cancer stage docd metast                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33010  Drainage of heart sac                             A   2.24   0.80NA   0.80    0.45   3.49  3.490000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
33011  Repeat drainage of heart sac                      A   2.24   0.81NA   0.81    0.49   3.54  3.540000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
33015  Incision of heart sac                             A   8.52   4.85NA   4.85    1.67  15.04 15.040090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
33020  Incision of heart sac                             A  14.95   7.78NA   7.78    3.51  26.24 26.240090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33025  Incision of heart sac                             A  13.70   7.05NA   7.05    3.25  24.00 24.000090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33030  Partial removal of heart sac                      A  36.00  15.36NA  15.36    8.55  59.91 59.910090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33031  Partial removal of heart sac                      A  45.00  18.44NA  18.44   10.83  74.27 74.270090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33050  Resect heart sac lesion                           A  16.97   9.06NA   9.06    3.97  30.00 30.000090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33120  Removal of heart lesion                           A  38.45  15.25NA  15.25    9.20  62.90 62.900090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33130  Removal of heart lesion                           A  24.17  11.46NA  11.46    6.04  41.67 41.670090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33140  Heart revascularize (tmr)                         A  28.34  12.05NA  12.05    7.08  47.47 47.470090.09.84.0720200             25.0008 090 99      0.00   0.00   0.00
33141  Heart tmr w/other procedure                       A   2.54   0.80NA   0.80    0.61   3.95  3.950ZZZ.00.00.0000210             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33202  Insert epicard eltrd open                         A  13.20   6.92NA   6.92    3.16  23.28 23.280090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
33203  Insert epicard eltrd endo                         A  13.97   6.80NA   6.80    3.28  24.05 24.050090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
33206  Insert heart pm atrial                            A   7.39   4.48NA   4.48    1.62  13.49 13.490090.09.84.0720120             25.0008 090 99      0.00   0.00   0.00
33207  Insert heart pm ventricular                       A   8.05   4.47NA   4.47    1.77  14.29 14.290090.09.84.0720120             25.0008 090 99      0.00   0.00   0.00
33208  Insrt heart pm atrial & vent                      A   8.77   4.75NA   4.75    1.92  15.44 15.440090.09.84.0720120             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33210  Insert electrd/pm cath sngl                       A   3.30   1.21NA   1.21    0.71   5.22  5.220000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
33211  Insert card electrodes dual                       A   3.39   1.20NA   1.20    0.75   5.34  5.340000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
33212  Insert pulse gen sngl lead                        A   5.26   3.41NA   3.41    1.15   9.82  9.820090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
33213  Insert pulse gen dual leads                       A   5.53   3.51NA   3.51    1.22  10.26 10.260090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
33214  Upgrade of pacemaker system                       A   7.84   4.71NA   4.71    1.70  14.25 14.250090.09.84.0720020             25.0008 090 99      0.00   0.00   0.00
33215  Reposition pacing-defib lead                      A   4.92   2.98NA   2.98    1.08   8.98  8.980090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
33216  Insert 1 electrode pm-defib                       A   5.87   3.93NA   3.93    1.28  11.08 11.080090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
33217  Insert 2 electrode pm-defib                       A   5.84   3.89NA   3.89    1.28  11.01 11.010090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
33218  Repair lead pace-defib one                        A   6.07   4.22NA   4.22    1.32  11.61 11.610090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
3322F  Melanomaajcc stage 0 or ia                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33220  Repair lead pace-defib dual                       A   6.15   4.23NA   4.23    1.33  11.71 11.710090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
33221  Insert pulse gen mult leads                       A   5.80   3.61NA   3.61    1.29  10.70 10.700090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
33222  Revise pocket pacemaker                           A   5.10   4.00NA   4.00    1.14  10.24 10.240090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
33223  Revise pocket for defib                           A   6.55   4.22NA   4.22    1.46  12.23 12.230090.09.84.0720000             25.0008 090 99      0.00   0.00   0.00
33224  Insert pacing lead & connect                      A   9.04   3.86NA   3.86    1.99  14.89 14.890000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
33225  L ventric pacing lead add-on                      A   8.33   3.25NA   3.25    1.82  13.40 13.400ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
33226  Reposition l ventric lead                         A   8.68   3.73NA   3.73    1.91  14.32 14.320000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
33227  Remove&replace pm gen singl                       A   5.50   3.50NA   3.50    1.23  10.23 10.230090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
33228  Remv&replc pm gen dual lead                       A   5.77   3.60NA   3.60    1.29  10.66 10.660090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
33229  Remv&replc pm gen mult leads                      A   6.04   3.70NA   3.70    1.35  11.09 11.090090.09.84.0720100             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33230  Insrt pulse gen w/dual leads                      A   6.32   3.84NA   3.84    1.41  11.57 11.570090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
33231  Insrt pulse gen w/mult leads                      A   6.59   3.95NA   3.95    1.47  12.01 12.010090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
33233  Removal of pm generator                           A   3.39   2.89NA   2.89    0.73   7.01  7.010090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
33234  Removal of pacemaker system                       A   7.91   4.72NA   4.72    1.74  14.37 14.370090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
33235  Removal pacemaker electrode                       A  10.15   6.38NA   6.38    2.25  18.78 18.780090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
33236  Remove electrode/thoracotomy                      A  12.73   7.91NA   7.91    3.18  23.82 23.820090.09.84.0720020             25.0008 090 99      0.00   0.00   0.00
33237  Remove electrode/thoracotomy                      A  13.84   8.25NA   8.25    3.24  25.33 25.330090.09.84.0720020             25.0008 090 99      0.00   0.00   0.00
33238  Remove electrode/thoracotomy                      A  15.40   9.16NA   9.16    3.69  28.25 28.250090.09.84.0720020             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33240  Insrt pulse gen w/singl lead                      A   6.05   3.74NA   3.74    1.35  11.14 11.140090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
33241  Remove pulse generator                            A   3.29   2.60NA   2.60    0.71   6.60  6.600090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
33243  Remove eltrd/thoracotomy                          A  23.57  11.77NA  11.77    5.57  40.91 40.910090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33244  Remove eltrd transven                             A  13.99   8.11NA   8.11    3.10  25.20 25.200090.09.84.0720110             25.0008 090 99      0.00   0.00   0.00
33249  Nsert pace-defib w/lead                           A  15.17   8.22NA   8.22    3.32  26.71 26.710090.09.84.0720110             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33250  Ablate heart dysrhythm focus                      A  25.90  11.96NA  11.96    6.46  44.32 44.320090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33251  Ablate heart dysrhythm focus                      A  28.92  12.91NA  12.91    7.01  48.84 48.840090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33254  Ablate atria lmtd                                 A  23.71  11.60NA  11.60    5.92  41.23 41.230090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33255  Ablate atria w/o bypass ext                       A  29.04  13.22NA  13.22    7.25  49.51 49.510090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33256  Ablate atria w/bypass exten                       A  34.90  15.10NA  15.10    8.75  58.75 58.750090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33257  Ablate atria lmtd add-on                          A   9.63   5.68NA   5.68    2.31  17.62 17.620ZZZ.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
33258  Ablate atria x10sv add-on                         A  11.00   6.20NA   6.20    2.63  19.83 19.830ZZZ.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
33259  Ablate atria w/bypass add-on                      A  14.14   8.01NA   8.01    3.43  25.58 25.580ZZZ.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
33261  Ablate heart dysrhythm focus                      A  28.92  12.91NA  12.91    7.23  49.06 49.060090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33262  Remv&replc cvd gen sing lead                      A   6.06   3.75NA   3.75    1.35  11.16 11.160090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
33263  Remv&replc cvd gen dual lead                      A   6.33   3.85NA   3.85    1.41  11.59 11.590090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
33264  Remv&replc cvd gen mult lead                      A   6.60   3.95NA   3.95    1.47  12.02 12.020090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
33265  Ablate atria lmtd endo                            A  23.71  11.49NA  11.49    5.65  40.85 40.850090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33266  Ablate atria x10sv endo                           A  33.04  14.68NA  14.68    7.98  55.70 55.700090.09.84.0720210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33282  Implant pat-active ht record                      A   4.80   3.62NA   3.62    1.05   9.47  9.470090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
33284  Remove pat-active ht record                       A   3.14   3.01NA   3.01    0.68   6.83  6.830090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
3330F  Imaging study ordered (bkp)                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33300  Repair of heart wound                             A  44.97  17.67NA  17.67   10.74  73.38 73.380090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33305  Repair of heart wound                             A  76.93  27.42NA  27.42   18.43 122.78122.780090.09.84.0720210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33310  Exploratory heart surgery                         A  20.34  10.26NA  10.26    4.49  35.09 35.090090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33315  Exploratory heart surgery                         A  35.00  14.16NA  14.16    8.41  57.57 57.570090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33320  Repair major blood vessel(s)                      A  18.54   8.80NA   8.80    4.30  31.64 31.640090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33321  Repair major vessel                               A  20.81  10.22NA  10.22    4.87  35.90 35.900090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33322  Repair major blood vessel(s)                      A  24.42  11.60NA  11.60    5.87  41.89 41.890090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33330  Insert major vessel graft                         A  25.29  14.26NA  14.26    6.33  45.88 45.880090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33332  Insert major vessel graft                         A  24.56  11.40NA  11.40    6.12  42.08 42.080090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33335  Insert major vessel graft                         A  33.91  14.45NA  14.45    8.18  56.54 56.540090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33361  Replace aortic valve perq                         A  25.13   8.99NA   8.99    5.61  39.73 39.730000.00.00.0020021             25.0008 090 99      0.00   0.00   0.00
33362  Replace aortic valve open                         A  27.52   9.80NA   9.80    6.14  43.46 43.460000.00.00.0020021             25.0008 090 99      0.00   0.00   0.00
33363  Replace aortic valve open                         A  28.50  10.14NA  10.14    6.36  45.00 45.000000.00.00.0020021             25.0008 090 99      0.00   0.00   0.00
33364  Replace aortic valve open                         A  30.00  11.18NA  11.18    6.70  47.88 47.880000.00.00.0020021             25.0008 090 99      0.00   0.00   0.00
33365  Replace aortic valve open                         A  33.12  11.46NA  11.46    7.93  52.51 52.510000.00.00.0020021             25.0008 090 99      0.00   0.00   0.00
33367  Replace aortic valve w/byp                        A  11.88   3.72NA   3.72    2.84  18.44 18.440ZZZ.00.00.0000001             25.0008 090 99      0.00   0.00   0.00
33368  Replace aortic valve w/byp                        A  14.39   4.51NA   4.51    3.45  22.35 22.350ZZZ.00.00.0000001             25.0008 090 99      0.00   0.00   0.00
33369  Replace aortic valve w/byp                        A  19.00   5.96NA   5.96    4.55  29.51 29.510ZZZ.00.00.0000001             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33400  Repair of aortic valve                            A  41.50  17.15NA  17.15    9.89  68.54 68.540090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33401  Valvuloplasty open                                A  24.63  12.70NA  12.70    5.38  42.71 42.710090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33403  Valvuloplasty w/cp bypass                         A  25.61  13.01NA  13.01    6.40  45.02 45.020090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33404  Prepare heart-aorta conduit                       A  31.37  14.04NA  14.04    7.34  52.75 52.750090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33405  Replacement of aortic valve                       A  41.32  16.75NA  16.75    9.92  67.99 67.990090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33406  Replacement of aortic valve                       A  52.68  21.12NA  21.12   12.77  86.57 86.570090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
3341F  Mammo assess negative docd                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33410  Replacement of aortic valve                       A  46.41  18.84NA  18.84   11.15  76.40 76.400090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33411  Replacement of aortic valve                       A  62.07  23.92NA  23.92   14.93 100.92100.920090.09.84.0720200             25.0008 090 99      0.00   0.00   0.00
33412  Replacement of aortic valve                       A  59.00  22.02NA  22.02   14.77  95.79 95.790090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33413  Replacement of aortic valve                       A  59.87  23.18NA  23.18   14.02  97.07 97.070090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33414  Repair of aortic valve                            A  39.37  15.55NA  15.55    9.84  64.76 64.760090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33415  Revision subvalvular tissue                       A  37.27  15.53NA  15.53    8.52  61.32 61.320090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33416  Revise ventricle muscle                           A  36.56  15.82NA  15.82    8.81  61.19 61.190090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33417  Repair of aortic valve                            A  29.33  13.70NA  13.70    7.04  50.07 50.070090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
3342F  Mammo assess bengn docd                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33420  Revision of mitral valve                          A  25.79  13.70NA  13.70    3.54  43.03 43.030090.09.84.0720110             25.0008 090 99      0.00   0.00   0.00
33422  Revision of mitral valve                          A  29.73  13.61NA  13.61    7.42  50.76 50.760090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33425  Repair of mitral valve                            A  49.96  20.38NA  20.38   11.99  82.33 82.330090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33426  Repair of mitral valve                            A  43.28  18.07NA  18.07   10.41  71.76 71.760090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33427  Repair of mitral valve                            A  44.83  17.92NA  17.92   10.78  73.53 73.530090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
3343F  Mammo probably bengn docd                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33430  Replacement of mitral valve                       A  50.93  20.68NA  20.68   12.26  83.87 83.870090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
3344F  Mammo assess susp docd                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3345F  Mammo assess hghlymalig doc                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33460  Revision of tricuspid valve                       A  44.70  17.18NA  17.18   11.17  73.05 73.050090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33463  Valvuloplasty tricuspid                           A  57.08  21.97NA  21.97   13.79  92.84 92.840090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33464  Valvuloplasty tricuspid                           A  44.62  18.26NA  18.26   10.74  73.62 73.620090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33465  Replace tricuspid valve                           A  50.72  19.98NA  19.98   12.29  82.99 82.990090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33468  Revision of tricuspid valve                       A  45.13  17.40NA  17.40   11.30  73.83 73.830090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33470  Revision of pulmonary valve                       A  21.54  12.53NA  12.53    5.05  39.12 39.120090.09.84.0720200             25.0008 090 99      0.00   0.00   0.00
33471  Valvotomy pulmonary valve                         A  22.96  12.67NA  12.67    5.76  41.39 41.390090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33472  Revision of pulmonary valve                       A  23.06  10.54NA  10.54    5.80  39.40 39.400090.09.84.0720200             25.0008 090 99      0.00   0.00   0.00
33474  Revision of pulmonary valve                       A  39.40  16.40NA  16.40    9.23  65.03 65.030090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33475  Replacement pulmonary valve                       A  42.40  17.74NA  17.74   10.60  70.74 70.740090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33476  Revision of heart chamber                         A  26.57  12.77NA  12.77    6.64  45.98 45.980090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33478  Revision of heart chamber                         A  27.54  13.07NA  13.07    6.89  47.50 47.500090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33496  Repair prosth valve clot                          A  29.84  13.45NA  13.45    6.98  50.27 50.270090.09.84.0720210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33500  Repair heart vessel fistula                       A  27.94  12.59NA  12.59    6.98  47.51 47.510090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33501  Repair heart vessel fistula                       A  19.51   9.62NA   9.62    4.89  34.02 34.020090.09.84.0720220             25.0008 090 99      0.00   0.00   0.00
33502  Coronary artery correction                        A  21.85  11.33NA  11.33    5.46  38.64 38.640090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33503  Coronary artery graft                             A  22.51  12.06NA  12.06    4.93  39.50 39.500090.09.84.0720010             25.0008 090 99      0.00   0.00   0.00
33504  Coronary artery graft                             A  25.46  12.47NA  12.47    6.36  44.29 44.290090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33505  Repair artery w/tunnel                            A  38.40  14.13NA  14.13    9.60  62.13 62.130090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33506  Repair artery translocation                       A  37.85  14.61NA  14.61    8.87  61.33 61.330090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33507  Repair art intramural                             A  31.40  12.69NA  12.69    7.35  51.44 51.440090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33508  Endoscopic vein harvest                           A   0.31   0.10NA   0.10    0.07   0.48  0.480ZZZ.00.00.0000210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33510  Cabg vein single                                  A  34.98  14.87NA  14.87    8.41  58.26 58.260090.09.84.0720200             25.0008 090 99      0.00   0.00   0.00
33511  Cabg vein two                                     A  38.45  16.28NA  16.28    9.25  63.98 63.980090.09.84.0720200             25.0008 090 99      0.00   0.00   0.00
33512  Cabg vein three                                   A  43.98  18.10NA  18.10   10.60  72.68 72.680090.09.84.0720200             25.0008 090 99      0.00   0.00   0.00
33513  Cabg vein four                                    A  45.37  18.42NA  18.42   10.97  74.76 74.760090.09.84.0720200             25.0008 090 99      0.00   0.00   0.00
33514  Cabg vein five                                    A  48.08  19.21NA  19.21   11.54  78.83 78.830090.09.84.0720200             25.0008 090 99      0.00   0.00   0.00
33516  Cabg vein six or more                             A  49.76  20.03NA  20.03   12.43  82.22 82.220090.09.84.0720200             25.0008 090 99      0.00   0.00   0.00
33517  Cabg artery-vein single                           A   3.61   1.15NA   1.15    0.86   5.62  5.620ZZZ.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
33518  Cabg artery-vein two                              A   7.93   2.52NA   2.52    1.91  12.36 12.360ZZZ.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
33519  Cabg artery-vein three                            A  10.49   3.33NA   3.33    2.52  16.34 16.340ZZZ.00.00.0000200             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33521  Cabg artery-vein four                             A  12.59   3.99NA   3.99    3.05  19.63 19.630ZZZ.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
33522  Cabg artery-vein five                             A  14.14   4.47NA   4.47    3.43  22.04 22.040ZZZ.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
33523  Cabg art-vein six or more                         A  16.08   5.08NA   5.08    3.87  25.03 25.030ZZZ.00.00.0000200             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33530  Coronary artery bypass/reop                       A  10.13   3.21NA   3.21    2.42  15.76 15.760ZZZ.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
33533  Cabg arterial single                              A  33.75  14.12NA  14.12    8.13  56.00 56.000090.09.82.0920200             25.0008 090 99      0.00   0.00   0.00
33534  Cabg arterial two                                 A  39.88  16.75NA  16.75    9.58  66.21 66.210090.09.82.0920200             25.0008 090 99      0.00   0.00   0.00
33535  Cabg arterial three                               A  44.75  18.26NA  18.26   10.75  73.76 73.760090.09.82.0920200             25.0008 090 99      0.00   0.00   0.00
33536  Cabg arterial four or more                        A  48.43  18.85NA  18.85   11.70  78.98 78.980090.09.82.0920200             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33542  Removal of heart lesion                           A  48.21  19.26NA  19.26   11.64  79.11 79.110090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33545  Repair of heart damage                            A  57.06  22.05NA  22.05   13.68  92.79 92.790090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33548  Restore/remodel ventricle                         A  54.14  22.01NA  22.01   13.11  89.26 89.260090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33572  Open coronary endarterectomy                      A   4.44   1.41NA   1.41    1.08   6.93  6.930ZZZ.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
33600  Closure of valve                                  A  30.31  14.05NA  14.05    7.08  51.44 51.440090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33602  Closure of valve                                  A  29.34  13.74NA  13.74    6.25  49.33 49.330090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33606  Anastomosis/artery-aorta                          A  31.53  14.24NA  14.24    6.72  52.49 52.490090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33608  Repair anomaly w/conduit                          A  31.88  14.54NA  14.54    7.46  53.88 53.880090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33610  Repair by enlargement                             A  31.40  16.41NA  16.41    7.35  55.16 55.160090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33611  Repair double ventricle                           A  35.57  14.36NA  14.36    8.90  58.83 58.830090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33612  Repair double ventricle                           A  36.57  14.68NA  14.68    7.98  59.23 59.230090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33615  Repair modified fontan                            A  35.89  15.35NA  15.35    8.41  59.65 59.650090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33617  Repair single ventricle                           A  39.09  16.35NA  16.35    9.16  64.60 64.600090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33619  Repair single ventricle                           A  48.76  21.29NA  21.29   11.42  81.47 81.470090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33620  Apply r&l pulm art bands                          A  30.00   5.59NA   5.59    7.50  43.09 43.090090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33621  Transthor cath for stent                          A  16.18   6.09NA   6.09    3.76  26.03 26.030090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33622  Redo compl cardiac anomaly                        A  64.00  23.40NA  23.40   14.98 102.38102.380090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33641  Repair heart septum defect                        A  29.58  12.55NA  12.55    7.12  49.25 49.250090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33645  Revision of heart veins                           A  31.30  13.12NA  13.12    7.82  52.24 52.240090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33647  Repair heart septum defects                       A  33.00  13.56NA  13.56    8.25  54.81 54.810090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33660  Repair of heart defects                           A  31.83  13.19NA  13.19    7.96  52.98 52.980090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33665  Repair of heart defects                           A  34.85  14.14NA  14.14    8.74  57.73 57.730090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33670  Repair of heart chambers                          A  36.63  13.68NA  13.68    9.17  59.48 59.480090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33675  Close mult vsd                                    A  35.95  14.52NA  14.52    8.98  59.45 59.450090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33676  Close mult vsd w/resection                        A  36.95  17.61NA  17.61    9.36  63.92 63.920090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33677  Cl mult vsd w/rem pul band                        A  38.45  15.37NA  15.37    9.75  63.57 63.570090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33681  Repair heart septum defect                        A  32.34  15.13NA  15.13    7.80  55.27 55.270090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33684  Repair heart septum defect                        A  34.37  14.04NA  14.04    8.60  57.01 57.010090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33688  Repair heart septum defect                        A  34.75  13.37NA  13.37    8.70  56.82 56.820090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33690  Reinforce pulmonary artery                        A  20.36  10.87NA  10.87    4.76  35.99 35.990090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33692  Repair of heart defects                           A  36.15  16.60NA  16.60    9.11  61.86 61.860090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33694  Repair of heart defects                           A  35.57  17.02NA  17.02    8.90  61.49 61.490090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33697  Repair of heart defects                           A  37.57  15.68NA  15.68    8.19  61.44 61.440090.09.84.0720210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33702  Repair of heart defects                           A  27.24  12.69NA  12.69    6.81  46.74 46.740090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33710  Repair of heart defects                           A  37.50  17.80NA  17.80    8.78  64.08 64.080090.09.84.0720200             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33720  Repair of heart defect                            A  27.26  12.69NA  12.69    6.38  46.33 46.330090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33722  Repair of heart defect                            A  29.21  12.52NA  12.52    7.29  49.02 49.020090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33724  Repair venous anomaly                             A  27.63  11.92NA  11.92    6.45  46.00 46.000090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33726  Repair pul venous stenosis                        A  37.12  17.68NA  17.68    9.28  64.08 64.080090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33730  Repair heart-vein defect(s)                       A  36.14  15.29NA  15.29    9.05  60.48 60.480090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33732  Repair heart-vein defect                          A  28.96  13.62NA  13.62    7.24  49.82 49.820090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33735  Revision of heart chamber                         A  22.20  10.95NA  10.95    5.57  38.72 38.720090.09.84.0720200             25.0008 090 99      0.00   0.00   0.00
33736  Revision of heart chamber                         A  24.32  12.12NA  12.12    6.07  42.51 42.510090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33737  Revision of heart chamber                         A  22.47  12.48NA  12.48    5.27  40.22 40.220090.09.84.0720210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33750  Major vessel shunt                                A  22.22  12.52NA  12.52    7.98  42.72 42.720090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33755  Major vessel shunt                                A  22.60  12.86NA  12.86    4.94  40.40 40.400090.09.84.0720210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33762  Major vessel shunt                                A  22.60  11.92NA  11.92    5.73  40.25 40.250090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33764  Major vessel shunt & graft                        A  22.60  11.58NA  11.58    4.83  39.01 39.010090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33766  Major vessel shunt                                A  23.57  12.31NA  12.31    5.13  41.01 41.010090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33767  Major vessel shunt                                A  25.30  11.30NA  11.30    6.33  42.93 42.930090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33768  Cavopulmonary shunting                            A   8.00   3.16NA   3.16    1.99  13.15 13.150ZZZ.00.00.0000220             25.0008 090 99      0.00   0.00   0.00
33770  Repair great vessels defect                       A  39.07  17.99NA  17.99    9.16  66.22 66.220090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33771  Repair great vessels defect                       A  40.63  18.08NA  18.08   10.32  69.03 69.030090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33774  Repair great vessels defect                       A  31.73  14.73NA  14.73    7.93  54.39 54.390090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33775  Repair great vessels defect                       A  32.99  16.93NA  16.93    8.29  58.21 58.210090.09.84.0720200             25.0008 090 99      0.00   0.00   0.00
33776  Repair great vessels defect                       A  34.75  18.03NA  18.03    8.72  61.50 61.500090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33777  Repair great vessels defect                       A  34.17  16.78NA  16.78    8.61  59.56 59.560090.09.84.0720200             25.0008 090 99      0.00   0.00   0.00
33778  Repair great vessels defect                       A  42.75  17.43NA  17.43   10.85  71.03 71.030090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33779  Repair great vessels defect                       A  43.23  19.45NA  19.45   10.99  73.67 73.670090.09.84.0720210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33780  Repair great vessels defect                       A  43.90  19.94NA  19.94   11.14  74.98 74.980090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33781  Repair great vessels defect                       A  43.21  19.12NA  19.12   10.99  73.32 73.320090.09.84.0720200             25.0008 090 99      0.00   0.00   0.00
33782  Nikaidoh proc                                     A  60.08  22.09NA  22.09   14.07  96.24 96.240090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33783  Nikaidoh proc w/ostia implt                       A  65.08  23.66NA  23.66   15.24 103.98103.980090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33786  Repair arterial trunk                             A  41.87  16.21NA  16.21   10.60  68.68 68.680090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33788  Revision of pulmonary artery                      A  27.42  14.57NA  14.57    6.87  48.86 48.860090.09.84.0720210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33800  Aortic suspension                                 A  17.28   5.97NA   5.97    4.31  27.56 27.560090.09.84.0720220             25.0008 090 99      0.00   0.00   0.00
33802  Repair vessel defect                              A  18.37  11.82NA  11.82    4.60  34.79 34.790090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33803  Repair vessel defect                              A  20.31   9.35NA   9.35    5.08  34.74 34.740090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33813  Repair septal defect                              A  21.36  12.03NA  12.03    5.01  38.40 38.400090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33814  Repair septal defect                              A  26.57  12.87NA  12.87    6.64  46.08 46.080090.09.84.0720210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33820  Revise major vessel                               A  16.69   8.44NA   8.44    4.18  29.31 29.310090.09.84.0720200             25.0008 090 99      0.00   0.00   0.00
33822  Revise major vessel                               A  17.71   9.82NA   9.82    4.45  31.98 31.980090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33824  Revise major vessel                               A  20.23  10.39NA  10.39    4.74  35.36 35.360090.09.84.0720210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33840  Remove aorta constriction                         A  21.34  10.79NA  10.79    5.34  37.47 37.470090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33845  Remove aorta constriction                         A  22.93  11.68NA  11.68    5.73  40.34 40.340090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33851  Remove aorta constriction                         A  21.98  11.03NA  11.03    5.48  38.49 38.490090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33852  Repair septal defect                              A  24.41  11.75NA  11.75    6.10  42.26 42.260090.09.84.0720200             25.0008 090 99      0.00   0.00   0.00
33853  Repair septal defect                              A  32.51  14.68NA  14.68    8.14  55.33 55.330090.09.84.0720210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33860  Ascending aortic graft                            A  59.46  22.84NA  22.84   14.25  96.55 96.550090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33863  Ascending aortic graft                            A  58.79  21.68NA  21.68   14.07  94.54 94.540090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33864  Ascending aortic graft                            A  60.08  22.16NA  22.16   14.32  96.56 96.560090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33870  Transverse aortic arch graft                      A  46.06  18.64NA  18.64   11.00  75.70 75.700090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33875  Thoracic aortic graft                             A  50.72  19.75NA  19.75   12.12  82.59 82.590090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33877  Thoracoabdominal graft                            A  69.03  24.30NA  24.30   16.35 109.68109.680090.09.84.0720210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33880  Endovasc taa repr incl subcl                      A  34.58  12.30NA  12.30    7.72  54.60 54.600090.09.84.0722220             25.0008 090 99      0.00   0.00   0.00
33881  Endovasc taa repr w/o subcl                       A  29.58  10.70NA  10.70    6.60  46.88 46.880090.09.84.0722220             25.0008 090 99      0.00   0.00   0.00
33883  Insert endovasc prosth taa                        A  21.09   8.16NA   8.16    4.70  33.95 33.950090.09.84.0720220             25.0008 090 99      0.00   0.00   0.00
33884  Endovasc prosth taa add-on                        A   8.20   2.34NA   2.34    1.84  12.38 12.380ZZZ.00.00.0000220             25.0008 090 99      0.00   0.00   0.00
33886  Endovasc prosth delayed                           A  18.09   7.21NA   7.21    4.30  29.60 29.600090.09.84.0720220             25.0008 090 99      0.00   0.00   0.00
33889  Artery transpose/endovas taa                      A  15.92   4.33NA   4.33    3.78  24.03 24.030000.00.00.0021220             25.0008 090 99      0.00   0.00   0.00
33891  Car-car bp grft/endovas taa                       A  20.00   4.80NA   4.80    4.75  29.55 29.550000.00.00.0021220             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33910  Remove lung artery emboli                         A  48.21  19.17NA  19.17   12.04  79.42 79.420090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33915  Remove lung artery emboli                         A  24.95  10.75NA  10.75    5.44  41.14 41.140090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33916  Surgery of great vessel                           A  78.00  28.66NA  28.66   19.49 126.15126.150090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33917  Repair pulmonary artery                           A  25.30  12.47NA  12.47    5.92  43.69 43.690090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33920  Repair pulmonary atresia                          A  32.74  13.63NA  13.63    8.18  54.55 54.550090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33922  Transect pulmonary artery                         A  24.22  11.74NA  11.74    6.06  42.02 42.020090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33924  Remove pulmonary shunt                            A   5.49   1.72NA   1.72    1.28   8.49  8.490ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
33925  Rpr pul art unifocal w/o cpb                      A  31.30  12.71NA  12.71    7.32  51.33 51.330090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
33926  Repr pul art unifocal w/cpb                       A  44.73  16.87NA  16.87   11.17  72.77 72.770090.09.84.0720210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33933  Prepare donor heart/lung                          C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
33935  Transplantation heart/lung                        R  91.78  35.32NA  35.32   22.94 150.04150.040090.09.84.0720212             25.0008 090 99      0.00   0.00   0.00
3394F  Quant her2 ihc eval brst cx                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33940  Removal of donor heart                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33944  Prepare donor heart                               C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
33945  Transplantation of heart                          R  89.50  34.74NA  34.74   21.34 145.58145.580090.09.84.0720212             25.0008 090 99      0.00   0.00   0.00
3395F  Quant nonher2 ihc brst cx                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
33960  External circulation assist                       A  19.33   6.39NA   6.39    3.82  29.54 29.540000.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
33961  External circulation assist                       A  10.91   3.84NA   3.84    1.66  16.41 16.410ZZZ.00.00.0000110             25.0008 090 99      0.00   0.00   0.00
33967  Insert ia percut device                           A   4.84   1.73NA   1.73    1.08   7.65  7.650000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
33968  Remove aortic assist device                       A   0.64   0.22NA   0.22    0.14   1.00  1.000000.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
33970  Aortic circulation assist                         A   6.74   2.25NA   2.25    1.57  10.56 10.560000.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
33971  Aortic circulation assist                         A  11.99   6.65NA   6.65    2.80  21.44 21.440090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
33973  Insert balloon device                             A   9.75   3.35NA   3.35    2.26  15.36 15.360000.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
33974  Remove intra-aortic balloon                       A  15.03   8.40NA   8.40    3.77  27.20 27.200090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
33975  Implant ventricular device                        A  25.00   8.60NA   8.60    5.95  39.55 39.550XXX.00.00.0020200             25.0008 090 99      0.00   0.00   0.00
33976  Implant ventricular device                        A  30.75   9.64NA   9.64    7.68  48.07 48.070XXX.00.00.0022200             25.0008 090 99      0.00   0.00   0.00
33977  Remove ventricular device                         A  20.86   8.07NA   8.07    4.96  33.89 33.890XXX.00.00.0020200             25.0008 090 99      0.00   0.00   0.00
33978  Remove ventricular device                         A  25.00   9.22NA   9.22    6.26  40.48 40.480XXX.00.00.0022200             25.0008 090 99      0.00   0.00   0.00
33979  Insert intracorporeal device                      A  37.50  11.97NA  11.97    8.98  58.45 58.450XXX.00.00.0020200             25.0008 090 99      0.00   0.00   0.00
33980  Remove intracorporeal device                      A  33.50  11.99NA  11.99    8.08  53.57 53.570XXX.00.00.0020200             25.0008 090 99      0.00   0.00   0.00
33981  Replace vad pump ext                              A  16.11   5.07NA   5.07    4.02  25.20 25.200XXX.00.00.0020200             25.0008 090 99      0.00   0.00   0.00
33982  Replace vad intra w/o bp                          A  37.86  14.94NA  14.94    9.07  61.87 61.870XXX.00.00.0020200             25.0008 090 99      0.00   0.00   0.00
33983  Replace vad intra w/bp                            A  44.54  13.96NA  13.96   10.67  69.17 69.170XXX.00.00.0020200             25.0008 090 99      0.00   0.00   0.00
33990  Insert vad artery access                          A   8.15   2.95NA   2.95    1.82  12.92 12.920XXX.00.00.0020200             25.0008 090 99      0.00   0.00   0.00
33991  Insert vad art&vein access                        A  11.88   4.30NA   4.30    2.65  18.83 18.830XXX.00.00.0020200             25.0008 090 99      0.00   0.00   0.00
33992  Remove vad different session                      A   4.00   1.26NA   1.26    0.89   6.15  6.150XXX.00.00.0020200             25.0008 090 99      0.00   0.00   0.00
33993  Reposition vad diff session                       A   3.51   1.11NA   1.11    0.78   5.40  5.400XXX.00.00.0020200             25.0008 090 99      0.00   0.00   0.00
33999  Cardiac surgery procedure                         C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020211             25.0008 090 99      0.00   0.00   0.00
34001  Removal of artery clot                            A  17.88   7.65NA   7.65    4.07  29.60 29.600090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
34051  Removal of artery clot                            A  16.99   8.93NA   8.93    4.25  30.17 30.170090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
34101  Removal of artery clot                            A  10.93   5.05NA   5.05    2.46  18.44 18.440090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
34111  Removal of arm artery clot                        A  10.93   5.08NA   5.08    2.44  18.45 18.450090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
34151  Removal of artery clot                            A  26.52  10.40NA  10.40    5.97  42.89 42.890090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
34201  Removal of artery clot                            A  19.48   7.72NA   7.72    4.48  31.68 31.680090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
34203  Removal of leg artery clot                        A  17.86   7.42NA   7.42    4.11  29.39 29.390090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
34401  Removal of vein clot                              A  26.52  11.83NA  11.83    5.66  44.01 44.010090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
34421  Removal of vein clot                              A  13.37   6.00NA   6.00    2.97  22.34 22.340090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
34451  Removal of vein clot                              A  28.52  14.70NA  14.70    6.78  50.00 50.000090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
34471  Removal of vein clot                              A  21.11   7.07NA   7.07    4.50  32.68 32.680090.09.84.0721110             25.0008 090 99      0.00   0.00   0.00
34490  Removal of vein clot                              A  10.91   5.60NA   5.60    2.42  18.93 18.930090.09.84.0721100             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
34501  Repair valve femoral vein                         A  16.85   6.72NA   6.72    4.00  27.57 27.570090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
34502  Reconstruct vena cava                             A  28.07  12.31NA  12.31    5.89  46.27 46.270090.09.84.0720200             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
34510  Transposition of vein valve                       A  19.91  11.32NA  11.32    4.23  35.46 35.460090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
3452F  Dyspnea not screened                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
34520  Cross-over vein graft                             A  19.18   6.72NA   6.72    4.55  30.45 30.450090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
34530  Leg vein fusion                                   A  17.93   6.75NA   6.75    3.82  28.50 28.500090.09.84.0721210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3470F  Ra disease activity low                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3471F  Ra disease activity mod                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3472F  Ra disease activity high                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
34800  Endovas aaa repr w/sm tube                        A  21.54   8.08NA   8.08    4.57  34.19 34.190090.09.84.0720220             25.0008 090 99      0.00   0.00   0.00
34802  Endovas aaa repr w/2-p part                       A  23.79   8.98NA   8.98    5.09  37.86 37.860090.09.84.0720220             25.0008 090 99      0.00   0.00   0.00
34803  Endovas aaa repr w/3-p part                       A  24.82   8.94NA   8.94    5.34  39.10 39.100090.09.84.0722220             25.0008 090 99      0.00   0.00   0.00
34804  Endovas aaa repr w/1-p part                       A  23.79   8.95NA   8.95    5.14  37.88 37.880090.09.84.0720220             25.0008 090 99      0.00   0.00   0.00
34805  Endovas aaa repr w/long tube                      A  22.67   8.57NA   8.57    5.04  36.28 36.280090.09.84.0720220             25.0008 090 99      0.00   0.00   0.00
34806  Aneurysm press sensor add-on                      A   2.06   0.58NA   0.58    0.45   3.09  3.090ZZZ.00.00.0000220             25.0008 090 99      0.00   0.00   0.00
34808  Endovas iliac a device addon                      A   4.12   1.23NA   1.23    0.90   6.25  6.250ZZZ.00.00.0000220             25.0008 090 99      0.00   0.00   0.00
34812  Xpose for endoprosth femorl                       A   6.74   1.95NA   1.95    1.55  10.24 10.240000.00.00.0021220             25.0008 090 99      0.00   0.00   0.00
34813  Femoral endovas graft add-on                      A   4.79   1.32NA   1.32    1.10   7.21  7.210ZZZ.00.00.0000220             25.0008 090 99      0.00   0.00   0.00
34820  Xpose for endoprosth iliac                        A   9.74   2.94NA   2.94    2.18  14.86 14.860000.00.00.0021220             25.0008 090 99      0.00   0.00   0.00
34825  Endovasc extend prosth init                       A  12.80   5.71NA   5.71    2.75  21.26 21.260090.09.84.0720220             25.0008 090 99      0.00   0.00   0.00
34826  Endovasc exten prosth addl                        A   4.12   1.20NA   1.20    0.88   6.20  6.200ZZZ.00.00.0000220             25.0008 090 99      0.00   0.00   0.00
34830  Open aortic tube prosth repr                      A  35.23  10.56NA  10.56    8.36  54.15 54.150090.09.84.0720220             25.0008 090 99      0.00   0.00   0.00
34831  Open aortoiliac prosth repr                       A  37.98  11.22NA  11.22    9.02  58.22 58.220090.09.84.0720220             25.0008 090 99      0.00   0.00   0.00
34832  Open aortofemor prosth repr                       A  37.98  11.22NA  11.22    9.02  58.22 58.220090.09.84.0720220             25.0008 090 99      0.00   0.00   0.00
34833  Xpose for endoprosth iliac                        A  11.98   3.75NA   3.75    2.79  18.52 18.520000.00.00.0021220             25.0008 090 99      0.00   0.00   0.00
34834  Xpose endoprosth brachial                         A   5.34   1.79NA   1.79    1.24   8.37  8.370000.00.00.0021220             25.0008 090 99      0.00   0.00   0.00
3490F  History aids-defining cond                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
34900  Endovasc iliac repr w/graft                       A  16.85   6.73NA   6.73    3.58  27.16 27.160090.09.84.0721220             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3497F  CD4+ cell percentage <15%                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3498F  Cd4+ cell =15% (hiv)                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
35001  Repair defect of artery                           A  20.81   9.15NA   9.15    4.82  34.78 34.780090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35002  Repair artery rupture neck                        A  22.23   7.42NA   7.42    4.75  34.40 34.400090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35005  Repair defect of artery                           A  19.29  11.21NA  11.21    4.57  35.07 35.070090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35011  Repair defect of artery                           A  18.58   7.73NA   7.73    4.22  30.53 30.530090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35013  Repair artery rupture arm                         A  23.23   9.68NA   9.68    5.28  38.19 38.190090.09.84.0721210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
35021  Repair defect of artery                           A  22.17  10.60NA  10.60    5.20  37.97 37.970090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35022  Repair artery rupture chest                       A  25.70  11.67NA  11.67    6.02  43.39 43.390090.09.84.0721210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
35045  Repair defect of arm artery                       A  18.01   8.17NA   8.17    4.00  30.18 30.180090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35081  Repair defect of artery                           A  33.53  12.43NA  12.43    7.77  53.73 53.730090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
35082  Repair artery rupture aorta                       A  42.09  15.17NA  15.17    9.66  66.92 66.920090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
35091  Repair defect of artery                           A  35.35  11.28NA  11.28    8.19  54.82 54.820090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35092  Repair artery rupture aorta                       A  50.97  16.84NA  16.84   11.79  79.60 79.600090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
3510F  Doc tb scrng-rslts interpd                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
35102  Repair defect of artery                           A  36.53  13.05NA  13.05    8.45  58.03 58.030090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35103  Repair artery rupture groin                       A  43.62  15.07NA  15.07    9.99  68.68 68.680090.09.84.0721210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
35111  Repair defect of artery                           A  26.28   8.31NA   8.31    5.61  40.20 40.200090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35112  Repair artery rupture spleen                      A  32.57  16.48NA  16.48    6.94  55.99 55.990090.09.84.0721210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
35121  Repair defect of artery                           A  31.52  11.50NA  11.50    7.25  50.27 50.270090.09.84.0721200             25.0008 090 99      0.00   0.00   0.00
35122  Repair artery rupture belly                       A  37.89  18.58NA  18.58    8.08  64.55 64.550090.09.84.0721210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
35131  Repair defect of artery                           A  26.40   9.98NA   9.98    6.10  42.48 42.480090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35132  Repair artery rupture groin                       A  32.57   9.92NA   9.92    7.44  49.93 49.930090.09.84.0721210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
35141  Repair defect of artery                           A  20.91   8.32NA   8.32    4.83  34.06 34.060090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35142  Repair artery rupture thigh                       A  25.16   9.69NA   9.69    5.78  40.63 40.630090.09.84.0721210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
35151  Repair defect of artery                           A  23.72   9.01NA   9.01    5.47  38.20 38.200090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35152  Repair ruptd popliteal art                        A  27.66   8.74NA   8.74    6.57  42.97 42.970090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
3517F  Hbv assess&results intrp 1yr                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
35180  Repair blood vessel lesion                        A  15.10   9.13NA   9.13    3.58  27.81 27.810090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
35182  Repair blood vessel lesion                        A  31.71  14.27NA  14.27    6.76  52.74 52.740090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
35184  Repair blood vessel lesion                        A  18.82   9.09NA   9.09    4.01  31.92 31.920090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
35188  Repair blood vessel lesion                        A  18.00   5.99NA   5.99    3.85  27.84 27.840090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
35189  Repair blood vessel lesion                        A  29.98   9.30NA   9.30    7.50  46.78 46.780090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
35190  Repair blood vessel lesion                        A  13.42   6.71NA   6.71    3.06  23.19 23.190090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
3520F  Cdifficile testing performed                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
35201  Repair blood vessel lesion                        A  16.93   8.05NA   8.05    3.76  28.74 28.740090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35206  Repair blood vessel lesion                        A  13.84   6.80NA   6.80    3.06  23.70 23.700090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35207  Repair blood vessel lesion                        A  10.94   9.54NA   9.54    1.93  22.41 22.410090.09.84.0721110             25.0008 090 99      0.00   0.00   0.00
35211  Repair blood vessel lesion                        A  24.58  11.10NA  11.10    5.91  41.59 41.590090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35216  Repair blood vessel lesion                        A  36.61  16.28NA  16.28    8.64  61.53 61.530090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35221  Repair blood vessel lesion                        A  26.62  11.22NA  11.22    5.83  43.67 43.670090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35226  Repair blood vessel lesion                        A  15.30   6.77NA   6.77    3.52  25.59 25.590090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35231  Repair blood vessel lesion                        A  21.16  11.04NA  11.04    4.16  36.36 36.360090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35236  Repair blood vessel lesion                        A  18.02   8.03NA   8.03    3.99  30.04 30.040090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35241  Repair blood vessel lesion                        A  25.58  11.64NA  11.64    6.30  43.52 43.520090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35246  Repair blood vessel lesion                        A  28.23   9.00NA   9.00    6.70  43.93 43.930090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35251  Repair blood vessel lesion                        A  31.91  12.51NA  12.51    7.00  51.42 51.420090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35256  Repair blood vessel lesion                        A  19.06   7.80NA   7.80    4.36  31.22 31.220090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35261  Repair blood vessel lesion                        A  18.96   8.44NA   8.44    4.64  32.04 32.040090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35266  Repair blood vessel lesion                        A  15.83   6.83NA   6.83    3.62  26.28 26.280090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35271  Repair blood vessel lesion                        A  24.58  11.19NA  11.19    6.14  41.91 41.910090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35276  Repair blood vessel lesion                        A  25.83  12.06NA  12.06    6.04  43.93 43.930090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35281  Repair blood vessel lesion                        A  30.06  12.70NA  12.70    6.79  49.55 49.550090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35286  Repair blood vessel lesion                        A  17.19   7.44NA   7.44    3.96  28.59 28.590090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35301  Rechanneling of artery                            A  19.61   8.04NA   8.04    4.56  32.21 32.210090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35302  Rechanneling of artery                            A  21.35   8.36NA   8.36    4.93  34.64 34.640090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35303  Rechanneling of artery                            A  23.60   9.19NA   9.19    5.43  38.22 38.220090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35304  Rechanneling of artery                            A  24.60   9.12NA   9.12    5.65  39.37 39.370090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35305  Rechanneling of artery                            A  23.60   8.81NA   8.81    5.43  37.84 37.840090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35306  Rechanneling of artery                            A   9.25   2.22NA   2.22    2.19  13.66 13.660ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
35311  Rechanneling of artery                            A  28.60  11.55NA  11.55    6.70  46.85 46.850090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35321  Rechanneling of artery                            A  16.59   6.91NA   6.91    3.77  27.27 27.270090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35331  Rechanneling of artery                            A  27.72  10.55NA  10.55    6.44  44.71 44.710090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35341  Rechanneling of artery                            A  26.21   9.94NA   9.94    6.06  42.21 42.210090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35351  Rechanneling of artery                            A  24.61   9.05NA   9.05    5.65  39.31 39.310090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35355  Rechanneling of artery                            A  19.86   7.40NA   7.40    4.56  31.82 31.820090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35361  Rechanneling of artery                            A  30.24   9.36NA   9.36    7.19  46.79 46.790090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35363  Rechanneling of artery                            A  32.35  12.72NA  12.72    7.57  52.64 52.640090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35371  Rechanneling of artery                            A  15.31   6.39NA   6.39    3.52  25.22 25.220090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35372  Rechanneling of artery                            A  18.58   7.29NA   7.29    4.26  30.13 30.130090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35390  Reoperation carotid add-on                        A   3.19   0.94NA   0.94    0.73   4.86  4.860ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
35400  Angioscopy                                        A   3.00   0.86NA   0.86    0.68   4.54  4.540ZZZ.00.00.0000010             25.0008 090 99      0.00   0.00   0.00
35450  Repair arterial blockage                          A  10.05   3.26NA   3.26    2.25  15.56 15.560000.00.00.0021210             25.0008 090 99      0.00   0.00   0.00
35452  Repair arterial blockage                          A   6.90   2.41NA   2.41    1.58  10.89 10.890000.00.00.0021210             25.0008 090 99      0.00   0.00   0.00
35458  Repair arterial blockage                          A   9.48   3.31NA   3.31    2.14  14.93 14.930000.00.00.0021210             25.0008 090 99      0.00   0.00   0.00
35460  Repair venous blockage                            A   6.03   2.21NA   2.21    1.32   9.56  9.560000.00.00.0021110             25.0008 090 99      0.00   0.00   0.00
35471  Repair arterial blockage                          A  10.05  66.18     3.63    1.99  78.22 15.670000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
35472  Repair arterial blockage                          A   6.90  50.74     2.45    1.44  59.08 10.790000.00.00.0021010             25.0008 090 99      0.00   0.00   0.00
35475  Repair arterial blockage                          R   5.75  42.95     2.64    0.92  49.62  9.310000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
35476  Repair venous blockage                            A   4.71  38.74     1.85    0.65  44.10  7.210000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
3550F  Low rsk thromboembolism                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
35500  Harvest vein for bypass                           A   6.44   1.84NA   1.84    1.50   9.78  9.780ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
35501  Art byp grft ipsilat carotid                      A  29.09  10.43NA  10.43    6.70  46.22 46.220090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35506  Art byp grft subclav-carotid                      A  25.33   9.74NA   9.74    6.02  41.09 41.090090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35508  Art byp grft carotid-vertbrl                      A  26.09   8.62NA   8.62    6.52  41.23 41.230090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35509  Art byp grft contral carotid                      A  28.09   8.74NA   8.74    6.67  43.50 43.500090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
3551F  Intrmed rsk thromboembolism                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
35510  Art byp grft carotid-brchial                      A  24.39   7.67NA   7.67    5.78  37.84 37.840090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35511  Art byp grft subclav-subclav                      A  22.20  11.65NA  11.65    5.28  39.13 39.130090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35512  Art byp grft subclav-brchial                      A  23.89   7.55NA   7.55    5.68  37.12 37.120090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35515  Art byp grft subclav-vertbrl                      A  26.09   8.62NA   8.62    6.19  40.90 40.900090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35516  Art byp grft subclav-axilary                      A  24.21   7.58NA   7.58    5.74  37.53 37.530090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35518  Art byp grft axillary-axilry                      A  22.65  11.82NA  11.82    5.38  39.85 39.850090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
3552F  Hgh risk for thromboembolism                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
35521  Art byp grft axill-femoral                        A  24.13  13.15NA  13.15    5.73  43.01 43.010090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35522  Art byp grft axill-brachial                       A  23.15   9.47NA   9.47    5.48  38.10 38.100090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35523  Art byp grft brchl-ulnr-rdl                       A  24.13   9.57NA   9.57    5.48  39.18 39.180090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35525  Art byp grft brachial-brchl                       A  21.69   8.46NA   8.46    4.83  34.98 34.980090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35526  Art byp grft aor/carot/innom                      A  31.55  13.25NA  13.25    7.89  52.69 52.690090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35531  Art byp grft aorcel/aormesen                      A  39.11  13.91NA  13.91    8.91  61.93 61.930090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35533  Art byp grft axill/fem/fem                        A  29.92   9.28NA   9.28    7.10  46.30 46.300090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35535  Art byp grft hepatorenal                          A  38.13  11.30NA  11.30    2.71  52.14 52.140090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35536  Art byp grft splenorenal                          A  33.73  19.82NA  19.82    8.02  61.57 61.570090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35537  Art byp grft aortoiliac                           A  41.88  12.24NA  12.24    9.94  64.06 64.060090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
35538  Art byp grft aortobi-iliac                        A  47.03  13.51NA  13.51   11.16  71.70 71.700090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
35539  Art byp grft aortofemoral                         A  44.11  12.77NA  12.77   10.48  67.36 67.360090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35540  Art byp grft aortbifemoral                        A  49.33  17.89NA  17.89   11.35  78.57 78.570090.09.84.0721110             25.0008 090 99      0.00   0.00   0.00
3555F  Pt inr measurement performed                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
35556  Art byp grft fem-popliteal                        A  26.75  10.25NA  10.25    6.14  43.14 43.140090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35558  Art byp grft fem-femoral                          A  23.13   9.62NA   9.62    5.34  38.09 38.090090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35560  Art byp grft aortorenal                           A  34.03  10.27NA  10.27    8.08  52.38 52.380090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35563  Art byp grft ilioiliac                            A  26.12   8.37NA   8.37    6.19  40.68 40.680090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35565  Art byp grft iliofemoral                          A  25.13   9.59NA   9.59    5.74  40.46 40.460090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35566  Art byp fem-ant-post tib/prl                      A  32.35  11.58NA  11.58    7.50  51.43 51.430090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35570  Art byp tibial-tib/peroneal                       A  29.15  10.58NA  10.58    2.07  41.80 41.800090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35571  Art byp pop-tibl-prl-other                        A  25.52   9.45NA   9.45    5.89  40.86 40.860090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35572  Harvest femoropopliteal vein                      A   6.81   2.11NA   2.11    1.59  10.51 10.510ZZZ.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
35583  Vein byp grft fem-popliteal                       A  27.75  10.26NA  10.26    6.36  44.37 44.370090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35585  Vein byp fem-tibial peroneal                      A  32.35  11.84NA  11.84    7.40  51.59 51.590090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35587  Vein byp pop-tibl peroneal                        A  26.21   9.73NA   9.73    6.04  41.98 41.980090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35600  Harvest art for cabg add-on                       A   4.94   1.58NA   1.58    1.20   7.72  7.720ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
35601  Art byp common ipsi carotid                       A  27.09   9.92NA   9.92    6.34  43.35 43.350090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35606  Art byp carotid-subclavian                        A  22.46   8.44NA   8.44    5.25  36.15 36.150090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35612  Art byp subclav-subclavian                        A  20.35   6.98NA   6.98    4.84  32.17 32.170090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35616  Art byp subclav-axillary                          A  21.82   6.91NA   6.91    4.65  33.38 33.380090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35621  Art byp axillary-femoral                          A  21.03   7.89NA   7.89    4.87  33.79 33.790090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35623  Art byp axillary-pop-tibial                       A  25.92   8.32NA   8.32    6.14  40.38 40.380090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35626  Art byp aorsubcl/carot/innom                      A  29.14  11.82NA  11.82    6.98  47.94 47.940090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35631  Art byp aor-celiac-msn-renal                      A  36.03  12.13NA  12.13    8.42  56.58 56.580090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35632  Art byp ilio-celiac                               A  36.13  10.82NA  10.82    2.57  49.52 49.520090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35633  Art byp ilio-mesenteric                           A  39.11  13.28NA  13.28    2.78  55.17 55.170090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35634  Art byp iliorenal                                 A  35.33  10.63NA  10.63    2.50  48.46 48.460090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35636  Art byp spenorenal                                A  31.75   9.72NA   9.72    7.54  49.01 49.010090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35637  Art byp aortoiliac                                A  33.05  12.49NA  12.49    7.65  53.19 53.190090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
35638  Art byp aortobi-iliac                             A  33.60  12.75NA  12.75    7.83  54.18 54.180090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
35642  Art byp carotid-vertebral                         A  18.94   6.98NA   6.98    4.49  30.41 30.410090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35645  Art byp subclav-vertebrl                          A  18.43  10.55NA  10.55    4.61  33.59 33.590090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35646  Art byp aortobifemoral                            A  32.98  12.14NA  12.14    7.59  52.71 52.710090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
35647  Art byp aortofemoral                              A  29.73  11.23NA  11.23    6.90  47.86 47.860090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35650  Art byp axillary-axillary                         A  20.16   7.93NA   7.93    4.60  32.69 32.690090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35654  Art byp axill-fem-femoral                         A  26.28   9.60NA   9.60    6.07  41.95 41.950090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
35656  Art byp femoral-popliteal                         A  20.47   8.16NA   8.16    4.71  33.34 33.340090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35661  Art byp femoral-femoral                           A  20.35   8.41NA   8.41    4.70  33.46 33.460090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35663  Art byp ilioiliac                                 A  23.93   9.32NA   9.32    5.47  38.72 38.720090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35665  Art byp iliofemoral                               A  22.35   8.68NA   8.68    5.12  36.15 36.150090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35666  Art byp fem-ant-post tib/prl                      A  23.66  10.06NA  10.06    5.44  39.16 39.160090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35671  Art byp pop-tibl-prl-other                        A  20.77   9.05NA   9.05    4.78  34.60 34.600090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35681  Composite byp grft pros&vein                      A   1.60   0.47NA   0.47    0.37   2.44  2.440ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
35682  Composite byp grft 2 veins                        A   7.19   1.93NA   1.93    1.66  10.78 10.780ZZZ.00.00.0000010             25.0008 090 99      0.00   0.00   0.00
35683  Composite byp grft 3/> segmt                      A   8.49   2.04NA   2.04    2.00  12.53 12.530ZZZ.00.00.0000010             25.0008 090 99      0.00   0.00   0.00
35685  Bypass graft patency/patch                        A   4.04   1.13NA   1.13    0.93   6.10  6.100ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
35686  Bypass graft/av fist patency                      A   3.34   0.94NA   0.94    0.75   5.03  5.030ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
35691  Art trnsposj vertbrl carotid                      A  18.41   6.32NA   6.32    4.37  29.10 29.100090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35693  Art trnsposj subclavian                           A  15.73   6.30NA   6.30    3.74  25.77 25.770090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35694  Art trnsposj subclav carotid                      A  19.28   6.53NA   6.53    4.57  30.38 30.380090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35695  Art trnsposj carotid subclav                      A  20.06   6.72NA   6.72    4.76  31.54 31.540090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35697  Reimplant artery each                             A   3.00   0.83NA   0.83    0.69   4.52  4.520ZZZ.00.00.0000220             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
35700  Reoperation bypass graft                          A   3.08   0.88NA   0.88    0.71   4.67  4.670ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
35701  Exploration carotid artery                        A   9.19   6.25NA   6.25    1.80  17.24 17.240090.09.84.0721210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
35721  Exploration femoral artery                        A   7.72   4.48NA   4.48    1.74  13.94 13.940090.09.84.0721210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
35741  Exploration popliteal artery                      A   8.69   5.06NA   5.06    1.93  15.68 15.680090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35761  Exploration of artery/vein                        A   5.93   4.67NA   4.67    1.29  11.89 11.890090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35800  Explore neck vessels                              A  12.00   7.18NA   7.18    2.53  21.71 21.710090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
35820  Explore chest vessels                             A  36.89  14.75NA  14.75    8.83  60.47 60.470090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
35840  Explore abdominal vessels                         A  20.75  10.40NA  10.40    4.45  35.60 35.600090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
35860  Explore limb vessels                              A  15.25   7.01NA   7.01    3.48  25.74 25.740090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
35870  Repair vessel graft defect                        A  24.50   7.97NA   7.97    5.81  38.28 38.280090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
35875  Removal of clot in graft                          A  10.72   5.19NA   5.19    2.44  18.35 18.350090.09.84.0720110             25.0008 090 99      0.00   0.00   0.00
35876  Removal of clot in graft                          A  17.82   7.21NA   7.21    4.08  29.11 29.110090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
35879  Revise graft w/vein                               A  17.41   7.13NA   7.13    4.01  28.55 28.550090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35881  Revise graft w/vein                               A  19.35   7.64NA   7.64    4.49  31.48 31.480090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35883  Revise graft w/nonauto graft                      A  23.15   8.71NA   8.71    5.34  37.20 37.200090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35884  Revise graft w/vein                               A  24.65   7.66NA   7.66    5.84  38.15 38.150090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
35901  Excision graft neck                               A   8.38   5.08NA   5.08    1.91  15.37 15.370090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
35903  Excision graft extremity                          A   9.53   5.81NA   5.81    2.15  17.49 17.490090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
35905  Excision graft thorax                             A  33.52  10.15NA  10.15    7.96  51.63 51.630090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
35907  Excision graft abdomen                            A  37.27  12.81NA  12.81    8.59  58.67 58.670090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
36000  Place needle in vein                              B+  0.18   0.57     0.07    0.03   0.78  0.289XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
36002  Pseudoaneurysm injection trt                      A   1.96   2.62     0.93    0.30   4.88  3.190000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
36005  Injection ext venography                          A   0.95   8.86     0.33    0.14   9.95  1.420000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
36010  Place catheter in vein                            A   2.43  12.68     0.82    0.35  15.46  3.600XXX.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
36011  Place catheter in vein                            A   3.14  22.49     1.09    0.44  26.07  4.670XXX.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
36012  Place catheter in vein                            A   3.51  22.67     1.22    0.52  26.70  5.250XXX.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
36013  Place catheter in artery                          A   2.52  22.05     0.94    0.45  25.02  3.910XXX.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36014  Place catheter in artery                          A   3.02  21.80     1.07    0.33  25.15  4.420XXX.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
36015  Place catheter in artery                          A   3.51  23.22     1.25    0.37  27.10  5.130XXX.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
36100  Establish access to artery                        A   3.02  12.14     1.09    0.67  15.83  4.780XXX.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
36120  Establish access to artery                        A   2.01  11.09     0.63    0.33  13.43  2.970XXX.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36140  Establish access to artery                        A   2.01  11.23     0.66    0.39  13.63  3.060XXX.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36147  Access av dial grft for eval                      A   3.72  21.84     1.33    0.50  26.06  5.550XXX.00.00.0020200             25.0008 090 99      0.00   0.00   0.00
36148  Access av dial grft for proc                      A   1.00   7.01     0.34    0.12   8.13  1.460ZZZ.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
36160  Establish access to aorta                         A   2.52  12.92     0.90    0.38  15.82  3.800XXX.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36200  Place catheter in aorta                           A   3.02  15.92     0.93    0.60  19.54  4.550000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
36215  Place catheter in artery                          A   4.67  28.54     1.70    0.82  34.03  7.190XXX.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36216  Place catheter in artery                          A   5.27  31.74     1.98    0.93  37.94  8.180XXX.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36217  Place catheter in artery                          A   6.29  58.00     2.45    1.06  65.35  9.800XXX.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36218  Place catheter in artery                          A   1.01   4.87     0.39    0.16   6.04  1.560ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
36221  Place cath thoracic aorta                         A   4.17  29.02     1.39    0.83  34.02  6.390000.00.00.0022100             25.0008 090 99     86.33  86.33   2.46
36222  Place cath carotid/inom art                       A   5.53  36.08     2.13    0.98  42.59  8.640000.00.00.0020100             25.0008 090 99     86.45  86.45   2.34
36223  Place cath carotid/inom art                       A   6.00  39.36     2.28    1.06  46.42  9.340000.00.00.0020100             25.0008 090 99     86.47  86.47   2.32
36224  Place cath carotd art                             A   6.50  42.84     2.58    1.10  50.44 10.180000.00.00.0020100             25.0008 090 99    141.59 141.59   3.63
36225  Place cath subclavian art                         A   6.00  39.00     2.25    1.05  46.05  9.300000.00.00.0020100             25.0008 090 99     86.47  86.47   2.32
36226  Place cath vertebral art                          A   6.50  43.85     2.60    1.10  51.45 10.200000.00.00.0020100             25.0008 090 99    141.67 141.67   3.54
36227  Place cath xtrnl carotid                          A   2.09   5.00     0.80    0.33   7.42  3.220ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
36228  Place cath intracranial art                       A   4.25  30.49     1.65    0.67  35.41  6.570ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
36245  Ins cath abd/l-ext art 1st                        A   4.67  25.11     1.65    0.87  30.65  7.190XXX.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
36246  Ins cath abd/l-ext art 2nd                        A   5.27  21.28     1.74    0.98  27.53  7.990000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
36247  Ins cath abd/l-ext art 3rd                        A   6.29  41.70     2.08    1.18  49.17  9.550000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
36248  Ins cath abd/l-ext art addl                       A   1.01   3.54     0.34    0.16   4.71  1.510ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
36251  Ins cath ren art 1st unilat                       A   5.35  38.44     1.95    1.00  44.79  8.300000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36252  Ins cath ren art 1st bilat                        A   6.99  40.69     2.51    1.30  48.98 10.800000.00.00.0022100             25.0008 090 99      0.00   0.00   0.00
36253  Ins cath ren art 2nd+ unilat                      A   7.55  59.35     2.56    1.41  68.31 11.520000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36254  Ins cath ren art 2nd+ bilat                       A   8.15  61.26     2.75    1.52  70.93 12.420000.00.00.0022100             25.0008 090 99      0.00   0.00   0.00
36260  Insertion of infusion pump                        A   9.91   7.20NA   7.20    2.12  19.23 19.230090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
36261  Revision of infusion pump                         A   5.63   5.14NA   5.14    1.33  12.10 12.100090.09.84.0720200             25.0008 090 99      0.00   0.00   0.00
36262  Removal of infusion pump                          A   4.11   4.22NA   4.22    0.87   9.20  9.200090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
36299  Vessel injection procedure                        C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 090 99      0.00   0.00   0.00
36400  Bl draw < 3 yrs fem/jugular                       A   0.38   0.43     0.15    0.05   0.86  0.580XXX.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36405  Bl draw <3 yrs scalp vein                         A   0.31   0.43     0.13    0.05   0.79  0.490XXX.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36406  Bl draw <3 yrs other vein                         A   0.18   0.38     0.08    0.03   0.59  0.290XXX.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36410  Non-routine bl draw 3/> yrs                       A   0.18   0.30     0.07    0.03   0.51  0.280XXX.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36415  Routine venipuncture                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
36416  Capillary blood draw                              B   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
36420  Vein access cutdown < 1 yr                        A   1.01   0.41NA   0.41    0.12   1.54  1.540XXX.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
36425  Vein access cutdown > 1 yr                        A   0.76   0.31NA   0.31    0.11   1.18  1.180XXX.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36430  Blood transfusion service                         A   0.00   1.02     1.02NA  0.01   1.03  1.035XXX.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
36440  Bl push transfuse 2 yr/<                          A   1.03   0.47NA   0.47    0.24   1.74  1.740XXX.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
36450  Bl exchange/transfuse nb                          A   2.23   0.80NA   0.80    0.11   3.14  3.140XXX.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
36455  Bl exchange/transfuse non-nb                      A   2.43   0.76NA   0.76    0.14   3.33  3.330XXX.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36460  Transfusion service fetal                         A   6.58   2.81NA   2.81    1.40  10.79 10.790XXX.00.00.0020200             25.0008 090 99      0.00   0.00   0.00
36468  Injection(s) spider veins                         R   0.00   0.00     0.00    0.00   0.00  0.000000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
36469  Injection(s) spider veins                         R   0.00   0.00     0.00    0.00   0.00  0.000000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
36470  Injection therapy of vein                         A   1.10   3.36     1.27    0.22   4.68  2.590010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
36471  Injection therapy of veins                        A   1.65   3.35     1.05    0.33   5.33  3.030010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
36475  Endovenous rf 1st vein                            A   6.72  45.17     2.46    1.42  53.31 10.600000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
36476  Endovenous rf vein add-on                         A   3.38   7.75     1.11    0.72  11.85  5.210ZZZ.00.00.0001100             25.0008 090 99      0.00   0.00   0.00
36478  Endovenous laser 1st vein                         A   6.72  33.71     2.47    1.32  41.75 10.510000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
36479  Endovenous laser vein addon                       A   3.38   8.00     1.15    0.65  12.03  5.180ZZZ.00.00.0001100             25.0008 090 99      0.00   0.00   0.00
36481  Insertion of catheter vein                        A   6.98  56.80     2.74    0.88  64.66 10.600000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
3650F  Eeg ordered rvwd reqstd                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
36500  Insertion of catheter vein                        A   3.51   1.27NA   1.27    0.53   5.31  5.310000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36510  Insertion of catheter vein                        A   1.09   1.54     0.46    0.24   2.87  1.790000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
36511  Apheresis wbc                                     A   1.74   0.83NA   0.83    0.27   2.84  2.840000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36512  Apheresis rbc                                     A   1.74   0.84NA   0.84    0.16   2.74  2.740000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36513  Apheresis platelets                               A   1.74   0.83NA   0.83    0.34   2.91  2.910000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36514  Apheresis plasma                                  A   1.74  14.21     0.77    0.27  16.22  2.780000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36515  Apheresis adsorp/reinfuse                         A   1.74  63.66     0.60    0.24  65.64  2.580000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36516  Apheresis selective                               A   1.22  62.43     0.52    0.35  64.00  2.090000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36522  Photopheresis                                     A   1.67  40.98     1.21    0.16  42.81  3.040000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36555  Insert non-tunnel cv cath                         A   2.68   4.73     0.52    0.22   7.63  3.420000.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
36556  Insert non-tunnel cv cath                         A   2.50   4.24     0.75    0.31   7.05  3.560000.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
36557  Insert tunneled cv cath                           A   5.14  17.62     2.93    1.09  23.85  9.160010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
36558  Insert tunneled cv cath                           A   4.84  18.61     2.77    0.72  24.17  8.330010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
36560  Insert tunneled cv cath                           A   6.29  35.57     4.03    0.59  42.45 10.910010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
36561  Insert tunneled cv cath                           A   6.04  29.76     3.52    1.10  36.90 10.660010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
36563  Insert tunneled cv cath                           A   6.24  34.35     3.83    1.31  41.90 11.380010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
36565  Insert tunneled cv cath                           A   6.04  23.71     3.21    1.29  31.04 10.540010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
36566  Insert tunneled cv cath                           A   6.54 165.44     3.69    1.27 173.25 11.500010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
36568  Insert picc cath                                  A   1.92   6.81     0.75    0.18   8.91  2.850000.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
36569  Insert picc cath                                  A   1.82   5.48     0.69    0.18   7.48  2.690000.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
36570  Insert picvad cath                                A   5.36  30.64     3.33    0.49  36.49  9.180010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
36571  Insert picvad cath                                A   5.34  34.19     3.32    1.02  40.55  9.680010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
36575  Repair tunneled cv cath                           A   0.67   4.44     0.28    0.10   5.21  1.050000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
36576  Repair tunneled cv cath                           A   3.24   8.04     2.07    0.56  11.84  5.870010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
36578  Replace tunneled cv cath                          A   3.54  11.99     2.43    0.53  16.06  6.500010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
36580  Replace cvad cath                                 A   1.31   5.09     0.51    0.16   6.56  1.980000.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
36581  Replace tunneled cv cath                          A   3.48  19.80     1.97    0.44  23.72  5.890010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
36582  Replace tunneled cv cath                          A   5.24  28.24     3.05    0.88  34.36  9.170010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
36583  Replace tunneled cv cath                          A   5.29  36.59     3.65    1.14  43.02 10.080010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
36584  Replace picc cath                                 A   1.20   4.86     0.65    0.11   6.17  1.960000.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
36585  Replace picvad cath                               A   4.84  32.05     3.05    0.67  37.56  8.560010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
36589  Removal tunneled cv cath                          A   2.28   2.36     1.54    0.37   5.01  4.190010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
36590  Removal tunneled cv cath                          A   3.35   4.95     2.19    0.63   8.93  6.170010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
36591  Draw blood off venous device                      T   0.00   0.69     0.69NA  0.01   0.70  0.703XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
36592  Collect blood from picc                           T   0.00   0.80     0.80NA  0.01   0.81  0.813XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
36593  Declot vascular device                            A   0.00   0.92     0.92NA  0.01   0.93  0.933XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
36595  Mech remov tunneled cv cath                       A   3.59  13.37     1.50    0.39  17.35  5.480000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36596  Mech remov tunneled cv cath                       A   0.75   3.26     0.50    0.10   4.11  1.350000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36597  Reposition venous catheter                        A   1.21   2.47     0.47    0.11   3.79  1.790000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36598  Inj w/fluor eval cv device                        T   0.74   2.52     0.26    0.07   3.33  1.079000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
36600  Withdrawal of arterial blood                      A   0.32   0.59     0.11    0.03   0.94  0.460XXX.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36620  Insertion catheter artery                         A   1.15   0.23NA   0.23    0.10   1.48  1.480000.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
36625  Insertion catheter artery                         A   2.11   0.60NA   0.60    0.42   3.13  3.130000.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
36640  Insertion catheter artery                         A   2.10   1.39NA   1.39    0.42   3.91  3.910000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36660  Insertion catheter artery                         A   1.40   0.44NA   0.44    0.34   2.18  2.180000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
36680  Insert needle bone cavity                         A   1.20   0.34NA   0.34    0.22   1.76  1.760000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
36800  Insertion of cannula                              A   2.43   2.09NA   2.09    0.42   4.94  4.940000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36810  Insertion of cannula                              A   3.96   1.70NA   1.70    0.73   6.39  6.390000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36815  Insertion of cannula                              A   2.62   1.32NA   1.32    0.56   4.50  4.500000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36818  Av fuse uppr arm cephalic                         A  11.89   5.90NA   5.90    2.65  20.44 20.440090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
36819  Av fuse uppr arm basilic                          A  13.29   6.18NA   6.18    2.98  22.45 22.450090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
36820  Av fusion/forearm vein                            A  14.47   6.86NA   6.86    3.24  24.57 24.570090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
36821  Av fusion direct any site                         A  12.11   6.32NA   6.32    2.71  21.14 21.140090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
36822  Insertion of cannula(s)                           A   5.57   4.87NA   4.87    1.29  11.73 11.730090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
36823  Insertion of cannula(s)                           A  22.98  12.01NA  12.01    5.01  40.00 40.000090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
36825  Artery-vein autograft                             A  14.17   6.90NA   6.90    3.17  24.24 24.240090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
36830  Artery-vein nonautograft                          A  12.03   5.23NA   5.23    2.71  19.97 19.970090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
36831  Open thrombect av fistula                         A   8.04   4.03NA   4.03    1.80  13.87 13.870090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
36832  Av fistula revision open                          A  10.53   4.75NA   4.75    2.34  17.62 17.620090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
36833  Av fistula revision                               A  11.98   5.25NA   5.25    2.69  19.92 19.920090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
36835  Artery to vein shunt                              A   7.51   3.57NA   3.57    1.78  12.86 12.860090.09.84.0720100             25.0008 090 99      0.00   0.00   0.00
36838  Dist revas ligation hemo                          A  21.69   8.42NA   8.42    4.94  35.05 35.050090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
36860  External cannula declotting                       A   2.01   4.02     1.02    0.26   6.29  3.290000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36861  Cannula declotting                                A   2.52   1.78NA   1.78    0.48   4.78  4.780000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
36870  Percut thrombect av fistula                       A   5.20  51.59     3.17    0.68  57.47  9.050090.09.84.0721120             25.0008 090 99      0.00   0.00   0.00
3700F  Psych disorders assessed                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
37140  Revision of circulation                           A  40.00  19.62NA  19.62    8.53  68.15 68.150090.09.84.0720110             25.0008 090 99      0.00   0.00   0.00
37145  Revision of circulation                           A  37.00  18.32NA  18.32    8.07  63.39 63.390090.09.84.0720200             25.0008 090 99      0.00   0.00   0.00
37160  Revision of circulation                           A  38.00  18.83NA  18.83    8.13  64.96 64.960090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
37180  Revision of circulation                           A  36.50  18.19NA  18.19    7.80  62.49 62.490090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
37181  Splice spleen/kidney veins                        A  40.00  19.62NA  19.62    8.52  68.14 68.140090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
37182  Insert hepatic shunt (tips)                       A  16.97   6.16NA   6.16    1.62  24.75 24.750000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
37183  Remove hepatic shunt (tips)                       A   7.99 173.84     2.93    0.73 182.56 11.650000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
37184  Prim art mech thrombectomy                        A   8.66  60.61     3.40    1.51  70.78 13.570000.00.00.0021120             25.0008 090 99      0.00   0.00   0.00
37185  Prim art m-thrombect add-on                       A   3.28  18.65     1.08    0.61  22.54  4.970ZZZ.00.00.0002120             25.0008 090 99      0.00   0.00   0.00
37186  Sec art m-thrombect add-on                        A   4.92  37.61     1.66    0.95  43.48  7.530ZZZ.00.00.0002120             25.0008 090 99      0.00   0.00   0.00
37187  Venous mech thrombectomy                          A   8.03  56.30     2.96    1.13  65.46 12.120000.00.00.0021120             25.0008 090 99      0.00   0.00   0.00
37188  Venous m-thrombectomy add-on                      A   5.71  48.54     2.22    0.69  54.94  8.620000.00.00.0021120             25.0008 090 99      0.00   0.00   0.00
37191  Ins endovas vena cava filtr                       A   4.71  77.14     1.69    0.69  82.54  7.090000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
37192  Redo endovas vena cava filtr                      A   7.35  45.22     2.46    1.08  53.65 10.890000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
37193  Rem endovas vena cava filter                      A   7.35  42.89     2.49    1.08  51.32 10.920000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
37195  Thrombolytic therapy stroke                       C   0.00   0.00     0.00    0.00   0.00  0.005XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
37197  Remove intrvas foreign body                       A   6.29  42.95     2.17    0.57  49.81  9.030000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
3720F  Cognit impairment assessed                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
37200  Transcatheter biopsy                              A   4.55   1.57NA   1.57    0.42   6.54  6.540000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
37202  Transcatheter therapy infuse                      A   5.67   2.93NA   2.93    1.18   9.78  9.780000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
37204  Transcatheter occlusion                           A  18.11   6.10NA   6.10    2.22  26.43 26.430000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
37205  Transcath iv stent percut                         A   8.27 124.67     2.80    1.57 134.51 12.640000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
37206  Transcath iv stent/perc addl                      A   4.12  74.53     1.35    0.82  79.47  6.290ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
37207  Transcath iv stent open                           A   8.27   2.80NA   2.80    1.86  12.93 12.930000.00.00.0021220             25.0008 090 99      0.00   0.00   0.00
37208  Transcath iv stent/open addl                      A   4.12   1.15NA   1.15    0.93   6.20  6.200ZZZ.00.00.0000220             25.0008 090 99      0.00   0.00   0.00
37210  Embolization uterine fibroid                      A  10.60 100.46     3.90    1.02 112.08 15.520000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
37211  Thrombolytic art therapy                          A   8.00   2.57NA   2.57    1.39  11.96 11.960000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
37212  Thrombolytic venous therapy                       A   7.06   2.27NA   2.27    1.23  10.56 10.560000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
37213  Thromblytic art/ven therapy                       A   5.00   1.51NA   1.51    0.87   7.38  7.380000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
37214  Cessj therapy cath removal                        A   2.74   1.11NA   1.11    0.48   4.33  4.330000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
37215  Transcath stent cca w/eps                         R  19.68   8.41NA   8.41    4.19  32.28 32.280090.09.84.0721000             25.0008 090 99      0.00   0.00   0.00
37216  Transcath stent cca w/o eps                       N+ 18.95   9.66NA   9.66    1.33  29.94 29.949090.09.84.0799999             25.0008 090 99      0.00   0.00   0.00
37220  Iliac revasc                                      A   8.15  90.99     2.65    1.67 100.81 12.470000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
37221  Iliac revasc w/stent                              A  10.00 135.58     3.28    1.89 147.47 15.170000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
37222  Iliac revasc add-on                               A   3.73  23.86     1.13    0.76  28.35  5.620ZZZ.00.00.0001000             25.0008 090 99      0.00   0.00   0.00
37223  Iliac revasc w/stent add-on                       A   4.25  77.19     1.33    0.84  82.28  6.420ZZZ.00.00.0001000             25.0008 090 99      0.00   0.00   0.00
37224  Fem/popl revas w/tla                              A   9.00 110.64     2.95    1.81 121.45 13.760000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
37225  Fem/popl revas w/ather                            A  12.00 333.87     4.06    2.52 348.39 18.580000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
37226  Fem/popl revasc w/stent                           A  10.49 274.68     3.45    1.29 286.46 15.230000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
37227  Fem/popl revasc stnt & ather                      A  14.50 453.16     4.86    3.05 470.71 22.410000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
37228  Tib/per revasc w/tla                              A  11.00 159.88     3.54    2.26 173.14 16.800000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
37229  Tib/per revasc w/ather                            A  14.05 326.12     4.66    2.98 343.15 21.690000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
37230  Tib/per revasc w/stent                            A  13.80 245.17     4.60    2.61 261.58 21.010000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
37231  Tib/per revasc stent & ather                      A  15.00 399.63     5.01    2.84 417.47 22.850000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
37232  Tib/per revasc add-on                             A   4.00  33.59     1.27    0.82  38.41  6.090ZZZ.00.00.0001000             25.0008 090 99      0.00   0.00   0.00
37233  Tibper revasc w/ather add-on                      A   6.50  38.04     2.07    1.37  45.91  9.940ZZZ.00.00.0001000             25.0008 090 99      0.00   0.00   0.00
37234  Revsc opn/prq tib/pero stent                      A   5.50 117.64     1.80    1.09 124.23  8.390ZZZ.00.00.0001000             25.0008 090 99      0.00   0.00   0.00
37235  Tib/per revasc stnt & ather                       A   7.80 117.32     2.26    1.55 126.67 11.610ZZZ.00.00.0001000             25.0008 090 99      0.00   0.00   0.00
3725F  Screen depression performed                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
37250  Iv us first vessel add-on                         A   2.10   0.64NA   0.64    0.45   3.19  3.190ZZZ.00.00.0000010             25.0008 090 99      0.00   0.00   0.00
37251  Iv us each add vessel add-on                      A   1.60   0.45NA   0.45    0.35   2.40  2.400ZZZ.00.00.0000010             25.0008 090 99      0.00   0.00   0.00
3750F  Ptnotrcvngsteroid>/=10mg/day                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
37500  Endoscopy ligate perf veins                       A  11.67   5.28NA   5.28    2.63  19.58 19.580090.09.84.0721110             25.0008 090 99      0.00   0.00   0.00
37501  Vascular endoscopy procedure                      C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021111             25.0008 090 99      0.00   0.00   0.00
3751F  Electrodiag polyneuro 6mon                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3752F  no electrodiag polyneuro6mon                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3753F  Pt has symp+signs neuropathy                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3754F  Screening tests dm done                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3755F  Cog+behav imprmnt scrng done                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3756F  Pt w/pseudobulb affect/als                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
37565  Ligation of neck vein                             A  12.05   8.45NA   8.45    2.57  23.07 23.070090.09.84.0721010             25.0008 090 99      0.00   0.00   0.00
3757F  Pt w/no pseudobulbaffect/als                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3758F  Pt ref pulmon fx test/peak                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3759F  Pt scrn dysphag/wt loss/nutr                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3760F  Pt w/dysphag/wt loss/nutr                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
37600  Ligation of neck artery                           A  12.42   6.35NA   6.35    2.55  21.32 21.320090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
37605  Ligation of neck artery                           A  14.28   6.86NA   6.86    3.39  24.53 24.530090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
37606  Ligation of neck artery                           A   8.81   6.64NA   6.64    1.88  17.33 17.330090.09.84.0720200             25.0008 090 99      0.00   0.00   0.00
37607  Ligation of a-v fistula                           A   6.25   3.93NA   3.93    1.37  11.55 11.550090.09.84.0720110             25.0008 090 99      0.00   0.00   0.00
37609  Temporal artery procedure                         A   3.05   5.94     2.64    0.64   9.63  6.330010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
3761F  Pt w/o dysphag/wt loss/nutr                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
37615  Ligation of neck artery                           A   7.80   6.11NA   6.11    1.65  15.56 15.560090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
37616  Ligation of chest artery                          A  18.97   9.71NA   9.71    4.06  32.74 32.740090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
37617  Ligation of abdomen artery                        A  23.79  11.36NA  11.36    5.02  40.17 40.170090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
37618  Ligation of extremity artery                      A   6.03   4.44NA   4.44    1.32  11.79 11.790090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
37619  Ligation of inf vena cava                         A  30.00  13.90NA  13.90    6.89  50.79 50.790090.09.84.0720200             25.0008 090 99      0.00   0.00   0.00
3762F  Patient is dysarthric                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
3763F  Patient is not dysarthric                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
37650  Revision of major vein                            A   8.49   3.71NA   3.71    1.88  14.08 14.080090.09.84.0721110             25.0008 090 99      0.00   0.00   0.00
37660  Revision of major vein                            A  22.28   7.03NA   7.03    4.75  34.06 34.060090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
37700  Revise leg vein                                   A   3.82   3.05NA   3.05    0.84   7.71  7.710090.09.84.0721100             25.0008 090 99      0.00   0.00   0.00
37718  Ligate/strip short leg vein                       A   7.13   4.74NA   4.74    1.57  13.44 13.440090.09.84.0721110             25.0008 090 99      0.00   0.00   0.00
37722  Ligate/strip long leg vein                        A   8.16   4.74NA   4.74    1.81  14.71 14.710090.09.84.0721110             25.0008 090 99      0.00   0.00   0.00
37735  Removal of leg veins/lesion                       A  10.90   6.20NA   6.20    2.40  19.50 19.500090.09.84.0721110             25.0008 090 99      0.00   0.00   0.00
37760  Ligate leg veins radical                          A  10.78   5.39NA   5.39    2.29  18.46 18.460090.09.84.0721110             25.0008 090 99      0.00   0.00   0.00
37761  Ligate leg veins open                             A   9.13   5.63NA   5.63    1.96  16.72 16.720090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
37765  Stab phleb veins xtr 10-20                        A   7.71  10.94     4.41    1.57  20.22 13.690090.09.84.0721110             25.0008 090 99      0.00   0.00   0.00
37766  Phleb veins - extrem 20+                          A   9.66  12.37     5.17    2.01  24.04 16.840090.09.84.0721110             25.0008 090 99      0.00   0.00   0.00
37780  Revision of leg vein                              A   3.93   2.98NA   2.98    0.86   7.77  7.770090.09.84.0721110             25.0008 090 99      0.00   0.00   0.00
37785  Ligate/divide/excise vein                         A   3.93   6.23     3.26    0.86  11.02  8.050090.09.84.0721100             25.0008 090 99      0.00   0.00   0.00
37788  Revascularization penis                           A  23.33  13.17NA  13.17    4.98  41.48 41.480090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
37790  Penile venous occlusion                           A   8.43   4.95NA   4.95    0.82  14.20 14.200090.08.83.0920000             25.0008 090 99      0.00   0.00   0.00
37799  Vascular surgery procedure                        C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 090 99      0.00   0.00   0.00
38100  Removal of spleen total                           A  19.55  10.37NA  10.37    4.08  34.00 34.000090.11.73.1620210             25.0008 090 99      0.00   0.00   0.00
38101  Removal of spleen partial                         A  19.55  10.61NA  10.61    4.16  34.32 34.320090.11.73.1620210             25.0008 090 99      0.00   0.00   0.00
38102  Removal of spleen total                           A   4.79   1.89NA   1.89    0.99   7.67  7.670ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
38115  Repair of ruptured spleen                         A  21.88  11.30NA  11.30    4.29  37.47 37.470090.11.73.1620210             25.0008 090 99      0.00   0.00   0.00
38120  Laparoscopy splenectomy                           A  17.07  10.46NA  10.46    3.61  31.14 31.140090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
38129  Laparoscope proc spleen                           C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020211             25.0008 090 99      0.00   0.00   0.00
38200  Injection for spleen x-ray                        A   2.64   0.97NA   0.97    0.63   4.24  4.240000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
38204  Bl donor search management                        B+  2.00   0.81NA   0.81    0.14   2.95  2.959XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
38205  Harvest allogeneic stem cell                      R   1.50   0.78NA   0.78    0.08   2.36  2.360000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
38206  Harvest auto stem cells                           R   1.50   0.80NA   0.80    0.11   2.41  2.410000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
38207  Cryopreserve stem cells                           I+  0.89   0.36NA   0.36    0.05   1.30  1.309XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
38208  Thaw preserved stem cells                         I+  0.56   0.23NA   0.23    0.04   0.83  0.839XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
38209  Wash harvest stem cells                           I+  0.24   0.10NA   0.10    0.01   0.35  0.359XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
38210  T-cell depletion of harvest                       I+  1.57   0.63NA   0.63    0.10   2.30  2.309XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
38211  Tumor cell deplete of harvst                      I+  1.42   0.57NA   0.57    0.10   2.09  2.099XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
38212  Rbc depletion of harvest                          I+  0.94   0.38NA   0.38    0.05   1.37  1.379XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
38213  Platelet deplete of harvest                       I+  0.24   0.10NA   0.10    0.01   0.35  0.359XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
38214  Volume deplete of harvest                         I+  0.81   0.33NA   0.33    0.05   1.19  1.199XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
38215  Harvest stem cell concentrte                      I+  0.94   0.38NA   0.38    0.05   1.37  1.379XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
38220  Bone marrow aspiration                            A   1.08   3.66     0.57    0.11   4.85  1.760XXX.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
38221  Bone marrow biopsy                                A   1.37   3.48     0.71    0.08   4.93  2.160XXX.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
38230  Bone marrow harvest allogen                       A   3.50   1.82NA   1.82    0.79   6.11  6.110000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
38232  Bone marrow harvest autolog                       A   3.50   1.82NA   1.82    0.79   6.11  6.110000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
38240  Transplt allo hct/donor                           R   3.00   1.65NA   1.65    0.21   4.86  4.860XXX.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
38241  Transplt autol hct/donor                          R   3.00   1.64NA   1.64    0.19   4.83  4.830XXX.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
38242  Transplt allo lymphocytes                         A   2.11   1.15NA   1.15    0.12   3.38  3.380000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
38243  Transplj hematopoietic boost                      A   2.13   1.16NA   1.16    0.12   3.41  3.410000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
38300  Drainage lymph node lesion                        A   2.36   5.84     2.84    0.41   8.61  5.610010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
38305  Drainage lymph node lesion                        A   6.68   5.83NA   5.83    1.33  13.84 13.840090.11.73.1620100             25.0008 090 99      0.00   0.00   0.00
38308  Incision of lymph channels                        A   6.81   5.20NA   5.20    1.46  13.47 13.470090.11.73.1620210             25.0008 090 99      0.00   0.00   0.00
38380  Thoracic duct procedure                           A   8.46   7.56NA   7.56    1.09  17.11 17.110090.11.73.1620210             25.0008 090 99      0.00   0.00   0.00
38381  Thoracic duct procedure                           A  13.38   7.44NA   7.44    3.14  23.96 23.960090.11.73.1620210             25.0008 090 99      0.00   0.00   0.00
38382  Thoracic duct procedure                           A  10.65   7.11NA   7.11    2.26  20.02 20.020090.11.73.1620210             25.0008 090 99      0.00   0.00   0.00
38500  Biopsy/removal lymph nodes                        A   3.79   5.43     2.98    0.78  10.00  7.550010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
38505  Needle biopsy lymph nodes                         A   1.14   2.55     0.86    0.12   3.81  2.120000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
38510  Biopsy/removal lymph nodes                        A   6.74   7.68     4.55    1.21  15.63 12.500010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
38520  Biopsy/removal lymph nodes                        A   7.03   5.42NA   5.42    1.42  13.87 13.870090.11.73.1621100             25.0008 090 99      0.00   0.00   0.00
38525  Biopsy/removal lymph nodes                        A   6.43   5.19NA   5.19    1.36  12.98 12.980090.11.73.1621100             25.0008 090 99      0.00   0.00   0.00
38530  Biopsy/removal lymph nodes                        A   8.34   6.25NA   6.25    1.82  16.41 16.410090.11.73.1621210             25.0008 090 99      0.00   0.00   0.00
38542  Explore deep node(s) neck                         A   7.95   6.19NA   6.19    1.33  15.47 15.470090.11.73.1621210             25.0008 090 99      0.00   0.00   0.00
38550  Removal neck/armpit lesion                        A   7.11   6.56NA   6.56    1.52  15.19 15.190090.11.73.1620000             25.0008 090 99      0.00   0.00   0.00
38555  Removal neck/armpit lesion                        A  15.59   9.19NA   9.19    3.35  28.13 28.130090.11.73.1620210             25.0008 090 99      0.00   0.00   0.00
38562  Removal pelvic lymph nodes                        A  11.06   7.69NA   7.69    1.96  20.71 20.710090.11.73.1622210             25.0008 090 99      0.00   0.00   0.00
38564  Removal abdomen lymph nodes                       A  11.38   7.08NA   7.08    2.25  20.71 20.710090.11.73.1620210             25.0008 090 99      0.00   0.00   0.00
38570  Laparoscopy lymph node biop                       A   9.34   4.92NA   4.92    1.37  15.63 15.630010.10.80.1030220       49320 25.0008 090 99      0.00   0.00   0.00
38571  Laparoscopy lymphadenectomy                       A  14.76   6.68NA   6.68    1.48  22.92 22.920010.10.80.1022220             25.0008 090 99      0.00   0.00   0.00
38572  Laparoscopy lymphadenectomy                       A  16.94   8.65NA   8.65    2.40  27.99 27.990010.10.80.1022220             25.0008 090 99      0.00   0.00   0.00
38589  Laparoscope proc lymphatic                        C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021211             25.0008 090 99      0.00   0.00   0.00
38700  Removal of lymph nodes neck                       A  12.81   9.47NA   9.47    1.77  24.05 24.050090.11.73.1621210             25.0008 090 99      0.00   0.00   0.00
38720  Removal of lymph nodes neck                       A  21.95  14.68NA  14.68    3.39  40.02 40.020090.11.73.1621210             25.0008 090 99      0.00   0.00   0.00
38724  Removal of lymph nodes neck                       A  23.95  15.98NA  15.98    3.35  43.28 43.280090.11.73.1621210             25.0008 090 99      0.00   0.00   0.00
38740  Remove armpit lymph nodes                         A  10.70   7.56NA   7.56    2.26  20.52 20.520090.11.73.1621210             25.0008 090 99      0.00   0.00   0.00
38745  Remove armpit lymph nodes                         A  13.87   9.13NA   9.13    2.95  25.95 25.950090.11.73.1621210             25.0008 090 99      0.00   0.00   0.00
38746  Remove thoracic lymph nodes                       A   4.12   1.33NA   1.33    0.96   6.41  6.410ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
38747  Remove abdominal lymph nodes                      A   4.88   1.90NA   1.90    1.03   7.81  7.810ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
38760  Remove groin lymph nodes                          A  13.62   8.50NA   8.50    2.79  24.91 24.910090.11.73.1621210             25.0008 090 99      0.00   0.00   0.00
38765  Remove groin lymph nodes                          A  21.91  11.80NA  11.80    4.23  37.94 37.940090.11.73.1621210             25.0008 090 99      0.00   0.00   0.00
38770  Remove pelvis lymph nodes                         A  14.06   7.64NA   7.64    1.77  23.47 23.470090.11.73.1621210             25.0008 090 99      0.00   0.00   0.00
38780  Remove abdomen lymph nodes                        A  17.70   9.84NA   9.84    2.56  30.10 30.100090.11.73.1620210             25.0008 090 99      0.00   0.00   0.00
38790  Inject for lymphatic x-ray                        A   1.29   0.95NA   0.95    0.24   2.48  2.480000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
38792  Ra tracer id of sentinl node                      A   0.52   0.61NA   0.61    0.08   1.21  1.210000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
38794  Access thoracic lymph duct                        A   4.62   3.70NA   3.70    0.42   8.74  8.740090.11.73.1620000             25.0008 090 99      0.00   0.00   0.00
38900  Io map of sent lymph node                         A   2.50   1.00     1.00    0.53   4.03  4.030ZZZ.00.00.0001210             25.0008 090 99      0.00   0.00   0.00
38999  Blood/lymph system procedure                      C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 090 99      0.00   0.00   0.00
39000  Exploration of chest                              A   7.57   5.78NA   5.78    1.67  15.02 15.020090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
39010  Exploration of chest                              A  13.19   7.43NA   7.43    3.13  23.75 23.750090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
39200  Resect mediastinal cyst                           A  15.09   7.54NA   7.54    3.54  26.17 26.170090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
39220  Resect mediastinal tumor                          A  19.55  10.15NA  10.15    4.44  34.14 34.140090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
39400  Mediastinoscopy incl biopsy                       A   8.05   5.34NA   5.34    1.88  15.27 15.270010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
39499  Chest procedure                                   C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020211             25.0008 090 99      0.00   0.00   0.00
39501  Repair diaphragm laceration                       A  13.98   8.32NA   8.32    2.95  25.25 25.250090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
39503  Repair of diaphragm hernia                        A 108.91  48.28NA  48.28   23.23 180.42180.420090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
39540  Repair of diaphragm hernia                        A  14.57   8.01NA   8.01    3.12  25.70 25.700090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
39541  Repair of diaphragm hernia                        A  15.75   8.74NA   8.74    3.40  27.89 27.890090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
39545  Revision of diaphragm                             A  14.67   8.70NA   8.70    3.42  26.79 26.790090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
39560  Resect diaphragm simple                           A  13.06   7.63NA   7.63    2.79  23.48 23.480090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
39561  Resect diaphragm complex                          A  19.99  12.79NA  12.79    4.38  37.16 37.160090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
39599  Diaphragm surgery procedure                       C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020211             25.0008 090 99      0.00   0.00   0.00
4000F  Tobacco use txmnt counseling                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4001F  Tobacco use txmnt pharmacol                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4003F  Pt ed write/oral pts w/ hf                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4008F  Beta-blocker therapy rxd/tkn                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4010F  ACE/ARB therapy rxd/taken                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4011F  Oral antiplatelet therapy rx                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4012F  Warfarin therapy rx                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4013F  Statin therapy/currently tkn                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4014F  Written discharge instr prvd                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4015F  Persist asthma medicine ctrl                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4018F  Therapy exercise joint rx                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4025F  Inhaled bronchodilator rx                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4030F  Oxygen therapy rx                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4033F  Pulmonary rehab rec                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4035F  Influenza imm rec                                 M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4037F  Influenza imm order/admin                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4040F  Pneumoc vac/admin/rcvd                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4041F  Doc order cefazolin/cefurox                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4042F  Doc antibio not given                             M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4045F  Empiric antibiotic rx                             M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
40490  Biopsy of lip                                     A   1.22   2.52     0.79    0.18   3.92  2.190000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
4050F  Ht care plan doc                                  I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
40500  Partial excision of lip                           A   4.47  10.40     5.92    0.67  15.54 11.060090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
4051F  Referred for an AV fistula                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
40510  Partial excision of lip                           A   4.82   9.19     5.20    0.71  14.72 10.730090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
4052F  Hemodialysis via AV fistula                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
40520  Partial excision of lip                           A   4.79   9.43     5.32    0.75  14.97 10.860090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
40525  Reconstruct lip with flap                         A   7.72   7.72NA   7.72    1.27  16.71 16.710090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
40527  Reconstruct lip with flap                         A   9.32   8.06NA   8.06    1.20  18.58 18.580090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
4053F  Hemodialysis via AV graft                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
40530  Partial removal of lip                            A   5.54  10.07     5.82    0.86  16.47 12.220090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
4054F  Hemodialysis via catheter                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4055F  Pt rcvng periton dialysis                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4056F  Approp oral rehyd recommd                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4060F  Psych svcs provided                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4062F  Pt referral psych docd                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4063F  Antidepres rxthxpy not rxd                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4064F  Antidepressant rx                                 I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4065F  Antipsychotic rx                                  I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
40650  Repair lip                                        A   3.78   9.21     4.75    0.65  13.64  9.180090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
40652  Repair lip                                        A   4.43   9.92     5.52    0.76  15.11 10.710090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
40654  Repair lip                                        A   5.48  11.01     6.48    0.93  17.42 12.890090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
4066F  ECT provided                                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4069F  Vte prophylaxis rcvd                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
40700  Repair cleft lip/nasal                            A  14.17  13.53NA  13.53    1.82  29.52 29.520090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
40701  Repair cleft lip/nasal                            A  17.23  12.76NA  12.76    2.20  32.19 32.190090.09.81.1022200             25.0008 090 99      0.00   0.00   0.00
40702  Repair cleft lip/nasal                            A  14.27  13.23NA  13.23    1.02  28.52 28.520090.09.81.1022200             25.0008 090 99      0.00   0.00   0.00
40720  Repair cleft lip/nasal                            A  14.72  13.51NA  13.51    2.91  31.14 31.140090.09.81.1021000             25.0008 090 99      0.00   0.00   0.00
4073F  Oral antiplat thx rx dischrg                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
40761  Repair cleft lip/nasal                            A  15.84  13.84NA  13.84    3.13  32.81 32.810090.09.81.1020100             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4079F  Doc rehab svcs considered                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
40799  Lip surgery procedure                             C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020211             25.0008 090 99      0.00   0.00   0.00
40800  Drainage of mouth lesion                          A   1.23   5.19     2.65    0.18   6.60  4.060010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
40801  Drainage of mouth lesion                          A   2.63   6.68     3.75    0.37   9.68  6.750010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
40804  Removal foreign body mouth                        A   1.30   5.28     2.64    0.16   6.74  4.100010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
40805  Removal foreign body mouth                        A   2.79   9.09     4.17    0.35  12.23  7.310010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
40806  Incision of lip fold                              A   0.31   3.24     0.61    0.04   3.59  0.960000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
40808  Biopsy of mouth lesion                            A   1.01   4.71     2.21    0.12   5.84  3.340010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
40810  Excision of mouth lesion                          A   1.36   4.90     2.39    0.18   6.44  3.930010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
40812  Excise/repair mouth lesion                        A   2.37   6.19     3.31    0.31   8.87  5.990010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
40814  Excise/repair mouth lesion                        A   3.52   7.82     5.31    0.48  11.82  9.310090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
40816  Excision of mouth lesion                          A   3.77   8.09     5.39    0.52  12.38  9.680090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
40818  Excise oral mucosa for graft                      A   2.83   7.65     5.02    0.37  10.85  8.220090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
40819  Excise lip or cheek fold                          A   2.51   6.71     4.38    0.33   9.55  7.220090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
40820  Treatment of mouth lesion                         A   1.34   6.85     3.88    0.18   8.37  5.400010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
40830  Repair mouth laceration                           A   1.82   6.19     3.03    0.31   8.32  5.160010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
40831  Repair mouth laceration                           A   2.57   7.54     3.94    0.42  10.53  6.930010.10.80.1020000             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
40840  Reconstruction of mouth                           R   9.15  14.21     8.48    1.18  24.54 18.810090.09.81.1020200             25.0008 090 99      0.00   0.00   0.00
40842  Reconstruction of mouth                           R   9.15  14.12     8.92    1.18  24.45 19.250090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
40843  Reconstruction of mouth                           R  12.79  17.93    10.84    2.52  33.24 26.150090.09.81.1022200             25.0008 090 99      0.00   0.00   0.00
40844  Reconstruction of mouth                           R  16.80  20.47    12.67    3.32  40.59 32.790090.09.81.1020200             25.0008 090 99      0.00   0.00   0.00
40845  Reconstruction of mouth                           R  19.36  22.26    14.78    2.48  44.10 36.620090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
4086F  Aspirin/clopidogrel rxd                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
40899  Mouth surgery procedure                           C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 090 99      0.00   0.00   0.00
4090F  Pt rcvng epo thxpy                                M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
41000  Drainage of mouth lesion                          A   1.35   3.46     1.88    0.18   4.99  3.410010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
41005  Drainage of mouth lesion                          A   1.31   5.74     2.42    0.16   7.21  3.890010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
41006  Drainage of mouth lesion                          A   3.34   7.32     4.24    0.42  11.08  8.000090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
41007  Drainage of mouth lesion                          A   3.20   7.31     3.86    0.41  10.92  7.470090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
41008  Drainage of mouth lesion                          A   3.46   7.65     4.21    0.44  11.55  8.110090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
41009  Drainage of mouth lesion                          A   3.71   8.07     4.65    0.48  12.26  8.840090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
41010  Incision of tongue fold                           A   1.11   5.19     2.12    0.14   6.44  3.370010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
41015  Drainage of mouth lesion                          A   4.08   9.10     5.92    0.52  13.70 10.520090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
41016  Drainage of mouth lesion                          A   4.19   8.51     5.97    0.53  13.23 10.690090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
41017  Drainage of mouth lesion                          A   4.19   8.79     5.95    0.53  13.51 10.670090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
41018  Drainage of mouth lesion                          A   5.22   9.76     6.65    0.67  15.65 12.540090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
41019  Place needles h&n for rt                          A   8.84   3.91NA   3.91    0.72  13.47 13.470000.00.00.0020011             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
41100  Biopsy of tongue                                  A   1.42   3.59     1.67    0.20   5.21  3.290010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
41105  Biopsy of tongue                                  A   1.47   3.61     1.73    0.20   5.28  3.400010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
41108  Biopsy of floor of mouth                          A   1.10   3.36     1.52    0.14   4.60  2.760010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
41110  Excision of tongue lesion                         A   1.56   4.87     2.28    0.22   6.65  4.060010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
41112  Excision of tongue lesion                         A   2.83   7.13     4.55    0.37  10.33  7.750090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
41113  Excision of tongue lesion                         A   3.29   7.53     4.83    0.42  11.24  8.540090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
41114  Excision of tongue lesion                         A   8.82   9.12NA   9.12    1.17  19.11 19.110090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
41115  Excision of tongue fold                           A   1.79   5.76     2.46    0.23   7.78  4.480010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
41116  Excision of mouth lesion                          A   2.52   7.44     3.90    0.34  10.30  6.760090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
41120  Partial removal of tongue                         A  11.14  19.43NA  19.43    1.48  32.05 32.050090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
41130  Partial removal of tongue                         A  15.74  21.67NA  21.67    2.08  39.49 39.490090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
41135  Tongue and neck surgery                           A  30.14  30.56NA  30.56    4.04  64.74 64.740090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
41140  Removal of tongue                                 A  29.15  32.82NA  32.82    3.76  65.73 65.730090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
41145  Tongue removal neck surgery                       A  37.93  40.18NA  40.18    4.87  82.98 82.980090.09.81.1020210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
41150  Tongue mouth jaw surgery                          A  29.86  32.06NA  32.06    3.96  65.88 65.880090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
41153  Tongue mouth neck surgery                         A  33.59  33.43NA  33.43    4.41  71.43 71.430090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
41155  Tongue jaw & neck surgery                         A  44.30  39.35NA  39.35    5.92  89.57 89.570090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
4120F  Antibiot rxd/given                                M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4124F  Antibiot not rxd/given                            M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
41250  Repair tongue laceration                          A   1.96   6.08     2.49    0.33   8.37  4.780010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
41251  Repair tongue laceration                          A   2.32   6.55     2.99    0.30   9.17  5.610010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
41252  Repair tongue laceration                          A   3.02   6.26     2.90    0.48   9.76  6.400010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
4130F  Topical prep rx aoe                               M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4131F  Syst antimicrobial thx rx                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4133F  Antihist/decong rx/recom                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4135F  Systemic corticosteroids rx                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4136F  Syst corticosteroids not rx                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4140F  Inhaled corticosteroids rxd                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4142F  Corticoster sparng thrpy rxd                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4144F  Alt long-term cntrl med rxd                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4145F  2+ anti-hyprtnsv agents tkn                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
41500  Fixation of tongue                                A   3.80   9.91NA   9.91    0.49  14.20 14.200090.09.81.1020000             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
41510  Tongue to lip surgery                             A   3.51   9.56NA   9.56    0.44  13.51 13.510090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
41512  Tongue suspension                                 A   6.86  11.75NA  11.75    0.49  19.10 19.100090.10.76.1420000             25.0008 090 99      0.00   0.00   0.00
41520  Reconstruction tongue fold                        A   2.83   7.62     4.62    0.35  10.80  7.800090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
4153F  Combo pegintf/rib rx                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
41530  Tongue base vol reduction                         A   4.51  98.48     7.60    0.31 103.30 12.420010.10.80.1020000             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
41599  Tongue and mouth surgery                          C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4164F  Adjv hrmnl thxpy rxd                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4165F  3d-crt/imrt received                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4171F  Pt rcvng esa thxpy                                M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4174F  Couns potent glauc impct                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4175F  Vis 20/40/> w/in 90 days                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4179F  Tamoxifen/AI prescribed                           M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4180F  Adjv thxpyrxd/rcvd colon ca                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
41800  Drainage of gum lesion                            A   1.27   7.11     3.13    0.22   8.60  4.620010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
41805  Removal foreign body gum                          A   1.34   6.17     3.76    0.18   7.69  5.280010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
41806  Removal foreign body jawbone                      A   2.79   7.71     4.76    0.54  11.04  8.090010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
4181F  Conformal radn thxpy rcvd                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4182F  No conformal radn thxpy                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
41820  Excision gum each quadrant                        R   0.00   0.00     0.00    0.00   0.00  0.000000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
41821  Excision of gum flap                              R   0.00   0.00     0.00    0.00   0.00  0.000000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
41822  Excision of gum lesion                            R   2.41   6.19     2.79    0.31   8.91  5.510010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
41823  Excision of gum lesion                            R   3.77   8.83     5.57    0.48  13.08  9.820090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
41825  Excision of gum lesion                            A   1.41   4.98     2.13    0.20   6.59  3.740010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
41826  Excision of gum lesion                            A   2.41   6.96     3.75    0.31   9.68  6.470010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
41827  Excision of gum lesion                            A   3.83   9.20     4.99    0.49  13.52  9.310090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
41828  Excision of gum lesion                            R   3.14   5.76     2.84    0.39   9.29  6.370010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
41830  Removal of gum tissue                             R   3.45   8.11     4.70    0.44  12.00  8.590010.10.80.1020000             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
41850  Treatment of gum lesion                           R   0.00   0.00     0.00    0.00   0.00  0.000000.00.00.0020000             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4187F  Anti rheum drugthxpyrxd/gvn                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
41870  Gum graft                                         R   0.00   0.00     0.00    0.00   0.00  0.000000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
41872  Repair gum                                        R   3.01   8.13     4.57    0.60  11.74  8.180090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
41874  Repair tooth socket                               R   3.19   7.83     4.12    0.39  11.41  7.700090.09.81.1020000             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4189F  Approp digoxin tstng done                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
41899  Dental surgery procedure                          C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 090 99      0.00   0.00   0.00
4190F  Approp diuretic tstng done                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4191F  Approp anticonvuls tstng                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4194F  Pt rcvng10mg daily predniso                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4200F  External beam to prost only                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
42000  Drainage mouth roof lesion                        A   1.28   4.83     2.08    0.16   6.27  3.520010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
4201F  Extrnl beam other than prost                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4210F  Ace/arb thxpy for mos/>                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
42100  Biopsy roof of mouth                              A   1.36   3.09     1.80    0.18   4.63  3.340010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
42104  Excision lesion mouth roof                        A   1.69   4.79     2.35    0.23   6.71  4.270010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
42106  Excision lesion mouth roof                        A   2.15   6.00     2.99    0.29   8.44  5.430010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
42107  Excision lesion mouth roof                        A   4.56   9.05     5.37    0.59  14.20 10.520090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
42120  Remove palate/lesion                              A  11.86  16.87NA  16.87    1.57  30.30 30.300090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
42140  Excision of uvula                                 A   1.70   6.07     2.88    0.23   8.00  4.810090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
42145  Repair palate pharynx/uvula                       A   9.78  10.35NA  10.35    1.25  21.38 21.380090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
42160  Treatment mouth roof lesion                       A   1.85   5.12     2.40    0.24   7.21  4.490010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
42180  Repair palate                                     A   2.55   4.66     2.71    0.33   7.54  5.590010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
42182  Repair palate                                     A   3.87   5.43     3.37    0.49   9.79  7.730010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
4220F  Digoxin thxpy for 6 mos/>                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
42200  Reconstruct cleft palate                          A  12.53  11.53NA  11.53    1.61  25.67 25.670090.09.81.1020200             25.0008 090 99      0.00   0.00   0.00
42205  Reconstruct cleft palate                          A  13.66  11.28NA  11.28    1.77  26.71 26.710090.09.81.1020200             25.0008 090 99      0.00   0.00   0.00
4221F  Diuretic thxpy for 6 mos/>                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
42210  Reconstruct cleft palate                          A  15.03  12.79NA  12.79    2.97  30.79 30.790090.09.81.1020200             25.0008 090 99      0.00   0.00   0.00
42215  Reconstruct cleft palate                          A   8.99  11.26NA  11.26    1.78  22.03 22.030090.09.81.1020200             25.0008 090 99      0.00   0.00   0.00
42220  Reconstruct cleft palate                          A   7.16   8.06NA   8.06    0.50  15.72 15.720090.09.81.1020200             25.0008 090 99      0.00   0.00   0.00
42225  Reconstruct cleft palate                          A   9.77  15.84NA  15.84    1.25  26.86 26.860090.09.81.1020200             25.0008 090 99      0.00   0.00   0.00
42226  Lengthening of palate                             A  10.35  15.59NA  15.59    1.32  27.26 27.260090.09.81.1020200             25.0008 090 99      0.00   0.00   0.00
42227  Lengthening of palate                             A   9.90  14.39NA  14.39    1.27  25.56 25.560090.09.81.1020200             25.0008 090 99      0.00   0.00   0.00
42235  Repair palate                                     A   8.01  13.45NA  13.45    1.03  22.49 22.490090.09.81.1020200             25.0008 090 99      0.00   0.00   0.00
42260  Repair nose to lip fistula                        A  10.22  14.05     9.62    1.31  25.58 21.150090.09.81.1020200             25.0008 090 99      0.00   0.00   0.00
42280  Preparation palate mold                           A   1.59   3.18     1.46    0.34   5.11  3.390010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
42281  Insertion palate prosthesis                       A   1.98   4.13     2.38    0.26   6.37  4.620010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
42299  Palate/uvula surgery                              C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020211             25.0008 090 99      0.00   0.00   0.00
4230F  Anticonv thxpy for 6 mos/>                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
42300  Drainage of salivary gland                        A   1.98   4.23     2.42    0.27   6.48  4.670010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
42305  Drainage of salivary gland                        A   6.31   5.75NA   5.75    0.86  12.92 12.920090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
42310  Drainage of salivary gland                        A   1.61   3.22     2.04    0.22   5.05  3.870010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
42320  Drainage of salivary gland                        A   2.40   5.04     2.64    0.31   7.75  5.350010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
42330  Removal of salivary stone                         A   2.26   4.61     2.45    0.30   7.17  5.010010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
42335  Removal of salivary stone                         A   3.41   7.77     4.01    0.42  11.60  7.840090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
42340  Removal of salivary stone                         A   4.72   9.03     4.87    0.61  14.36 10.200090.09.81.1021000             25.0008 090 99      0.00   0.00   0.00
4240F  Instr xrcz back pain 12 wks                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
42400  Biopsy of salivary gland                          A   0.78   2.43     0.80    0.08   3.29  1.660000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
42405  Biopsy of salivary gland                          A   3.34   5.34     3.04    0.42   9.10  6.800010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
42408  Excision of salivary cyst                         A   4.66   8.71     4.63    0.60  13.97  9.890090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
42409  Drainage of salivary cyst                         A   2.91   7.11     3.50    0.37  10.39  6.780090.09.81.1020200             25.0008 090 99      0.00   0.00   0.00
42410  Excise parotid gland/lesion                       A   9.57   7.72NA   7.72    1.44  18.73 18.730090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
42415  Excise parotid gland/lesion                       A  17.16  12.16NA  12.16    2.29  31.61 31.610090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
4242F  Sprvsd xrcz back pn >12 wks                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
42420  Excise parotid gland/lesion                       A  19.53  13.30NA  13.30    2.63  35.46 35.460090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
42425  Excise parotid gland/lesion                       A  13.42   9.81NA   9.81    1.84  25.07 25.070090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
42426  Excise parotid gland/lesion                       A  22.66  14.53NA  14.53    3.12  40.31 40.310090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
42440  Excise submaxillary gland                         A   6.14   5.46NA   5.46    0.82  12.42 12.420090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
4245F  Pt instr nrml lifest                              M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
42450  Excise sublingual gland                           A   4.74   8.57     5.55    0.64  13.95 10.930090.09.81.1020000             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4250F  Wrmng 4 surg normothermia                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
42500  Repair salivary duct                              A   4.42   8.34     5.45    0.60  13.36 10.470090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
42505  Repair salivary duct                              A   6.32   9.93     6.66    0.80  17.05 13.780090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
42507  Parotid duct diversion                            A   6.25   8.66NA   8.66    0.80  15.71 15.710090.09.81.1022200             25.0008 090 99      0.00   0.00   0.00
42508  Parotid duct diversion                            A   9.33  11.17NA  11.17    1.20  21.70 21.700090.09.81.1022200             25.0008 090 99      0.00   0.00   0.00
42509  Parotid duct diversion                            A  11.76  10.45NA  10.45    2.30  24.51 24.510090.09.81.1022000             25.0008 090 99      0.00   0.00   0.00
42510  Parotid duct diversion                            A   8.35   9.70NA   9.70    1.08  19.13 19.130090.09.81.1022210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
42550  Injection for salivary x-ray                      A   1.25   2.63     0.46    0.11   3.99  1.820000.00.00.0020100             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4260F  Wound srfc culturetech used                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
42600  Closure of salivary fistula                       A   4.94   9.22     4.98    0.64  14.80 10.560090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
4261F  Tech other than surfc cultr                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4265F  Wet-dry dressings rx recmd                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
42650  Dilation of salivary duct                         A   0.77   1.72     0.93    0.10   2.59  1.800000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
4266F  No wet-dry drssings rx recmd                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
42660  Dilation of salivary duct                         A   1.13   2.49     1.25    0.14   3.76  2.520000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
42665  Ligation of salivary duct                         A   2.63   6.83     3.36    0.34   9.80  6.330090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
4267F  Comprssion thxpy prescribed                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4269F  Appropos mthd offloading Rxd                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
42699  Salivary surgery procedure                        C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020211             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
42700  Drainage of tonsil abscess                        A   1.67   4.00     2.27    0.23   5.90  4.170010.10.80.1020100             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
42720  Drainage of throat abscess                        A   6.31   6.62     4.64    0.83  13.76 11.780010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
42725  Drainage of throat abscess                        A  12.41  10.35NA  10.35    1.59  24.35 24.350090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
4274F  Flu immuno admind rcvd                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4276F  Potent antivir thxpy Rxd                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4279F  PCP prophylaxis Rxd                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
42800  Biopsy of throat                                  A   1.44   3.30     1.79    0.20   4.94  3.430010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
42802  Biopsy of throat                                  A   1.59   5.41     2.28    0.22   7.22  4.090010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
42804  Biopsy of upper nose/throat                       A   1.29   4.69     2.03    0.16   6.14  3.480010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
42806  Biopsy of upper nose/throat                       A   1.63   5.03     2.19    0.22   6.88  4.040010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
42808  Excise pharynx lesion                             A   2.35   4.36     2.26    0.30   7.01  4.910010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
42809  Remove pharynx foreign body                       A   1.86   3.18     1.91    0.27   5.31  4.040010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
42810  Excision of neck cyst                             A   3.38   8.28     5.09    0.42  12.08  8.890090.09.81.1021200             25.0008 090 99      0.00   0.00   0.00
42815  Excision of neck cyst                             A   7.31   8.70NA   8.70    1.01  17.02 17.020090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
42820  Remove tonsils and adenoids                       A   4.22   4.01NA   4.01    0.53   8.76  8.760090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
42821  Remove tonsils and adenoids                       A   4.36   4.19NA   4.19    0.56   9.11  9.110090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
42825  Removal of tonsils                                A   3.51   4.01NA   4.01    0.44   7.96  7.960090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
42826  Removal of tonsils                                A   3.45   3.74NA   3.74    0.44   7.63  7.630090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
42830  Removal of adenoids                               A   2.65   3.34NA   3.34    0.34   6.33  6.330090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
42831  Removal of adenoids                               A   2.81   3.66NA   3.66    0.35   6.82  6.820090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
42835  Removal of adenoids                               A   2.38   3.21NA   3.21    0.30   5.89  5.890090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
42836  Removal of adenoids                               A   3.26   3.64NA   3.64    0.41   7.31  7.310090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
42842  Extensive surgery of throat                       A  12.23  16.48NA  16.48    1.58  30.29 30.290090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
42844  Extensive surgery of throat                       A  17.78  21.38NA  21.38    2.27  41.43 41.430090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
42845  Extensive surgery of throat                       A  32.56  29.93NA  29.93    4.18  66.67 66.670090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
42860  Excision of tonsil tags                           A   2.30   3.17NA   3.17    0.30   5.77  5.770090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
42870  Excision of lingual tonsil                        A   5.52  11.64NA  11.64    0.71  17.87 17.870090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
42890  Partial removal of pharynx                        A  19.13  21.09NA  21.09    2.52  42.74 42.740090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
42892  Revision of pharyngeal walls                      A  26.03  27.18NA  27.18    3.42  56.63 56.630090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
42894  Revision of pharyngeal walls                      A  33.92  32.93NA  32.93    4.42  71.27 71.270090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
4290F  Pt scrned for inj drug use                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
42900  Repair throat wound                               A   5.29   4.21NA   4.21    0.68  10.18 10.180010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
4293F  Pt scrnd hgh-risk sex behav                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
42950  Reconstruction of throat                          A   8.27  14.91NA  14.91    1.14  24.32 24.320090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
42953  Repair throat esophagus                           A   9.45  18.37NA  18.37    1.31  29.13 29.130090.09.81.1020200             25.0008 090 99      0.00   0.00   0.00
42955  Surgical opening of throat                        A   8.01  14.04NA  14.04    1.03  23.08 23.080090.09.81.1020200             25.0008 090 99      0.00   0.00   0.00
42960  Control throat bleeding                           A   2.38   2.46NA   2.46    0.31   5.15  5.150010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
42961  Control throat bleeding                           A   5.77   6.33NA   6.33    0.73  12.83 12.830090.09.81.1020200             25.0008 090 99      0.00   0.00   0.00
42962  Control throat bleeding                           A   7.40   7.33NA   7.33    0.95  15.68 15.680090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
42970  Control nose/throat bleeding                      A   5.82   5.75NA   5.75    0.84  12.41 12.410090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
42971  Control nose/throat bleeding                      A   6.60   6.39NA   6.39    0.84  13.83 13.830090.09.81.1020200             25.0008 090 99      0.00   0.00   0.00
42972  Control nose/throat bleeding                      A   7.59   6.88NA   6.88    0.98  15.45 15.450090.09.81.1020200             25.0008 090 99      0.00   0.00   0.00
42999  Throat surgery procedure                          C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 090 99      0.00   0.00   0.00
4300F  Pt rcvng warf thxpy                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
43020  Incision of esophagus                             A   8.23   6.59NA   6.59    1.06  15.88 15.880090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43030  Throat muscle surgery                             A   7.99   6.46NA   6.46    1.17  15.62 15.620090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43045  Incision of esophagus                             A  21.88  11.99NA  11.99    5.12  38.99 38.990090.09.81.1020210             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
43100  Excision of esophagus lesion                      A   9.66   7.95NA   7.95    1.24  18.85 18.850090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43101  Excision of esophagus lesion                      A  17.07   9.06NA   9.06    4.00  30.13 30.130090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43107  Removal of esophagus                              A  44.18  21.57NA  21.57    9.87  75.62 75.620090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43108  Removal of esophagus                              A  82.87  37.47NA  37.47   17.67 138.01138.010090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43112  Removal of esophagus                              A  47.48  21.47NA  21.47   10.77  79.72 79.720090.09.81.1020220             25.0008 090 99      0.00   0.00   0.00
43113  Removal of esophagus                              A  80.06  30.92NA  30.92   17.08 128.06128.060090.09.81.1020220             25.0008 090 99      0.00   0.00   0.00
43116  Partial removal of esophagus                      A  92.99  50.15NA  50.15   11.94 155.08155.080090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43117  Partial removal of esophagus                      A  43.65  19.65NA  19.65    9.87  73.17 73.170090.09.81.1020220             25.0008 090 99      0.00   0.00   0.00
43118  Partial removal of esophagus                      A  67.07  31.23NA  31.23   14.30 112.60112.600090.09.81.1020220             25.0008 090 99      0.00   0.00   0.00
43121  Partial removal of esophagus                      A  51.43  21.85NA  21.85   12.03  85.31 85.310090.09.81.1020220             25.0008 090 99      0.00   0.00   0.00
43122  Partial removal of esophagus                      A  44.18  22.05NA  22.05    9.64  75.87 75.870090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43123  Partial removal of esophagus                      A  83.12  31.88NA  31.88   17.71 132.71132.710090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43124  Removal of esophagus                              A  69.09  28.36NA  28.36   16.18 113.63113.630090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43130  Removal of esophagus pouch                        A  12.53   9.06NA   9.06    1.99  23.58 23.580090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43135  Removal of esophagus pouch                        A  26.17  12.17NA  12.17    5.97  44.31 44.310090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
4320F  Pt talk psychsoc&rx oh dpnd                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
43200  Esophagus endoscopy                               A   1.59   4.77     1.32    0.23   6.59  3.140000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
43201  Esoph scope w/submucous inj                       A   2.09   7.22     1.42    0.30   9.61  3.810000.00.00.0030100       43200 25.0008 090 99      0.00   0.00   0.00
43202  Esophagus endoscopy biopsy                        A   1.89   6.68     1.29    0.29   8.86  3.470000.00.00.0030100       43200 25.0008 090 99      0.00   0.00   0.00
43204  Esoph scope w/sclerosis inj                       A   3.76   2.36NA   2.36    0.59   6.71  6.710000.00.00.0030100       43200 25.0008 090 99      0.00   0.00   0.00
43205  Esophagus endoscopy/ligation                      A   3.78   2.34NA   2.34    0.56   6.68  6.680000.00.00.0030000       43200 25.0008 090 99      0.00   0.00   0.00
43206  Esoph optical endomicroscopy                      C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
43215  Esophagus endoscopy                               A   2.60   1.60NA   1.60    0.41   4.61  4.610000.00.00.0030100       43200 25.0008 090 99      0.00   0.00   0.00
43216  Esophagus endoscopy/lesion                        A   2.40   4.07     1.70    0.35   6.82  4.450000.00.00.0030000       43200 25.0008 090 99      0.00   0.00   0.00
43217  Esophagus endoscopy                               A   2.90   8.42     1.76    0.49  11.81  5.150000.00.00.0030100       43200 25.0008 090 99      0.00   0.00   0.00
43219  Esophagus endoscopy                               A   2.80   1.81NA   1.81    0.48   5.09  5.090000.00.00.0030100       43200 25.0008 090 99      0.00   0.00   0.00
4322F  Crgvr prov w/ ed addl rsrcs                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
43220  Esoph endoscopy dilation                          A   2.10   1.39NA   1.39    0.31   3.80  3.800000.00.00.0030100       43200 25.0008 090 99      0.00   0.00   0.00
43226  Esoph endoscopy dilation                          A   2.34   1.50NA   1.50    0.37   4.21  4.210000.00.00.0030100       43200 25.0008 090 99      0.00   0.00   0.00
43227  Esoph endoscopy repair                            A   3.59   2.21NA   2.21    0.54   6.34  6.340000.00.00.0030100       43200 25.0008 090 99      0.00   0.00   0.00
43228  Esoph endoscopy ablation                          A   3.76   2.29NA   2.29    0.59   6.64  6.640000.00.00.0030100       43200 25.0008 090 99      0.00   0.00   0.00
43231  Esoph endoscopy w/us exam                         A   3.19   2.00NA   2.00    0.48   5.67  5.670000.00.00.0030020       43200 25.0008 090 99      0.00   0.00   0.00
43232  Esoph endoscopy w/us fn bx                        A   4.47   2.60NA   2.60    0.69   7.76  7.760000.00.00.0030020       43200 25.0008 090 99      0.00   0.00   0.00
43235  Uppr gi endoscopy diagnosis                       A   2.39   6.40     1.59    0.37   9.16  4.350000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
43236  Uppr gi scope w/submuc inj                        A   2.92   8.40     1.88    0.42  11.74  5.220000.00.00.0030100       43235 25.0008 090 99      0.00   0.00   0.00
43237  Endoscopic us exam esoph                          A   3.98   2.38NA   2.38    0.60   6.96  6.960000.00.00.0030000       43235 25.0008 090 99      0.00   0.00   0.00
43238  Uppr gi endoscopy w/us fn bx                      A   5.02   2.88NA   2.88    0.75   8.65  8.650000.00.00.0030000       43235 25.0008 090 99      0.00   0.00   0.00
43239  Upper gi endoscopy biopsy                         A   2.87   7.28     1.84    0.42  10.57  5.130000.00.00.0030100       43235 25.0008 090 99      0.00   0.00   0.00
4324F  Pt queried prkns complic                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
43240  Esoph endoscope w/drain cyst                      A   6.85   3.91NA   3.91    1.03  11.79 11.790000.00.00.0030100       43235 25.0008 090 99      0.00   0.00   0.00
43241  Upper GI endoscopy with tube                      A   2.59   1.68NA   1.68    0.39   4.66  4.660000.00.00.0030100       43235 25.0008 090 99      0.00   0.00   0.00
43242  Uppr gi endoscopy w/us fn bx                      A   7.30   4.19NA   4.19    1.08  12.57 12.570000.00.00.0030000       43235 25.0008 090 99      0.00   0.00   0.00
43243  Upper gi endoscopy & inject                       A   4.56   2.71NA   2.71    0.68   7.95  7.950000.00.00.0030100       43235 25.0008 090 99      0.00   0.00   0.00
43244  Upper GI endoscopy/ligation                       A   5.04   3.00NA   3.00    0.73   8.77  8.770000.00.00.0030000       43235 25.0008 090 99      0.00   0.00   0.00
43245  Uppr gi scope dilate strictr                      A   3.18   1.93NA   1.93    0.50   5.61  5.610000.00.00.0030100       43235 25.0008 090 99      0.00   0.00   0.00
43246  Place gastrostomy tube                            A   4.32   2.49NA   2.49    0.69   7.50  7.500000.00.00.0030020       43235 25.0008 090 99      0.00   0.00   0.00
43247  Operative upper GI endoscopy                      A   3.38   2.08NA   2.08    0.52   5.98  5.980000.00.00.0030100       43235 25.0008 090 99      0.00   0.00   0.00
43248  Uppr gi endoscopy/guide wire                      A   3.15   2.01NA   2.01    0.45   5.61  5.610000.00.00.0030100       43235 25.0008 090 99      0.00   0.00   0.00
43249  Esoph endoscopy dilation                          A   2.90   1.86NA   1.86    0.42   5.18  5.180000.00.00.0030100       43235 25.0008 090 99      0.00   0.00   0.00
4325F  Med txmnt options rvwd w/pt                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
43250  Upper GI endoscopy/tumor                          A   3.20   1.93NA   1.93    0.52   5.65  5.650000.00.00.0030100       43235 25.0008 090 99      0.00   0.00   0.00
43251  Operative upper GI endoscopy                      A   3.69   2.26NA   2.26    0.56   6.51  6.510000.00.00.0030100       43235 25.0008 090 99      0.00   0.00   0.00
43252  Uppr gi opticl endomicrscopy                      C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
43255  Operative upper GI endoscopy                      A   4.81   2.88NA   2.88    0.71   8.40  8.400000.00.00.0030100       43235 25.0008 090 99      0.00   0.00   0.00
43256  Uppr gi endoscopy w/stent                         A   4.34   2.54NA   2.54    0.68   7.56  7.560000.00.00.0030100       43235 25.0008 090 99      0.00   0.00   0.00
43257  Uppr gi scope w/thrml txmnt                       A   5.50   3.34NA   3.34    0.80   9.64  9.640000.00.00.0030100       43235 25.0008 090 99      0.00   0.00   0.00
43258  Operative upper GI endoscopy                      A   4.54   2.72NA   2.72    0.68   7.94  7.940000.00.00.0030100       43235 25.0008 090 99      0.00   0.00   0.00
43259  Endoscopic ultrasound exam                        A   5.19   3.09NA   3.09    0.75   9.03  9.030000.00.00.0030000       43235 25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
43260  Endo cholangiopancreatograph                      A   5.95   3.47NA   3.47    0.87  10.29 10.290000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
43261  Endo cholangiopancreatograph                      A   6.26   3.64NA   3.64    0.91  10.81 10.810000.00.00.0030100       43260 25.0008 090 99      0.00   0.00   0.00
43262  Endo cholangiopancreatograph                      A   7.38   4.22NA   4.22    1.09  12.69 12.690000.00.00.0030100       43260 25.0008 090 99      0.00   0.00   0.00
43263  Endo cholangiopancreatograph                      A   7.28   4.20NA   4.20    1.08  12.56 12.560000.00.00.0030100       43260 25.0008 090 99      0.00   0.00   0.00
43264  Endo cholangiopancreatograph                      A   8.89   5.01NA   5.01    1.31  15.21 15.210000.00.00.0030100       43260 25.0008 090 99      0.00   0.00   0.00
43265  Endo cholangiopancreatograph                      A  10.00   5.60NA   5.60    1.48  17.08 17.080000.00.00.0030100       43260 25.0008 090 99      0.00   0.00   0.00
43267  Endo cholangiopancreatograph                      A   7.38   4.12NA   4.12    1.09  12.59 12.590000.00.00.0030100       43260 25.0008 090 99      0.00   0.00   0.00
43268  Endo cholangiopancreatograph                      A   7.38   4.41NA   4.41    1.09  12.88 12.880000.00.00.0030100       43260 25.0008 090 99      0.00   0.00   0.00
43269  Endo cholangiopancreatograph                      A   8.20   4.64NA   4.64    1.21  14.05 14.050000.00.00.0030100       43260 25.0008 090 99      0.00   0.00   0.00
43271  Endo cholangiopancreatograph                      A   7.38   4.22NA   4.22    1.09  12.69 12.690000.00.00.0030100       43260 25.0008 090 99      0.00   0.00   0.00
43272  Endo cholangiopancreatograph                      A   7.38   4.25NA   4.25    1.09  12.72 12.720000.00.00.0030000       43260 25.0008 090 99      0.00   0.00   0.00
43273  Endoscopic pancreatoscopy                         A   2.24   1.17NA   1.17    0.33   3.74  3.740ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
43279  Lap myotomy heller                                A  22.10  11.32NA  11.32    4.71  38.13 38.130090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
4328F  Pt asked re sleep disturb                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
43280  Laparoscopy fundoplasty                           A  18.10  10.03NA  10.03    3.85  31.98 31.980090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43281  Lap paraesophag hern repair                       A  26.60  13.30NA  13.30    5.66  45.56 45.560090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43282  Lap paraesoph her rpr w/mesh                      A  30.10  14.71NA  14.71    6.38  51.19 51.190090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43283  Lap esoph lengthening                             A   2.95   1.06NA   1.06    0.60   4.61  4.610ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
43289  Laparoscope proc esoph                            C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021211             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
43300  Repair of esophagus                               A   9.33   8.00NA   8.00    1.20  18.53 18.530090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43305  Repair esophagus and fistula                      A  18.10  12.18NA  12.18    2.31  32.59 32.590090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43310  Repair of esophagus                               A  26.26  11.89NA  11.89    6.14  44.29 44.290090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43312  Repair esophagus and fistula                      A  29.25  11.48NA  11.48    6.86  47.59 47.590090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43313  Esophagoplasty congenital                         A  48.45  32.34NA  32.34   11.35  92.14 92.140090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43314  Tracheo-esophagoplasty cong                       A  53.43  25.64NA  25.64    6.87  85.94 85.940090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43320  Fuse esophagus & stomach                          A  23.31  12.90NA  12.90    4.98  41.19 41.190090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43325  Revise esophagus & stomach                        A  22.60  12.24NA  12.24    4.83  39.67 39.670090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43327  Esoph fundoplasty lap                             A  13.35   7.95NA   7.95    2.84  24.14 24.140090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43328  Esoph fundoplasty thor                            A  19.91   9.58NA   9.58    4.98  34.47 34.470090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43330  Esophagomyotomy abdominal                         A  22.19  12.46NA  12.46    4.78  39.43 39.430090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43331  Esophagomyotomy thoracic                          A  23.06  11.67NA  11.67    5.40  40.13 40.130090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43332  Transab esoph hiat hern rpr                       A  19.62  10.56NA  10.56    4.18  34.36 34.360090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43333  Transab esoph hiat hern rpr                       A  21.46  11.35NA  11.35    4.55  37.36 37.360090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43334  Transthor diaphrag hern rpr                       A  22.12  10.20NA  10.20    4.71  37.03 37.030090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43335  Transthor diaphrag hern rpr                       A  23.97  10.43NA  10.43    5.08  39.48 39.480090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43336  Thorabd diaphr hern repair                        A  25.81  13.48NA  13.48    5.85  45.14 45.140090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43337  Thorabd diaphr hern repair                        A  27.65  14.71NA  14.71    6.27  48.63 48.630090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43338  Esoph lengthening                                 A   2.21   0.72NA   0.72    0.50   3.43  3.430ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
43340  Fuse esophagus & intestine                        A  22.99  12.77NA  12.77    4.90  40.66 40.660090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43341  Fuse esophagus & intestine                        A  24.23  14.46NA  14.46    5.68  44.37 44.370090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43350  Surgical opening esophagus                        A  19.49  12.13NA  12.13    4.15  35.77 35.770090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43351  Surgical opening esophagus                        A  22.05  12.20NA  12.20    5.16  39.41 39.410090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43352  Surgical opening esophagus                        A  17.81  10.02NA  10.02    4.16  31.99 31.990090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43360  Gastrointestinal repair                           A  40.11  17.84NA  17.84    9.40  67.35 67.350090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43361  Gastrointestinal repair                           A  45.68  19.69NA  19.69    9.74  75.11 75.110090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
4340F  Cnslng chldbrng women epi                         M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
43400  Ligate esophagus veins                            A  25.60  16.94NA  16.94    3.77  46.31 46.310090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43401  Esophagus surgery for veins                       A  26.49  14.15NA  14.15    5.65  46.29 46.290090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43405  Ligate/staple esophagus                           A  24.73  13.09NA  13.09    5.28  43.10 43.100090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43410  Repair esophagus wound                            A  16.41  12.34NA  12.34    3.84  32.59 32.590090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43415  Repair esophagus wound                            A  44.88  21.52NA  21.52   10.25  76.65 76.650090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43420  Repair esophagus opening                          A  16.78  11.49NA  11.49    2.15  30.42 30.420090.09.81.1020010             25.0008 090 99      0.00   0.00   0.00
43425  Repair esophagus opening                          A  25.04  12.30NA  12.30    5.35  42.69 42.690090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43450  Dilate esophagus                                  A   1.38   3.14     1.08    0.22   4.74  2.680000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
43453  Dilate esophagus                                  A   1.51   7.42     1.14    0.23   9.16  2.880000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
43456  Dilate esophagus                                  A   2.57  15.66     1.68    0.38  18.61  4.630000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
43458  Dilate esophagus                                  A   3.06   8.37     1.89    0.45  11.88  5.400000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
43460  Pressure treatment esophagus                      A   3.79   2.36NA   2.36    0.54   6.69  6.690000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
43496  Free jejunum flap microvasc                       C   0.00   0.00     0.00    0.00   0.00  0.000090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43499  Esophagus surgery procedure                       C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020111             25.0008 090 99      0.00   0.00   0.00
4350F  Cnslng provided symp mngmnt                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
43500  Surgical opening of stomach                       A  12.79   7.77NA   7.77    2.71  23.27 23.270090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43501  Surgical repair of stomach                        A  22.60  12.36NA  12.36    4.78  39.74 39.740090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43502  Surgical repair of stomach                        A  25.69  13.78NA  13.78    5.47  44.94 44.940090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43510  Surgical opening of stomach                       A  15.14   9.61NA   9.61    2.22  26.97 26.970090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43520  Incision of pyloric muscle                        A  11.29   6.58NA   6.58    2.50  20.37 20.370090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43605  Biopsy of stomach                                 A  13.72   8.12NA   8.12    2.87  24.71 24.710090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43610  Excision of stomach lesion                        A  16.34   9.17NA   9.17    3.46  28.97 28.970090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43611  Excision of stomach lesion                        A  20.38  11.37NA  11.37    4.30  36.05 36.050090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43620  Removal of stomach                                A  34.04  16.43NA  16.43    7.25  57.72 57.720090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43621  Removal of stomach                                A  39.53  18.70NA  18.70    8.41  66.64 66.640090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43622  Removal of stomach                                A  40.03  18.98NA  18.98    8.55  67.56 67.560090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43631  Removal of stomach partial                        A  24.51  13.10NA  13.10    5.20  42.81 42.810090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43632  Removal of stomach partial                        A  35.14  17.20NA  17.20    7.42  59.76 59.760090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43633  Removal of stomach partial                        A  33.14  16.43NA  16.43    7.00  56.57 56.570090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43634  Removal of stomach partial                        A  36.64  18.10NA  18.10    7.81  62.55 62.550090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43635  Removal of stomach partial                        A   2.06   0.80NA   0.80    0.42   3.28  3.280ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
43640  Vagotomy & pylorus repair                         A  19.56  11.15NA  11.15    4.12  34.83 34.830090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43641  Vagotomy & pylorus repair                         A  19.81  11.46NA  11.46    4.22  35.49 35.490090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43644  Lap gastric bypass/roux-en-y                      A  29.40  15.46NA  15.46    6.22  51.08 51.080090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43645  Lap gastr bypass incl smll i                      A  31.53  16.21NA  16.21    6.74  54.48 54.480090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43647  Lap impl electrode antrum                         C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020210             25.0008 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  0.000YYY.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
43651  Laparoscopy vagus nerve                           A  10.13   7.14NA   7.14    2.16  19.43 19.430090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
43652  Laparoscopy vagus nerve                           A  12.13   7.93NA   7.93    2.59  22.65 22.650090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
43653  Laparoscopy gastrostomy                           A   8.48   6.81NA   6.81    1.81  17.10 17.100090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43659  Laparoscope proc stom                             C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021211             25.0008 090 99      0.00   0.00   0.00
43752  Nasal/orogastric w/stent                          A   0.81   0.30NA   0.30    0.08   1.19  1.190000.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
43753  Tx gastro intub w/asp                             A   0.45   0.12NA   0.12    0.03   0.60  0.600000.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
43754  Dx gastr intub w/asp spec                         A   0.45   2.44     0.52    0.04   2.93  1.010000.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
43755  Dx gastr intub w/asp specs                        A   0.94   3.40     0.72    0.08   4.42  1.740000.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
43756  Dx duod intub w/asp spec                          A   0.77   5.99     0.73    0.05   6.81  1.550000.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
43757  Dx duod intub w/asp specs                         A   1.26   8.21     0.99    0.08   9.55  2.330000.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
43760  Change gastrostomy tube                           A   0.90  14.60     0.39    0.14  15.64  1.430000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
43761  Reposition gastrostomy tube                       A   2.01   1.19     0.79    0.24   3.44  3.040000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
43770  Lap place gastr adj device                        A  18.00  11.30NA  11.30    3.81  33.11 33.110090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43771  Lap revise gastr adj device                       A  20.79  12.37NA  12.37    4.44  37.60 37.600090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
43772  Lap rmvl gastr adj device                         A  15.70   9.12NA   9.12    3.36  28.18 28.180090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43773  Lap replace gastr adj device                      A  20.79  12.34NA  12.34    4.44  37.57 37.570090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43774  Lap rmvl gastr adj all parts                      A  15.76   9.29NA   9.29    3.36  28.41 28.410090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
43775  Lap sleeve gastrectomy                            C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020211             25.0008 090 99      0.00   0.00   0.00
43800  Reconstruction of pylorus                         A  15.43   8.75NA   8.75    3.31  27.49 27.490090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43810  Fusion of stomach and bowel                       A  16.88   9.56NA   9.56    3.59  30.03 30.030090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43820  Fusion of stomach and bowel                       A  22.53  12.26NA  12.26    4.76  39.55 39.550090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43825  Fusion of stomach and bowel                       A  21.76  11.74NA  11.74    4.64  38.14 38.140090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43830  Place gastrostomy tube                            A  10.85   7.68NA   7.68    2.23  20.76 20.760090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43831  Place gastrostomy tube                            A   8.49   7.48NA   7.48    1.81  17.78 17.780090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43832  Place gastrostomy tube                            A  17.34   9.98NA   9.98    3.58  30.90 30.900090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43840  Repair of stomach lesion                          A  22.83  12.45NA  12.45    4.82  40.10 40.100090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43842  V-band gastroplasty                               N+ 21.03  11.24NA  11.24    1.50  33.77 33.779090.09.81.1099999             25.0008 090 99      0.00   0.00   0.00
43843  Gastroplasty w/o v-band                           A  21.21  12.06NA  12.06    4.52  37.79 37.790090.09.81.1020220             25.0008 090 99      0.00   0.00   0.00
43845  Gastroplasty duodenal switch                      A  33.30  17.56NA  17.56    7.06  57.92 57.920090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43846  Gastric bypass for obesity                        A  27.41  14.77NA  14.77    5.80  47.98 47.980090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43847  Gastric bypass incl small i                       A  30.28  16.40NA  16.40    6.45  53.13 53.130090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43848  Revision gastroplasty                             A  32.75  17.15NA  17.15    6.94  56.84 56.840090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43850  Revise stomach-bowel fusion                       A  27.58  14.52NA  14.52    5.88  47.98 47.980090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43855  Revise stomach-bowel fusion                       A  28.69  14.96NA  14.96    6.11  49.76 49.760090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43860  Revise stomach-bowel fusion                       A  27.89  14.39NA  14.39    5.88  48.16 48.160090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43865  Revise stomach-bowel fusion                       A  29.05  15.10NA  15.10    6.19  50.34 50.340090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43870  Repair stomach opening                            A  11.44   7.33NA   7.33    2.35  21.12 21.120090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43880  Repair stomach-bowel fistula                      A  27.18  14.11NA  14.11    5.70  46.99 46.990090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43881  Impl/redo electrd antrum                          C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
43882  Revise/remove electrd antrum                      C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
43886  Revise gastric port open                          A   4.64   5.30NA   5.30    0.99  10.93 10.930090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
43887  Remove gastric port open                          A   4.32   4.59NA   4.59    0.91   9.82  9.820090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
43888  Change gastric port open                          A   6.44   5.92NA   5.92    1.37  13.73 13.730090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
43999  Stomach surgery procedure                         C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 090 99      0.00   0.00   0.00
4400F  Rehab thxpy options w/pt                          M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
44005  Freeing of bowel adhesion                         A  18.46  10.00NA  10.00    3.84  32.30 32.300090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44010  Incision of small bowel                           A  14.26   8.48NA   8.48    3.01  25.75 25.750090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44015  Insert needle cath bowel                          A   2.62   0.99NA   0.99    0.56   4.17  4.170ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
44020  Explore small intestine                           A  16.22   9.17NA   9.17    3.40  28.79 28.790090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44021  Decompress small bowel                            A  16.31   9.11NA   9.11    3.44  28.86 28.860090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44025  Incision of large bowel                           A  16.51   9.33NA   9.33    3.43  29.27 29.270090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44050  Reduce bowel obstruction                          A  15.52   8.89NA   8.89    3.24  27.65 27.650090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44055  Correct malrotation of bowel                      A  25.63  13.10NA  13.10    5.42  44.15 44.150090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44100  Biopsy of bowel                                   A   2.01   1.04NA   1.04    0.31   3.36  3.360000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
44110  Excise intestine lesion(s)                        A  14.04   8.22NA   8.22    2.90  25.16 25.160090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44111  Excision of bowel lesion(s)                       A  16.52   9.21NA   9.21    3.44  29.17 29.170090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44120  Removal of small intestine                        A  20.82  10.94NA  10.94    4.33  36.09 36.090090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44121  Removal of small intestine                        A   4.44   1.75NA   1.75    0.90   7.09  7.090ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
44125  Removal of small intestine                        A  20.03  10.81NA  10.81    4.07  34.91 34.910090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44126  Enterectomy w/o taper cong                        A  42.23  21.38NA  21.38    9.00  72.61 72.610090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44127  Enterectomy w/taper cong                          A  49.30  24.05NA  24.05   10.51  83.86 83.860090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44128  Enterectomy cong add-on                           A   4.44   1.75NA   1.75    0.93   7.12  7.120ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
44130  Bowel to bowel fusion                             A  22.11  12.16NA  12.16    4.56  38.83 38.830090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44132  Enterectomy cadaver donor                         R   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
44133  Enterectomy live donor                            R   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
44135  Intestine transplnt cadaver                       R   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
44136  Intestine transplant live                         R   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
44137  Remove intestinal allograft                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
44139  Mobilization of colon                             A   2.23   0.88NA   0.88    0.44   3.55  3.550ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
44140  Partial removal of colon                          A  22.59  12.40NA  12.40    4.64  39.63 39.630090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44141  Partial removal of colon                          A  29.91  18.02NA  18.02    6.18  54.11 54.110090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44143  Partial removal of colon                          A  27.79  15.75NA  15.75    5.74  49.28 49.280090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44144  Partial removal of colon                          A  29.91  16.32NA  16.32    6.18  52.41 52.410090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44145  Partial removal of colon                          A  28.58  14.79NA  14.79    5.66  49.03 49.030090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44146  Partial removal of colon                          A  35.30  20.65NA  20.65    6.87  62.82 62.820090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44147  Partial removal of colon                          A  33.69  16.86NA  16.86    6.78  57.33 57.330090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44150  Removal of colon                                  A  30.18  19.34NA  19.34    6.12  55.64 55.640090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44151  Removal of colon/ileostomy                        A  34.92  21.27NA  21.27    7.44  63.63 63.630090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44155  Removal of colon/ileostomy                        A  34.42  20.94NA  20.94    6.46  61.82 61.820090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44156  Removal of colon/ileostomy                        A  37.42  23.11NA  23.11    7.99  68.52 68.520090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44157  Colectomy w/ileoanal anast                        A  35.70  21.09NA  21.09    7.62  64.41 64.410090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44158  Colectomy w/neo-rectum pouch                      A  36.70  21.59NA  21.59    7.83  66.12 66.120090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44160  Removal of colon                                  A  20.89  11.57NA  11.57    4.26  36.72 36.720090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44180  Lap enterolysis                                   A  15.27   8.74NA   8.74    3.17  27.18 27.180090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44186  Lap jejunostomy                                   A  10.38   6.75NA   6.75    2.22  19.35 19.350090.09.84.0720210             25.0008 090 99      0.00   0.00   0.00
44187  Lap ileo/jejuno-stomy                             A  17.40  12.39NA  12.39    3.31  33.10 33.100090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44188  Lap colostomy                                     A  19.35  13.40NA  13.40    3.84  36.59 36.590090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44202  Lap enterectomy                                   A  23.39  12.75NA  12.75    4.85  40.99 40.990090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44203  Lap resect s/intestine addl                       A   4.44   1.73NA   1.73    0.93   7.10  7.100ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
44204  Laparo partial colectomy                          A  26.42  13.93NA  13.93    5.23  45.58 45.580090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44205  Lap colectomy part w/ileum                        A  22.95  12.22NA  12.22    4.50  39.67 39.670090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44206  Lap part colectomy w/stoma                        A  29.79  16.19NA  16.19    6.06  52.04 52.040090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44207  L colectomy/coloproctostomy                       A  31.92  15.99NA  15.99    6.18  54.09 54.090090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44208  L colectomy/coloproctostomy                       A  33.99  18.70NA  18.70    6.40  59.09 59.090090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44210  Laparo total proctocolectomy                      A  30.09  17.48NA  17.48    5.81  53.38 53.380090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44211  Lap colectomy w/proctectomy                       A  37.08  21.55NA  21.55    7.92  66.55 66.550090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44212  Laparo total proctocolectomy                      A  34.58  20.53NA  20.53    6.37  61.48 61.480090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44213  Lap mobil splenic fl add-on                       A   3.50   1.38NA   1.38    0.67   5.55  5.550ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
44227  Lap close enterostomy                             A  28.62  14.94NA  14.94    5.84  49.40 49.400090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44238  Laparoscope proc intestine                        C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021211             25.0008 090 99      0.00   0.00   0.00
44300  Open bowel to skin                                A  13.75   8.31NA   8.31    2.91  24.97 24.970090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44310  Ileostomy/jejunostomy                             A  17.59   9.88NA   9.88    3.46  30.93 30.930090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44312  Revision of ileostomy                             A   9.43   6.42NA   6.42    1.71  17.56 17.560090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
44314  Revision of ileostomy                             A  16.74   9.99NA   9.99    3.16  29.89 29.890090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44316  Devise bowel pouch                                A  23.59  13.09NA  13.09    5.04  41.72 41.720090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44320  Colostomy                                         A  19.91  11.67NA  11.67    4.07  35.65 35.650090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44322  Colostomy with biopsies                           A  13.32  13.96NA  13.96    2.84  30.12 30.120090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44340  Revision of colostomy                             A   9.28   7.51NA   7.51    1.88  18.67 18.670090.09.81.1020110             25.0008 090 99      0.00   0.00   0.00
44345  Revision of colostomy                             A  17.22  10.61NA  10.61    3.44  31.27 31.270090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44346  Revision of colostomy                             A  19.63  11.64NA  11.64    3.88  35.15 35.150090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44360  Small bowel endoscopy                             A   2.59   1.72NA   1.72    0.38   4.69  4.690000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
44361  Small bowel endoscopy/biopsy                      A   2.87   1.87NA   1.87    0.41   5.15  5.150000.00.00.0030100       44360 25.0008 090 99      0.00   0.00   0.00
44363  Small bowel endoscopy                             A   3.49   2.14NA   2.14    0.52   6.15  6.150000.00.00.0030000       44360 25.0008 090 99      0.00   0.00   0.00
44364  Small bowel endoscopy                             A   3.73   2.29NA   2.29    0.54   6.56  6.560000.00.00.0030000       44360 25.0008 090 99      0.00   0.00   0.00
44365  Small bowel endoscopy                             A   3.31   2.05NA   2.05    0.49   5.85  5.850000.00.00.0030000       44360 25.0008 090 99      0.00   0.00   0.00
44366  Small bowel endoscopy                             A   4.40   2.68NA   2.68    0.64   7.72  7.720000.00.00.0030100       44360 25.0008 090 99      0.00   0.00   0.00
44369  Small bowel endoscopy                             A   4.51   2.74NA   2.74    0.65   7.90  7.900000.00.00.0030000       44360 25.0008 090 99      0.00   0.00   0.00
44370  Small bowel endoscopy/stent                       A   4.79   3.06NA   3.06    0.69   8.54  8.540000.00.00.0030000       44360 25.0008 090 99      0.00   0.00   0.00
44372  Small bowel endoscopy                             A   4.40   2.58NA   2.58    0.69   7.67  7.670000.00.00.0030100       44360 25.0008 090 99      0.00   0.00   0.00
44373  Small bowel endoscopy                             A   3.49   2.12NA   2.12    0.53   6.14  6.140000.00.00.0030100       44360 25.0008 090 99      0.00   0.00   0.00
44376  Small bowel endoscopy                             A   5.25   2.95NA   2.95    0.82   9.02  9.020000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
44377  Small bowel endoscopy/biopsy                      A   5.52   3.20NA   3.20    0.82   9.54  9.540000.00.00.0030000       44376 25.0008 090 99      0.00   0.00   0.00
44378  Small bowel endoscopy                             A   7.12   4.07NA   4.07    1.05  12.24 12.240000.00.00.0030000       44376 25.0008 090 99      0.00   0.00   0.00
44379  S bowel endoscope w/stent                         A   7.46   4.51NA   4.51    1.09  13.06 13.060000.00.00.0030000       44376 25.0008 090 99      0.00   0.00   0.00
44380  Small bowel endoscopy                             A   1.05   0.84NA   0.84    0.14   2.03  2.030000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
44382  Small bowel endoscopy                             A   1.27   0.97NA   0.97    0.20   2.44  2.440000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
44383  Ileoscopy w/stent                                 A   2.94   1.54NA   1.54    0.33   4.81  4.810000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
44385  Endoscopy of bowel pouch                          A   1.82   6.08     1.12    0.26   8.16  3.200000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
44386  Endoscopy bowel pouch/biop                        A   2.12   8.67     1.38    0.33  11.12  3.830000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
44388  Colonoscopy                                       A   2.82   7.69     1.71    0.45  10.96  4.980000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
44389  Colonoscopy with biopsy                           A   3.13   8.77     1.92    0.49  12.39  5.540000.00.00.0030100       44388 25.0008 090 99      0.00   0.00   0.00
44390  Colonoscopy for foreign body                      A   3.82  10.22     2.40    0.56  14.60  6.780000.00.00.0030000       44388 25.0008 090 99      0.00   0.00   0.00
44391  Colonoscopy for bleeding                          A   4.31  10.60     2.56    0.65  15.56  7.520000.00.00.0030000       44388 25.0008 090 99      0.00   0.00   0.00
44392  Colonoscopy & polypectomy                         A   3.81   9.27     2.16    0.63  13.71  6.600000.00.00.0030100       44388 25.0008 090 99      0.00   0.00   0.00
44393  Colonoscopy lesion removal                        A   4.83  10.10     2.70    0.76  15.69  8.290000.00.00.0030100       44388 25.0008 090 99      0.00   0.00   0.00
44394  Colonoscopy w/snare                               A   4.42  10.34     2.53    0.69  15.45  7.640000.00.00.0030100       44388 25.0008 090 99      0.00   0.00   0.00
44397  Colonoscopy w/stent                               A   4.70   2.83NA   2.83    0.68   8.21  8.210000.00.00.0030100       44388 25.0008 090 99      0.00   0.00   0.00
4450F  Self-care ed provided to pt                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
44500  Intro gastrointestinal tube                       A   0.49   0.18NA   0.18    0.04   0.71  0.710000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
44602  Suture small intestine                            A  24.72  11.72NA  11.72    5.10  41.54 41.540090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44603  Suture small intestine                            A  28.16  13.82NA  13.82    5.76  47.74 47.740090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44604  Suture large intestine                            A  18.16   9.31NA   9.31    3.72  31.19 31.190090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44605  Repair of bowel lesion                            A  22.08  11.89NA  11.89    4.56  38.53 38.530090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44615  Intestinal stricturoplasty                        A  18.16   9.91NA   9.91    3.73  31.80 31.800090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44620  Repair bowel opening                              A  14.43   8.46NA   8.46    2.83  25.72 25.720090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44625  Repair bowel opening                              A  17.28   9.61NA   9.61    3.36  30.25 30.250090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44626  Repair bowel opening                              A  27.90  13.78NA  13.78    5.70  47.38 47.380090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44640  Repair bowel-skin fistula                         A  24.20  12.35NA  12.35    4.89  41.44 41.440090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44650  Repair bowel fistula                              A  25.12  12.71NA  12.71    5.06  42.89 42.890090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44660  Repair bowel-bladder fistula                      A  23.91  11.50NA  11.50    3.85  39.26 39.260090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44661  Repair bowel-bladder fistula                      A  27.35  13.28NA  13.28    5.10  45.73 45.730090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44680  Surgical revision intestine                       A  17.96   9.83NA   9.83    3.84  31.63 31.630090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
4470F  Icd counseling provided                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
44700  Suspend bowel w/prosthesis                        A  17.48   9.71NA   9.71    3.04  30.23 30.230090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44701  Intraop colon lavage add-on                       A   3.10   1.23NA   1.23    0.59   4.92  4.920ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
44705  Prepare fecal microbiota                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
44715  Prepare donor intestine                           C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
44720  Prep donor intestine/venous                       A   5.00   2.02NA   2.02    0.35   7.37  7.370XXX.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
44721  Prep donor intestine/artery                       A   7.00   2.76NA   2.76    1.50  11.26 11.260XXX.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
44799  Unlisted procedure intestine                      C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020111             25.0008 090 99      0.00   0.00   0.00
4480F  Pt rcvng ace/arb b-blockertx                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
44800  Excision of bowel pouch                           A  12.05   8.19NA   8.19    2.44  22.68 22.680090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
4481F  Pt rcvng ace/arb blker >3mos                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
44820  Excision of mesentery lesion                      A  13.73   8.32NA   8.32    2.83  24.88 24.880090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44850  Repair of mesentery                               A  12.11   7.69NA   7.69    2.52  22.32 22.320090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44899  Bowel surgery procedure                           C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020211             25.0008 090 99      0.00   0.00   0.00
44900  Drain app abscess open                            A  12.57   7.75NA   7.75    2.64  22.96 22.960090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44901  Drain app abscess percut                          A   3.37  23.43     1.20    0.35  27.15  4.920000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
44950  Appendectomy                                      A  10.60   6.14NA   6.14    2.23  18.97 18.970090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44955  Appendectomy add-on                               A   1.53   0.62NA   0.62    0.31   2.46  2.460ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
44960  Appendectomy                                      A  14.50   8.23NA   8.23    3.08  25.81 25.810090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
44970  Laparoscopy appendectomy                          A   9.45   6.39NA   6.39    1.97  17.81 17.810090.09.81.1020220             25.0008 090 99      0.00   0.00   0.00
44979  Laparoscope proc app                              C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021211             25.0008 090 99      0.00   0.00   0.00
4500F  Ref to outpt card rehab prog                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
45000  Drainage of pelvic abscess                        A   6.30   5.27NA   5.27    1.09  12.66 12.660090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
45005  Drainage of rectal abscess                        A   2.02   5.93     2.38    0.38   8.33  4.780010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
45020  Drainage of rectal abscess                        A   8.56   6.84NA   6.84    1.62  17.02 17.020090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
4510F  Prev cardrehab qualcardevent                      M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
45100  Biopsy of rectum                                  A   4.04   4.28NA   4.28    0.72   9.04  9.040090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
45108  Removal of anorectal lesion                       A   5.12   4.84NA   4.84    1.09  11.05 11.050090.09.81.1020110             25.0008 090 99      0.00   0.00   0.00
45110  Removal of rectum                                 A  30.76  18.51NA  18.51    5.83  55.10 55.100090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
45111  Partial removal of rectum                         A  18.01  10.80NA  10.80    3.55  32.36 32.360090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
45112  Removal of rectum                                 A  33.18  16.67NA  16.67    6.08  55.93 55.930090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
45113  Partial proctectomy                               A  33.22  18.80NA  18.80    7.08  59.10 59.100090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
45114  Partial removal of rectum                         A  30.79  16.19NA  16.19    6.57  53.55 53.550090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
45116  Partial removal of rectum                         A  27.72  14.96NA  14.96    3.96  46.64 46.640090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
45119  Remove rectum w/reservoir                         A  33.48  18.65NA  18.65    5.87  58.00 58.000090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
45120  Removal of rectum                                 A  26.40  14.78NA  14.78    5.63  46.81 46.810090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
45121  Removal of rectum and colon                       A  29.08  15.98NA  15.98    6.19  51.25 51.250090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
45123  Partial proctectomy                               A  18.86  11.35NA  11.35    3.17  33.38 33.380090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
45126  Pelvic exenteration                               A  49.10  25.12NA  25.12   10.47  84.69 84.690090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
45130  Excision of rectal prolapse                       A  18.50  10.88NA  10.88    3.13  32.51 32.510090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
45135  Excision of rectal prolapse                       A  22.36  13.41NA  13.41    4.76  40.53 40.530090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
45136  Excise ileoanal reservior                         A  30.82  18.96NA  18.96    4.41  54.19 54.190090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
45150  Excision of rectal stricture                      A   5.85   5.11NA   5.11    0.83  11.79 11.790090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
45160  Excision of rectal lesion                         A  16.33  10.47NA  10.47    3.48  30.28 30.280090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
45171  Exc rect tum transanal part                       A   8.13   8.44NA   8.44    1.51  18.08 18.080090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
45172  Exc rect tum transanal full                       A  12.13   9.99NA   9.99    2.23  24.35 24.350090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
45190  Destruction rectal tumor                          A  10.42   8.31NA   8.31    1.86  20.59 20.590090.09.81.1020110             25.0008 090 99      0.00   0.00   0.00
4525F  Neuropsychia interven order                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4526F  Neuropsychia interven rcvd                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
45300  Proctosigmoidoscopy dx                            A   0.80   2.89     0.71    0.12   3.81  1.630000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
45303  Proctosigmoidoscopy dilate                        A   1.50  28.50     1.00    0.26  30.26  2.760000.00.00.0030100       45300 25.0008 090 99      0.00   0.00   0.00
45305  Proctosigmoidoscopy w/bx                          A   1.25   4.63     0.90    0.23   6.11  2.380000.00.00.0030100       45300 25.0008 090 99      0.00   0.00   0.00
45307  Proctosigmoidoscopy fb                            A   1.70   5.14     1.08    0.33   7.17  3.110000.00.00.0030000       45300 25.0008 090 99      0.00   0.00   0.00
45308  Proctosigmoidoscopy removal                       A   1.40   4.90     0.97    0.26   6.56  2.630000.00.00.0030100       45300 25.0008 090 99      0.00   0.00   0.00
45309  Proctosigmoidoscopy removal                       A   1.50   4.95     1.02    0.27   6.72  2.790000.00.00.0030100       45300 25.0008 090 99      0.00   0.00   0.00
45315  Proctosigmoidoscopy removal                       A   1.80   4.96     1.16    0.33   7.09  3.290000.00.00.0030100       45300 25.0008 090 99      0.00   0.00   0.00
45317  Proctosigmoidoscopy bleed                         A   2.00   5.21     1.22    0.33   7.54  3.550000.00.00.0030100       45300 25.0008 090 99      0.00   0.00   0.00
45320  Proctosigmoidoscopy ablate                        A   1.78   5.42     1.11    0.31   7.51  3.200000.00.00.0030100       45300 25.0008 090 99      0.00   0.00   0.00
45321  Proctosigmoidoscopy volvul                        A   1.75   1.16NA   1.16    0.33   3.24  3.240000.00.00.0030100       45300 25.0008 090 99      0.00   0.00   0.00
45327  Proctosigmoidoscopy w/stent                       A   2.00   1.43NA   1.43    0.42   3.85  3.850000.00.00.0030100       45300 25.0008 090 99      0.00   0.00   0.00
45330  Diagnostic sigmoidoscopy                          A   0.96   3.17     0.82    0.14   4.27  1.920000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
45331  Sigmoidoscopy and biopsy                          A   1.15   3.82     0.96    0.18   5.15  2.290000.00.00.0030100       45330 25.0008 090 99      0.00   0.00   0.00
45332  Sigmoidoscopy w/fb removal                        A   1.79   7.14     1.25    0.29   9.22  3.330000.00.00.0030100       45330 25.0008 090 99      0.00   0.00   0.00
45333  Sigmoidoscopy & polypectomy                       A   1.79   7.27     1.23    0.29   9.35  3.310000.00.00.0030100       45330 25.0008 090 99      0.00   0.00   0.00
45334  Sigmoidoscopy for bleeding                        A   2.73   1.77NA   1.77    0.39   4.89  4.890000.00.00.0030100       45330 25.0008 090 99      0.00   0.00   0.00
45335  Sigmoidoscopy w/submuc inj                        A   1.46   7.02     1.09    0.23   8.71  2.780000.00.00.0030100       45330 25.0008 090 99      0.00   0.00   0.00
45337  Sigmoidoscopy & decompress                        A   2.36   1.53NA   1.53    0.38   4.27  4.270000.00.00.0030100       45330 25.0008 090 99      0.00   0.00   0.00
45338  Sigmoidoscopy w/tumr remove                       A   2.34   7.32     1.53    0.35  10.01  4.220000.00.00.0030100       45330 25.0008 090 99      0.00   0.00   0.00
45339  Sigmoidoscopy w/ablate tumr                       A   3.14   7.01     1.95    0.48  10.63  5.570000.00.00.0030100       45330 25.0008 090 99      0.00   0.00   0.00
45340  Sig w/balloon dilation                            A   1.89  13.41     1.29    0.30  15.60  3.480000.00.00.0030100       45330 25.0008 090 99      0.00   0.00   0.00
45341  Sigmoidoscopy w/ultrasound                        A   2.60   1.71NA   1.71    0.38   4.69  4.690000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
45342  Sigmoidoscopy w/us guide bx                       A   4.05   2.48NA   2.48    0.60   7.13  7.130000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
45345  Sigmoidoscopy w/stent                             A   2.92   1.86NA   1.86    0.44   5.22  5.220000.00.00.0030100       45330 25.0008 090 99      0.00   0.00   0.00
45355  Surgical colonoscopy                              A   3.51   2.03NA   2.03    0.59   6.13  6.130000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
45378  Diagnostic colonoscopy                            A   3.69   7.79     2.20    0.59  12.07  6.480000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
4537853Diagnostic colonoscopy                            A   0.96   3.17     0.82    0.14   4.27  1.920000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
45379  Colonoscopy w/fb removal                          A   4.68  10.13     2.71    0.72  15.53  8.110000.00.00.0030100       45378 25.0008 090 99      0.00   0.00   0.00
45380  Colonoscopy and biopsy                            A   4.43   9.28     2.63    0.67  14.38  7.730000.00.00.0030100       45378 25.0008 090 99      0.00   0.00   0.00
45381  Colonoscopy submucous inj                         A   4.19   9.67     2.52    0.63  14.49  7.340000.00.00.0030100       45378 25.0008 090 99      0.00   0.00   0.00
45382  Colonoscopy/control bleeding                      A   5.68  12.22     3.31    0.84  18.74  9.830000.00.00.0030100       45378 25.0008 090 99      0.00   0.00   0.00
45383  Lesion removal colonoscopy                        A   5.86  10.59     3.25    0.91  17.36 10.020000.00.00.0030100       45378 25.0008 090 99      0.00   0.00   0.00
45384  Lesion remove colonoscopy                         A   4.69   8.88     2.65    0.73  14.30  8.070000.00.00.0030100       45378 25.0008 090 99      0.00   0.00   0.00
45385  Lesion removal colonoscopy                        A   5.30  10.08     3.07    0.80  16.18  9.170000.00.00.0030100       45378 25.0008 090 99      0.00   0.00   0.00
45386  Colonoscopy dilate stricture                      A   4.57  15.71     2.65    0.72  21.00  7.940000.00.00.0030100       45378 25.0008 090 99      0.00   0.00   0.00
45387  Colonoscopy w/stent                               A   5.90   3.51NA   3.51    0.88  10.29 10.290000.00.00.0030100       45378 25.0008 090 99      0.00   0.00   0.00
45391  Colonoscopy w/endoscope us                        A   5.09   2.99NA   2.99    0.73   8.81  8.810000.00.00.0030100       45378 25.0008 090 99      0.00   0.00   0.00
45392  Colonoscopy w/endoscopic fnb                      A   6.54   3.73NA   3.73    1.02  11.29 11.290000.00.00.0030100       45378 25.0008 090 99      0.00   0.00   0.00
45395  Lap removal of rectum                             A  33.00  20.11NA  20.11    5.99  59.10 59.100090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
45397  Lap remove rectum w/pouch                         A  36.50  21.56NA  21.56    6.02  64.08 64.080090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
4540F  Disease modif pharmacothxpy                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
45400  Laparoscopic proc                                 A  19.44  11.34NA  11.34    3.57  34.35 34.350090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
45402  Lap proctopexy w/sig resect                       A  26.51  14.14NA  14.14    4.82  45.47 45.470090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
4541F  Pt offered tx for pseudobulb                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
45499  Laparoscope proc rectum                           C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020211             25.0008 090 99      0.00   0.00   0.00
4550F  noninvas resp support talk                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
45500  Repair of rectum                                  A   7.73   6.90NA   6.90    1.21  15.84 15.840090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
45505  Repair of rectum                                  A   8.36   7.91NA   7.91    1.51  17.78 17.780090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
4551F  Nutritional support offered                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4552F  Pt ref for speech lang path                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
45520  Treatment of rectal prolapse                      A   0.55   4.31     0.60    0.07   4.93  1.220000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
4553F  Pt asst re end life issues                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4554F  Pt recvd inhal anesthetic                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
45540  Correct rectal prolapse                           A  18.12  10.22NA  10.22    3.12  31.46 31.460090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
45541  Correct rectal prolapse                           A  14.85  10.26NA  10.26    2.59  27.70 27.700090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
4555F  Pt recvd no inhal anesthic                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
45550  Repair rectum/remove sigmoid                      A  24.80  14.26NA  14.26    4.48  43.54 43.540090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
4556F  Ptw/ 3+ post-op nausea+vomm                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
45560  Repair of rectocele                               A  11.50   7.41NA   7.41    1.80  20.71 20.710090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
45562  Exploration/repair of rectum                      A  17.98  11.82NA  11.82    3.38  33.18 33.180090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
45563  Exploration/repair of rectum                      A  26.38  16.74NA  16.74    5.63  48.75 48.750090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
4557F  Pt w/o 3+ post-opnausea+vomm                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4558F  Pt recvd 2 rx anti-emetagnts                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4559F  1 bodytemp >=35.5cw/in 30min                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4560F  Anesth w/o gen/neurax anesth                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4561F  Pt w/coronary artery stent                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4562F  Pt w/o coronary artery stent                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
4563F  Pt recvd aspirin w/in 24 hrs                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
45800  Repair rect/bladder fistula                       A  20.31  11.59NA  11.59    3.39  35.29 35.290090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
45805  Repair fistula w/colostomy                        A  23.32  14.96NA  14.96    4.98  43.26 43.260090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
45820  Repair rectourethral fistula                      A  20.37  10.40NA  10.40    1.96  32.73 32.730090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
45825  Repair fistula w/colostomy                        A  24.17  15.87NA  15.87    3.46  43.50 43.500090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
45900  Reduction of rectal prolapse                      A   2.99   2.55NA   2.55    0.56   6.10  6.100010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
45905  Dilation of anal sphincter                        A   2.35   2.31NA   2.31    0.41   5.07  5.070010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
45910  Dilation of rectal narrowing                      A   2.85   2.53NA   2.53    0.48   5.86  5.860010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
45915  Remove rectal obstruction                         A   3.19   6.31     3.07    0.52  10.02  6.780010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
45990  Surg dx exam anorectal                            A   1.80   1.07NA   1.07    0.31   3.18  3.180000.00.00.0020011             25.0008 090 99      0.00   0.00   0.00
45999  Rectum surgery procedure                          C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 090 99      0.00   0.00   0.00
46020  Placement of seton                                A   3.00   4.86     3.55    0.54   8.40  7.090010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
46030  Removal of rectal marker                          A   1.26   2.79     1.24    0.23   4.28  2.730010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
46040  Incision of rectal abscess                        A   5.37   9.75     6.01    1.05  16.17 12.430090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
46045  Incision of rectal abscess                        A   5.87   5.98NA   5.98    1.17  13.02 13.020090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
46050  Incision of anal abscess                          A   1.24   4.78     1.49    0.24   6.26  2.970010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
46060  Incision of rectal abscess                        A   6.37   6.76NA   6.76    1.18  14.31 14.310090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
46070  Incision of anal septum                           A   2.79   3.57NA   3.57    0.20   6.56  6.560090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
46080  Incision of anal sphincter                        A   2.52   4.57     1.74    0.49   7.58  4.750010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
46083  Incise external hemorrhoid                        A   1.45   3.70     1.51    0.24   5.39  3.200010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
46200  Removal of anal fissure                           A   3.59   9.36     5.64    0.63  13.58  9.860090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
46220  Excise anal ext tag/papilla                       A   1.61   4.43     1.67    0.30   6.34  3.580010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
46221  Ligation of hemorrhoid(s)                         A   2.36   5.50     3.05    0.41   8.27  5.820010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
46230  Removal of anal tags                              A   2.62   5.26     2.08    0.48   8.36  5.180010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
46250  Remove ext hem groups 2+                          A   4.25   8.99     4.36    0.82  14.06  9.430090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
46255  Remove int/ext hem 1 group                        A   4.96   9.46     4.67    0.95  15.37 10.580090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
46257  Remove in/ex hem grp & fiss                       A   5.76   5.80NA   5.80    1.08  12.64 12.640090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
46258  Remove in/ex hem grp w/fistu                      A   6.41   6.16NA   6.16    1.37  13.94 13.940090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
46260  Remove in/ex hem groups 2+                        A   6.73   6.22NA   6.22    1.27  14.22 14.220090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
46261  Remove in/ex hem grps & fiss                      A   7.76   6.54NA   6.54    1.39  15.69 15.690090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
46262  Remove in/ex hem grps w/fist                      A   7.91   7.29NA   7.29    1.44  16.64 16.640090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
46270  Remove anal fist subq                             A   4.92   9.45     5.88    0.98  15.35 11.780090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
46275  Remove anal fist inter                            A   5.42   9.93     6.07    0.98  16.33 12.470090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
46280  Remove anal fist complex                          A   6.39   6.60NA   6.60    1.13  14.12 14.120090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
46285  Remove anal fist 2 stage                          A   5.42   9.92     6.13    0.91  16.25 12.460090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
46288  Repair anal fistula                               A   7.81   7.25NA   7.25    1.33  16.39 16.390090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
46320  Removal of hemorrhoid clot                        A   1.64   3.67     1.39    0.30   5.61  3.330010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
46500  Injection into hemorrhoid(s)                      A   1.69   5.36     1.94    0.29   7.34  3.920010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
46505  Chemodenervation anal musc                        A   3.18   4.96     3.50    0.59   8.73  7.270010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
46600  Diagnostic anoscopy                               A   0.55   2.10     0.60    0.08   2.73  1.230000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
46604  Anoscopy and dilation                             A   1.03  18.48     0.80    0.16  19.67  1.990000.00.00.0030100       46600 25.0008 090 99      0.00   0.00   0.00
46606  Anoscopy and biopsy                               A   1.20   5.61     0.87    0.23   7.04  2.300000.00.00.0030100       46600 25.0008 090 99      0.00   0.00   0.00
46608  Anoscopy remove for body                          A   1.30   5.68     0.89    0.24   7.22  2.430000.00.00.0030000       46600 25.0008 090 99      0.00   0.00   0.00
46610  Anoscopy remove lesion                            A   1.28   5.54     0.91    0.24   7.06  2.430000.00.00.0030100       46600 25.0008 090 99      0.00   0.00   0.00
46611  Anoscopy                                          A   1.30   3.84     0.92    0.23   5.37  2.450000.00.00.0030000       46600 25.0008 090 99      0.00   0.00   0.00
46612  Anoscopy remove lesions                           A   1.50   6.77     1.00    0.31   8.58  2.810000.00.00.0030000       46600 25.0008 090 99      0.00   0.00   0.00
46614  Anoscopy control bleeding                         A   1.00   2.78     0.79    0.14   3.92  1.930000.00.00.0030100       46600 25.0008 090 99      0.00   0.00   0.00
46615  Anoscopy                                          A   1.50   2.60     0.99    0.29   4.39  2.780000.00.00.0030000       46600 25.0008 090 99      0.00   0.00   0.00
46700  Repair of anal stricture                          A   9.81   8.12NA   8.12    1.63  19.56 19.560090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
46705  Repair of anal stricture                          A   7.43   7.45NA   7.45    0.52  15.40 15.400090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
46706  Repr of anal fistula w/glue                       A   2.44   2.22NA   2.22    0.42   5.08  5.080010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
46707  Repair anorectal fist w/plug                      A   6.39   6.59NA   6.59    0.90  13.88 13.880090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
46710  Repr per/vag pouch sngl proc                      A  17.14  11.95NA  11.95    3.67  32.76 32.760090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
46712  Repr per/vag pouch dbl proc                       A  36.45  21.31NA  21.31    2.59  60.35 60.350090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
46715  Rep perf anoper fistu                             A   7.62   6.62NA   6.62    0.53  14.77 14.770090.09.81.1020200             25.0008 090 99      0.00   0.00   0.00
46716  Rep perf anoper/vestib fistu                      A  17.54  14.22NA  14.22    1.24  33.00 33.000090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
46730  Construction of absent anus                       A  30.65  20.89NA  20.89    2.18  53.72 53.720090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
46735  Construction of absent anus                       A  36.14  21.15NA  21.15    2.57  59.86 59.860090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
46740  Construction of absent anus                       A  33.90  18.23NA  18.23    7.23  59.36 59.360090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
46742  Repair of imperforated anus                       A  40.14  22.76NA  22.76    8.56  71.46 71.460090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
46744  Repair of cloacal anomaly                         A  58.94  32.17NA  32.17    8.42  99.53 99.530090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
46746  Repair of cloacal anomaly                         A  65.44  33.12NA  33.12    4.64 103.20103.200090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
46748  Repair of cloacal anomaly                         A  71.42  37.03NA  37.03    5.08 113.53113.530090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
46750  Repair of anal sphincter                          A  12.15   8.60NA   8.60    1.97  22.72 22.720090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
46751  Repair of anal sphincter                          A   9.30   7.05NA   7.05    1.57  17.92 17.920090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
46753  Reconstruction of anus                            A   8.89   7.17NA   7.17    1.51  17.57 17.570090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
46754  Removal of suture from anus                       A   3.01   5.69     3.60    0.42   9.12  7.030010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
46760  Repair of anal sphincter                          A  17.45  12.77NA  12.77    2.48  32.70 32.700090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
46761  Repair of anal sphincter                          A  15.29   9.93NA   9.93    2.42  27.64 27.640090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
46762  Implant artificial sphincter                      A  14.82  10.65NA  10.65    2.12  27.59 27.590090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
46900  Destruction anal lesion(s)                        A   1.91   5.18     1.95    0.30   7.39  4.160010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
46910  Destruction anal lesion(s)                        A   1.91   5.57     1.80    0.34   7.82  4.050010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
46916  Cryosurgery anal lesion(s)                        A   1.91   4.81     2.13    0.27   6.99  4.310010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
46917  Laser surgery anal lesions                        A   1.91  11.86     1.77    0.33  14.10  4.010010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
46922  Excision of anal lesion(s)                        A   1.91   5.98     1.81    0.35   8.24  4.070010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
46924  Destruction anal lesion(s)                        A   2.81  13.31     2.27    0.45  16.57  5.530010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
46930  Destroy internal hemorrhoids                      A   1.61   4.40     2.62    0.26   6.27  4.490090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
46940  Treatment of anal fissure                         A   2.35   4.27     1.66    0.37   6.99  4.380010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
46942  Treatment of anal fissure                         A   2.07   4.22     1.55    0.33   6.62  3.950010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
46945  Remove by ligat int hem grp                       A   2.21   6.86     4.30    0.38   9.45  6.890090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
46946  Remove by ligat int hem grps                      A   2.63   6.49     3.74    0.44   9.56  6.810090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
46947  Hemorrhoidopexy by stapling                       A   5.57   4.79NA   4.79    1.09  11.45 11.450090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
46999  Anus surgery procedure                            C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 090 99      0.00   0.00   0.00
47000  Needle biopsy of liver                            A   1.90   9.00     0.96    0.20  11.10  3.060000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
47001  Needle biopsy liver add-on                        A   1.90   0.74NA   0.74    0.38   3.02  3.020ZZZ.00.00.0000110             25.0008 090 99      0.00   0.00   0.00
47010  Open drainage liver lesion                        A  19.40  12.23NA  12.23    3.96  35.59 35.590090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47011  Percut drain liver lesion                         A   3.69   1.30NA   1.30    0.35   5.34  5.340000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
47015  Inject/aspirate liver cyst                        A  18.50  11.99NA  11.99    3.93  34.42 34.420090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47100  Wedge biopsy of liver                             A  12.91   9.50NA   9.50    2.69  25.10 25.100090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47120  Partial removal of liver                          A  39.01  21.33NA  21.33    8.26  68.60 68.600090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47122  Extensive removal of liver                        A  59.48  28.46NA  28.46   12.64 100.58100.580090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47125  Partial removal of liver                          A  53.04  26.12NA  26.12   11.20  90.36 90.360090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47130  Partial removal of liver                          A  57.19  27.57NA  27.57   12.04  96.80 96.800090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47133  Removal of donor liver                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
47135  Transplantation of liver                          R  83.64  42.78NA  42.78   17.71 144.13144.130090.09.81.1020212             25.0008 090 99      0.00   0.00   0.00
47136  Transplantation of liver                          R  70.74  37.80NA  37.80   15.09 123.63123.630090.09.81.1020212             25.0008 090 99      0.00   0.00   0.00
47140  Partial removal donor liver                       A  59.40  33.19NA  33.19   12.67 105.26105.260090.09.81.1020212             25.0008 090 99      0.00   0.00   0.00
47141  Partial removal donor liver                       A  71.50  38.96NA  38.96    5.08 115.54115.540090.09.81.1020212             25.0008 090 99      0.00   0.00   0.00
47142  Partial removal donor liver                       A  79.44  42.09NA  42.09   16.93 138.46138.460090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47143  Prep donor liver whole                            C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0020210             25.0008 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  0.000090.09.81.1020210             25.0008 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  0.000XXX.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
47146  Prep donor liver/venous                           A   6.00   2.37NA   2.37    1.28   9.65  9.650XXX.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
47147  Prep donor liver/arterial                         A   7.00   2.77NA   2.77    1.48  11.25 11.250XXX.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
47300  Surgery for liver lesion                          A  18.14  11.59NA  11.59    3.84  33.57 33.570090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47350  Repair liver wound                                A  22.49  13.31NA  13.31    4.70  40.50 40.500090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47360  Repair liver wound                                A  31.31  17.37NA  17.37    6.67  55.35 55.350090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47361  Repair liver wound                                A  52.60  25.66NA  25.66   10.70  88.96 88.960090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47362  Repair liver wound                                A  23.54  14.31NA  14.31    4.94  42.79 42.790090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47370  Laparo ablate liver tumor rf                      A  20.80  11.51NA  11.51    4.22  36.53 36.530090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47371  Laparo ablate liver cryosurg                      A  20.80  11.83NA  11.83    4.44  37.07 37.070090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47379  Laparoscope procedure liver                       C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020211             25.0008 090 99      0.00   0.00   0.00
47380  Open ablate liver tumor rf                        A  24.56  12.80NA  12.80    4.95  42.31 42.310090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47381  Open ablate liver tumor cryo                      A  24.88  13.44NA  13.44    5.31  43.63 43.630090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47382  Percut ablate liver rf                            A  15.22 136.91     6.06    1.48 153.61 22.760010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
47399  Liver surgery procedure                           C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020111             25.0008 090 99      0.00   0.00   0.00
47400  Incision of liver duct                            A  36.36  19.37NA  19.37    7.74  63.47 63.470090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47420  Incision of bile duct                             A  22.03  13.08NA  13.08    4.67  39.78 39.780090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47425  Incision of bile duct                             A  22.31  13.32NA  13.32    4.76  40.39 40.390090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47460  Incise bile duct sphincter                        A  20.52  12.61NA  12.61    4.37  37.50 37.500090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47480  Incision of gallbladder                           A  13.25  10.06NA  10.06    2.75  26.06 26.060090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47490  Incision of gallbladder                           A   4.76   4.69NA   4.69    0.44   9.89  9.890010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
47500  Injection for liver x-rays                        A   1.96   0.69NA   0.69    0.20   2.85  2.850000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
47505  Injection for liver x-rays                        A   0.76   0.27NA   0.27    0.07   1.10  1.100000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
47510  Insert catheter bile duct                         A   8.03   5.08NA   5.08    0.80  13.91 13.910090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
47511  Insert bile duct drain                            A  10.77   5.23NA   5.23    1.02  17.02 17.020090.09.81.1021100             25.0008 090 99      0.00   0.00   0.00
47525  Change bile duct catheter                         A   1.54  13.45     0.82    0.14  15.13  2.500000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
47530  Revise/reinsert bile tube                         A   6.05  35.54     3.75    0.61  42.20 10.410090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
47550  Bile duct endoscopy add-on                        A   3.02   1.19NA   1.19    0.63   4.84  4.840ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
47552  Biliary endoscopy thru skin                       A   6.03   2.56NA   2.56    0.63   9.22  9.220000.00.00.0020110             25.0008 090 99      0.00   0.00   0.00
47553  Biliary endoscopy thru skin                       A   6.34   2.23NA   2.23    0.63   9.20  9.200000.00.00.0030100       47552 25.0008 090 99      0.00   0.00   0.00
47554  Biliary endoscopy thru skin                       A   9.05   3.83NA   3.83    1.51  14.39 14.390000.00.00.0030110       47552 25.0008 090 99      0.00   0.00   0.00
47555  Biliary endoscopy thru skin                       A   7.55   2.62NA   2.62    0.71  10.88 10.880000.00.00.0030100       47552 25.0008 090 99      0.00   0.00   0.00
47556  Biliary endoscopy thru skin                       A   8.55   3.01NA   3.01    0.80  12.36 12.360000.00.00.0030100       47552 25.0008 090 99      0.00   0.00   0.00
47560  Laparoscopy w/cholangio                           A   4.88   1.93NA   1.93    1.05   7.86  7.860000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
47561  Laparo w/cholangio/biopsy                         A   5.17   2.38NA   2.38    1.10   8.65  8.650000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
47562  Laparoscopic cholecystectomy                      A  10.47   6.80NA   6.80    2.21  19.48 19.480090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47563  Laparo cholecystectomy/graph                      A  11.47   7.25NA   7.25    2.43  21.15 21.150090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47564  Laparo cholecystectomy/explr                      A  18.00  11.11NA  11.11    3.84  32.95 32.950090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47570  Laparo cholecystoenterostomy                      A  12.56   7.68NA   7.68    2.67  22.91 22.910090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47579  Laparoscope proc biliary                          C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021211             25.0008 090 99      0.00   0.00   0.00
47600  Removal of gallbladder                            A  17.48  10.41NA  10.41    3.70  31.59 31.590090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47605  Removal of gallbladder                            A  18.48  10.82NA  10.82    3.93  33.23 33.230090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47610  Removal of gallbladder                            A  20.92  11.67NA  11.67    4.45  37.04 37.040090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47612  Removal of gallbladder                            A  21.21  11.68NA  11.68    4.50  37.39 37.390090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47620  Removal of gallbladder                            A  23.07  12.66NA  12.66    4.94  40.67 40.670090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47630  Remove bile duct stone                            A   9.65   5.34NA   5.34    1.21  16.20 16.200090.09.81.1020110             25.0008 090 99      0.00   0.00   0.00
47700  Exploration of bile ducts                         A  16.50  11.18NA  11.18    3.52  31.20 31.200090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47701  Bile duct revision                                A  28.73  16.34NA  16.34    6.11  51.18 51.180090.09.81.1020000             25.0008 090 99      0.00   0.00   0.00
47711  Excision of bile duct tumor                       A  25.90  14.37NA  14.37    5.48  45.75 45.750090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47712  Excision of bile duct tumor                       A  33.72  17.99NA  17.99    7.20  58.91 58.910090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47715  Excision of bile duct cyst                        A  21.55  13.19NA  13.19    4.60  39.34 39.340090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47720  Fuse gallbladder & bowel                          A  18.34  11.92NA  11.92    3.88  34.14 34.140090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47721  Fuse upper gi structures                          A  21.99  13.37NA  13.37    4.70  40.06 40.060090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47740  Fuse gallbladder & bowel                          A  21.23  13.07NA  13.07    4.52  38.82 38.820090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47741  Fuse gallbladder & bowel                          A  24.21  14.24NA  14.24    5.16  43.61 43.610090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47760  Fuse bile ducts and bowel                         A  38.32  19.92NA  19.92    8.11  66.35 66.350090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47765  Fuse liver ducts & bowel                          A  52.19  26.11NA  26.11   11.13  89.43 89.430090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47780  Fuse bile ducts and bowel                         A  42.32  21.46NA  21.46    8.98  72.76 72.760090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47785  Fuse bile ducts and bowel                         A  56.19  27.14NA  27.14   11.99  95.32 95.320090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47800  Reconstruction of bile ducts                      A  26.17  14.93NA  14.93    5.59  46.69 46.690090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47801  Placement bile duct support                       A  17.60  10.02NA  10.02    2.44  30.06 30.060090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47802  Fuse liver duct & intestine                       A  24.93  14.85NA  14.85    5.32  45.10 45.100090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47900  Suture bile duct injury                           A  22.44  13.50NA  13.50    4.72  40.66 40.660090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
47999  Bile tract surgery procedure                      C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020111             25.0008 090 99      0.00   0.00   0.00
48000  Drainage of abdomen                               A  31.95  16.43NA  16.43    6.18  54.56 54.560090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
48001  Placement of drain pancreas                       A  39.69  19.78NA  19.78    8.48  67.95 67.950090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
48020  Removal of pancreatic stone                       A  19.09  11.65NA  11.65    4.08  34.82 34.820090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
48100  Biopsy of pancreas open                           A  14.46   8.76NA   8.76    2.99  26.21 26.210090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
48102  Needle biopsy pancreas                            A   4.70  10.75     1.96    0.44  15.89  7.100010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
48105  Resect/debride pancreas                           A  49.26  24.37NA  24.37   10.30  83.93 83.930090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
48120  Removal of pancreas lesion                        A  18.41  10.46NA  10.46    3.91  32.78 32.780090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
48140  Partial removal of pancreas                       A  26.32  14.11NA  14.11    5.58  46.01 46.010090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
48145  Partial removal of pancreas                       A  27.39  14.92NA  14.92    5.83  48.14 48.140090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
48146  Pancreatectomy                                    A  30.60  18.02NA  18.02    6.52  55.14 55.140090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
48148  Removal of pancreatic duct                        A  20.39  12.16NA  12.16    4.34  36.89 36.890090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
48150  Partial removal of pancreas                       A  52.84  27.29NA  27.29   11.23  91.36 91.360090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
48152  Pancreatectomy                                    A  48.65  26.05NA  26.05   10.38  85.08 85.080090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
48153  Pancreatectomy                                    A  52.79  27.04NA  27.04   11.21  91.04 91.040090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
48154  Pancreatectomy                                    A  48.88  26.14NA  26.14   10.43  85.45 85.450090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
48155  Removal of pancreas                               A  29.45  17.99NA  17.99    6.27  53.71 53.710090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
48160  Pancreas removal/transplant                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
48400  Injection intraop add-on                          A   1.95   1.03NA   1.03    0.29   3.27  3.270ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
48500  Surgery of pancreatic cyst                        A  18.16  12.09NA  12.09    3.87  34.12 34.120090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
48510  Drain pancreatic pseudocyst                       A  17.19  11.28NA  11.28    3.59  32.06 32.060090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
48511  Drain pancreatic pseudocyst                       A   3.99  23.83     1.41    0.38  28.20  5.780000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
48520  Fuse pancreas cyst and bowel                      A  18.15  10.31NA  10.31    3.84  32.30 32.300090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
48540  Fuse pancreas cyst and bowel                      A  21.94  12.03NA  12.03    4.67  38.64 38.640090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
48545  Pancreatorrhaphy                                  A  22.23  12.75NA  12.75    4.75  39.73 39.730090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
48547  Duodenal exclusion                                A  30.38  15.96NA  15.96    6.46  52.80 52.800090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
48548  Fuse pancreas and bowel                           A  28.09  14.96NA  14.96    5.97  49.02 49.020090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
48550  Donor pancreatectomy                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
48551  Prep donor pancreas                               C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
48552  Prep donor pancreas/venous                        A   4.30   1.70NA   1.70    0.90   6.90  6.900XXX.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
48554  Transpl allograft pancreas                        R  37.80  30.59NA  30.59    7.89  76.28 76.280090.09.81.1020222             25.0008 090 99      0.00   0.00   0.00
48556  Removal allograft pancreas                        A  19.47  14.26NA  14.26    4.15  37.88 37.880090.09.81.1020222             25.0008 090 99      0.00   0.00   0.00
48999  Pancreas surgery procedure                        C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020211             25.0008 090 99      0.00   0.00   0.00
49000  Exploration of abdomen                            A  12.54   7.69NA   7.69    2.57  22.80 22.800090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
49002  Reopening of abdomen                              A  17.63   9.59NA   9.59    3.66  30.88 30.880090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
49010  Exploration behind abdomen                        A  16.06   8.38NA   8.38    3.20  27.64 27.640090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
49020  Drain abdominal abscess                           A  26.67  14.86NA  14.86    5.42  46.95 46.950090.09.81.1020200             25.0008 090 99      0.00   0.00   0.00
49021  Drain abdominal abscess                           A   3.37  22.99     1.20    0.31  26.67  4.880000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
49040  Drain open abdom abscess                          A  16.52   9.79NA   9.79    3.39  29.70 29.700090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
49041  Drain percut abdom abscess                        A   3.99  23.41     1.42    0.38  27.78  5.790000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
49060  Drain open retrop abscess                         A  18.53  10.23NA  10.23    3.69  32.45 32.450090.09.81.1020110             25.0008 090 99      0.00   0.00   0.00
49061  Drain percut retroper absc                        A   3.69  23.11     1.31    0.34  27.14  5.340000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
49062  Drain to peritoneal cavity                        A  12.22   7.17NA   7.17    2.46  21.85 21.850090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
49082  Abd paracentesis                                  A   1.24   3.95     0.78    0.11   5.30  2.130000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
49083  Abd paracentesis w/imaging                        A   2.00   7.39     1.11    0.18   9.57  3.290000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
49084  Peritoneal lavage                                 A   2.00   0.81NA   0.81    0.18   2.99  2.990000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
49180  Biopsy abdominal mass                             A   1.73   2.95     0.62    0.16   4.84  2.510000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
49203  Exc abd tum 5 cm or less                          A  20.13  11.13NA  11.13    3.93  35.19 35.190090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
49204  Exc abd tum over 5 cm                             A  26.13  13.65NA  13.65    5.08  44.86 44.860090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
49205  Exc abd tum over 10 cm                            A  30.13  15.35NA  15.35    6.03  51.51 51.510090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
49215  Excise sacral spine tumor                         A  37.81  19.65NA  19.65    7.54  65.00 65.000090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
49220  Multiple surgery abdomen                          A  15.79   8.87NA   8.87    3.39  28.05 28.050090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
49250  Excision of umbilicus                             A   9.01   6.49NA   6.49    1.84  17.34 17.340090.09.81.1020110             25.0008 090 99      0.00   0.00   0.00
49255  Removal of omentum                                A  12.56   8.38NA   8.38    2.55  23.49 23.490090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
49320  Diag laparo separate proc                         A   5.14   3.56NA   3.56    1.03   9.73  9.730010.10.80.1020200             25.0008 090 99      0.00   0.00   0.00
49321  Laparoscopy biopsy                                A   5.44   3.73NA   3.73    1.13  10.30 10.300010.10.80.1030220       49320 25.0008 090 99      0.00   0.00   0.00
49322  Laparoscopy aspiration                            A   6.01   3.84NA   3.84    1.16  11.01 11.010010.10.80.1030220       49320 25.0008 090 99      0.00   0.00   0.00
49323  Laparo drain lymphocele                           A  10.23   6.85NA   6.85    2.14  19.22 19.220090.10.80.1030220       49320 25.0008 090 99      0.00   0.00   0.00
49324  Lap insert tunnel ip cath                         A   6.32   4.03NA   4.03    1.33  11.68 11.680010.10.80.1030220       49320 25.0008 090 99      0.00   0.00   0.00
49325  Lap revision perm ip cath                         A   6.82   4.19NA   4.19    1.47  12.48 12.480010.10.80.1030220       49320 25.0008 090 99      0.00   0.00   0.00
49326  Lap w/omentopexy add-on                           A   3.50   1.31NA   1.31    0.73   5.54  5.540ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
49327  Lap ins device for rt                             A   2.38   0.94NA   0.94    0.48   3.80  3.800ZZZ.00.00.0000210             25.0008 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  0.000YYY.00.00.0021211             25.0008 090 99      0.00   0.00   0.00
49400  Air injection into abdomen                        A   1.88   1.92     0.67    0.24   4.04  2.790000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
49402  Remove foreign body adbomen                       A  14.09   8.30NA   8.30    2.90  25.29 25.290090.09.81.1020110             25.0008 090 99      0.00   0.00   0.00
49411  Ins mark abd/pel for rt perq                      A   3.82  12.14     1.59    0.35  16.31  5.760000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
49412  Ins device for rt guide open                      A   1.50   0.59NA   0.59    0.30   2.39  2.390ZZZ.00.00.0000010             25.0008 090 99      0.00   0.00   0.00
49418  Insert tun ip cath perc                           A   4.21  39.56     1.80    0.63  44.40  6.640000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
49419  Insert tun ip cath w/port                         A   7.08   4.65NA   4.65    1.22  12.95 12.950090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
49421  Ins tun ip cath for dial opn                      A   4.21   1.73NA   1.73    0.83   6.77  6.770000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
49422  Remove tunneled ip cath                           A   6.29   3.74NA   3.74    1.29  11.32 11.320010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
49423  Exchange drainage catheter                        A   1.46  15.28     0.54    0.12  16.86  2.120000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
49424  Assess cyst contrast inject                       A   0.76   3.62     0.30    0.07   4.45  1.130000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
49425  Insert abdomen-venous drain                       A  12.22   7.44NA   7.44    2.67  22.33 22.330090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
49426  Revise abdomen-venous shunt                       A  10.41   6.09NA   6.09    2.07  18.57 18.570090.09.81.1020100             25.0008 090 99      0.00   0.00   0.00
49427  Injection abdominal shunt                         A   0.89   0.34NA   0.34    0.10   1.33  1.330000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
49428  Ligation of shunt                                 A   6.87   4.45NA   4.45    1.47  12.79 12.790010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
49429  Removal of shunt                                  A   7.44   4.06NA   4.06    1.59  13.09 13.090010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
49435  Insert subq exten to ip cath                      A   2.25   0.81NA   0.81    0.45   3.51  3.510ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
49436  Embedded ip cath exit-site                        A   2.72   2.28NA   2.28    0.59   5.59  5.590010.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
49440  Place gastrostomy tube perc                       A   4.18  27.61     1.99    0.48  32.27  6.650010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
49441  Place duod/jej tube perc                          A   4.77  30.90     2.26    0.54  36.21  7.570010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
49442  Place cecostomy tube perc                         A   4.00  24.48     2.09    0.37  28.85  6.460010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
49446  Change g-tube to g-j perc                         A   3.31  27.05     1.18    0.31  30.67  4.800000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
49450  Replace g/c tube perc                             A   1.36  19.18     0.48    0.12  20.66  1.960000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
49451  Replace duod/jej tube perc                        A   1.84  20.49     0.66    0.20  22.53  2.700000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
49452  Replace g-j tube perc                             A   2.86  24.54     1.01    0.27  27.67  4.140000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
49460  Fix g/colon tube w/device                         A   0.96  21.71     0.35    0.10  22.77  1.410000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
49465  Fluoro exam of g/colon tube                       A   0.62   4.40     0.23    0.05   5.07  0.900000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
49491  Rpr hern preemie reduc                            A  12.53   8.29NA   8.29    2.67  23.49 23.490090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49492  Rpr ing hern premie blocked                       A  15.43   8.81NA   8.81    3.29  27.53 27.530090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49495  Rpr ing hernia baby reduc                         A   6.20   4.16NA   4.16    1.32  11.68 11.680090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49496  Rpr ing hernia baby blocked                       A   9.42   5.31NA   5.31    2.20  16.93 16.930090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49500  Rpr ing hernia init reduce                        A   5.84   4.07NA   4.07    1.24  11.15 11.150090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49501  Rpr ing hernia init blocked                       A   9.36   6.59NA   6.59    1.99  17.94 17.940090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49505  Prp i/hern init reduc >5 yr                       A   7.96   5.83NA   5.83    1.66  15.45 15.450090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49507  Prp i/hern init block >5 yr                       A   9.09   6.36NA   6.36    1.92  17.37 17.370090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49520  Rerepair ing hernia reduce                        A   9.99   6.61NA   6.61    2.10  18.70 18.700090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49521  Rerepair ing hernia blocked                       A  11.48   7.28NA   7.28    2.41  21.17 21.170090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49525  Repair ing hernia sliding                         A   8.93   6.18NA   6.18    1.86  16.97 16.970090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49540  Repair lumbar hernia                              A  10.74   7.01NA   7.01    2.26  20.01 20.010090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49550  Rpr rem hernia init reduce                        A   8.99   6.20NA   6.20    1.89  17.08 17.080090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49553  Rpr fem hernia init blocked                       A   9.92   6.68NA   6.68    2.10  18.70 18.700090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49555  Rerepair fem hernia reduce                        A   9.39   6.32NA   6.32    1.97  17.68 17.680090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49557  Rerepair fem hernia blocked                       A  11.62   7.29NA   7.29    2.45  21.36 21.360090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49560  Rpr ventral hern init reduc                       A  11.92   7.39NA   7.39    2.48  21.79 21.790090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49561  Rpr ventral hern init block                       A  15.38   8.84NA   8.84    3.24  27.46 27.460090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49565  Rerepair ventrl hern reduce                       A  12.37   7.74NA   7.74    2.60  22.71 22.710090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49566  Rerepair ventrl hern block                        A  15.53   8.93NA   8.93    3.29  27.75 27.750090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49568  Hernia repair w/mesh                              A   4.88   1.93NA   1.93    1.03   7.84  7.840ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
49570  Rpr epigastric hern reduce                        A   6.05   5.10NA   5.10    1.28  12.43 12.430090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49572  Rpr epigastric hern blocked                       A   7.87   5.79NA   5.79    1.65  15.31 15.310090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49580  Rpr umbil hern reduc < 5 yr                       A   4.47   4.55NA   4.55    0.95   9.97  9.970090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
49582  Rpr umbil hern block < 5 yr                       A   7.13   5.71NA   5.71    1.52  14.36 14.360090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
49585  Rpr umbil hern reduc > 5 yr                       A   6.59   5.25NA   5.25    1.37  13.21 13.210090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
49587  Rpr umbil hern block > 5 yr                       A   7.08   5.58NA   5.58    1.49  14.15 14.150090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
49590  Repair spigelian hernia                           A   8.90   6.20NA   6.20    1.88  16.98 16.980090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49600  Repair umbilical lesion                           A  11.55   7.61NA   7.61    2.45  21.61 21.610090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
49605  Repair umbilical lesion                           A  87.09  39.15NA  39.15   18.58 144.82144.820090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
49606  Repair umbilical lesion                           A  19.00  10.30NA  10.30    4.06  33.36 33.360090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
49610  Repair umbilical lesion                           A  10.91   5.10NA   5.10    2.31  18.32 18.320090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
49611  Repair umbilical lesion                           A   9.34   5.35NA   5.35    0.65  15.34 15.340090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
49650  Lap ing hernia repair init                        A   6.36   5.04NA   5.04    1.33  12.73 12.730090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49651  Lap ing hernia repair recur                       A   8.38   6.41NA   6.41    1.78  16.57 16.570090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49652  Lap vent/abd hernia repair                        A  11.92   7.60NA   7.60    0.83  20.35 20.350090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49653  Lap vent/abd hern proc comp                       A  14.94   9.36NA   9.36    1.07  25.37 25.370090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49654  Lap inc hernia repair                             A  13.76   8.34NA   8.34    0.97  23.07 23.070090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49655  Lap inc hern repair comp                          A  16.84  10.12NA  10.12    1.19  28.15 28.150090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49656  Lap inc hernia repair recur                       A  15.08   8.85NA   8.85    1.08  25.01 25.010090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49657  Lap inc hern recur comp                           A  22.11  12.20NA  12.20    1.57  35.88 35.880090.09.81.1021210             25.0008 090 99      0.00   0.00   0.00
49659  Laparo proc hernia repair                         C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021211             25.0008 090 99      0.00   0.00   0.00
49900  Repair of abdominal wall                          A  12.41   9.29NA   9.29    2.55  24.25 24.250090.09.81.1020210             25.0008 090 99      0.00   0.00   0.00
49904  Omental flap extra-abdom                          A  22.35  16.10NA  16.10    4.75  43.20 43.200090.10.80.1020111             25.0008 090 99      0.00   0.00   0.00
49905  Omental flap intra-abdom                          A   6.54   2.56NA   2.56    1.24  10.34 10.340ZZZ.00.00.0000220             25.0008 090 99      0.00   0.00   0.00
49906  Free omental flap microvasc                       C   0.00   0.00     0.00    0.00   0.00  0.000090.09.81.1020110             25.0008 090 99      0.00   0.00   0.00
49999  Abdomen surgery procedure                         C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020111             25.0008 090 99      0.00   0.00   0.00
50010  Exploration of kidney                             A  12.28   7.51NA   7.51    1.80  21.59 21.590090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50020  Renal abscess open drain                          A  18.08  10.71NA  10.71    2.41  31.20 31.200090.08.83.0920110             25.0008 090 99      0.00   0.00   0.00
50021  Renal abscess percut drain                        A   3.37  24.67     1.18    0.31  28.35  4.860000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
50040  Drainage of kidney                                A  16.68   8.57NA   8.57    1.69  26.94 26.940090.08.83.0921110             25.0008 090 99      0.00   0.00   0.00
50045  Exploration of kidney                             A  16.82   8.63NA   8.63    1.62  27.07 27.070090.08.83.0921210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
50060  Removal of kidney stone                           A  20.95  10.10NA  10.10    2.01  33.06 33.060090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50065  Incision of kidney                                A  22.32  10.59NA  10.59    2.16  35.07 35.070090.08.83.0921200             25.0008 090 99      0.00   0.00   0.00
50070  Incision of kidney                                A  21.85  10.42NA  10.42    2.12  34.39 34.390090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50075  Removal of kidney stone                           A  27.09  12.55NA  12.55    2.63  42.27 42.270090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50080  Removal of kidney stone                           A  15.74   7.98NA   7.98    1.55  25.27 25.270090.08.83.0921100             25.0008 090 99      0.00   0.00   0.00
50081  Removal of kidney stone                           A  23.50  11.27NA  11.27    2.31  37.08 37.080090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
5010F  Macul result phy/qhp mng dm                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
50100  Revise kidney blood vessels                       A  17.45   8.85NA   8.85    3.73  30.03 30.030090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50120  Exploration of kidney                             A  17.21   8.69NA   8.69    1.66  27.56 27.560090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50125  Explore and drain kidney                          A  17.82  10.84NA  10.84    1.71  30.37 30.370090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50130  Removal of kidney stone                           A  18.82   9.34NA   9.34    1.82  29.98 29.980090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50135  Exploration of kidney                             A  20.59   9.97NA   9.97    1.99  32.55 32.550090.08.83.0921210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
5020F  Txmnts 2 phys/qhp by 1 mon                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
50200  Renal biopsy perq                                 A   2.63  15.00     1.29    0.31  17.94  4.230000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
50205  Renal biopsy open                                 A  12.29   7.49NA   7.49    2.40  22.18 22.180090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50220  Remove kidney open                                A  18.68   9.51NA   9.51    2.25  30.44 30.440090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50225  Removal kidney open complex                       A  21.88  10.60NA  10.60    2.38  34.86 34.860090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50230  Removal kidney open radical                       A  23.81  10.91NA  10.91    2.45  37.17 37.170090.08.83.0921220             25.0008 090 99      0.00   0.00   0.00
50234  Removal of kidney & ureter                        A  24.05  11.25NA  11.25    2.44  37.74 37.740090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50236  Removal of kidney & ureter                        A  26.94  12.95NA  12.95    2.64  42.53 42.530090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50240  Partial removal of kidney                         A  24.21  11.82NA  11.82    2.42  38.45 38.450090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50250  Cryoablate renal mass open                        A  22.22  10.99NA  10.99    2.18  35.39 35.390090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
50280  Removal of kidney lesion                          A  17.09   8.90NA   8.90    1.86  27.85 27.850090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50290  Removal of kidney lesion                          A  16.15   8.39NA   8.39    1.57  26.11 26.110090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
50300  Remove cadaver donor kidney                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
50320  Remove kidney living donor                        A  22.43  16.31NA  16.31    3.88  42.62 42.620090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50323  Prep cadaver renal allograft                      C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
50325  Prep donor renal graft                            C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
50327  Prep renal graft/venous                           A   4.00   1.54NA   1.54    0.78   6.32  6.320XXX.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
50328  Prep renal graft/arterial                         A   3.50   1.35NA   1.35    0.67   5.52  5.520XXX.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
50329  Prep renal graft/ureteral                         A   3.34   1.28NA   1.28    0.48   5.10  5.100XXX.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
50340  Removal of kidney                                 A  14.04  11.17NA  11.17    3.01  28.22 28.220090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50360  Transplantation of kidney                         A  40.90  26.88NA  26.88    8.30  76.08 76.080090.08.83.0920222             25.0008 090 99      0.00   0.00   0.00
50365  Transplantation of kidney                         A  46.13  28.58NA  28.58    9.84  84.55 84.550090.08.83.0921222             25.0008 090 99      0.00   0.00   0.00
50370  Remove transplanted kidney                        A  18.88  12.89NA  12.89    3.76  35.53 35.530090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
50380  Reimplantation of kidney                          A  30.11  22.98NA  22.98    6.41  59.50 59.500090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
50382  Change ureter stent percut                        A   5.50  30.18     1.97    0.52  36.20  7.990000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
50384  Remove ureter stent percut                        A   5.00  23.50     1.78    0.48  28.98  7.260000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
50385  Change stent via transureth                       A   4.44  30.07     1.91    0.42  34.93  6.770000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
50386  Remove stent via transureth                       A   3.30  19.01     1.51    0.31  22.62  5.120000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
50387  Change ext/int ureter stent                       A   2.00  14.69     0.69    0.20  16.89  2.890000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
50389  Remove renal tube w/fluoro                        A   1.10   7.96     0.39    0.10   9.16  1.590000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
50390  Drainage of kidney lesion                         A   1.96   0.69NA   0.69    0.18   2.83  2.830000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
50391  Instll rx agnt into rnal tub                      A   1.96   1.41     0.70    0.20   3.57  2.860000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
50392  Insert kidney drain                               A   3.37   1.57NA   1.57    0.31   5.25  5.250000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
50393  Insert ureteral tube                              A   4.15   1.84NA   1.84    0.38   6.37  6.370000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
50394  Injection for kidney x-ray                        A   0.76   2.24     0.65    0.07   3.07  1.480000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
50395  Create passage to kidney                          A   3.37   1.56NA   1.56    0.33   5.26  5.260000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
50396  Measure kidney pressure                           A   2.09   0.99NA   0.99    0.20   3.28  3.280000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
50398  Change kidney tube                                A   1.46  13.65     0.55    0.12  15.23  2.130000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
50400  Revision of kidney/ureter                         A  21.27  10.25NA  10.25    2.10  33.62 33.620090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50405  Revision of kidney/ureter                         A  25.86  12.11NA  12.11    2.50  40.47 40.470090.08.83.0921210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
50500  Repair of kidney wound                            A  21.22  11.59NA  11.59    4.52  37.33 37.330090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
50520  Close kidney-skin fistula                         A  18.88   9.36NA   9.36    1.84  30.08 30.080090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
50525  Repair renal-abdomen fistula                      A  24.39  13.69NA  13.69    5.20  43.28 43.280090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
50526  Repair renal-abdomen fistula                      A  26.31  13.65NA  13.65    1.86  41.82 41.820090.08.83.0920200             25.0008 090 99      0.00   0.00   0.00
50540  Revision of horseshoe kidney                      A  21.10  10.16NA  10.16    2.03  33.29 33.290090.08.83.0922210             25.0008 090 99      0.00   0.00   0.00
50541  Laparo ablate renal cyst                          A  16.86   8.15NA   8.15    1.70  26.71 26.710090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50542  Laparo ablate renal mass                          A  21.36  10.41NA  10.41    2.10  33.87 33.870090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50543  Laparo partial nephrectomy                        A  27.41  13.11NA  13.11    2.72  43.24 43.240090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50544  Laparoscopy pyeloplasty                           A  23.37  10.48NA  10.48    2.31  36.16 36.160090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50545  Laparo radical nephrectomy                        A  25.06  11.32NA  11.32    2.55  38.93 38.930090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50546  Laparoscopic nephrectomy                          A  21.87  10.77NA  10.77    2.30  34.94 34.940090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50547  Laparo removal donor kidney                       A  26.34  16.19NA  16.19    4.83  47.36 47.360090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50548  Laparo remove w/ureter                            A  25.36  11.19NA  11.19    2.50  39.05 39.050090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50549  Laparoscope proc renal                            C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021211             25.0008 090 99      0.00   0.00   0.00
50551  Kidney endoscopy                                  A   5.59   4.34     2.43    0.54  10.47  8.560000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
50553  Kidney endoscopy                                  A   5.98   4.64     2.53    0.65  11.27  9.160000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
50555  Kidney endoscopy & biopsy                         A   6.52   4.84     2.76    0.63  11.99  9.910000.00.00.0031000       50551 25.0008 090 99      0.00   0.00   0.00
50557  Kidney endoscopy & treatment                      A   6.61   4.95     2.79    0.64  12.20 10.040000.00.00.0031000       50551 25.0008 090 99      0.00   0.00   0.00
50561  Kidney endoscopy & treatment                      A   7.58   5.51     3.12    0.75  13.84 11.450000.00.00.0031000       50551 25.0008 090 99      0.00   0.00   0.00
50562  Renal scope w/tumor resect                        A  10.90   4.91NA   4.91    1.06  16.87 16.870090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
50570  Kidney endoscopy                                  A   9.53   3.79NA   3.79    0.91  14.23 14.230000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
50572  Kidney endoscopy                                  A  10.33   4.08NA   4.08    1.01  15.42 15.420000.00.00.0031000       50570 25.0008 090 99      0.00   0.00   0.00
50574  Kidney endoscopy & biopsy                         A  11.00   4.32NA   4.32    1.08  16.40 16.400000.00.00.0031000       50570 25.0008 090 99      0.00   0.00   0.00
50575  Kidney endoscopy                                  A  13.96   5.37NA   5.37    1.36  20.69 20.690000.00.00.0031100       50570 25.0008 090 99      0.00   0.00   0.00
50576  Kidney endoscopy & treatment                      A  10.97   4.31NA   4.31    1.06  16.34 16.340000.00.00.0031000       50570 25.0008 090 99      0.00   0.00   0.00
50580  Kidney endoscopy & treatment                      A  11.84   4.62NA   4.62    1.16  17.62 17.620000.00.00.0031000       50570 25.0008 090 99      0.00   0.00   0.00
50590  Fragmenting of kidney stone                       A   9.77  10.42     5.83    0.95  21.14 16.550090.08.83.0921100             25.0008 090 99      0.00   0.00   0.00
50592  Perc rf ablate renal tumor                        A   6.80  87.91     3.17    0.64  95.35 10.610010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
50593  Perc cryo ablate renal tum                        A   9.13 130.98     4.16    0.86 140.97 14.150010.10.80.1021200             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
50600  Exploration of ureter                             A  17.17   8.42NA   8.42    1.66  27.25 27.250090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50605  Insert ureteral support                           A  16.79   9.23NA   9.23    2.65  28.67 28.670090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50610  Removal of ureter stone                           A  17.25   8.53NA   8.53    1.66  27.44 27.440090.08.83.0921210             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
50620  Removal of ureter stone                           A  16.43   8.23NA   8.23    1.59  26.25 26.250090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50630  Removal of ureter stone                           A  16.21   8.15NA   8.15    1.57  25.93 25.930090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50650  Removal of ureter                                 A  18.82   9.39NA   9.39    1.89  30.10 30.100090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50660  Removal of ureter                                 A  21.02  10.13NA  10.13    2.03  33.18 33.180090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
50684  Injection for ureter x-ray                        A   0.76   2.35     0.65    0.07   3.18  1.480000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
50686  Measure ureter pressure                           A   1.51   2.70     1.01    0.22   4.43  2.740000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
50688  Change of ureter tube/stent                       A   1.20   1.05NA   1.05    0.11   2.36  2.360010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
50690  Injection for ureter x-ray                        A   1.16   1.62     0.80    0.10   2.88  2.060000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
50700  Revision of ureter                                A  16.69   8.58NA   8.58    1.62  26.89 26.890090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50715  Release of ureter                                 A  20.64  11.50NA  11.50    3.01  35.15 35.150090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50722  Release of ureter                                 A  17.95  10.12NA  10.12    3.05  31.12 31.120090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
50725  Release/revise ureter                             A  20.20   9.83NA   9.83    1.95  31.98 31.980090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
50727  Revise ureter                                     A   8.28   5.67NA   5.67    0.84  14.79 14.790090.08.83.0920220             25.0008 090 99      0.00   0.00   0.00
50728  Revise ureter                                     A  12.18   6.97NA   6.97    1.18  20.33 20.330090.08.83.0920220             25.0008 090 99      0.00   0.00   0.00
50740  Fusion of ureter & kidney                         A  20.07  11.73NA  11.73    4.29  36.09 36.090090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50750  Fusion of ureter & kidney                         A  21.22  10.20NA  10.20    2.04  33.46 33.460090.08.83.0921200             25.0008 090 99      0.00   0.00   0.00
50760  Fusion of ureters                                 A  20.07  10.25NA  10.25    2.67  32.99 32.990090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50770  Splicing of ureters                               A  21.22  10.20NA  10.20    2.04  33.46 33.460090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
50780  Reimplant ureter in bladder                       A  19.95   9.98NA   9.98    2.31  32.24 32.240090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50782  Reimplant ureter in bladder                       A  19.66  11.57NA  11.57    4.19  35.42 35.420090.08.83.0921220             25.0008 090 99      0.00   0.00   0.00
50783  Reimplant ureter in bladder                       A  20.70  10.01NA  10.01    2.00  32.71 32.710090.08.83.0921220             25.0008 090 99      0.00   0.00   0.00
50785  Reimplant ureter in bladder                       A  22.23  10.66NA  10.66    2.25  35.14 35.140090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50800  Implant ureter in bowel                           A  16.41   8.89NA   8.89    1.74  27.04 27.040090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50810  Fusion of ureter & bowel                          A  22.61  11.46NA  11.46    4.83  38.90 38.900090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
50815  Urine shunt to intestine                          A  22.26  11.08NA  11.08    2.16  35.50 35.500090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50820  Construct bowel bladder                           A  24.07  11.64NA  11.64    2.65  38.36 38.360090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50825  Construct bowel bladder                           A  30.68  14.31NA  14.31    3.17  48.16 48.160090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
50830  Revise urine flow                                 A  33.77  15.19NA  15.19    3.29  52.25 52.250090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
50840  Replace ureter by bowel                           A  22.39  11.13NA  11.13    2.18  35.70 35.700090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50845  Appendico-vesicostomy                             A  22.46  11.76NA  11.76    2.18  36.40 36.400090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
50860  Transplant ureter to skin                         A  17.08   8.72NA   8.72    1.65  27.45 27.450090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50900  Repair of ureter                                  A  15.04   8.21NA   8.21    1.47  24.72 24.720090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50920  Closure ureter/skin fistula                       A  15.81   8.26NA   8.26    1.54  25.61 25.610090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
50930  Closure ureter/bowel fistula                      A  20.19   9.83NA   9.83    4.30  34.32 34.320090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
50940  Release of ureter                                 A  15.93   8.31NA   8.31    1.55  25.79 25.790090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50945  Laparoscopy ureterolithotomy                      A  17.97   8.53NA   8.53    1.74  28.24 28.240090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50947  Laparo new ureter/bladder                         A  25.78  11.90NA  11.90    2.50  40.18 40.180090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50948  Laparo new ureter/bladder                         A  23.82  10.84NA  10.84    2.30  36.96 36.960090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
50949  Laparoscope proc ureter                           C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021211             25.0008 090 99      0.00   0.00   0.00
50951  Endoscopy of ureter                               A   5.83   4.53     2.51    0.56  10.92  8.900000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
50953  Endoscopy of ureter                               A   6.23   4.76     3.04    0.61  11.60  9.880000.00.00.0031000       50951 25.0008 090 99      0.00   0.00   0.00
50955  Ureter endoscopy & biopsy                         A   6.74   4.97     3.22    0.65  12.36 10.610000.00.00.0031000       50951 25.0008 090 99      0.00   0.00   0.00
50957  Ureter endoscopy & treatment                      A   6.78   5.05     2.85    0.65  12.48 10.280000.00.00.0031000       50951 25.0008 090 99      0.00   0.00   0.00
50961  Ureter endoscopy & treatment                      A   6.04   4.62     2.58    0.59  11.25  9.210000.00.00.0031000       50951 25.0008 090 99      0.00   0.00   0.00
50970  Ureter endoscopy                                  A   7.13   2.93NA   2.93    0.68  10.74 10.740000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
50972  Ureter endoscopy & catheter                       A   6.88   2.84NA   2.84    0.67  10.39 10.390000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
50974  Ureter endoscopy & biopsy                         A   9.16   3.66NA   3.66    0.88  13.70 13.700000.00.00.0031000       50970 25.0008 090 99      0.00   0.00   0.00
50976  Ureter endoscopy & treatment                      A   9.03   3.61NA   3.61    0.87  13.51 13.510000.00.00.0031000       50970 25.0008 090 99      0.00   0.00   0.00
50980  Ureter endoscopy & treatment                      A   6.84   2.83NA   2.83    0.65  10.32 10.320000.00.00.0021000             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
51020  Incise & treat bladder                            A   7.69   5.24NA   5.24    0.78  13.71 13.710090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51030  Incise & treat bladder                            A   7.81   5.17NA   5.17    0.75  13.73 13.730090.08.83.0920000             25.0008 090 99      0.00   0.00   0.00
51040  Incise & drain bladder                            A   4.49   3.55NA   3.55    0.44   8.48  8.480090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51045  Incise bladder/drain ureter                       A   7.81   5.54NA   5.54    1.06  14.41 14.410090.08.83.0920200             25.0008 090 99      0.00   0.00   0.00
51050  Removal of bladder stone                          A   7.97   5.03NA   5.03    0.78  13.78 13.780090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51060  Removal of ureter stone                           A   9.95   6.01NA   6.01    0.98  16.94 16.940090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51065  Remove ureter calculus                            A   9.95   5.93NA   5.93    0.98  16.86 16.860090.08.83.0920000             25.0008 090 99      0.00   0.00   0.00
51080  Drainage of bladder abscess                       A   6.71   4.57NA   4.57    0.65  11.93 11.930090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51100  Drain bladder by needle                           A   0.78   0.97     0.26    0.08   1.83  1.120000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
51101  Drain bladder by trocar/cath                      A   1.02   2.61     0.39    0.12   3.75  1.530000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
51102  Drain bl w/cath insertion                         A   2.70   3.74     1.25    0.29   6.73  4.240000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
51500  Removal of bladder cyst                           A  11.05   6.40NA   6.40    1.08  18.53 18.530090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51520  Removal of bladder lesion                         A  10.21   6.10NA   6.10    0.99  17.30 17.300090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51525  Removal of bladder lesion                         A  15.42   8.02NA   8.02    1.57  25.01 25.010090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51530  Removal of bladder lesion                         A  13.71   7.69NA   7.69    1.65  23.05 23.050090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51535  Repair of ureter lesion                           A  13.90   7.41NA   7.41    1.33  22.64 22.640090.08.83.0921210             25.0008 090 99      0.00   0.00   0.00
51550  Partial removal of bladder                        A  17.23   8.86NA   8.86    2.14  28.23 28.230090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51555  Partial removal of bladder                        A  23.18  11.20NA  11.20    2.60  36.98 36.980090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51565  Revise bladder & ureter(s)                        A  23.68  11.56NA  11.56    2.42  37.66 37.660090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51570  Removal of bladder                                A  27.46  12.66NA  12.66    2.80  42.92 42.920090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51575  Removal of bladder & nodes                        A  34.18  15.23NA  15.23    3.35  52.76 52.760090.08.83.0922210             25.0008 090 99      0.00   0.00   0.00
51580  Remove bladder/revise tract                       A  35.37  16.16NA  16.16    3.44  54.97 54.970090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51585  Removal of bladder & nodes                        A  39.64  17.69NA  17.69    3.85  61.18 61.180090.08.83.0922210             25.0008 090 99      0.00   0.00   0.00
51590  Remove bladder/revise tract                       A  36.33  16.04NA  16.04    3.67  56.04 56.040090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51595  Remove bladder/revise tract                       A  41.32  18.05NA  18.05    4.11  63.48 63.480090.08.83.0922210             25.0008 090 99      0.00   0.00   0.00
51596  Remove bladder/create pouch                       A  44.26  19.61NA  19.61    4.34  68.21 68.210090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51597  Removal of pelvic structures                      A  42.86  19.17NA  19.17    4.53  66.56 66.560090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51600  Injection for bladder x-ray                       A   0.88   4.52     0.32    0.08   5.48  1.280000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
51605  Preparation for bladder xray                      A   0.64   0.42NA   0.42    0.05   1.11  1.110000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
51610  Injection for bladder x-ray                       A   1.05   2.00     0.73    0.10   3.15  1.880000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
51700  Irrigation of bladder                             A   0.88   1.49     0.32    0.08   2.45  1.280000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
51701  Insert bladder catheter                           A   0.50   1.08     0.25    0.05   1.63  0.800000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
51702  Insert temp bladder cath                          A   0.50   1.56     0.33    0.05   2.11  0.880000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
51703  Insert bladder cath complex                       A   1.47   2.22     0.76    0.14   3.83  2.370000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
51705  Change of bladder tube                            A   0.90   1.71     0.53    0.09   2.70  1.520000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
51710  Change of bladder tube                            A   1.35   1.28     0.86    0.12   2.75  2.330000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
51715  Endoscopic injection/implant                      A   3.73   4.40     1.70    0.39   8.52  5.820000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
51720  Treatment of bladder lesion                       A   1.50   1.55     0.68    0.14   3.19  2.320000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
51725  Simple cystometrogram                             A   1.51   3.98     3.98NA  0.13   5.62  5.621000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
51725TCSimple cystometrogram                             A   0.00   3.40     3.40NA  0.01   3.41  3.411000.00.00.0020000             25.0008 020 99      0.00   0.00   0.00
5172526Simple cystometrogram                             A   1.51   0.58     0.58    0.12   2.21  2.211000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
51726  Complex cystometrogram                            A   1.71   6.06     6.06NA  0.17   7.94  7.941000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
51726TCComplex cystometrogram                            A   0.00   5.43     5.43NA  0.03   5.46  5.461000.00.00.0020100             25.0008 020 99      0.00   0.00   0.00
5172626Complex cystometrogram                            A   1.71   0.63     0.63    0.14   2.48  2.481000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
51727  Cystometrogram w/up                               A   2.11   7.13     7.13NA  0.23   9.47  9.471000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
51727TCCystometrogram w/up                               A   0.00   6.30     6.30NA  0.01   6.31  6.311000.00.00.0020000             25.0008 020 99      0.00   0.00   0.00
5172726Cystometrogram w/up                               A   2.11   0.83     0.83    0.22   3.16  3.161000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
51728  Cystometrogram w/vp                               A   2.11   7.17     7.17NA  0.19   9.47  9.471000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
51728TCCystometrogram w/vp                               A   0.00   6.40     6.40NA  0.01   6.41  6.411000.00.00.0020000             25.0008 020 99      0.00   0.00   0.00
5172826Cystometrogram w/vp                               A   2.11   0.77     0.77    0.18   3.06  3.061000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
51729  Cystometrogram w/vp&up                            A   2.51   7.51     7.51NA  0.25  10.27 10.271000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
51729TCCystometrogram w/vp&up                            A   0.00   6.54     6.54NA  0.01   6.55  6.551000.00.00.0020000             25.0008 020 99      0.00   0.00   0.00
5172926Cystometrogram w/vp&up                            A   2.51   0.97     0.97    0.24   3.72  3.721000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
51736  Urine flow measurement                            A   0.17   0.26     0.26NA  0.02   0.45  0.451XXX.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
51736TCUrine flow measurement                            A   0.00   0.20     0.20NA  0.01   0.21  0.211XXX.00.00.0020000             25.0008 020 99      0.00   0.00   0.00
5173626Urine flow measurement                            A   0.17   0.06     0.06    0.01   0.24  0.241XXX.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
51741  Electro-uroflowmetry first                        A   0.17   0.28     0.28NA  0.02   0.47  0.471XXX.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
51741TCElectro-uroflowmetry first                        A   0.00   0.22     0.22NA  0.01   0.23  0.231XXX.00.00.0020100             25.0008 020 99      0.00   0.00   0.00
5174126Electro-uroflowmetry first                        A   0.17   0.06     0.06    0.01   0.24  0.241XXX.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
51784  Anal/urinary muscle study                         A   1.53   4.10     4.10NA  0.13   5.76  5.761000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
51784TCAnal/urinary muscle study                         A   0.00   3.52     3.52NA  0.01   3.53  3.531000.00.00.0020100             25.0008 020 99      0.00   0.00   0.00
5178426Anal/urinary muscle study                         A   1.53   0.58     0.58    0.12   2.23  2.231000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
51785  Anal/urinary muscle study                         A   1.53   5.99     5.99NA  0.13   7.65  7.651000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
51785TCAnal/urinary muscle study                         A   0.00   5.33     5.33NA  0.01   5.34  5.341000.00.00.0020000             25.0008 030 99      0.00   0.00   0.00
5178526Anal/urinary muscle study                         A   1.53   0.66     0.66    0.12   2.31  2.311000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
51792  Urinary reflex study                              A   1.10   5.19     5.19NA  0.11   6.40  6.401000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
51792TCUrinary reflex study                              A   0.00   4.77     4.77NA  0.01   4.78  4.781000.00.00.0020000             25.0008 020 99      0.00   0.00   0.00
5179226Urinary reflex study                              A   1.10   0.42     0.42    0.10   1.62  1.621000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
51797  Intraabdominal pressure test                      A   0.80   2.50     2.50NA  0.06   3.36  3.361ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
51797TCIntraabdominal pressure test                      A   0.00   2.20     2.20NA  0.01   2.21  2.211ZZZ.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
5179726Intraabdominal pressure test                      A   0.80   0.30     0.30    0.05   1.15  1.151ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
51798  Us urine capacity measure                         A   0.00   0.57     0.57NA  0.01   0.58  0.583XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
51800  Revision of bladder/urethra                       A  18.89   9.52NA   9.52    1.95  30.36 30.360090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51820  Revision of urinary tract                         A  19.59   9.97NA   9.97    1.89  31.45 31.450090.08.83.0922210             25.0008 090 99      0.00   0.00   0.00
51840  Attach bladder/urethra                            A  11.36   6.63NA   6.63    1.50  19.49 19.490090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51841  Attach bladder/urethra                            A  13.68   7.62NA   7.62    1.84  23.14 23.140090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51845  Repair bladder neck                               A  10.15   5.88NA   5.88    1.20  17.23 17.230090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51860  Repair of bladder wound                           A  12.60   7.51NA   7.51    1.85  21.96 21.960090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51865  Repair of bladder wound                           A  15.80   8.51NA   8.51    1.92  26.23 26.230090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51880  Repair of bladder opening                         A   7.87   4.88NA   4.88    0.99  13.74 13.740090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51900  Repair bladder/vagina lesion                      A  14.63   8.11NA   8.11    1.42  24.16 24.160090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51920  Close bladder-uterus fistula                      A  13.41   9.22NA   9.22    1.29  23.92 23.920090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51925  Hysterectomy/bladder repair                       A  17.53  10.46NA  10.46    2.97  30.96 30.960090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51940  Correction of bladder defect                      A  30.66  13.75NA  13.75    2.98  47.39 47.390090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51960  Revision of bladder & bowel                       A  25.40  12.41NA  12.41    2.65  40.46 40.460090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51980  Construct bladder opening                         A  12.57   6.95NA   6.95    1.22  20.74 20.740090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51990  Laparo urethral suspension                        A  13.36   7.21NA   7.21    1.77  22.34 22.340090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51992  Laparo sling operation                            A  14.87   8.19NA   8.19    2.23  25.29 25.290090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
51999  Laparoscope proc bla                              C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000011             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
52000  Cystoscopy                                        A   2.23   3.54     1.22    0.23   6.00  3.680000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
52001  Cystoscopy removal of clots                       A   5.44   4.83     2.37    0.53  10.80  8.340000.00.00.0030100       52000 25.0008 090 99      0.00   0.00   0.00
52005  Cystoscopy & ureter catheter                      A   2.37   5.24     1.27    0.24   7.85  3.880000.00.00.0030100       52000 25.0008 090 99      0.00   0.00   0.00
52007  Cystoscopy and biopsy                             A   3.02   9.92     1.51    0.30  13.24  4.830000.00.00.0031100       52000 25.0008 090 99      0.00   0.00   0.00
52010  Cystoscopy & duct catheter                        A   3.02   7.56     1.50    0.30  10.88  4.820000.00.00.0030100       52000 25.0008 090 99      0.00   0.00   0.00
52204  Cystoscopy w/biopsy(s)                            A   2.59   8.14     1.28    0.26  10.99  4.130000.00.00.0030100       52000 25.0008 090 99      0.00   0.00   0.00
52214  Cystoscopy and treatment                          A   3.50  15.95     1.25    0.33  19.78  5.080000.00.00.0030100       52000 25.0008 090 99      0.00   0.00   0.00
52224  Cystoscopy and treatment                          A   4.05  15.08     1.45    0.40  19.53  5.900000.00.00.0030100       52000 25.0008 090 99      0.00   0.00   0.00
52234  Cystoscopy and treatment                          A   4.62   2.07NA   2.07    0.44   7.13  7.130000.00.00.0030100       52000 25.0008 090 99      0.00   0.00   0.00
52235  Cystoscopy and treatment                          A   5.44   2.41NA   2.41    0.53   8.38  8.380000.00.00.0030100       52000 25.0008 090 99      0.00   0.00   0.00
52240  Cystoscopy and treatment                          A   7.50   3.14NA   3.14    0.73  11.37 11.370000.00.00.0030100       52000 25.0008 090 99      0.00   0.00   0.00
52250  Cystoscopy and radiotracer                        A   4.49   2.12NA   2.12    0.45   7.06  7.060000.00.00.0030100       52000 25.0008 090 99      0.00   0.00   0.00
52260  Cystoscopy and treatment                          A   3.91   1.82NA   1.82    0.39   6.12  6.120000.00.00.0030100       52000 25.0008 090 99      0.00   0.00   0.00
52265  Cystoscopy and treatment                          A   2.94   7.64     1.50    0.35  10.93  4.790000.00.00.0030100       52000 25.0008 090 99      0.00   0.00   0.00
52270  Cystoscopy & revise urethra                       A   3.36   6.80     1.60    0.33  10.49  5.290000.00.00.0030100       52000 25.0008 090 99      0.00   0.00   0.00
52275  Cystoscopy & revise urethra                       A   4.69   9.01     2.07    0.45  14.15  7.210000.00.00.0030100       52000 25.0008 090 99      0.00   0.00   0.00
52276  Cystoscopy and treatment                          A   4.99   2.23NA   2.23    0.49   7.71  7.710000.00.00.0030100       52000 25.0008 090 99      0.00   0.00   0.00
52277  Cystoscopy and treatment                          A   6.16   2.71NA   2.71    0.60   9.47  9.470000.00.00.0030000       52000 25.0008 090 99      0.00   0.00   0.00
52281  Cystoscopy and treatment                          A   2.75   4.99     1.41    0.29   8.03  4.450000.00.00.0030100       52000 25.0008 090 99      0.00   0.00   0.00
52282  Cystoscopy implant stent                          A   6.39   2.74NA   2.74    0.65   9.78  9.780000.00.00.0030100       52000 25.0008 090 99      0.00   0.00   0.00
52283  Cystoscopy and treatment                          A   3.73   3.96     1.76    0.37   8.06  5.860000.00.00.0030100       52000 25.0008 090 99      0.00   0.00   0.00
52285  Cystoscopy and treatment                          A   3.60   4.20     1.74    0.37   8.17  5.710000.00.00.0030100       52000 25.0008 090 99      0.00   0.00   0.00
52287  Cystoscopy chemodenervation                       A   3.20   5.63     1.37    0.33   9.16  4.900000.00.00.0030100       52000 25.0008 090 99      0.00   0.00   0.00
52290  Cystoscopy and treatment                          A   4.58   2.08NA   2.08    0.44   7.10  7.100000.00.00.0032100       52000 25.0008 090 99      0.00   0.00   0.00
52300  Cystoscopy and treatment                          A   5.30   2.44NA   2.44    0.56   8.30  8.300000.00.00.0032000       52000 25.0008 090 99      0.00   0.00   0.00
52301  Cystoscopy and treatment                          A   5.50   2.46NA   2.46    0.53   8.49  8.490000.00.00.0032000       52000 25.0008 090 99      0.00   0.00   0.00
52305  Cystoscopy and treatment                          A   5.30   2.27NA   2.27    0.52   8.09  8.090000.00.00.0030100       52000 25.0008 090 99      0.00   0.00   0.00
52310  Cystoscopy and treatment                          A   2.81   4.03     1.31    0.29   7.13  4.410000.00.00.0030100       52000 25.0008 090 99      0.00   0.00   0.00
52315  Cystoscopy and treatment                          A   5.20   6.36     2.26    0.50  12.06  7.960000.00.00.0030100       52000 25.0008 090 99      0.00   0.00   0.00
52317  Remove bladder stone                              A   6.71  16.51     2.71    0.65  23.87 10.070000.00.00.0030100       52000 25.0008 090 99      0.00   0.00   0.00
52318  Remove bladder stone                              A   9.18   3.65NA   3.65    0.88  13.71 13.710000.00.00.0030100       52000 25.0008 090 99      0.00   0.00   0.00
52320  Cystoscopy and treatment                          A   4.69   2.01NA   2.01    0.45   7.15  7.150000.00.00.0031100       52000 25.0008 090 99      0.00   0.00   0.00
52325  Cystoscopy stone removal                          A   6.15   2.56NA   2.56    0.60   9.31  9.310000.00.00.0031100       52000 25.0008 090 99      0.00   0.00   0.00
52327  Cystoscopy inject material                        A   5.18   1.90NA   1.90    0.52   7.60  7.600000.00.00.0031100       52000 25.0008 090 99      0.00   0.00   0.00
52330  Cystoscopy and treatment                          A   5.03   9.04     2.13    0.49  14.56  7.650000.00.00.0031100       52000 25.0008 090 99      0.00   0.00   0.00
52332  Cystoscopy and treatment                          A   2.82  12.12     1.43    0.28  15.22  4.530000.00.00.0031100       52000 25.0008 090 99      0.00   0.00   0.00
52334  Create passage to kidney                          A   4.82   2.16NA   2.16    0.48   7.46  7.460000.00.00.0031100       52000 25.0008 090 99      0.00   0.00   0.00
52341  Cysto w/ureter stricture tx                       A   5.35   2.53NA   2.53    0.52   8.40  8.400000.00.00.0031100       52000 25.0008 090 99      0.00   0.00   0.00
52342  Cysto w/up stricture tx                           A   5.85   2.71NA   2.71    0.56   9.12  9.120000.00.00.0031100       52000 25.0008 090 99      0.00   0.00   0.00
52343  Cysto w/renal stricture tx                        A   6.55   2.95NA   2.95    0.64  10.14 10.140000.00.00.0031100       52000 25.0008 090 99      0.00   0.00   0.00
52344  Cysto/uretero stricture tx                        A   7.05   3.30NA   3.30    0.68  11.03 11.030000.00.00.0031100       52000 25.0008 090 99      0.00   0.00   0.00
52345  Cysto/uretero w/up stricture                      A   7.55   3.48NA   3.48    0.72  11.75 11.750000.00.00.0031000       52351 25.0008 090 99      0.00   0.00   0.00
52346  Cystouretero w/renal strict                       A   8.58   3.87NA   3.87    0.83  13.28 13.280000.00.00.0031000       52351 25.0008 090 99      0.00   0.00   0.00
52351  Cystouretero & or pyeloscope                      A   5.75   2.67NA   2.67    0.55   8.97  8.970000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
52352  Cystouretero w/stone remove                       A   6.75   3.13NA   3.13    0.66  10.54 10.540000.00.00.0031100       52351 25.0008 090 99      0.00   0.00   0.00
52353  Cystouretero w/lithotripsy                        A   7.50   3.40NA   3.40    0.72  11.62 11.620000.00.00.0031100       52351 25.0008 090 99      0.00   0.00   0.00
52354  Cystouretero w/biopsy                             A   8.00   3.58NA   3.58    0.77  12.35 12.350000.00.00.0031100       52351 25.0008 090 99      0.00   0.00   0.00
52355  Cystouretero w/excise tumor                       A   9.00   3.93NA   3.93    0.88  13.81 13.810000.00.00.0031100       52351 25.0008 090 99      0.00   0.00   0.00
52400  Cystouretero w/congen repr                        A   8.69   4.36NA   4.36    0.84  13.89 13.890090.08.83.0930100       52000 25.0008 090 99      0.00   0.00   0.00
52402  Cystourethro cut ejacul duct                      A   5.27   1.94NA   1.94    0.50   7.71  7.710000.00.00.0030000       52000 25.0008 090 99      0.00   0.00   0.00
52450  Incision of prostate                              A   7.78   5.19NA   5.19    0.75  13.72 13.720090.08.83.0920100             25.0008 090 99      0.00   0.00   0.00
5250F  Asthma discharge plan presnt                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
52500  Revision of bladder neck                          A   8.14   5.31NA   5.31    0.78  14.23 14.230090.08.83.0920100             25.0008 090 99      0.00   0.00   0.00
52601  Prostatectomy (TURP)                              A  15.26   7.81NA   7.81    1.50  24.57 24.570090.08.83.0920100             25.0008 090 99      0.00   0.00   0.00
52630  Remove prostate regrowth                          A   6.55   4.50NA   4.50    0.64  11.69 11.690090.08.83.0920100             25.0008 090 99      0.00   0.00   0.00
52640  Relieve bladder contracture                       A   4.79   3.99NA   3.99    0.45   9.23  9.230090.08.83.0920100             25.0008 090 99      0.00   0.00   0.00
52647  Laser surgery of prostate                         A  11.30  40.91     6.44    1.10  53.31 18.840090.08.83.0920100             25.0008 090 99      0.00   0.00   0.00
52648  Laser surgery of prostate                         A  12.15  41.52     6.75    1.20  54.87 20.100090.08.83.0920100             25.0008 090 99      0.00   0.00   0.00
52649  Prostate laser enucleation                        A  14.56   7.72NA   7.72    1.41  23.69 23.690090.08.83.0920000             25.0008 090 99      0.00   0.00   0.00
52700  Drainage of prostate abscess                      A   7.49   4.63NA   4.63    0.72  12.84 12.840090.08.83.0920000             25.0008 090 99      0.00   0.00   0.00
53000  Incision of urethra                               A   2.33   1.78NA   1.78    0.24   4.35  4.350010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
53010  Incision of urethra                               A   4.45   3.75NA   3.75    0.42   8.62  8.620090.08.83.0920100             25.0008 090 99      0.00   0.00   0.00
53020  Incision of urethra                               A   1.77   0.88NA   0.88    0.18   2.83  2.830000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
53025  Incision of urethra                               A   1.13   0.97NA   0.97    0.07   2.17  2.170000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
53040  Drainage of urethra abscess                       A   6.55   4.27NA   4.27    0.64  11.46 11.460090.08.83.0920000             25.0008 090 99      0.00   0.00   0.00
53060  Drainage of urethra abscess                       A   2.68   2.34     1.74    0.44   5.46  4.860010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
53080  Drainage of urinary leakage                       A   6.92   4.68NA   4.68    0.67  12.27 12.270090.08.83.0920100             25.0008 090 99      0.00   0.00   0.00
53085  Drainage of urinary leakage                       A  11.18   6.63NA   6.63    1.46  19.27 19.270090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
53200  Biopsy of urethra                                 A   2.59   1.68     1.27    0.27   4.54  4.130000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
53210  Removal of urethra                                A  13.72   7.55NA   7.55    1.32  22.59 22.590090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
53215  Removal of urethra                                A  16.85   8.45NA   8.45    1.63  26.93 26.930090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
53220  Treatment of urethra lesion                       A   7.63   4.89NA   4.89    0.73  13.25 13.250090.08.83.0920000             25.0008 090 99      0.00   0.00   0.00
53230  Removal of urethra lesion                         A  10.44   6.19NA   6.19    1.17  17.80 17.800090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
53235  Removal of urethra lesion                         A  10.99   6.36NA   6.36    1.06  18.41 18.410090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
53240  Surgery for urethra pouch                         A   7.08   4.62NA   4.62    0.68  12.38 12.380090.08.83.0920100             25.0008 090 99      0.00   0.00   0.00
53250  Removal of urethra gland                          A   6.52   4.40NA   4.40    1.42  12.34 12.340090.08.83.0920100             25.0008 090 99      0.00   0.00   0.00
53260  Treatment of urethra lesion                       A   3.03   2.55     1.92    0.35   5.93  5.300010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
53265  Treatment of urethra lesion                       A   3.17   2.90     1.94    0.34   6.41  5.450010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
53270  Removal of urethra gland                          A   3.14   2.56     1.90    0.53   6.23  5.570010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
53275  Repair of urethra defect                          A   4.57   2.63NA   2.63    0.45   7.65  7.650010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
53400  Revise urethra stage 1                            A  14.13   7.86NA   7.86    1.42  23.41 23.410090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
53405  Revise urethra stage 2                            A  15.66   8.20NA   8.20    1.52  25.38 25.380090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
53410  Reconstruction of urethra                         A  17.68   9.08NA   9.08    1.71  28.47 28.470090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
53415  Reconstruction of urethra                         A  20.70  10.09NA  10.09    2.04  32.83 32.830090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
53420  Reconstruct urethra stage 1                       A  15.17   7.78NA   7.78    1.48  24.43 24.430090.08.83.0920110             25.0008 090 99      0.00   0.00   0.00
53425  Reconstruct urethra stage 2                       A  17.07   8.46NA   8.46    1.65  27.18 27.180090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
53430  Reconstruction of urethra                         A  17.43   8.85NA   8.85    1.97  28.25 28.250090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
53431  Reconstruct urethra/bladder                       A  21.18  10.26NA  10.26    2.04  33.48 33.480090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
53440  Male sling procedure                              A  13.36   7.24NA   7.24    1.31  21.91 21.910090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
53442  Remove/revise male sling                          A  13.49   8.00NA   8.00    1.31  22.80 22.800090.08.83.0920200             25.0008 090 99      0.00   0.00   0.00
53444  Insert tandem cuff                                A  14.19   7.49NA   7.49    1.37  23.05 23.050090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
53445  Insert uro/ves nck sphincter                      A  13.00   7.65NA   7.65    1.28  21.93 21.930090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
53446  Remove uro sphincter                              A  11.02   6.61NA   6.61    1.09  18.72 18.720090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
53447  Remove/replace ur sphincter                       A  14.28   7.84NA   7.84    1.40  23.52 23.520090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
53448  Remov/replc ur sphinctr comp                      A  23.44  11.45NA  11.45    2.26  37.15 37.150090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
53449  Repair uro sphincter                              A  10.56   6.21NA   6.21    1.05  17.82 17.820090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
53450  Revision of urethra                               A   6.77   4.49NA   4.49    0.65  11.91 11.910090.08.83.0920100             25.0008 090 99      0.00   0.00   0.00
53460  Revision of urethra                               A   7.75   4.85NA   4.85    0.73  13.33 13.330090.08.83.0920000             25.0008 090 99      0.00   0.00   0.00
53500  Urethrlys transvag w/ scope                       A  13.00   7.47NA   7.47    1.50  21.97 21.970090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
53502  Repair of urethra injury                          A   8.26   5.12NA   5.12    0.80  14.18 14.180090.08.83.0920100             25.0008 090 99      0.00   0.00   0.00
53505  Repair of urethra injury                          A   8.26   5.10NA   5.10    0.80  14.16 14.160090.08.83.0920200             25.0008 090 99      0.00   0.00   0.00
53510  Repair of urethra injury                          A  10.96   6.35NA   6.35    1.06  18.37 18.370090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
53515  Repair of urethra injury                          A  14.22   7.52NA   7.52    1.37  23.11 23.110090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
53520  Repair of urethra defect                          A   9.48   5.82NA   5.82    0.91  16.21 16.210090.08.83.0920100             25.0008 090 99      0.00   0.00   0.00
53600  Dilate urethra stricture                          A   1.21   1.10     0.52    0.11   2.42  1.840000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
53601  Dilate urethra stricture                          A   0.98   1.31     0.48    0.08   2.37  1.540000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
53605  Dilate urethra stricture                          A   1.28   0.46NA   0.46    0.12   1.86  1.860000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
53620  Dilate urethra stricture                          A   1.62   1.62     0.76    0.16   3.40  2.540000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
53621  Dilate urethra stricture                          A   1.35   1.73     0.61    0.12   3.20  2.080000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
53660  Dilation of urethra                               A   0.71   1.31     0.44    0.07   2.09  1.220000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
53661  Dilation of urethra                               A   0.72   1.26     0.39    0.07   2.05  1.180000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
53665  Dilation of urethra                               A   0.76   0.28NA   0.28    0.08   1.12  1.120000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
53850  Prostatic microwave thermotx                      A  10.08  51.35     6.66    0.99  62.42 17.730090.08.83.0920100             25.0008 090 99      0.00   0.00   0.00
53852  Prostatic rf thermotx                             A  10.83  45.50     6.24    1.06  57.39 18.130090.08.83.0920100             25.0008 090 99      0.00   0.00   0.00
53855  Insert prost urethral stent                       A   1.64  21.82     0.59    0.16  23.62  2.390000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
53860  Transurethral rf treatment                        A   3.97  43.14     2.24    0.68  47.79  6.890090.08.83.0920000             25.0008 090 99      0.00   0.00   0.00
53899  Urology surgery procedure                         C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 090 99      0.00   0.00   0.00
54000  Slitting of prepuce                               A   1.59   2.64     1.43    0.14   4.37  3.160010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
54001  Slitting of prepuce                               A   2.24   2.98     1.59    0.23   5.45  4.060010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
54015  Drain penis lesion                                A   5.36   3.08NA   3.08    0.56   9.00  9.000010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
54050  Destruction penis lesion(s)                       A   1.29   2.50     1.69    0.16   3.95  3.140010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
54055  Destruction penis lesion(s)                       A   1.25   2.15     1.36    0.14   3.54  2.750010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
54056  Cryosurgery penis lesion(s)                       A   1.29   2.82     1.87    0.18   4.29  3.340010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
54057  Laser surg penis lesion(s)                        A   1.29   2.62     1.38    0.12   4.03  2.790010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
54060  Excision of penis lesion(s)                       A   1.98   3.11     1.63    0.22   5.31  3.830010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
54065  Destruction penis lesion(s)                       A   2.47   3.77     2.38    0.31   6.55  5.160010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
54100  Biopsy of penis                                   A   1.90   3.77     1.61    0.24   5.91  3.750000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
54105  Biopsy of penis                                   A   3.54   3.83     2.30    0.35   7.72  6.190010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
54110  Treatment of penis lesion                         A  10.92   6.19NA   6.19    1.06  18.17 18.170090.10.80.1020200             25.0008 090 99      0.00   0.00   0.00
54111  Treat penis lesion graft                          A  14.42   7.44NA   7.44    1.40  23.26 23.260090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54112  Treat penis lesion graft                          A  16.98   8.61NA   8.61    1.63  27.22 27.220090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54115  Treatment of penis lesion                         A   6.95   5.59     4.77    0.67  13.21 12.390090.10.80.1020200             25.0008 090 99      0.00   0.00   0.00
54120  Partial removal of penis                          A  11.01   6.30NA   6.30    1.09  18.40 18.400090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54125  Removal of penis                                  A  14.56   7.60NA   7.60    1.48  23.64 23.640090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54130  Remove penis & nodes                              A  21.84  10.67NA  10.67    2.12  34.63 34.630090.10.80.1022210             25.0008 090 99      0.00   0.00   0.00
54135  Remove penis & nodes                              A  28.17  12.94NA  12.94    2.74  43.85 43.850090.10.80.1022200             25.0008 090 99      0.00   0.00   0.00
54150  Circumcision w/regionl block                      A   1.90   2.46     0.73    0.23   4.59  2.860000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
54160  Circumcision neonate                              A   2.53   3.70     1.41    0.24   6.47  4.180010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
54161  Circum 28 days or older                           A   3.32   2.09NA   2.09    0.34   5.75  5.750010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
54162  Lysis penil circumic lesion                       A   3.32   3.93     2.17    0.33   7.58  5.820010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
54163  Repair of circumcision                            A   3.32   2.76NA   2.76    0.33   6.41  6.410010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
54164  Frenulotomy of penis                              A   2.82   2.58NA   2.58    0.29   5.69  5.690010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
54200  Treatment of penis lesion                         A   1.11   1.97     1.26    0.10   3.18  2.470010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
54205  Treatment of penis lesion                         A   8.97   5.69NA   5.69    0.86  15.52 15.520090.10.80.1020200             25.0008 090 99      0.00   0.00   0.00
54220  Treatment of penis lesion                         A   2.42   3.31     1.25    0.26   5.99  3.930000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
54230  Prepare penis study                               A   1.34   1.36     0.86    0.12   2.82  2.320000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
54231  Dynamic cavernosometry                            A   2.04   1.86     1.15    0.20   4.10  3.390000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
54235  Penile injection                                  A   1.19   1.35     0.85    0.11   2.65  2.150000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
54240  Penis study                                       A   1.31   1.53     1.53NA  0.09   2.93  2.931000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
54240TCPenis study                                       A   0.00   1.06     1.06NA  0.01   1.07  1.071000.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
5424026Penis study                                       A   1.31   0.47     0.47    0.08   1.86  1.861000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
54250  Penis study                                       A   2.22   1.11     1.11NA  0.15   3.48  3.481000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
54250TCPenis study                                       A   0.00   0.32     0.32NA  0.01   0.33  0.331000.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
5425026Penis study                                       A   2.22   0.79     0.79    0.14   3.15  3.151000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
54300  Revision of penis                                 A  11.20   6.37NA   6.37    1.09  18.66 18.660090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54304  Revision of penis                                 A  13.28   7.24NA   7.24    1.28  21.80 21.800090.10.80.1020200             25.0008 090 99      0.00   0.00   0.00
54308  Reconstruction of urethra                         A  12.62   6.96NA   6.96    1.22  20.80 20.800090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54312  Reconstruction of urethra                         A  14.51   7.88NA   7.88    1.40  23.79 23.790090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54316  Reconstruction of urethra                         A  18.05   9.19NA   9.19    1.74  28.98 28.980090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54318  Reconstruction of urethra                         A  12.43   7.06NA   7.06    0.87  20.36 20.360090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54322  Reconstruction of urethra                         A  13.98   7.36NA   7.36    1.36  22.70 22.700090.10.80.1020200             25.0008 090 99      0.00   0.00   0.00
54324  Reconstruction of urethra                         A  17.55   8.89NA   8.89    1.69  28.13 28.130090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54326  Reconstruction of urethra                         A  17.02   8.81NA   8.81    1.65  27.48 27.480090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54328  Revise penis/urethra                              A  16.89   8.77NA   8.77    1.63  27.29 27.290090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54332  Revise penis/urethra                              A  18.37   9.30NA   9.30    1.78  29.45 29.450090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54336  Revise penis/urethra                              A  21.62  12.10NA  12.10    2.10  35.82 35.820090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54340  Secondary urethral surgery                        A   9.71   5.96NA   5.96    0.93  16.60 16.600090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54344  Secondary urethral surgery                        A  17.06   8.83NA   8.83    1.65  27.54 27.540090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54348  Secondary urethral surgery                        A  18.32   9.36NA   9.36    1.29  28.97 28.970090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54352  Reconstruct urethra/penis                         A  26.13  12.44NA  12.44    2.55  41.12 41.120090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54360  Penis plastic surgery                             A  12.78   6.94NA   6.94    1.24  20.96 20.960090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54380  Repair penis                                      A  14.18  11.00NA  11.00    1.37  26.55 26.550090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54385  Repair penis                                      A  16.56   9.83NA   9.83    2.42  28.81 28.810090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54390  Repair penis and bladder                          A  22.77  12.34NA  12.34    2.20  37.31 37.310090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54400  Insert semi-rigid prosthesis                      A   9.17   5.37NA   5.37    0.88  15.42 15.420090.10.80.1020110             25.0008 090 99      0.00   0.00   0.00
54401  Insert self-contd prosthesis                      A  10.44   7.72NA   7.72    1.03  19.19 19.190090.10.80.1020110             25.0008 090 99      0.00   0.00   0.00
54405  Insert multi-comp penis pros                      A  14.52   7.56NA   7.56    1.42  23.50 23.500090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54406  Remove muti-comp penis pros                       A  12.89   7.09NA   7.09    1.25  21.23 21.230090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54408  Repair multi-comp penis pros                      A  13.91   7.72NA   7.72    1.37  23.00 23.000090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54410  Remove/replace penis prosth                       A  15.18   8.34NA   8.34    1.48  25.00 25.000090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54411  Remov/replc penis pros comp                       A  18.35   9.69NA   9.69    1.78  29.82 29.820090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54415  Remove self-contd penis pros                      A   8.88   5.67NA   5.67    0.86  15.41 15.410090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54416  Remv/repl penis contain pros                      A  12.08   7.48NA   7.48    1.18  20.74 20.740090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54417  Remv/replc penis pros compl                       A  16.10   8.46NA   8.46    1.57  26.13 26.130090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54420  Revision of penis                                 A  12.39   6.91NA   6.91    1.21  20.51 20.510090.10.80.1020200             25.0008 090 99      0.00   0.00   0.00
54430  Revision of penis                                 A  11.06   6.51NA   6.51    1.08  18.65 18.650090.10.80.1022200             25.0008 090 99      0.00   0.00   0.00
54435  Revision of penis                                 A   6.81   4.71NA   4.71    0.65  12.17 12.170090.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
54440  Repair of penis                                   C   0.00   0.00     0.00    0.00   0.00  0.000090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
54450  Preputial stretching                              A   1.12   0.80     0.44    0.10   2.02  1.660000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
54500  Biopsy of testis                                  A   1.31   0.74NA   0.74    0.12   2.17  2.170000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
54505  Biopsy of testis                                  A   3.50   2.28NA   2.28    0.34   6.12  6.120010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
54512  Excise lesion testis                              A   9.33   5.45NA   5.45    0.93  15.71 15.710090.10.80.1021110             25.0008 090 99      0.00   0.00   0.00
54520  Removal of testis                                 A   5.30   3.67NA   3.67    0.61   9.58  9.580090.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
54522  Orchiectomy partial                               A  10.25   6.32NA   6.32    1.01  17.58 17.580090.10.80.1021210             25.0008 090 99      0.00   0.00   0.00
54530  Removal of testis                                 A   8.46   5.45NA   5.45    0.87  14.78 14.780090.10.80.1021210             25.0008 090 99      0.00   0.00   0.00
54535  Extensive testis surgery                          A  13.19   7.17NA   7.17    1.28  21.64 21.640090.10.80.1021200             25.0008 090 99      0.00   0.00   0.00
54550  Exploration for testis                            A   8.41   5.12NA   5.12    0.82  14.35 14.350090.10.80.1021200             25.0008 090 99      0.00   0.00   0.00
54560  Exploration for testis                            A  12.10   6.70NA   6.70    1.18  19.98 19.980090.10.80.1021210             25.0008 090 99      0.00   0.00   0.00
54600  Reduce testis torsion                             A   7.64   4.84NA   4.84    0.73  13.21 13.210090.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
54620  Suspension of testis                              A   5.21   3.02NA   3.02    0.50   8.73  8.730010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
54640  Suspension of testis                              A   7.73   5.51NA   5.51    0.87  14.11 14.110090.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
54650  Orchiopexy (Fowler-Stephens)                      A  12.39   7.12NA   7.12    1.21  20.72 20.720090.10.80.1021200             25.0008 090 99      0.00   0.00   0.00
54660  Revision of testis                                A   5.74   4.16NA   4.16    0.54  10.44 10.440090.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
54670  Repair testis injury                              A   6.65   4.55NA   4.55    0.64  11.84 11.840090.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
54680  Relocation of testis(es)                          A  14.04   7.48NA   7.48    1.36  22.88 22.880090.10.80.1021210             25.0008 090 99      0.00   0.00   0.00
54690  Laparoscopy orchiectomy                           A  11.70   7.68NA   7.68    2.48  21.86 21.860090.10.80.1021210             25.0008 090 99      0.00   0.00   0.00
54692  Laparoscopy orchiopexy                            A  13.74   8.43NA   8.43    1.32  23.49 23.490090.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
54699  Laparoscope proc testis                           C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021211             25.0008 090 99      0.00   0.00   0.00
54700  Drainage of scrotum                               A   3.47   2.42NA   2.42    0.39   6.28  6.280010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
54800  Biopsy of epididymis                              A   2.33   1.10NA   1.10    0.33   3.76  3.760000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
54830  Remove epididymis lesion                          A   6.01   4.30NA   4.30    0.63  10.94 10.940090.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
54840  Remove epididymis lesion                          A   5.27   3.60NA   3.60    0.52   9.39  9.390090.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
54860  Removal of epididymis                             A   6.95   4.60NA   4.60    0.68  12.23 12.230090.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
54861  Removal of epididymis                             A   9.70   5.85NA   5.85    0.93  16.48 16.480090.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
54865  Explore epididymis                                A   5.77   4.17NA   4.17    0.56  10.50 10.500090.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
54900  Fusion of spermatic ducts                         A  14.20   7.70NA   7.70    1.02  22.92 22.920090.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
54901  Fusion of spermatic ducts                         A  19.10   9.73NA   9.73    1.36  30.19 30.190090.10.80.1022000             25.0008 090 99      0.00   0.00   0.00
55000  Drainage of hydrocele                             A   1.43   1.89     0.91    0.14   3.46  2.480000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
55040  Removal of hydrocele                              A   5.45   3.88NA   3.88    0.61   9.94  9.940090.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
55041  Removal of hydroceles                             A   8.54   5.49NA   5.49    0.90  14.93 14.930090.10.80.1022100             25.0008 090 99      0.00   0.00   0.00
55060  Repair of hydrocele                               A   6.15   4.36NA   4.36    0.67  11.18 11.180090.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
55100  Drainage of scrotum abscess                       A   2.45   3.69     2.19    0.30   6.44  4.940010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
55110  Explore scrotum                                   A   6.33   4.35NA   4.35    0.68  11.36 11.360090.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
55120  Removal of scrotum lesion                         A   5.72   4.21NA   4.21    0.61  10.54 10.540090.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
55150  Removal of scrotum                                A   8.14   5.39NA   5.39    0.86  14.39 14.390090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
55175  Revision of scrotum                               A   5.87   4.17NA   4.17    0.60  10.64 10.640090.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
55180  Revision of scrotum                               A  11.78   7.10NA   7.10    1.29  20.17 20.170090.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
55200  Incision of sperm duct                            A   4.55   7.93     3.15    0.44  12.92  8.140090.10.80.1022000             25.0008 090 99      0.00   0.00   0.00
55250  Removal of sperm duct(s)                          A   3.37   7.75     2.98    0.33  11.45  6.680090.10.80.1022100             25.0008 090 99      0.00   0.00   0.00
55300  Prepare sperm duct x-ray                          A   3.50   1.60NA   1.60    0.34   5.44  5.440000.00.00.0022000             25.0008 090 99      0.00   0.00   0.00
55400  Repair of sperm duct                              A   8.61   5.07NA   5.07    0.83  14.51 14.510090.10.80.1021210             25.0008 090 99      0.00   0.00   0.00
55450  Ligation of sperm duct                            A   4.43   5.71     2.64    0.42  10.56  7.490010.10.80.1022000             25.0008 090 99      0.00   0.00   0.00
55500  Removal of hydrocele                              A   6.22   4.63NA   4.63    0.88  11.73 11.730090.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
55520  Removal of sperm cord lesion                      A   6.66   5.47NA   5.47    1.36  13.49 13.490090.10.80.1021210             25.0008 090 99      0.00   0.00   0.00
55530  Revise spermatic cord veins                       A   5.75   3.96NA   3.96    0.63  10.34 10.340090.10.80.1021110             25.0008 090 99      0.00   0.00   0.00
55535  Revise spermatic cord veins                       A   7.19   4.68NA   4.68    0.69  12.56 12.560090.10.80.1021210             25.0008 090 99      0.00   0.00   0.00
55540  Revise hernia & sperm veins                       A   8.30   6.04NA   6.04    1.65  15.99 15.990090.10.80.1021110             25.0008 090 99      0.00   0.00   0.00
55550  Laparo ligate spermatic vein                      A   7.20   4.60NA   4.60    0.69  12.49 12.490090.10.80.1021210             25.0008 090 99      0.00   0.00   0.00
55559  Laparo proc spermatic cord                        C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021211             25.0008 090 99      0.00   0.00   0.00
55600  Incise sperm duct pouch                           A   7.01   4.62NA   4.62    0.68  12.31 12.310090.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
55605  Incise sperm duct pouch                           A   8.76   5.59NA   5.59    0.84  15.19 15.190090.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
55650  Remove sperm duct pouch                           A  12.65   7.03NA   7.03    1.22  20.90 20.900090.10.80.1021210             25.0008 090 99      0.00   0.00   0.00
55680  Remove sperm pouch lesion                         A   5.67   3.90NA   3.90    0.54  10.11 10.110090.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
55700  Biopsy of prostate                                A   2.58   3.58     1.22    0.26   6.42  4.060000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
55705  Biopsy of prostate                                A   4.61   2.70NA   2.70    0.45   7.76  7.760010.10.80.1020110             25.0008 090 99      0.00   0.00   0.00
55706  Prostate saturation sampling                      A   6.28   3.98NA   3.98    0.44  10.70 10.700010.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
55720  Drainage of prostate abscess                      A   7.73   4.70NA   4.70    0.73  13.16 13.160090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
55725  Drainage of prostate abscess                      A  10.05   6.28NA   6.28    0.98  17.31 17.310090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
55801  Removal of prostate                               A  19.80  10.04NA  10.04    1.92  31.76 31.760090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
55810  Extensive prostate surgery                        A  24.29  11.47NA  11.47    2.48  38.24 38.240090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
55812  Extensive prostate surgery                        A  29.89  13.88NA  13.88    2.91  46.68 46.680090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
55815  Extensive prostate surgery                        A  32.95  14.98NA  14.98    3.20  51.13 51.130090.10.80.1022210             25.0008 090 99      0.00   0.00   0.00
55821  Removal of prostate                               A  15.76   8.09NA   8.09    1.55  25.40 25.400090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
55831  Removal of prostate                               A  17.19   8.59NA   8.59    1.66  27.44 27.440090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
55840  Extensive prostate surgery                        A  24.63  11.78NA  11.78    2.41  38.82 38.820090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
55842  Extensive prostate surgery                        A  26.49  12.48NA  12.48    2.60  41.57 41.570090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
55845  Extensive prostate surgery                        A  30.67  13.71NA  13.71    3.04  47.42 47.420090.10.80.1022210             25.0008 090 99      0.00   0.00   0.00
55860  Surgical exposure prostate                        A  15.84   8.06NA   8.06    1.52  25.42 25.420090.10.80.1020110             25.0008 090 99      0.00   0.00   0.00
55862  Extensive prostate surgery                        A  20.04   9.86NA   9.86    1.93  31.83 31.830090.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
55865  Extensive prostate surgery                        A  24.57  11.76NA  11.76    2.38  38.71 38.710090.10.80.1022210             25.0008 090 99      0.00   0.00   0.00
55866  Laparo radical prostatectomy                      A  32.06  15.16NA  15.16    3.18  50.40 50.400090.08.83.0920210             25.0008 090 99      0.00   0.00   0.00
55870  Electroejaculation                                A   2.58   2.30     1.31    0.26   5.14  4.150000.00.00.0020110             25.0008 090 99      0.00   0.00   0.00
55873  Cryoablate prostate                               A  13.60 194.48     7.30    1.36 209.44 22.260090.08.83.0920100             25.0008 090 99      0.00   0.00   0.00
55875  Transperi needle place pros                       A  13.46   7.42NA   7.42    1.29  22.17 22.170090.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
55876  Place rt device/marker pros                       A   1.73   2.08     1.03    0.16   3.97  2.920000.00.00.0020111             25.0008 090 99      0.00   0.00   0.00
55899  Genital surgery procedure                         C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 090 99      0.00   0.00   0.00
55920  Place needles pelvic for rt                       A   8.31   3.78NA   3.78    0.80  12.89 12.890000.00.00.0020000             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
56405  I & D of vulva/perineum                           A   1.49   1.55     1.53    0.26   3.30  3.280010.10.80.1020120             25.0008 090 99      0.00   0.00   0.00
56420  Drainage of gland abscess                         A   1.44   2.00     1.07    0.24   3.68  2.750010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
56440  Surgery for vulva lesion                          A   2.89   2.10NA   2.10    0.49   5.48  5.480010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
56441  Lysis of labial lesion(s)                         A   2.02   1.98     1.82    0.29   4.29  4.130010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
56442  Hymenotomy                                        A   0.68   0.65NA   0.65    0.11   1.44  1.440000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
56501  Destroy vulva lesions sim                         A   1.58   2.09     1.60    0.27   3.94  3.450010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
56515  Destroy vulva lesion/s compl                      A   3.08   3.14     2.39    0.50   6.72  5.970010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
56605  Biopsy of vulva/perineum                          A   1.10   1.19     0.52    0.18   2.47  1.800000.00.00.0020120             25.0008 090 99      0.00   0.00   0.00
56606  Biopsy of vulva/perineum                          A   0.55   0.48     0.24    0.08   1.11  0.870ZZZ.00.00.0000120             25.0008 090 99      0.00   0.00   0.00
56620  Partial removal of vulva                          A   7.53   6.45NA   6.45    1.27  15.25 15.250090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
56625  Complete removal of vulva                         A   9.68   6.91NA   6.91    1.62  18.21 18.210090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
56630  Extensive vulva surgery                           A  14.80   9.39NA   9.39    2.56  26.75 26.750090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
56631  Extensive vulva surgery                           A  18.99  11.72NA  11.72    3.21  33.92 33.920090.12.74.1420220             25.0008 090 99      0.00   0.00   0.00
56632  Extensive vulva surgery                           A  21.86  13.99NA  13.99    3.70  39.55 39.550090.12.74.1422220             25.0008 090 99      0.00   0.00   0.00
56633  Extensive vulva surgery                           A  19.62  11.81NA  11.81    3.32  34.75 34.750090.12.74.1420220             25.0008 090 99      0.00   0.00   0.00
56634  Extensive vulva surgery                           A  20.66  12.76NA  12.76    3.50  36.92 36.920090.12.74.1420220             25.0008 090 99      0.00   0.00   0.00
56637  Extensive vulva surgery                           A  24.75  14.09NA  14.09    4.18  43.02 43.020090.12.74.1420220             25.0008 090 99      0.00   0.00   0.00
56640  Extensive vulva surgery                           A  24.78  13.00NA  13.00    4.18  41.96 41.960090.12.74.1421210             25.0008 090 99      0.00   0.00   0.00
56700  Partial removal of hymen                          A   2.84   2.31NA   2.31    0.48   5.63  5.630010.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
56740  Remove vagina gland lesion                        A   4.88   3.22NA   3.22    0.83   8.93  8.930010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
56800  Repair of vagina                                  A   3.93   2.61NA   2.61    0.64   7.18  7.180010.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
56805  Repair clitoris                                   A  19.88  11.04NA  11.04    3.38  34.30 34.300090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
56810  Repair of perineum                                A   4.29   2.78NA   2.78    0.69   7.76  7.760010.10.80.1020220             25.0008 090 99      0.00   0.00   0.00
56820  Exam of vulva w/scope                             A   1.50   1.57     0.79    0.26   3.33  2.550000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
56821  Exam/biopsy of vulva w/scope                      A   2.05   2.01     1.03    0.34   4.40  3.420000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
57000  Exploration of vagina                             A   3.02   2.17NA   2.17    0.50   5.69  5.690010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
57010  Drainage of pelvic abscess                        A   6.84   5.05NA   5.05    1.16  13.05 13.050090.12.74.1420000             25.0008 090 99      0.00   0.00   0.00
57020  Drainage of pelvic fluid                          A   1.50   1.04     0.68    0.26   2.80  2.440000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
57022  I & d vaginal hematoma pp                         A   2.73   1.85NA   1.85    0.45   5.03  5.030010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
57023  I & d vag hematoma non-ob                         A   5.18   3.26NA   3.26    0.87   9.31  9.310010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
57061  Destroy vag lesions simple                        A   1.30   1.91     1.44    0.22   3.43  2.960010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
57065  Destroy vag lesions complex                       A   2.66   2.67     2.05    0.44   5.77  5.150010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
57100  Biopsy of vagina                                  A   1.20   1.24     0.57    0.20   2.64  1.970000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
57105  Biopsy of vagina                                  A   1.74   2.04     1.74    0.29   4.07  3.770010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
57106  Remove vagina wall partial                        A   7.50   5.80NA   5.80    1.21  14.51 14.510090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57107  Remove vagina tissue part                         A  24.56  13.41NA  13.41    4.15  42.12 42.120090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57109  Vaginectomy partial w/nodes                       A  28.40  16.09NA  16.09    4.80  49.29 49.290090.12.74.1422210             25.0008 090 99      0.00   0.00   0.00
57110  Remove vagina wall complete                       A  15.48   8.76NA   8.76    2.59  26.83 26.830090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57111  Remove vagina tissue compl                        A  28.40  14.79NA  14.79    4.80  47.99 47.990090.12.74.1422210             25.0008 090 99      0.00   0.00   0.00
57112  Vaginectomy w/nodes compl                         A  30.52  15.70NA  15.70    2.42  48.64 48.640090.12.74.1422210             25.0008 090 99      0.00   0.00   0.00
57120  Closure of vagina                                 A   8.28   5.64NA   5.64    1.36  15.28 15.280090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57130  Remove vagina lesion                              A   2.46   2.46     1.91    0.41   5.33  4.780010.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
57135  Remove vagina lesion                              A   2.70   2.60     2.02    0.44   5.74  5.160010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
57150  Treat vagina infection                            A   0.55   0.73     0.23    0.08   1.36  0.860000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
57155  Insert uteri tandem/ovoids                        A   5.40   7.17     2.40    0.48  13.05  8.280000.00.00.0020120             25.0008 090 99      0.00   0.00   0.00
57156  Ins vag brachytx device                           A   2.69   2.78     1.27    0.23   5.70  4.190000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
57160  Insert pessary/other device                       A   0.89   1.27     0.37    0.14   2.30  1.400000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
57170  Fitting of diaphragm/cap                          A   0.91   0.76     0.39    0.14   1.81  1.440000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
57180  Treat vaginal bleeding                            A   1.63   2.35     1.26    0.27   4.25  3.160010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
57200  Repair of vagina                                  A   4.42   3.84NA   3.84    0.71   8.97  8.970090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57210  Repair vagina/perineum                            A   5.71   4.34NA   4.34    0.91  10.96 10.960090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57220  Revision of urethra                               A   4.85   3.96NA   3.96    0.80   9.61  9.610090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57230  Repair of urethral lesion                         A   6.30   4.51NA   4.51    1.06  11.87 11.870090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57240  Repair bladder & vagina                           A  11.50   6.70NA   6.70    1.63  19.83 19.830090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57250  Repair rectum & vagina                            A  11.50   6.85NA   6.85    1.86  20.21 20.210090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57260  Repair of vagina                                  A  14.44   8.08NA   8.08    2.34  24.86 24.860090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57265  Extensive repair of vagina                        A  15.94   8.71NA   8.71    2.57  27.22 27.220090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57267  Insert mesh/pelvic flr addon                      A   4.88   1.99NA   1.99    0.72   7.59  7.590ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
57268  Repair of bowel bulge                             A   7.57   5.66NA   5.66    1.22  14.45 14.450090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57270  Repair of bowel pouch                             A  13.67   7.95NA   7.95    2.25  23.87 23.870090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57280  Suspension of vagina                              A  16.72   9.05NA   9.05    2.60  28.37 28.370090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57282  Colpopexy extraperitoneal                         A   7.97   5.75NA   5.75    1.24  14.96 14.960090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57283  Colpopexy intraperitoneal                         A  11.66   7.03NA   7.03    1.92  20.61 20.610090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57284  Repair paravag defect open                        A  14.33   7.74NA   7.74    2.16  24.23 24.230090.08.83.0920220             25.0008 090 99      0.00   0.00   0.00
57285  Repair paravag defect vag                         A  11.60   6.66NA   6.66    1.80  20.06 20.060090.08.83.0920220             25.0008 090 99      0.00   0.00   0.00
57287  Revise/remove sling repair                        A  11.15   7.48NA   7.48    1.47  20.10 20.100090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57288  Repair bladder defect                             A  12.13   7.34NA   7.34    1.59  21.06 21.060090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57289  Repair bladder & vagina                           A  12.80   7.16NA   7.16    1.24  21.20 21.200090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57291  Construction of vagina                            A   8.64   5.81NA   5.81    1.47  15.92 15.920090.12.74.1420200             25.0008 090 99      0.00   0.00   0.00
57292  Construct vagina with graft                       A  14.01   8.10NA   8.10    2.34  24.45 24.450090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57295  Revise vag graft via vagina                       A   7.82   5.23NA   5.23    1.20  14.25 14.250090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57296  Revise vag graft open abd                         A  16.56   9.06NA   9.06    2.79  28.41 28.410090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57300  Repair rectum-vagina fistula                      A   8.71   6.49NA   6.49    1.52  16.72 16.720090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57305  Repair rectum-vagina fistula                      A  15.35   9.44NA   9.44    2.97  27.76 27.760090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57307  Fistula repair & colostomy                        A  17.17  10.83NA  10.83    3.67  31.67 31.670090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57308  Fistula repair transperine                        A  10.59   6.81NA   6.81    1.80  19.20 19.200090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57310  Repair urethrovaginal lesion                      A   7.65   5.04NA   5.04    0.73  13.42 13.420090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57311  Repair urethrovaginal lesion                      A   8.91   5.49NA   5.49    0.86  15.26 15.260090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57320  Repair bladder-vagina lesion                      A   8.88   5.65NA   5.65    1.05  15.58 15.580090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57330  Repair bladder-vagina lesion                      A  13.21   6.98NA   6.98    1.28  21.47 21.470090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57335  Repair vagina                                     A  20.02  11.23NA  11.23    3.39  34.64 34.640090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57400  Dilation of vagina                                A   2.27   1.32NA   1.32    0.38   3.97  3.970000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
57410  Pelvic examination                                A   1.75   1.17NA   1.17    0.29   3.21  3.210000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
57415  Remove vaginal foreign body                       A   2.49   1.91NA   1.91    0.37   4.77  4.770010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
57420  Exam of vagina w/scope                            A   1.60   1.62     0.83    0.26   3.48  2.690000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
57421  Exam/biopsy of vag w/scope                        A   2.20   2.11     1.10    0.37   4.68  3.670000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
57423  Repair paravag defect lap                         A  16.08   8.62NA   8.62    2.72  27.42 27.420090.08.83.0920220             25.0008 090 99      0.00   0.00   0.00
57425  Laparoscopy surg colpopexy                        A  17.03   9.21NA   9.21    2.67  28.91 28.910090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57426  Revise prosth vag graft lap                       A  14.30   8.64NA   8.64    2.41  25.35 25.350090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57452  Exam of cervix w/scope                            A   1.50   1.52     1.01    0.24   3.26  2.750000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
57454  Bx/curett of cervix w/scope                       A   2.33   1.87     1.36    0.38   4.58  4.070000.00.00.0030100       57452 25.0008 090 99      0.00   0.00   0.00
57455  Biopsy of cervix w/scope                          A   1.99   1.97     0.99    0.33   4.29  3.310000.00.00.0030100       57452 25.0008 090 99      0.00   0.00   0.00
57456  Endocerv curettage w/scope                        A   1.85   1.89     0.93    0.31   4.05  3.090000.00.00.0030100       57452 25.0008 090 99      0.00   0.00   0.00
57460  Bx of cervix w/scope leep                         A   2.83   5.28     1.57    0.48   8.59  4.880000.00.00.0030100       57452 25.0008 090 99      0.00   0.00   0.00
57461  Conz of cervix w/scope leep                       A   3.43   5.67     1.60    0.59   9.69  5.620000.00.00.0030100       57452 25.0008 090 99      0.00   0.00   0.00
57500  Biopsy of cervix                                  A   1.20   2.48     0.88    0.20   3.88  2.280000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
57505  Endocervical curettage                            A   1.19   1.69     1.39    0.20   3.08  2.780010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
57510  Cauterization of cervix                           A   1.90   1.73     1.25    0.31   3.94  3.460010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
57511  Cryocautery of cervix                             A   1.95   2.10     1.71    0.33   4.38  3.990010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
57513  Laser surgery of cervix                           A   1.95   2.05     1.71    0.33   4.33  3.990010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
57520  Conization of cervix                              A   4.11   4.37     3.40    0.68   9.16  8.190090.12.74.1420100             25.0008 090 99      0.00   0.00   0.00
57522  Conization of cervix                              A   3.67   3.62     3.02    0.63   7.92  7.320090.12.74.1420100             25.0008 090 99      0.00   0.00   0.00
57530  Removal of cervix                                 A   5.27   4.20NA   4.20    0.87  10.34 10.340090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57531  Removal of cervix radical                         A  29.95  17.04NA  17.04    5.06  52.05 52.050090.12.74.1422210             25.0008 090 99      0.00   0.00   0.00
57540  Removal of residual cervix                        A  13.29   7.80NA   7.80    2.23  23.32 23.320090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57545  Remove cervix/repair pelvis                       A  14.10   8.15NA   8.15    2.35  24.60 24.600090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57550  Removal of residual cervix                        A   6.34   4.84NA   4.84    1.08  12.26 12.260090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57555  Remove cervix/repair vagina                       A   9.94   6.41NA   6.41    1.66  18.01 18.010090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57556  Remove cervix repair bowel                        A   9.36   6.08NA   6.08    1.46  16.90 16.900090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
57558  D&c of cervical stump                             A   1.72   1.75     1.41    0.29   3.76  3.420010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
57700  Revision of cervix                                A   4.35   4.29NA   4.29    0.72   9.36  9.360090.12.74.1420000             25.0008 090 99      0.00   0.00   0.00
57720  Revision of cervix                                A   4.61   3.87NA   3.87    0.76   9.24  9.240090.12.74.1420200             25.0008 090 99      0.00   0.00   0.00
57800  Dilation of cervical canal                        A   0.77   0.92     0.56    0.12   1.81  1.450000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
58100  Biopsy of uterus lining                           A   1.53   1.49     0.84    0.26   3.28  2.630000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
58110  Bx done w/colposcopy add-on                       A   0.77   0.54     0.33    0.12   1.43  1.220ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
58120  Dilation and curettage                            A   3.59   3.54     2.34    0.61   7.74  6.540010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
58140  Myomectomy abdom method                           A  15.79   8.91NA   8.91    2.80  27.50 27.500090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
58145  Myomectomy vag method                             A   8.91   5.89NA   5.89    1.50  16.30 16.300090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
58146  Myomectomy abdom complex                          A  20.34  10.73NA  10.73    3.44  34.51 34.510090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
58150  Total hysterectomy                                A  17.31   9.62NA   9.62    2.94  29.87 29.870090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
58152  Total hysterectomy                                A  21.86  11.66NA  11.66    3.74  37.26 37.260090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
58180  Partial hysterectomy                              A  16.60   9.25NA   9.25    2.80  28.65 28.650090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
58200  Extensive hysterectomy                            A  23.10  12.52NA  12.52    3.89  39.51 39.510090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
58210  Extensive hysterectomy                            A  30.91  16.75NA  16.75    5.27  52.93 52.930090.12.74.1422210             25.0008 090 99      0.00   0.00   0.00
58240  Removal of pelvis contents                        A  49.33  26.54NA  26.54    8.33  84.20 84.200090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
58260  Vaginal hysterectomy                              A  14.15   8.22NA   8.22    2.38  24.75 24.750090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
58262  Vag hyst including t/o                            A  15.94   8.96NA   8.96    2.69  27.59 27.590090.12.74.1420220             25.0008 090 99      0.00   0.00   0.00
58263  Vag hyst w/t/o & vag repair                       A  17.23   9.48NA   9.48    2.91  29.62 29.620090.12.74.1420220             25.0008 090 99      0.00   0.00   0.00
58267  Vag hyst w/urinary repair                         A  18.36  10.07NA  10.07    3.12  31.55 31.550090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
58270  Vag hyst w/enterocele repair                      A  15.30   8.48NA   8.48    2.57  26.35 26.350090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
58275  Hysterectomy/revise vagina                        A  17.03   9.52NA   9.52    2.90  29.45 29.450090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
58280  Hysterectomy/revise vagina                        A  18.33  10.12NA  10.12    3.08  31.53 31.530090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
58285  Extensive hysterectomy                            A  23.38  11.86NA  11.86    3.93  39.17 39.170090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
58290  Vag hyst complex                                  A  20.27  10.58NA  10.58    3.43  34.28 34.280090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
58291  Vag hyst incl t/o complex                         A  22.06  11.48NA  11.48    3.73  37.27 37.270090.12.74.1420220             25.0008 090 99      0.00   0.00   0.00
58292  Vag hyst t/o & repair compl                       A  23.35  12.00NA  12.00    3.93  39.28 39.280090.12.74.1420220             25.0008 090 99      0.00   0.00   0.00
58293  Vag hyst w/uro repair compl                       A  24.33  12.42NA  12.42    4.11  40.86 40.860090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
58294  Vag hyst w/enterocele compl                       A  21.55  11.24NA  11.24    3.66  36.45 36.450090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
58300  Insert intrauterine device                        N+  1.01   0.98     0.41    0.07   2.06  1.499XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
58301  Remove intrauterine device                        A   1.27   1.38     0.54    0.22   2.87  2.030000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
58321  Artificial insemination                           A   0.92   1.25     0.39    0.05   2.22  1.360000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
58322  Artificial insemination                           A   1.10   1.30     0.47    0.18   2.58  1.750000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
58323  Sperm washing                                     A   0.23   0.20     0.10    0.04   0.47  0.370000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
58340  Catheter for hysterography                        A   0.88   2.58     0.73    0.12   3.58  1.730000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
58345  Reopen fallopian tube                             A   4.70   2.87NA   2.87    0.78   8.35  8.350010.10.80.1021220             25.0008 090 99      0.00   0.00   0.00
58346  Insert heyman uteri capsule                       A   7.56   4.58NA   4.58    0.63  12.77 12.770090.12.74.1420100             25.0008 090 99      0.00   0.00   0.00
58350  Reopen fallopian tube                             A   1.06   1.68     1.13    0.18   2.92  2.370010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
58353  Endometr ablate thermal                           A   3.60  26.75     2.36    0.61  30.96  6.570010.10.80.1020120             25.0008 090 99      0.00   0.00   0.00
58356  Endometrial cryoablation                          A   6.41  50.31     2.83    1.08  57.80 10.320010.10.80.1020220             25.0008 090 99      0.00   0.00   0.00
58400  Suspension of uterus                              A   7.14   4.87NA   4.87    1.08  13.09 13.090090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
58410  Suspension of uterus                              A  13.80   7.95NA   7.95    2.31  24.06 24.060090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
58520  Repair of ruptured uterus                         A  13.48   7.81NA   7.81    2.90  24.19 24.190090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
58540  Revision of uterus                                A  15.71   8.84NA   8.84    2.65  27.20 27.200090.12.74.1420200             25.0008 090 99      0.00   0.00   0.00
58541  Lsh uterus 250 g or less                          A  14.70   8.71NA   8.71    2.46  25.87 25.870090.12.74.1430220       49320 25.0008 090 99      0.00   0.00   0.00
58542  Lsh w/t/o ut 250 g or less                        A  16.56   9.53NA   9.53    2.80  28.89 28.890090.12.74.1420220             25.0008 090 99      0.00   0.00   0.00
58543  Lsh uterus above 250 g                            A  16.87   9.62NA   9.62    2.86  29.35 29.350090.12.74.1420220             25.0008 090 99      0.00   0.00   0.00
58544  Lsh w/t/o uterus above 250 g                      A  18.37  10.31NA  10.31    3.12  31.80 31.800090.12.74.1420220             25.0008 090 99      0.00   0.00   0.00
58545  Laparoscopic myomectomy                           A  15.55   8.56NA   8.56    2.67  26.78 26.780090.12.74.1420220             25.0008 090 99      0.00   0.00   0.00
58546  Laparo-myomectomy complex                         A  19.94  10.35NA  10.35    3.39  33.68 33.680090.12.74.1420220             25.0008 090 99      0.00   0.00   0.00
58548  Lap radical hyst                                  A  31.63  17.45NA  17.45    5.32  54.40 54.400090.12.74.1422220             25.0008 090 99      0.00   0.00   0.00
58550  Laparo-asst vag hysterectomy                      A  15.10   8.76NA   8.76    2.56  26.42 26.420090.12.74.1430220       49320 25.0008 090 99      0.00   0.00   0.00
58552  Laparo-vag hyst incl t/o                          A  16.91   9.57NA   9.57    2.87  29.35 29.350090.12.74.1420220             25.0008 090 99      0.00   0.00   0.00
58553  Laparo-vag hyst complex                           A  20.06  10.47NA  10.47    3.40  33.93 33.930090.12.74.1420220             25.0008 090 99      0.00   0.00   0.00
58554  Laparo-vag hyst w/t/o compl                       A  23.11  12.32NA  12.32    3.93  39.36 39.360090.12.74.1420220             25.0008 090 99      0.00   0.00   0.00
58555  Hysteroscopy dx sep proc                          A   3.33   5.26     1.79    0.56   9.15  5.680000.00.00.0020020             25.0008 090 99      0.00   0.00   0.00
58558  Hysteroscopy biopsy                               A   4.74   6.39     2.43    0.80  11.93  7.970000.00.00.0030120       58555 25.0008 090 99      0.00   0.00   0.00
58559  Hysteroscopy lysis                                A   6.16   3.04NA   3.04    1.05  10.25 10.250000.00.00.0030120       58555 25.0008 090 99      0.00   0.00   0.00
58560  Hysteroscopy resect septum                        A   6.99   3.38NA   3.38    1.18  11.55 11.550000.00.00.0030220       58555 25.0008 090 99      0.00   0.00   0.00
58561  Hysteroscopy remove myoma                         A   9.99   4.67NA   4.67    1.67  16.33 16.330000.00.00.0030020       58555 25.0008 090 99      0.00   0.00   0.00
58562  Hysteroscopy remove fb                            A   5.20   6.26     2.58    0.87  12.33  8.650000.00.00.0030120       58555 25.0008 090 99      0.00   0.00   0.00
58563  Hysteroscopy ablation                             A   6.16  43.83     3.03    1.05  51.04 10.240000.00.00.0030020       58555 25.0008 090 99      0.00   0.00   0.00
58565  Hysteroscopy sterilization                        A   7.12  49.44     4.69    1.20  57.76 13.010090.12.74.1432120       58555 25.0008 090 99      0.00   0.00   0.00
58570  Tlh uterus 250 g or less                          A  15.88   9.24NA   9.24    2.69  27.81 27.810090.12.74.1420220             25.0008 090 99      0.00   0.00   0.00
58571  Tlh w/t/o 250 g or less                           A  17.69  10.34NA  10.34    3.01  31.04 31.040090.12.74.1420220             25.0008 090 99      0.00   0.00   0.00
58572  Tlh uterus over 250 g                             A  20.09  11.11NA  11.11    3.40  34.60 34.600090.12.74.1420220             25.0008 090 99      0.00   0.00   0.00
58573  Tlh w/t/o uterus over 250 g                       A  23.11  12.71NA  12.71    3.89  39.71 39.710090.12.74.1420220             25.0008 090 99      0.00   0.00   0.00
58578  Laparo proc uterus                                C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021211             25.0008 090 99      0.00   0.00   0.00
58579  Hysteroscope procedure                            C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021211             25.0008 090 99      0.00   0.00   0.00
58600  Division of fallopian tube                        A   5.91   4.03NA   4.03    1.01  10.95 10.950090.12.74.1422210             25.0008 090 99      0.00   0.00   0.00
58605  Division of fallopian tube                        A   5.28   3.72NA   3.72    0.88   9.88  9.880090.12.74.1422200             25.0008 090 99      0.00   0.00   0.00
58611  Ligate oviduct(s) add-on                          A   1.45   0.62NA   0.62    0.24   2.31  2.310ZZZ.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
58615  Occlude fallopian tube(s)                         A   3.94   2.71NA   2.71    0.67   7.32  7.320010.10.80.1020200             25.0008 090 99      0.00   0.00   0.00
58660  Laparoscopy lysis                                 A  11.59   6.48NA   6.48    2.04  20.11 20.110090.09.84.0730220       49320 25.0008 090 99      0.00   0.00   0.00
58661  Laparoscopy remove adnexa                         A  11.35   5.94NA   5.94    1.93  19.22 19.220010.10.80.1031220       49320 25.0008 090 99      0.00   0.00   0.00
58662  Laparoscopy excise lesions                        A  12.15   6.87NA   6.87    2.07  21.09 21.090090.09.84.0730220       49320 25.0008 090 99      0.00   0.00   0.00
58670  Laparoscopy tubal cautery                         A   5.91   4.04NA   4.04    1.01  10.96 10.960090.10.80.1030120       49320 25.0008 090 99      0.00   0.00   0.00
58671  Laparoscopy tubal block                           A   5.91   4.05NA   4.05    1.01  10.97 10.970090.10.80.1030120       49320 25.0008 090 99      0.00   0.00   0.00
58672  Laparoscopy fimbrioplasty                         A  12.91   6.91NA   6.91    2.18  22.00 22.000090.10.80.1031200       49320 25.0008 090 99      0.00   0.00   0.00
58673  Laparoscopy salpingostomy                         A  14.04   7.51NA   7.51    2.35  23.90 23.900090.10.80.1031200       49320 25.0008 090 99      0.00   0.00   0.00
58679  Laparo proc oviduct-ovary                         C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021211             25.0008 090 99      0.00   0.00   0.00
58700  Removal of fallopian tube                         A  12.95   7.91NA   7.91    2.41  23.27 23.270090.12.74.1422210             25.0008 090 99      0.00   0.00   0.00
58720  Removal of ovary/tube(s)                          A  12.16   7.37NA   7.37    2.15  21.68 21.680090.12.74.1422210             25.0008 090 99      0.00   0.00   0.00
58740  Adhesiolysis tube ovary                           A  14.90   8.72NA   8.72    2.64  26.26 26.260090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
58750  Repair oviduct                                    A  15.64   9.29NA   9.29    2.64  27.57 27.570090.12.74.1421210             25.0008 090 99      0.00   0.00   0.00
58752  Revise ovarian tube(s)                            A  15.64   8.55NA   8.55    1.10  25.29 25.290090.12.74.1421200             25.0008 090 99      0.00   0.00   0.00
58760  Fimbrioplasty                                     A  13.93   7.96NA   7.96    2.34  24.23 24.230090.12.74.1421210             25.0008 090 99      0.00   0.00   0.00
58770  Create new tubal opening                          A  14.77   8.25NA   8.25    2.48  25.50 25.500090.12.74.1421200             25.0008 090 99      0.00   0.00   0.00
58800  Drainage of ovarian cyst(s)                       A   4.62   4.17     3.57    0.76   9.55  8.950090.12.74.1422100             25.0008 090 99      0.00   0.00   0.00
58805  Drainage of ovarian cyst(s)                       A   6.42   4.60NA   4.60    1.09  12.11 12.110090.12.74.1422210             25.0008 090 99      0.00   0.00   0.00
58820  Drain ovary abscess open                          A   4.70   3.91NA   3.91    0.78   9.39  9.390090.12.74.1421200             25.0008 090 99      0.00   0.00   0.00
58822  Drain ovary abscess percut                        A  11.81   7.96NA   7.96    2.52  22.29 22.290090.12.74.1421210             25.0008 090 99      0.00   0.00   0.00
58823  Drain pelvic abscess percut                       A   3.37  23.49     1.20    0.38  27.24  4.950000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
58825  Transposition ovary(s)                            A  11.78   7.04NA   7.04    1.97  20.79 20.790090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
58900  Biopsy of ovary(s)                                A   6.59   4.71NA   4.71    1.40  12.70 12.700090.12.74.1422210             25.0008 090 99      0.00   0.00   0.00
58920  Partial removal of ovary(s)                       A  11.95   7.00NA   7.00    2.00  20.95 20.950090.12.74.1422210             25.0008 090 99      0.00   0.00   0.00
58925  Removal of ovarian cyst(s)                        A  12.43   7.51NA   7.51    2.23  22.17 22.170090.12.74.1422210             25.0008 090 99      0.00   0.00   0.00
58940  Removal of ovary(s)                               A   8.22   5.84NA   5.84    1.54  15.60 15.600090.12.74.1422210             25.0008 090 99      0.00   0.00   0.00
58943  Removal of ovary(s)                               A  19.52  10.92NA  10.92    3.52  33.96 33.960090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
58950  Resect ovarian malignancy                         A  18.37  10.97NA  10.97    3.25  32.59 32.590090.12.74.1422210             25.0008 090 99      0.00   0.00   0.00
58951  Resect ovarian malignancy                         A  24.26  13.33NA  13.33    4.18  41.77 41.770090.12.74.1422210             25.0008 090 99      0.00   0.00   0.00
58952  Resect ovarian malignancy                         A  27.29  15.13NA  15.13    4.74  47.16 47.160090.12.74.1422210             25.0008 090 99      0.00   0.00   0.00
58953  Tah rad dissect for debulk                        A  34.13  18.35NA  18.35    5.88  58.36 58.360090.12.74.1422210             25.0008 090 99      0.00   0.00   0.00
58954  Tah rad debulk/lymph remove                       A  37.13  19.73NA  19.73    6.36  63.22 63.220090.12.74.1422210             25.0008 090 99      0.00   0.00   0.00
58956  Bso omentectomy w/tah                             A  22.80  13.04NA  13.04    3.99  39.83 39.830090.12.74.1422210             25.0008 090 99      0.00   0.00   0.00
58957  Resect recurrent gyn mal                          A  26.22  14.69NA  14.69    4.80  45.71 45.710090.12.74.1422210             25.0008 090 99      0.00   0.00   0.00
58958  Resect recur gyn mal w/lym                        A  29.22  15.97NA  15.97    4.94  50.13 50.130090.12.74.1422210             25.0008 090 99      0.00   0.00   0.00
58960  Exploration of abdomen                            A  15.79   9.44NA   9.44    2.76  27.99 27.990090.12.74.1420210             25.0008 090 99      0.00   0.00   0.00
58970  Retrieval of oocyte                               A   3.52   2.56     1.90    0.26   6.34  5.680000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
58974  Transfer of embryo                                C   0.00   0.00     0.00    0.00   0.00  0.000000.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
58976  Transfer of embryo                                A   3.82   3.05     2.00    0.27   7.14  6.090000.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
58999  Genital surgery procedure                         C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020111             25.0008 090 99      0.00   0.00   0.00
59000  Amniocentesis diagnostic                          A   1.30   2.15     0.77    0.37   3.82  2.440000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
59001  Amniocentesis therapeutic                         A   3.00   1.56NA   1.56    0.86   5.42  5.420000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
59012  Fetal cord puncture prenatal                      A   3.44   1.68NA   1.68    0.99   6.11  6.110000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
59015  Chorion biopsy                                    A   2.20   1.88     1.16    0.63   4.71  3.990000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
59020  Fetal contract stress test                        A   0.66   1.32     1.32NA  0.17   2.15  2.151000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
59020TCFetal contract stress test                        A   0.00   1.04     1.04NA  0.01   1.05  1.051000.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
5902026Fetal contract stress test                        A   0.66   0.28     0.28    0.16   1.10  1.101000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
59025  Fetal non-stress test                             A   0.53   0.79     0.79NA  0.13   1.45  1.451000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
59025TCFetal non-stress test                             A   0.00   0.56     0.56NA  0.01   0.57  0.571000.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
5902526Fetal non-stress test                             A   0.53   0.23     0.23    0.12   0.88  0.881000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
59030  Fetal scalp blood sample                          A   1.99   1.06NA   1.06    0.12   3.17  3.170000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
59050  Fetal monitor w/report                            A   0.89   0.38NA   0.38    0.26   1.53  1.530XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
59051  Fetal monitor/interpret only                      A   0.74   0.32NA   0.32    0.22   1.28  1.280XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
59070  Transabdom amnioinfus w/us                        A   5.24   5.67     2.60    1.51  12.42  9.350000.00.00.0020200             25.0008 090 99      0.00   0.00   0.00
59072  Umbilical cord occlud w/us                        A   8.99   4.09NA   4.09    2.59  15.67 15.670000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
59074  Fetal fluid drainage w/us                         A   5.24   5.36     2.57    1.51  12.11  9.320000.00.00.0020200             25.0008 090 99      0.00   0.00   0.00
59076  Fetal shunt placement w/us                        A   8.99   4.09NA   4.09    2.59  15.67 15.670000.00.00.0020200             25.0008 090 99      0.00   0.00   0.00
59100  Remove uterus lesion                              A  13.37   7.97NA   7.97    3.84  25.18 25.180090.17.60.2320210             25.0008 090 99      0.00   0.00   0.00
59120  Treat ectopic pregnancy                           A  12.67   7.64NA   7.64    3.66  23.97 23.970090.17.60.2320210             25.0008 090 99      0.00   0.00   0.00
59121  Treat ectopic pregnancy                           A  12.74   7.57NA   7.57    3.67  23.98 23.980090.17.60.2320210             25.0008 090 99      0.00   0.00   0.00
59130  Treat ectopic pregnancy                           A  15.08   8.57NA   8.57    1.08  24.73 24.730090.17.60.2320000             25.0008 090 99      0.00   0.00   0.00
59135  Treat ectopic pregnancy                           A  14.92   8.40NA   8.40    1.06  24.38 24.380090.17.60.2320000             25.0008 090 99      0.00   0.00   0.00
59136  Treat ectopic pregnancy                           A  14.25   9.20NA   9.20    4.10  27.55 27.550090.17.60.2320200             25.0008 090 99      0.00   0.00   0.00
59140  Treat ectopic pregnancy                           A   5.94   4.47NA   4.47    0.41  10.82 10.820090.17.60.2320200             25.0008 090 99      0.00   0.00   0.00
59150  Treat ectopic pregnancy                           A  12.29   7.38NA   7.38    3.54  23.21 23.210090.17.60.2320200             25.0008 090 99      0.00   0.00   0.00
59151  Treat ectopic pregnancy                           A  12.11   6.96NA   6.96    3.48  22.55 22.550090.17.60.2320200             25.0008 090 99      0.00   0.00   0.00
59160  D & c after delivery                              A   2.76   2.61     1.67    0.78   6.15  5.210010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
59200  Insert cervical dilator                           A   0.79   1.17     0.34    0.23   2.19  1.360000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
59300  Episiotomy or vaginal repair                      A   2.41   2.76     1.39    0.68   5.85  4.480000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
59320  Revision of cervix                                A   2.48   1.42NA   1.42    0.69   4.59  4.590000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
59325  Revision of cervix                                A   4.06   2.09NA   2.09    0.29   6.44  6.440000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
59350  Repair of uterus                                  A   4.94   2.11NA   2.11    1.42   8.47  8.470000.00.00.0020200             25.0008 090 99      0.00   0.00   0.00
59400  Obstetrical care                                  A  32.16  22.07NA  22.07    8.96  63.19 63.190MMM.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
59409  Obstetrical care                                  A  14.37   6.22NA   6.22    3.98  24.57 24.570MMM.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
59410  Obstetrical care                                  A  18.01   8.32NA   8.32    4.99  31.32 31.320MMM.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
59412  Antepartum manipulation                           A   1.71   0.92NA   0.92    0.49   3.12  3.120MMM.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
59414  Deliver placenta                                  A   1.61   0.69NA   0.69    0.46   2.76  2.760MMM.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
59425  Antepartum care only                              A   6.31   5.74     2.70    1.74  13.79 10.750MMM.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
59426  Antepartum care only                              A  11.16  10.51     4.77    3.01  24.68 18.940MMM.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
59430  Care after delivery                               A   2.47   2.46     1.05    0.67   5.60  4.190MMM.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
59510  Cesarean delivery                                 A  35.64  24.05NA  24.05   10.15  69.84 69.840MMM.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
59514  Cesarean delivery only                            A  16.13   6.95NA   6.95    4.57  27.65 27.650MMM.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
59515  Cesarean delivery                                 A  21.47  10.43NA  10.43    6.09  37.99 37.990MMM.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
59525  Remove uterus after cesarean                      A   8.53   3.64NA   3.64    2.44  14.61 14.610ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
59610  Vbac delivery                                     A  33.87  22.60NA  22.60    9.75  66.22 66.220MMM.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
59612  Vbac delivery only                                A  16.09   6.86NA   6.86    4.62  27.57 27.570MMM.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
59614  Vbac care after delivery                          A  19.73   8.92NA   8.92    5.66  34.31 34.310MMM.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
59618  Attempted vbac delivery                           A  36.16  24.22NA  24.22   10.40  70.78 70.780MMM.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
59620  Attempted vbac delivery only                      A  16.66   7.11NA   7.11    4.79  28.56 28.560MMM.00.00.0020200             25.0008 090 99      0.00   0.00   0.00
59622  Attempted vbac after care                         A  22.00  10.70NA  10.70    6.33  39.03 39.030MMM.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
59812  Treatment of miscarriage                          A   4.44   3.91     3.22    1.25   9.60  8.910090.17.60.2320100             25.0008 090 99      0.00   0.00   0.00
59820  Care of miscarriage                               A   4.84   5.27     4.57    1.39  11.50 10.800090.17.60.2320100             25.0008 090 99      0.00   0.00   0.00
59821  Treatment of miscarriage                          A   5.09   5.01     4.25    1.47  11.57 10.810090.17.60.2320000             25.0008 090 99      0.00   0.00   0.00
59830  Treat uterus infection                            A   6.59   4.70NA   4.70    1.89  13.18 13.180090.17.60.2320000             25.0008 090 99      0.00   0.00   0.00
59840  Abortion                                          R   3.01   2.70     2.43    0.80   6.51  6.240010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
59841  Abortion                                          R   5.65   4.27     3.61    1.62  11.54 10.880010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
59850  Abortion                                          R   5.90   3.87NA   3.87    0.41  10.18 10.180090.17.60.2320000             25.0008 090 99      0.00   0.00   0.00
59851  Abortion                                          R   5.92   4.42NA   4.42    1.69  12.03 12.030090.17.60.2320000             25.0008 090 99      0.00   0.00   0.00
59852  Abortion                                          R   8.23   6.05NA   6.05    0.59  14.87 14.870090.17.60.2320000             25.0008 090 99      0.00   0.00   0.00
59855  Abortion                                          R   6.43   4.25NA   4.25    1.85  12.53 12.530090.17.60.2320000             25.0008 090 99      0.00   0.00   0.00
59856  Abortion                                          R   7.79   4.67NA   4.67    2.23  14.69 14.690090.17.60.2320000             25.0008 090 99      0.00   0.00   0.00
59857  Abortion                                          R   9.33   5.19NA   5.19    0.65  15.17 15.170090.17.60.2320000             25.0008 090 99      0.00   0.00   0.00
59866  Abortion (mpr)                                    R   3.99   2.07NA   2.07    0.29   6.35  6.350000.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
59870  Evacuate mole of uterus                           A   6.57   5.82NA   5.82    1.89  14.28 14.280090.17.60.2320200             25.0008 090 99      0.00   0.00   0.00
59871  Remove cerclage suture                            A   2.13   1.31NA   1.31    0.61   4.05  4.050000.00.00.0020000             25.0008 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  0.000YYY.00.00.0020100             25.0008 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  0.000YYY.00.00.0021211             25.0008 090 99      0.00   0.00   0.00
59899  Maternity care procedure                          C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020211             25.0008 090 99      0.00   0.00   0.00
60000  Drain thyroid/tongue cyst                         A   1.81   3.19     2.63    0.24   5.24  4.680010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
6005F  Care level rationale doc                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
60100  Biopsy of thyroid                                 A   1.56   1.59     0.58    0.16   3.31  2.300000.00.00.0020100             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
6020F  Npo (nothing-mouth) ordered                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
60200  Remove thyroid lesion                             A  10.02   7.98NA   7.98    1.70  19.70 19.700090.09.82.0920210             25.0008 090 99      0.00   0.00   0.00
60210  Partial thyroid excision                          A  11.23   7.78NA   7.78    2.07  21.08 21.080090.09.82.0920210             25.0008 090 99      0.00   0.00   0.00
60212  Partial thyroid excision                          A  16.43  10.49NA  10.49    3.06  29.98 29.980090.09.82.0920210             25.0008 090 99      0.00   0.00   0.00
60220  Partial removal of thyroid                        A  11.19   7.94NA   7.94    1.94  21.07 21.070090.09.82.0920210             25.0008 090 99      0.00   0.00   0.00
60225  Partial removal of thyroid                        A  14.79  10.28NA  10.28    2.64  27.71 27.710090.09.82.0920210             25.0008 090 99      0.00   0.00   0.00
60240  Removal of thyroid                                A  15.04   9.50NA   9.50    2.74  27.28 27.280090.09.82.0920210             25.0008 090 99      0.00   0.00   0.00
60252  Removal of thyroid                                A  22.01  13.21NA  13.21    3.88  39.10 39.100090.09.82.0920210             25.0008 090 99      0.00   0.00   0.00
60254  Extensive thyroid surgery                         A  28.42  16.48NA  16.48    4.53  49.43 49.430090.09.82.0920210             25.0008 090 99      0.00   0.00   0.00
60260  Repeat thyroid surgery                            A  18.26  11.00NA  11.00    3.13  32.39 32.390090.09.82.0921210             25.0008 090 99      0.00   0.00   0.00
60270  Removal of thyroid                                A  23.20  13.06NA  13.06    4.38  40.64 40.640090.09.82.0920210             25.0008 090 99      0.00   0.00   0.00
60271  Removal of thyroid                                A  17.62  10.69NA  10.69    3.01  31.32 31.320090.09.82.0920210             25.0008 090 99      0.00   0.00   0.00
60280  Remove thyroid duct lesion                        A   6.16   6.32NA   6.32    0.84  13.32 13.320090.09.82.0920210             25.0008 090 99      0.00   0.00   0.00
60281  Remove thyroid duct lesion                        A   8.82   7.66NA   7.66    1.14  17.62 17.620090.09.82.0920210             25.0008 090 99      0.00   0.00   0.00
6030F  Max sterile barriers follwd                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
60300  Aspir/inj thyroid cyst                            A   0.97   2.47     0.37    0.11   3.55  1.450000.00.00.0020100             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
60500  Explore parathyroid glands                        A  15.60  10.04NA  10.04    3.01  28.65 28.650090.09.82.0920210             25.0008 090 99      0.00   0.00   0.00
60502  Re-explore parathyroids                           A  21.15  12.87NA  12.87    4.15  38.17 38.170090.09.82.0920210             25.0008 090 99      0.00   0.00   0.00
60505  Explore parathyroid glands                        A  23.06  14.06NA  14.06    4.33  41.45 41.450090.09.82.0920210             25.0008 090 99      0.00   0.00   0.00
60512  Autotransplant parathyroid                        A   4.44   1.87NA   1.87    0.83   7.14  7.140ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
60520  Removal of thymus gland                           A  17.16  10.15NA  10.15    3.47  30.78 30.780090.09.82.0920210             25.0008 090 99      0.00   0.00   0.00
60521  Removal of thymus gland                           A  19.18   9.86NA   9.86    4.53  33.57 33.570090.09.82.0920210             25.0008 090 99      0.00   0.00   0.00
60522  Removal of thymus gland                           A  23.48  11.93NA  11.93    5.46  40.87 40.870090.09.82.0920210             25.0008 090 99      0.00   0.00   0.00
60540  Explore adrenal gland                             A  18.02  10.06NA  10.06    3.04  31.12 31.120090.09.82.0921210             25.0008 090 99      0.00   0.00   0.00
60545  Explore adrenal gland                             A  20.93  11.12NA  11.12    3.69  35.74 35.740090.09.82.0921210             25.0008 090 99      0.00   0.00   0.00
60600  Remove carotid body lesion                        A  25.09  10.85NA  10.85    5.31  41.25 41.250090.09.82.0920210             25.0008 090 99      0.00   0.00   0.00
60605  Remove carotid body lesion                        A  31.96  18.14NA  18.14    4.11  54.21 54.210090.09.82.0920210             25.0008 090 99      0.00   0.00   0.00
60650  Laparoscopy adrenalectomy                         A  20.73  10.55NA  10.55    3.74  35.02 35.020090.09.84.0721210             25.0008 090 99      0.00   0.00   0.00
60659  Laparo proc endocrine                             C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021200             25.0008 090 99      0.00   0.00   0.00
60699  Endocrine surgery procedure                       C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020211             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
6080F  Pt/caregiver queried falls                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
6090F  Pt/caregiver counsel safety                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
6100F  Verify pt site pxd docd                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
61000  Remove cranial cavity fluid                       A   1.58   1.74NA   1.74    0.14   3.46  3.460000.00.00.0022100             25.0008 090 99      0.00   0.00   0.00
61001  Remove cranial cavity fluid                       A   1.49   1.34NA   1.34    0.53   3.36  3.360000.00.00.0022100             25.0008 090 99      0.00   0.00   0.00
6101F  Safety counseling dementia                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
6102F  Safety counseling dem order                       M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
61020  Remove brain cavity fluid                         A   1.51   2.17NA   2.17    0.50   4.18  4.180000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
61026  Injection into brain canal                        A   1.69   1.81NA   1.81    0.38   3.88  3.880000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
61050  Remove brain canal fluid                          A   1.51   1.58NA   1.58    0.12   3.21  3.210000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
61055  Injection into brain canal                        A   2.10   1.67NA   1.67    0.29   4.06  4.060000.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
61070  Brain canal shunt procedure                       A   0.89   1.50NA   1.50    0.20   2.59  2.590000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
6110F  Counsel prov driving risks                        M   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
61105  Twist drill hole                                  A   5.45   6.56NA   6.56    1.92  13.93 13.930090.11.76.1320000             25.0008 090 99      0.00   0.00   0.00
61107  Drill skull for implantation                      A   4.99   2.52NA   2.52    1.78   9.29  9.290000.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
61108  Drill skull for drainage                          A  11.64  11.43NA  11.43    4.14  27.21 27.210090.11.76.1320100             25.0008 090 99      0.00   0.00   0.00
61120  Burr hole for puncture                            A   9.60   9.30NA   9.30    3.46  22.36 22.360090.11.76.1320000             25.0008 090 99      0.00   0.00   0.00
61140  Pierce skull for biopsy                           A  17.23  14.30NA  14.30    6.11  37.64 37.640090.11.76.1320200             25.0008 090 99      0.00   0.00   0.00
61150  Pierce skull for drainage                         A  18.90  14.57NA  14.57    6.78  40.25 40.250090.11.76.1320110             25.0008 090 99      0.00   0.00   0.00
61151  Pierce skull for drainage                         A  13.49  11.28NA  11.28    4.85  29.62 29.620090.11.76.1320100             25.0008 090 99      0.00   0.00   0.00
61154  Pierce skull & remove clot                        A  17.07  14.75NA  14.75    6.10  37.92 37.920090.11.76.1321210             25.0008 090 99      0.00   0.00   0.00
61156  Pierce skull for drainage                         A  17.45  13.25NA  13.25    6.26  36.96 36.960090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61210  Pierce skull implant device                       A   5.83   2.94NA   2.94    2.08  10.85 10.850000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
61215  Insert brain-fluid device                         A   5.85   7.28NA   7.28    2.07  15.20 15.200090.11.76.1320110             25.0008 090 99      0.00   0.00   0.00
61250  Pierce skull & explore                            A  11.49  10.26NA  10.26    4.12  25.87 25.870090.11.76.1321210             25.0008 090 99      0.00   0.00   0.00
61253  Pierce skull & explore                            A  13.49   6.69NA   6.69    1.71  21.89 21.890090.11.76.1322200             25.0008 090 99      0.00   0.00   0.00
61304  Open skull for exploration                        A  23.41  17.11NA  17.11    8.15  48.67 48.670090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61305  Open skull for exploration                        A  28.64  20.68NA  20.68   10.28  59.60 59.600090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61312  Open skull for drainage                           A  30.17  20.70NA  20.70   10.79  61.66 61.660090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61313  Open skull for drainage                           A  28.09  20.85NA  20.85   10.03  58.97 58.970090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61314  Open skull for drainage                           A  25.90  19.10NA  19.10    9.27  54.27 54.270090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61315  Open skull for drainage                           A  29.65  21.07NA  21.07   10.66  61.38 61.380090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61316  Implt cran bone flap to abdo                      A   1.39   0.70NA   0.70    0.49   2.58  2.580ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
61320  Open skull for drainage                           A  27.42  19.32NA  19.32    9.69  56.43 56.430090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61321  Open skull for drainage                           A  30.53  21.63NA  21.63   10.97  63.13 63.130090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61322  Decompressive craniotomy                          A  34.26  23.96NA  23.96   12.24  70.46 70.460090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61323  Decompressive lobectomy                           A  35.06  23.09NA  23.09   12.45  70.60 70.600090.11.76.1320110             25.0008 090 99      0.00   0.00   0.00
61330  Decompress eye socket                             A  25.30  20.38NA  20.38    9.09  54.77 54.770090.11.76.1321210             25.0008 090 99      0.00   0.00   0.00
61332  Explore/biopsy eye socket                         A  28.60  17.13NA  17.13   10.26  55.99 55.990090.11.76.1321210             25.0008 090 99      0.00   0.00   0.00
61333  Explore orbit/remove lesion                       A  29.27  22.67NA  22.67   10.51  62.45 62.450090.11.76.1321210             25.0008 090 99      0.00   0.00   0.00
61334  Explore orbit/remove object                       A  19.60   9.21NA   9.21    7.02  35.83 35.830090.11.76.1321210             25.0008 090 99      0.00   0.00   0.00
61340  Subtemporal decompression                         A  20.11  15.63NA  15.63    7.23  42.97 42.970090.11.76.1321210             25.0008 090 99      0.00   0.00   0.00
61343  Incise skull (press relief)                       A  31.86  21.95NA  21.95   11.35  65.16 65.160090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61345  Relieve cranial pressure                          A  29.23  20.75NA  20.75   10.49  60.47 60.470090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61440  Incise skull for surgery                          A  28.66  15.07NA  15.07   10.28  54.01 54.010090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61450  Incise skull for surgery                          A  27.69  19.34NA  19.34    9.94  56.97 56.970090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61458  Incise skull for brain wound                      A  28.84  20.46NA  20.46   10.25  59.55 59.550090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61460  Incise skull for surgery                          A  30.24  21.26NA  21.26   10.85  62.35 62.350090.11.76.1320220             25.0008 090 99      0.00   0.00   0.00
61470  Incise skull for surgery                          A  27.62  13.66NA  13.66    9.91  51.19 51.190090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61480  Incise skull for surgery                          A  28.05  19.35NA  19.35    1.97  49.37 49.370090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61490  Incise skull for surgery                          A  27.22  19.11NA  19.11    9.79  56.12 56.120090.11.76.1321210             25.0008 090 99      0.00   0.00   0.00
6150F  Pt notrcvng1st antitnf txmnt                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
61500  Removal of skull lesion                           A  19.18  14.65NA  14.65    5.78  39.61 39.610090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61501  Remove infected skull bone                        A  16.35  13.11NA  13.11    4.67  34.13 34.130090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61510  Removal of brain lesion                           A  30.83  23.11NA  23.11   11.01  64.95 64.950090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61512  Remove brain lining lesion                        A  37.14  25.19NA  25.19   13.28  75.61 75.610090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61514  Removal of brain abscess                          A  27.23  19.63NA  19.63    9.72  56.58 56.580090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61516  Removal of brain lesion                           A  26.58  19.24NA  19.24    9.23  55.05 55.050090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61517  Implt brain chemotx add-on                        A   1.38   0.70NA   0.70    0.49   2.57  2.570ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
61518  Removal of brain lesion                           A  39.89  27.72NA  27.72   14.30  81.91 81.910090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61519  Remove brain lining lesion                        A  43.43  28.35NA  28.35   15.49  87.27 87.270090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61520  Removal of brain lesion                           A  57.09  35.52NA  35.52   17.97 110.58110.580090.11.76.1320220             25.0008 090 99      0.00   0.00   0.00
61521  Removal of brain lesion                           A  46.99  30.28NA  30.28   16.86  94.13 94.130090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61522  Removal of brain abscess                          A  31.54  21.92NA  21.92   11.32  64.78 64.780090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61524  Removal of brain lesion                           A  29.89  21.08NA  21.08   10.74  61.71 61.710090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61526  Removal of brain lesion                           A  54.08  34.38NA  34.38   19.41 107.87107.870090.11.76.1320120             25.0008 090 99      0.00   0.00   0.00
61530  Removal of brain lesion                           A  45.56  29.03NA  29.03   16.37  90.96 90.960090.11.76.1320120             25.0008 090 99      0.00   0.00   0.00
61531  Implant brain electrodes                          A  16.41  14.13NA  14.13    5.89  36.43 36.430090.11.76.1320220             25.0008 090 99      0.00   0.00   0.00
61533  Implant brain electrodes                          A  21.46  16.17NA  16.17    7.69  45.32 45.320090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61534  Removal of brain lesion                           A  23.01  17.59NA  17.59    8.26  48.86 48.860090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61535  Remove brain electrodes                           A  13.15  11.97NA  11.97    4.72  29.84 29.840090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61536  Removal of brain lesion                           A  37.72  25.05NA  25.05   13.54  76.31 76.310090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61537  Removal of brain tissue                           A  36.45  23.51NA  23.51   13.01  72.97 72.970090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61538  Removal of brain tissue                           A  39.45  25.28NA  25.28   14.18  78.91 78.910090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61539  Removal of brain tissue                           A  34.28  23.31NA  23.31   12.30  69.89 69.890090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61540  Removal of brain tissue                           A  31.43  21.96NA  21.96   11.28  64.67 64.670090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61541  Incision of brain tissue                          A  30.94  21.61NA  21.61   11.11  63.66 63.660090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61542  Removal of brain tissue                           A  33.16  16.10NA  16.10   11.90  61.16 61.160090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61543  Removal of brain tissue                           A  31.31  21.80NA  21.80   11.23  64.34 64.340090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61544  Remove & treat brain lesion                       A  27.36  13.55NA  13.55    9.83  50.74 50.740090.11.76.1320200             25.0008 090 99      0.00   0.00   0.00
61545  Excision of brain tumor                           A  46.43  31.15NA  31.15   16.66  94.24 94.240090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61546  Removal of pituitary gland                        A  33.44  22.88NA  22.88   11.99  68.31 68.310090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61548  Removal of pituitary gland                        A  23.37  16.05NA  16.05    6.67  46.09 46.090090.11.76.1320220             25.0008 090 99      0.00   0.00   0.00
61550  Release of skull seams                            A  15.59  11.15NA  11.15    1.10  27.84 27.840090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61552  Release of skull seams                            A  20.40   9.49NA   9.49    1.46  31.35 31.350090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61556  Incise skull/sutures                              A  24.09  17.82NA  17.82    8.66  50.57 50.570090.11.76.1320200             25.0008 090 99      0.00   0.00   0.00
61557  Incise skull/sutures                              A  23.31  18.28NA  18.28    8.37  49.96 49.960090.11.76.1320200             25.0008 090 99      0.00   0.00   0.00
61558  Excision of skull/sutures                         A  26.50  11.52NA  11.52    9.51  47.53 47.530090.11.76.1320200             25.0008 090 99      0.00   0.00   0.00
61559  Excision of skull/sutures                         A  34.02  17.25NA  17.25    2.41  53.68 53.680090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61563  Excision of skull tumor                           A  28.44  20.02NA  20.02   10.21  58.67 58.670090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61564  Excision of skull tumor                           A  34.74  17.08NA  17.08   12.45  64.27 64.270090.11.76.1321210             25.0008 090 99      0.00   0.00   0.00
61566  Removal of brain tissue                           A  32.45  22.48NA  22.48   11.64  66.57 66.570090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61567  Incision of brain tissue                          A  37.00  25.62NA  25.62   13.30  75.92 75.920090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61570  Remove foreign body brain                         A  26.51  19.37NA  19.37    9.51  55.39 55.390090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61571  Incise skull for brain wound                      A  28.42  20.34NA  20.34   10.19  58.95 58.950090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61575  Skull base/brainstem surgery                      A  36.56  24.46NA  24.46   13.12  74.14 74.140090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61576  Skull base/brainstem surgery                      A  55.31  39.45NA  39.45    7.10 101.86101.860090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61580  Craniofacial approach skull                       A  34.51  33.65NA  33.65    5.89  74.05 74.050090.11.76.1321112             25.0008 090 99      0.00   0.00   0.00
61581  Craniofacial approach skull                       A  39.13  36.12NA  36.12    5.04  80.29 80.290090.11.76.1321122             25.0008 090 99      0.00   0.00   0.00
61582  Craniofacial approach skull                       A  35.14  44.12NA  44.12   12.62  91.88 91.880090.11.76.1320212             25.0008 090 99      0.00   0.00   0.00
61583  Craniofacial approach skull                       A  38.50  35.12NA  35.12   12.94  86.56 86.560090.11.76.1320212             25.0008 090 99      0.00   0.00   0.00
61584  Orbitocranial approach/skull                      A  37.70  34.82NA  34.82   12.70  85.22 85.220090.11.76.1321212             25.0008 090 99      0.00   0.00   0.00
61585  Orbitocranial approach/skull                      A  42.57  38.81NA  38.81   15.28  96.66 96.660090.11.76.1321212             25.0008 090 99      0.00   0.00   0.00
61586  Resect nasopharynx skull                          A  27.48  36.56NA  36.56    9.87  73.91 73.910090.11.76.1320212             25.0008 090 99      0.00   0.00   0.00
61590  Infratemporal approach/skull                      A  47.04  35.49NA  35.49    8.45  90.98 90.980090.11.76.1321212             25.0008 090 99      0.00   0.00   0.00
61591  Infratemporal approach/skull                      A  47.02  35.61NA  35.61    9.60  92.23 92.230090.11.76.1321212             25.0008 090 99      0.00   0.00   0.00
61592  Orbitocranial approach/skull                      A  43.08  37.13NA  37.13   14.51  94.72 94.720090.11.76.1321212             25.0008 090 99      0.00   0.00   0.00
61595  Transtemporal approach/skull                      A  33.74  29.85NA  29.85    7.15  70.74 70.740090.11.76.1321112             25.0008 090 99      0.00   0.00   0.00
61596  Transcochlear approach/skull                      A  39.43  28.60NA  28.60    5.06  73.09 73.090090.11.76.1321212             25.0008 090 99      0.00   0.00   0.00
61597  Transcondylar approach/skull                      A  40.82  30.60NA  30.60   14.66  86.08 86.080090.11.76.1321212             25.0008 090 99      0.00   0.00   0.00
61598  Transpetrosal approach/skull                      A  36.53  35.16NA  35.16   13.11  84.80 84.800090.11.76.1320212             25.0008 090 99      0.00   0.00   0.00
61600  Resect/excise cranial lesion                      A  30.01  27.70NA  27.70    6.22  63.93 63.930090.11.76.1320212             25.0008 090 99      0.00   0.00   0.00
61601  Resect/excise cranial lesion                      A  31.14  30.30NA  30.30   10.17  71.61 71.610090.11.76.1320212             25.0008 090 99      0.00   0.00   0.00
61605  Resect/excise cranial lesion                      A  32.57  27.48NA  27.48    4.95  65.00 65.000090.11.76.1320212             25.0008 090 99      0.00   0.00   0.00
61606  Resect/excise cranial lesion                      A  42.05  33.35NA  33.35   13.68  89.08 89.080090.11.76.1320212             25.0008 090 99      0.00   0.00   0.00
61607  Resect/excise cranial lesion                      A  40.93  30.03NA  30.03   14.69  85.65 85.650090.11.76.1320212             25.0008 090 99      0.00   0.00   0.00
61608  Resect/excise cranial lesion                      A  45.54  35.74NA  35.74   15.38  96.66 96.660090.11.76.1320212             25.0008 090 99      0.00   0.00   0.00
61609  Transect artery sinus                             A   9.88   4.89NA   4.89    3.55  18.32 18.320ZZZ.00.00.0000212             25.0008 090 99      0.00   0.00   0.00
61610  Transect artery sinus                             A  29.63  15.02NA  15.02   10.64  55.29 55.290ZZZ.00.00.0000212             25.0008 090 99      0.00   0.00   0.00
61611  Transect artery sinus                             A   7.41   2.99NA   2.99    0.52  10.92 10.920ZZZ.00.00.0000212             25.0008 090 99      0.00   0.00   0.00
61612  Transect artery sinus                             A  27.84  11.23NA  11.23    1.96  41.03 41.030ZZZ.00.00.0000212             25.0008 090 99      0.00   0.00   0.00
61613  Remove aneurysm sinus                             A  45.03  36.48NA  36.48   16.17  97.68 97.680090.11.76.1321212             25.0008 090 99      0.00   0.00   0.00
61615  Resect/excise lesion skull                        A  35.77  26.96NA  26.96    4.60  67.33 67.330090.11.76.1320212             25.0008 090 99      0.00   0.00   0.00
61616  Resect/excise lesion skull                        A  46.74  37.72NA  37.72   14.41  98.87 98.870090.11.76.1320212             25.0008 090 99      0.00   0.00   0.00
61618  Repair dura                                       A  18.69  14.38NA  14.38    5.76  38.83 38.830090.11.76.1320212             25.0008 090 99      0.00   0.00   0.00
61619  Repair dura                                       A  22.10  15.29NA  15.29    6.33  43.72 43.720090.11.76.1320212             25.0008 090 99      0.00   0.00   0.00
61623  Endovasc tempory vessel occl                      A   9.95   4.41NA   4.41    1.85  16.21 16.210000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
61624  Transcath occlusion cns                           A  20.12   8.44NA   8.44    3.77  32.33 32.330000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
61626  Transcath occlusion non-cns                       A  16.60   6.16NA   6.16    2.14  24.90 24.900000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
61630  Intracranial angioplasty                          R  22.07  11.11NA  11.11    4.18  37.36 37.360XXX.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
61635  Intracran angioplsty w/stent                      R  24.28  12.25NA  12.25    4.07  40.60 40.600XXX.00.00.0020210             25.0008 090 99      0.00   0.00   0.00
61640  Dilate ic vasospasm init                          N+ 12.32   4.97NA   4.97    0.87  18.16 18.169000.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
61641  Dilate ic vasospasm add-on                        N+  4.33   1.75NA   1.75    0.31   6.39  6.399ZZZ.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
61642  Dilate ic vasospasm add-on                        N+  8.66   3.49NA   3.49    0.61  12.76 12.769ZZZ.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
61680  Intracranial vessel surgery                       A  32.55  22.86NA  22.86   11.68  67.09 67.090090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61682  Intracranial vessel surgery                       A  63.41  37.38NA  37.38   22.76 123.55123.550090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61684  Intracranial vessel surgery                       A  41.64  27.57NA  27.57   14.94  84.15 84.150090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61686  Intracranial vessel surgery                       A  67.50  41.19NA  41.19   24.24 132.93132.930090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61690  Intracranial vessel surgery                       A  31.34  22.20NA  22.20   11.26  64.80 64.800090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61692  Intracranial vessel surgery                       A  54.59  33.99NA  33.99   19.60 108.18108.180090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61697  Brain aneurysm repr complx                        A  63.40  38.89NA  38.89   22.52 124.81124.810090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61698  Brain aneurysm repr complx                        A  69.63  42.27NA  42.27   24.99 136.89136.890090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61700  Brain aneurysm repr simple                        A  50.62  32.37NA  32.37   18.06 101.05101.050090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61702  Inner skull vessel surgery                        A  60.04  37.40NA  37.40   21.54 118.98118.980090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61703  Clamp neck artery                                 A  18.80  14.84NA  14.84    6.75  40.39 40.390090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61705  Revise circulation to head                        A  38.10  25.24NA  25.24   13.68  77.02 77.020090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61708  Revise circulation to head                        A  37.20  23.83NA  23.83    3.08  64.11 64.110090.11.76.1320200             25.0008 090 99      0.00   0.00   0.00
61710  Revise circulation to head                        A  31.29  11.07NA  11.07    6.52  48.88 48.880090.11.76.1320000             25.0008 090 99      0.00   0.00   0.00
61711  Fusion of skull arteries                          A  38.23  25.31NA  25.31   13.72  77.26 77.260090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61720  Incise skull/brain surgery                        A  17.62  13.80NA  13.80    6.33  37.75 37.750090.11.76.1320100             25.0008 090 99      0.00   0.00   0.00
61735  Incise skull/brain surgery                        A  22.35  16.82NA  16.82    8.02  47.19 47.190090.11.76.1320110             25.0008 090 99      0.00   0.00   0.00
61750  Incise skull/brain biopsy                         A  19.83  14.86NA  14.86    7.06  41.75 41.750090.11.76.1320110             25.0008 090 99      0.00   0.00   0.00
61751  Brain biopsy w/ct/mr guide                        A  18.79  15.41NA  15.41    6.70  40.90 40.900090.11.76.1320110             25.0008 090 99      0.00   0.00   0.00
61760  Implant brain electrodes                          A  22.39  16.46NA  16.46    8.03  46.88 46.880090.11.76.1320120             25.0008 090 99      0.00   0.00   0.00
61770  Incise skull for treatment                        A  23.19  16.62NA  16.62    8.19  48.00 48.000090.11.76.1320110             25.0008 090 99      0.00   0.00   0.00
61781  Scan proc cranial intra                           A   3.75   1.89NA   1.89    1.25   6.89  6.890ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
61782  Scan proc cranial extra                           A   3.18   1.58NA   1.58    0.87   5.63  5.630ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
61783  Scan proc spinal                                  A   3.75   1.90NA   1.90    1.25   6.90  6.900ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
61790  Treat trigeminal nerve                            A  11.60  10.32NA  10.32    4.07  25.99 25.990090.11.76.1321100             25.0008 090 99      0.00   0.00   0.00
61791  Treat trigeminal tract                            A  15.41  12.50NA  12.50    5.20  33.11 33.110090.11.76.1321000             25.0008 090 99      0.00   0.00   0.00
61796  Srs cranial lesion simple                         A  13.93  11.30NA  11.30    4.63  29.86 29.860090.11.76.1300200             25.0008 090 99      0.00   0.00   0.00
61797  Srs cran les simple addl                          A   3.48   1.76NA   1.76    1.16   6.40  6.400ZZZ.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
61798  Srs cranial lesion complex                        A  19.85  14.24NA  14.24    6.60  40.69 40.690090.11.76.1300200             25.0008 090 99      0.00   0.00   0.00
61799  Srs cran les complex addl                         A   4.81   2.44NA   2.44    1.59   8.84  8.840ZZZ.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
61800  Apply srs headframe add-on                        A   2.25   1.52NA   1.52    0.73   4.50  4.500ZZZ.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
61850  Implant neuroelectrodes                           A  13.34  11.10NA  11.10    4.80  29.24 29.240090.11.76.1320200             25.0008 090 99      0.00   0.00   0.00
61860  Implant neuroelectrodes                           A  22.26  16.15NA  16.15    7.99  46.40 46.400090.11.76.1320200             25.0008 090 99      0.00   0.00   0.00
61863  Implant neuroelectrode                            A  20.71  16.60NA  16.60    7.40  44.71 44.710090.11.76.1321210             25.0008 090 99      0.00   0.00   0.00
61864  Implant neuroelectrde addl                        A   4.49   2.27NA   2.27    1.61   8.37  8.370ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
61867  Implant neuroelectrode                            A  33.03  22.75NA  22.75   11.83  67.61 67.610090.11.76.1321210             25.0008 090 99      0.00   0.00   0.00
61868  Implant neuroelectrde addl                        A   7.91   3.98NA   3.98    2.84  14.73 14.730ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
61870  Implant neuroelectrodes                           A  16.34  12.97NA  12.97    5.87  35.18 35.180090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
61875  Implant neuroelectrodes                           A  16.46  10.71NA  10.71    1.17  28.34 28.340090.11.76.1320200             25.0008 090 99      0.00   0.00   0.00
61880  Revise/remove neuroelectrode                      A   6.95   7.74NA   7.74    2.46  17.15 17.150090.11.76.1321210             25.0008 090 99      0.00   0.00   0.00
61885  Insrt/redo neurostim 1 array                      A   6.05   7.50NA   7.50    2.07  15.62 15.620090.11.76.1321000             25.0008 090 99      0.00   0.00   0.00
61886  Implant neurostim arrays                          A   9.93  12.05NA  12.05    3.52  25.50 25.500090.11.76.1320000             25.0008 090 99      0.00   0.00   0.00
61888  Revise/remove neuroreceiver                       A   5.23   4.75NA   4.75    1.71  11.69 11.690010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
62000  Treat skull fracture                              A  13.93  11.75NA  11.75    5.01  30.69 30.690090.11.76.1320100             25.0008 090 99      0.00   0.00   0.00
62005  Treat skull fracture                              A  17.63  13.80NA  13.80    6.33  37.76 37.760090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
62010  Treatment of head injury                          A  21.43  16.35NA  16.35    7.69  45.47 45.470090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
62100  Repair brain fluid leakage                        A  23.53  16.37NA  16.37    7.51  47.41 47.410090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
62115  Reduction of skull defect                         A  22.91  12.56NA  12.56    1.62  37.09 37.090090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
62116  Reduction of skull defect                         A  25.02  18.62NA  18.62    8.98  52.62 52.620090.11.76.1320200             25.0008 090 99      0.00   0.00   0.00
62117  Reduction of skull defect                         A  28.35  14.50NA  14.50    3.66  46.51 46.510090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
62120  Repair skull cavity lesion                        A  24.59  22.24NA  22.24    3.17  50.00 50.000090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
62121  Incise skull repair                               A  23.03  17.96NA  17.96    8.27  49.26 49.260090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
62140  Repair of skull defect                            A  14.55  11.59NA  11.59    4.75  30.89 30.890090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
62141  Repair of skull defect                            A  16.07  12.67NA  12.67    5.31  34.05 34.050090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
62142  Remove skull plate/flap                           A  11.83  10.56NA  10.56    4.08  26.47 26.470090.11.76.1320200             25.0008 090 99      0.00   0.00   0.00
62143  Replace skull plate/flap                          A  14.15  11.96NA  11.96    5.01  31.12 31.120090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
62145  Repair of skull & brain                           A  20.09  14.84NA  14.84    7.21  42.14 42.140090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
62146  Repair of skull with graft                        A  17.28  13.63NA  13.63    6.21  37.12 37.120090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
62147  Repair of skull with graft                        A  20.67  15.17NA  15.17    7.40  43.24 43.240090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
62148  Retr bone flap to fix skull                       A   2.00   1.01NA   1.01    0.71   3.72  3.720ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
62160  Neuroendoscopy add-on                             A   3.00   1.51NA   1.51    1.08   5.59  5.590ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
62161  Dissect brain w/scope                             A  21.23  16.25NA  16.25    7.62  45.10 45.100090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
62162  Remove colloid cyst w/scope                       A  26.80  19.65NA  19.65    9.61  56.06 56.060090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
62163  Zneuroendoscopy w/fb removal                      A  16.53  14.00NA  14.00    5.92  36.45 36.450090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
62164  Remove brain tumor w/scope                        A  29.43  22.02NA  22.02   10.57  62.02 62.020090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
62165  Remove pituit tumor w/scope                       A  23.23  16.26NA  16.26    6.37  45.86 45.860090.11.76.1320010             25.0008 090 99      0.00   0.00   0.00
62180  Establish brain cavity shunt                      A  22.58  16.82NA  16.82    8.11  47.51 47.510090.11.76.1320200             25.0008 090 99      0.00   0.00   0.00
62190  Establish brain cavity shunt                      A  12.17  11.04NA  11.04    4.37  27.58 27.580090.11.76.1320110             25.0008 090 99      0.00   0.00   0.00
62192  Establish brain cavity shunt                      A  13.35  11.08NA  11.08    4.63  29.06 29.060090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
62194  Replace/irrigate catheter                         A   5.78   4.90NA   4.90    0.45  11.13 11.130010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
62200  Establish brain cavity shunt                      A  19.29  14.65NA  14.65    6.93  40.87 40.870090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
62201  Brain cavity shunt w/scope                        A  16.04  14.08NA  14.08    5.73  35.85 35.850090.11.76.1320100             25.0008 090 99      0.00   0.00   0.00
62220  Establish brain cavity shunt                      A  14.10  11.77NA  11.77    4.83  30.70 30.700090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
62223  Establish brain cavity shunt                      A  14.05  12.62NA  12.62    4.85  31.52 31.520090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
62225  Replace/irrigate catheter                         A   6.19   7.43NA   7.43    2.20  15.82 15.820090.11.76.1320100             25.0008 090 99      0.00   0.00   0.00
62230  Replace/revise brain shunt                        A  11.43   9.81NA   9.81    3.97  25.21 25.210090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
62252  Csf shunt reprogram                               A   0.74   1.61     1.61NA  0.25   2.60  2.601XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
62252TCCsf shunt reprogram                               A   0.00   1.24     1.24NA  0.01   1.25  1.251XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
6225226Csf shunt reprogram                               A   0.74   0.37     0.37    0.24   1.35  1.351XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
62256  Remove brain cavity shunt                         A   7.38   7.98NA   7.98    2.63  17.99 17.990090.11.76.1320200             25.0008 090 99      0.00   0.00   0.00
62258  Replace brain cavity shunt                        A  15.64  12.45NA  12.45    5.43  33.52 33.520090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
62263  Epidural lysis mult sessions                      A   5.00  15.84     5.10    0.40  21.24 10.500010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
62264  Epidural lysis on single day                      A   4.42   8.17     2.32    0.35  12.94  7.090010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
62267  Interdiscal perq aspir dx                         A   3.00   4.06     1.38    0.30   7.36  4.680000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
62268  Drain spinal cord cyst                            A   4.73   2.57NA   2.57    0.45   7.75  7.750000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
62269  Needle biopsy spinal cord                         A   5.01   2.24NA   2.24    0.56   7.81  7.810000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
62270  Spinal fluid tap diagnostic                       A   1.37   3.22     0.72    0.23   4.82  2.320000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
62272  Drain cerebro spinal fluid                        A   1.35   4.49     0.83    0.33   6.17  2.510000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
62273  Inject epidural patch                             A   2.15   2.87     1.02    0.20   5.22  3.370000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
62280  Treat spinal cord lesion                          A   2.63   7.01     2.08    0.50  10.14  5.210010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
62281  Treat spinal cord lesion                          A   2.66   4.42     1.81    0.27   7.35  4.740010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
62282  Treat spinal canal lesion                         A   2.33   6.03     1.68    0.29   8.65  4.300010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
62284  Injection for myelogram                           A   1.54   4.07     0.80    0.18   5.79  2.520000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
62287  Percutaneous diskectomy                           A   9.03   6.88NA   6.88    0.82  16.73 16.730090.11.76.1320100             25.0008 090 99      0.00   0.00   0.00
62290  Inject for spine disk x-ray                       A   3.00   6.93     1.87    0.30  10.23  5.170000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
62291  Inject for spine disk x-ray                       A   2.91   6.46     1.79    0.27   9.64  4.970000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
62292  Injection into disk lesion                        A   9.24   7.68NA   7.68    0.75  17.67 17.670090.11.76.1320000             25.0008 090 99      0.00   0.00   0.00
62294  Injection into spinal artery                      A  12.87   6.53NA   6.53    1.02  20.42 20.420090.11.76.1320100             25.0008 090 99      0.00   0.00   0.00
62310  Inject spine cerv/thoracic                        A   1.91   5.33     1.17    0.16   7.40  3.240000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
62311  Inject spine lumbar/sacral                        A   1.54   4.57     0.98    0.12   6.23  2.640000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
62318  Inject spine w/cath crv/thrc                      A   2.04   4.86     0.74    0.16   7.06  2.940000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
62319  Inject spine w/cath lmb/scrl                      A   1.87   3.07     0.82    0.16   5.10  2.850000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
62350  Implant spinal canal cath                         A   6.05   4.90NA   4.90    1.05  12.00 12.000010.10.80.1020110             25.0008 090 99      0.00   0.00   0.00
62351  Implant spinal canal cath                         A  11.66  11.22NA  11.22    3.39  26.27 26.270090.11.76.1320220             25.0008 090 99      0.00   0.00   0.00
62355  Remove spinal canal catheter                      A   3.55   3.72NA   3.72    0.60   7.87  7.870010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
62360  Insert spine infusion device                      A   4.33   4.10NA   4.10    0.87   9.30  9.300010.10.80.1020010             25.0008 090 99      0.00   0.00   0.00
62361  Implant spine infusion pump                       A   5.00   3.87NA   3.87    0.97   9.84  9.840010.10.80.1020010             25.0008 090 99      0.00   0.00   0.00
62362  Implant spine infusion pump                       A   5.60   4.88NA   4.88    1.12  11.60 11.600010.10.80.1020010             25.0008 090 99      0.00   0.00   0.00
62365  Remove spine infusion device                      A   3.93   4.11NA   4.11    0.74   8.78  8.780010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
62367  Analyze spine infus pump                          A   0.48   0.72     0.22    0.05   1.25  0.750XXX.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
62368  Analyze sp inf pump w/reprog                      A   0.67   0.97     0.31    0.04   1.68  1.020XXX.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
62369  Anal sp inf pmp w/reprg&fill                      A   0.67   3.06     0.31    0.04   3.77  1.020XXX.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
62370  Anl sp inf pmp w/mdreprg&fil                      A   0.90   2.98     0.41    0.06   3.94  1.370XXX.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
63001  Remove spine lamina 1/2 crvl                      A  17.61  13.50NA  13.50    5.69  36.80 36.800090.11.76.1320220             25.0008 090 99      0.00   0.00   0.00
63003  Remove spine lamina 1/2 thrc                      A  17.74  13.43NA  13.43    5.63  36.80 36.800090.11.76.1320220             25.0008 090 99      0.00   0.00   0.00
63005  Remove spine lamina 1/2 lmbr                      A  16.43  13.61NA  13.61    5.08  35.12 35.120090.11.76.1320220             25.0008 090 99      0.00   0.00   0.00
63011  Remove spine lamina 1/2 scrl                      A  15.91  12.55NA  12.55    4.01  32.47 32.470090.11.76.1320220             25.0008 090 99      0.00   0.00   0.00
63012  Remove lamina/facets lumbar                       A  16.85  13.52NA  13.52    5.10  35.47 35.470090.11.76.1320220             25.0008 090 99      0.00   0.00   0.00
63015  Remove spine lamina >2 crvcl                      A  20.85  16.30NA  16.30    7.01  44.16 44.160090.11.76.1320220             25.0008 090 99      0.00   0.00   0.00
63016  Remove spine lamina >2 thrc                       A  22.03  16.17NA  16.17    6.78  44.98 44.980090.11.76.1320220             25.0008 090 99      0.00   0.00   0.00
63017  Remove spine lamina >2 lmbr                       A  17.33  14.42NA  14.42    5.57  37.32 37.320090.11.76.1320220             25.0008 090 99      0.00   0.00   0.00
63020  Neck spine disk surgery                           A  16.20  13.57NA  13.57    5.06  34.83 34.830090.11.76.1321220             25.0008 090 99      0.00   0.00   0.00
63030  Low back disk surgery                             A  13.18  11.74NA  11.74    3.87  28.79 28.790090.11.76.1321220             25.0008 090 99      0.00   0.00   0.00
63035  Spinal disk surgery add-on                        A   3.15   1.63NA   1.63    0.88   5.66  5.660ZZZ.00.00.0001220             25.0008 090 99      0.00   0.00   0.00
63040  Laminotomy single cervical                        A  20.31  15.09NA  15.09    6.27  41.67 41.670090.11.76.1321220             25.0008 090 99      0.00   0.00   0.00
63042  Laminotomy single lumbar                          A  18.76  14.72NA  14.72    5.20  38.68 38.680090.11.76.1321220             25.0008 090 99      0.00   0.00   0.00
63043  Laminotomy addl cervical                          C   0.00   0.00     0.00    0.00   0.00  0.000ZZZ.00.00.0001220             25.0008 090 99      0.00   0.00   0.00
63044  Laminotomy addl lumbar                            C   0.00   0.00     0.00    0.00   0.00  0.000ZZZ.00.00.0001220             25.0008 090 99      0.00   0.00   0.00
63045  Remove spine lamina 1 crvl                        A  17.95  14.21NA  14.21    5.73  37.89 37.890090.11.76.1322220             25.0008 090 99      0.00   0.00   0.00
63046  Remove spine lamina 1 thrc                        A  17.25  13.64NA  13.64    5.14  36.03 36.030090.11.76.1322220             25.0008 090 99      0.00   0.00   0.00
63047  Remove spine lamina 1 lmbr                        A  15.37  13.09NA  13.09    4.41  32.87 32.870090.11.76.1322220             25.0008 090 99      0.00   0.00   0.00
63048  Remove spinal lamina add-on                       A   3.47   1.79NA   1.79    1.01   6.27  6.270ZZZ.00.00.0000220             25.0008 090 99      0.00   0.00   0.00
63050  Cervical laminoplsty 2/> seg                      A  22.01  16.26NA  16.26    7.91  46.18 46.180090.11.76.1320220             25.0008 090 99      0.00   0.00   0.00
63051  C-laminoplasty w/graft/plate                      A  25.51  18.13NA  18.13    7.24  50.88 50.880090.11.76.1320220             25.0008 090 99      0.00   0.00   0.00
63055  Decompress spinal cord thrc                       A  23.55  17.06NA  17.06    7.66  48.27 48.270090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63056  Decompress spinal cord lmbr                       A  21.86  15.94NA  15.94    6.19  43.99 43.990090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63057  Decompress spine cord add-on                      A   5.25   2.72NA   2.72    1.51   9.48  9.480ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
63064  Decompress spinal cord thrc                       A  26.22  18.24NA  18.24    7.95  52.41 52.410090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63066  Decompress spine cord add-on                      A   3.26   1.65NA   1.65    1.17   6.08  6.080ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
63075  Neck spine disk surgery                           A  19.60  15.01NA  15.01    6.11  40.72 40.720090.11.76.1320220             25.0008 090 99      0.00   0.00   0.00
63076  Neck spine disk surgery                           A   4.04   2.07NA   2.07    1.25   7.36  7.360ZZZ.00.00.0000220             25.0008 090 99      0.00   0.00   0.00
63077  Spine disk surgery thorax                         A  22.88  15.21NA  15.21    5.87  43.96 43.960090.11.76.1320220             25.0008 090 99      0.00   0.00   0.00
63078  Spine disk surgery thorax                         A   3.28   1.65NA   1.65    0.75   5.68  5.680ZZZ.00.00.0000220             25.0008 090 99      0.00   0.00   0.00
63081  Remove vert body dcmprn crvl                      A  26.10  18.54NA  18.54    7.89  52.53 52.530090.11.76.1320212             25.0008 090 99      0.00   0.00   0.00
63082  Remove vertebral body add-on                      A   4.36   2.25NA   2.25    1.31   7.92  7.920ZZZ.00.00.0000212             25.0008 090 99      0.00   0.00   0.00
63085  Remove vert body dcmprn thrc                      A  29.47  18.63NA  18.63    7.93  56.03 56.030090.11.76.1320222             25.0008 090 99      0.00   0.00   0.00
63086  Remove vertebral body add-on                      A   3.19   1.54NA   1.54    0.87   5.60  5.600ZZZ.00.00.0000222             25.0008 090 99      0.00   0.00   0.00
63087  Remov vertbr dcmprn thrclmbr                      A  37.53  23.39NA  23.39    9.73  70.65 70.650090.11.76.1320222             25.0008 090 99      0.00   0.00   0.00
63088  Remove vertebral body add-on                      A   4.32   2.20NA   2.20    1.06   7.58  7.580ZZZ.00.00.0000222             25.0008 090 99      0.00   0.00   0.00
63090  Remove vert body dcmprn lmbr                      A  30.93  20.06NA  20.06    7.20  58.19 58.190090.11.76.1320222             25.0008 090 99      0.00   0.00   0.00
63091  Remove vertebral body add-on                      A   3.03   1.53NA   1.53    0.68   5.24  5.240ZZZ.00.00.0000222             25.0008 090 99      0.00   0.00   0.00
63101  Remove vert body dcmprn thrc                      A  34.10  24.03NA  24.03   10.63  68.76 68.760090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63102  Remove vert body dcmprn lmbr                      A  34.10  23.65NA  23.65    8.60  66.35 66.350090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63103  Remove vertebral body add-on                      A   4.82   2.48NA   2.48    1.29   8.59  8.590ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
63170  Incise spinal cord tract(s)                       A  22.21  17.13NA  17.13    7.98  47.32 47.320090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63172  Drainage of spinal cyst                           A  19.76  14.91NA  14.91    7.08  41.75 41.750090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63173  Drainage of spinal cyst                           A  24.31  18.20NA  18.20    8.75  51.26 51.260090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63180  Revise spinal cord ligaments                      A  20.53  16.28NA  16.28    7.36  44.17 44.170090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63182  Revise spinal cord ligaments                      A  22.82  17.44NA  17.44    8.19  48.45 48.450090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63185  Incise spine nrv half segmnt                      A  16.49  13.06NA  13.06    5.92  35.47 35.470090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63190  Incise spine nrv >2 segmnts                       A  18.89  14.07NA  14.07    4.29  37.25 37.250090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63191  Incise spine accessory nerve                      A  18.92  15.29NA  15.29    3.74  37.95 37.950090.11.76.1321210             25.0008 090 99      0.00   0.00   0.00
63194  Incise spine & cord cervical                      A  22.10  11.88NA  11.88    2.84  36.82 36.820090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63195  Incise spine & cord thoracic                      A  21.64  16.22NA  16.22    7.77  45.63 45.630090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63196  Incise spine&cord 2 trx crvl                      A  25.27  12.89NA  12.89    1.80  39.96 39.960090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63197  Incise spine&cord 2 trx thrc                      A  24.08  18.08NA  18.08    8.66  50.82 50.820090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63198  Incise spin&cord 2 stgs crvl                      A  29.90  15.01NA  15.01    2.12  47.03 47.030090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63199  Incise spin&cord 2 stgs thrc                      A  31.47  22.18NA  22.18    2.23  55.88 55.880090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63200  Release spinal cord lumbar                        A  21.44  16.63NA  16.63    7.58  45.65 45.650090.11.76.1320200             25.0008 090 99      0.00   0.00   0.00
63250  Revise spinal cord vsls crvl                      A  43.86  28.17NA  28.17   15.75  87.78 87.780090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63251  Revise spinal cord vsls thrc                      A  44.64  29.09NA  29.09   16.03  89.76 89.760090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63252  Revise spine cord vsl thrlmb                      A  44.63  29.09NA  29.09   16.03  89.75 89.750090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63265  Excise intraspinl lesion crv                      A  23.82  17.78NA  17.78    8.08  49.68 49.680090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63266  Excise intrspinl lesion thrc                      A  24.68  18.07NA  18.07    8.40  51.15 51.150090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63267  Excise intrspinl lesion lmbr                      A  19.45  15.30NA  15.30    6.26  41.01 41.010090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63268  Excise intrspinl lesion scrl                      A  20.02  16.08NA  16.08    7.19  43.29 43.290090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63270  Excise intrspinl lesion crvl                      A  29.80  21.04NA  21.04   10.71  61.55 61.550090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63271  Excise intrspinl lesion thrc                      A  29.92  20.77NA  20.77   10.57  61.26 61.260090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63272  Excise intrspinl lesion lmbr                      A  27.50  19.70NA  19.70    9.47  56.67 56.670090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63273  Excise intrspinl lesion scrl                      A  26.47  19.35NA  19.35    9.50  55.32 55.320090.11.76.1320200             25.0008 090 99      0.00   0.00   0.00
63275  Bx/exc xdrl spine lesn crvl                       A  25.86  18.81NA  18.81    8.82  53.49 53.490090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63276  Bx/exc xdrl spine lesn thrc                       A  25.69  18.63NA  18.63    8.71  53.03 53.030090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63277  Bx/exc xdrl spine lesn lmbr                       A  22.39  16.82NA  16.82    7.00  46.21 46.210090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63278  Bx/exc xdrl spine lesn scrl                       A  22.12  17.14NA  17.14    7.95  47.21 47.210090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63280  Bx/exc idrl spine lesn crvl                       A  30.29  21.70NA  21.70   10.83  62.82 62.820090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63281  Bx/exc idrl spine lesn thrc                       A  29.99  21.49NA  21.49   10.67  62.15 62.150090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63282  Bx/exc idrl spine lesn lmbr                       A  28.15  20.47NA  20.47    9.95  58.57 58.570090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63283  Bx/exc idrl spine lesn scrl                       A  26.76  20.03NA  20.03    9.60  56.39 56.390090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63285  Bx/exc idrl imed lesn cervl                       A  38.05  25.75NA  25.75   13.66  77.46 77.460090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63286  Bx/exc idrl imed lesn thrc                        A  37.62  25.35NA  25.35   13.20  76.17 76.170090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63287  Bx/exc idrl imed lesn thrlmb                      A  40.08  26.78NA  26.78   14.40  81.26 81.260090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63290  Bx/exc xdrl/idrl lsn any lvl                      A  40.82  27.16NA  27.16   14.66  82.64 82.640090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63295  Repair laminectomy defect                         A   5.25   2.66NA   2.66    1.88   9.79  9.790ZZZ.00.00.0002220             25.0008 090 99      0.00   0.00   0.00
63300  Remove vert xdrl body crvcl                       A  26.80  18.95NA  18.95    8.68  54.43 54.430090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63301  Remove vert xdrl body thrc                        A  31.57  20.52NA  20.52   11.34  63.43 63.430090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63302  Remove vert xdrl body thrlmb                      A  31.15  22.25NA  22.25   11.17  64.57 64.570090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63303  Remov vert xdrl bdy lmbr/sac                      A  33.55  22.94NA  22.94   12.03  68.52 68.520090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63304  Remove vert idrl body crvcl                       A  33.85  23.62NA  23.62   12.14  69.61 69.610090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63305  Remove vert idrl body thrc                        A  36.24  18.40NA  18.40   13.01  67.65 67.650090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63306  Remov vert idrl bdy thrclmbr                      A  35.55  15.26NA  15.26   12.77  63.58 63.580090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63307  Remov vert idrl bdy lmbr/sac                      A  34.96  23.74NA  23.74   12.56  71.26 71.260090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63308  Remove vertebral body add-on                      A   5.24   2.65NA   2.65    1.57   9.46  9.460ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
63600  Remove spinal cord lesion                         A  15.12  10.76NA  10.76    1.58  27.46 27.460090.11.76.1320000             25.0008 090 99      0.00   0.00   0.00
63610  Stimulation of spinal cord                        A   8.72   3.62NA   3.62    0.68  13.02 13.020000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
63615  Remove lesion of spinal cord                      A  17.32  13.20NA  13.20    6.21  36.73 36.730090.11.76.1320110             25.0008 090 99      0.00   0.00   0.00
63620  Srs spinal lesion                                 A  15.60  12.11NA  12.11    5.19  32.90 32.900090.11.76.1300200             25.0008 090 99      0.00   0.00   0.00
63621  Srs spinal lesion addl                            A   4.00   2.03NA   2.03    1.32   7.35  7.350ZZZ.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
63650  Implant neuroelectrodes                           A   7.15   5.06NA   5.06    0.64  12.85 12.850010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
63655  Implant neuroelectrodes                           A  10.92  10.40NA  10.40    3.42  24.74 24.740090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63661  Remove spine eltrd perq aray                      A   5.08  11.76     3.79    0.71  17.55  9.580010.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
63662  Remove spine eltrd plate                          A  11.00  10.58NA  10.58    1.55  23.13 23.130090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63663  Revise spine eltrd perq aray                      A   7.75  15.82     5.04    1.09  24.66 13.880010.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
63664  Revise spine eltrd plate                          A  11.52  10.54NA  10.54    1.61  23.67 23.670090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63685  Insrt/redo spine n generator                      A   5.19   4.75NA   4.75    0.94  10.88 10.880010.10.80.1020210             25.0008 090 99      0.00   0.00   0.00
63688  Revise/remove neuroreceiver                       A   5.30   4.69NA   4.69    1.01  11.00 11.000010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
63700  Repair of spinal herniation                       A  17.47  13.69NA  13.69    6.26  37.42 37.420090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63702  Repair of spinal herniation                       A  19.41  15.92NA  15.92    6.97  42.30 42.300090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63704  Repair of spinal herniation                       A  22.43  18.60NA  18.60    8.04  49.07 49.070090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63706  Repair of spinal herniation                       A  25.35  20.08NA  20.08    9.12  54.55 54.550090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63707  Repair spinal fluid leakage                       A  12.65  11.14NA  11.14    3.50  27.29 27.290090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63709  Repair spinal fluid leakage                       A  15.65  12.69NA  12.69    4.50  32.84 32.840090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63710  Graft repair of spine defect                      A  15.40  12.57NA  12.57    4.86  32.83 32.830090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63740  Install spinal shunt                              A  12.63  11.51NA  11.51    4.26  28.40 28.400090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63741  Install spinal shunt                              A   9.12   7.95NA   7.95    2.19  19.26 19.260090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63744  Revision of spinal shunt                          A   8.94   8.45NA   8.45    3.06  20.45 20.450090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
63746  Removal of spinal shunt                           A   7.33   8.05NA   8.05    2.63  18.01 18.010090.11.76.1320000             25.0008 090 99      0.00   0.00   0.00
64400  N block inj trigeminal                            A   1.11   2.41     0.76    0.18   3.70  2.050000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
64402  N block inj facial                                A   1.25   2.23     0.82    0.18   3.66  2.250000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
64405  N block inj occipital                             A   0.94   1.91     0.74    0.19   3.04  1.870000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
64408  N block inj vagus                                 A   1.41   1.36     0.58    0.16   2.93  2.150000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
64410  N block inj phrenic                               A   1.43   2.03     0.45    0.33   3.79  2.210000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
64412  N block inj spinal accessor                       A   1.18   2.82     0.78    0.20   4.20  2.160000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
64413  N block inj cervical plexus                       A   1.40   2.16     0.80    0.20   3.76  2.400000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
64415  N block inj brachial plexus                       A   1.48   1.91     0.29    0.11   3.50  1.880000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
64416  N block cont infuse b plex                        A   1.81   0.33NA   0.33    0.14   2.28  2.280000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
64417  N block inj axillary                              A   1.44   2.28     0.49    0.11   3.83  2.040000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
64418  N block inj suprascapular                         A   1.32   2.81     0.78    0.12   4.25  2.220000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
64420  N block inj intercost sng                         A   1.18   2.14     0.75    0.12   3.44  2.050000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
64421  N block inj intercost mlt                         A   1.68   2.78     0.93    0.20   4.66  2.810000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
64425  N block inj ilio-ing/hypogi                       A   1.75   2.10     0.87    0.20   4.05  2.820000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
64430  N block inj pudendal                              A   1.46   2.51     0.81    0.14   4.11  2.410000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
64435  N block inj paracervical                          A   1.45   2.40     0.81    0.24   4.09  2.500000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
64445  N block inj sciatic sng                           A   1.48   2.42     0.47    0.16   4.06  2.110000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
64446  N blk inj sciatic cont inf                        A   1.81   0.33NA   0.33    0.14   2.28  2.280000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
64447  N block inj fem single                            A   1.50   1.90     0.28    0.11   3.51  1.890000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
64448  N block inj fem cont inf                          A   1.63   0.30NA   0.30    0.12   2.05  2.050000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
64449  N block inj lumbar plexus                         A   1.81   0.45NA   0.45    0.14   2.40  2.400000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
64450  N block other peripheral                          A   0.75   1.58     0.52    0.06   2.39  1.330000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
64455  N block inj plantar digit                         A   0.75   0.59     0.20    0.08   1.42  1.030000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
64479  Inj foramen epidural c/t                          A   2.29   4.74     1.45    0.27   7.30  4.010000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
64480  Inj foramen epidural add-on                       A   1.20   2.08     0.55    0.18   3.46  1.930ZZZ.00.00.0001100             25.0008 090 99      0.00   0.00   0.00
64483  Inj foramen epidural l/s                          A   1.90   4.77     1.32    0.16   6.83  3.380000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
64484  Inj foramen epidural add-on                       A   1.00   1.59     0.47    0.08   2.67  1.550ZZZ.00.00.0001100             25.0008 090 99      0.00   0.00   0.00
64490  Inj paravert f jnt c/t 1 lev                      A   1.82   3.92     1.22    0.20   5.94  3.240000.00.00.0021200             25.0008 090 99      0.00   0.00   0.00
64491  Inj paravert f jnt c/t 2 lev                      A   1.16   1.60     0.53    0.11   2.87  1.800ZZZ.00.00.0001200             25.0008 090 99      0.00   0.00   0.00
64492  Inj paravert f jnt c/t 3 lev                      A   1.16   1.61     0.55    0.11   2.88  1.820ZZZ.00.00.0001200             25.0008 090 99      0.00   0.00   0.00
64493  Inj paravert f jnt l/s 1 lev                      A   1.52   3.71     1.08    0.14   5.37  2.740000.00.00.0021200             25.0008 090 99      0.00   0.00   0.00
64494  Inj paravert f jnt l/s 2 lev                      A   1.00   1.55     0.45    0.08   2.63  1.530ZZZ.00.00.0001200             25.0008 090 99      0.00   0.00   0.00
64495  Inj paravert f jnt l/s 3 lev                      A   1.00   1.56     0.48    0.08   2.64  1.560ZZZ.00.00.0001200             25.0008 090 99      0.00   0.00   0.00
64505  N block spenopalatine gangl                       A   1.36   1.63     1.09    0.10   3.09  2.550000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
64508  N block carotid sinus s/p                         A   1.12   0.57     0.95    0.24   1.93  2.310000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
64510  N block stellate ganglion                         A   1.22   2.56     0.87    0.10   3.88  2.190000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
64517  N block inj hypogas plxs                          A   2.20   3.03     1.25    0.18   5.41  3.630000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
64520  N block lumbar/thoracic                           A   1.35   4.23     0.93    0.11   5.69  2.390000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
64530  N block inj celiac pelus                          A   1.58   4.18     1.07    0.14   5.90  2.790000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
64550  Apply neurostimulator                             A   0.18   0.28     0.07    0.01   0.47  0.260000.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
64553  Implant neuroelectrodes                           A   2.36   4.14     2.28    0.38   6.88  5.020010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
64555  Implant neuroelectrodes                           A   2.32   3.43     1.84    0.26   6.01  4.420010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
64561  Implant neuroelectrodes                           A   7.15  16.14     3.75    0.78  24.07 11.680010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
64565  Implant neuroelectrodes                           A   1.81   3.31     1.74    0.24   5.36  3.790010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
64566  Neuroeltrd stim post tibial                       A   0.60   3.02     0.22    0.05   3.67  0.870000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
64568  Inc for vagus n elect impl                        A   9.00   7.99NA   7.99    1.25  18.24 18.240090.11.76.1321000             25.0008 090 99      0.00   0.00   0.00
64569  Revise/repl vagus n eltrd                         A  11.00   9.01NA   9.01    3.16  23.17 23.170090.11.76.1321011             25.0008 090 99      0.00   0.00   0.00
64570  Remove vagus n eltrd                              A   9.10   8.08NA   8.08    3.27  20.45 20.450090.11.76.1321011             25.0008 090 99      0.00   0.00   0.00
64575  Implant neuroelectrodes                           A   4.42   4.51NA   4.51    0.44   9.37  9.370090.11.76.1320100             25.0008 090 99      0.00   0.00   0.00
64580  Implant neuroelectrodes                           A   4.19   4.05NA   4.05    0.88   9.12  9.120090.11.76.1320200             25.0008 090 99      0.00   0.00   0.00
64581  Implant neuroelectrodes                           A  12.20   5.76NA   5.76    1.58  19.54 19.540090.11.76.1320100             25.0008 090 99      0.00   0.00   0.00
64585  Revise/remove neuroelectrode                      A   2.11   5.10     1.93    0.27   7.48  4.310010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
64590  Insrt/redo pn/gastr stimul                        A   2.45   5.17     2.00    0.29   7.91  4.740010.10.80.1020110             25.0008 090 99      0.00   0.00   0.00
64595  Revise/rmv pn/gastr stimul                        A   1.78   5.49     1.77    0.22   7.49  3.770010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
64600  Injection treatment of nerve                      A   3.49   7.79     2.43    0.53  11.81  6.450010.10.80.1022100             25.0008 090 99      0.00   0.00   0.00
64605  Injection treatment of nerve                      A   5.65  10.36     3.86    0.44  16.45  9.950010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
64610  Injection treatment of nerve                      A   7.20  12.93     5.01    2.15  22.28 14.360010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
64611  Chemodenerv saliv glands                          A   1.03   2.05     1.61    0.29   3.37  2.930010.10.80.1022000             25.0008 090 99      0.00   0.00   0.00
64612  Destroy nerve face muscle                         A   1.41   2.21     1.78    0.46   4.08  3.650010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
64613  Destroy nerve neck muscle                         A   2.01   2.55     2.10    0.59   5.15  4.700010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
64614  Destroy nerve extrem musc                         A   2.20   2.90     2.28    0.42   5.52  4.900010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
64615  Chemodenerv musc migraine                         A   1.85   1.78     1.36    0.60   4.23  3.810010.10.80.1022100             25.0008 090 99      0.00   0.00   0.00
64620  Injection treatment of nerve                      A   2.89   3.04     2.03    0.29   6.22  5.210010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
64630  Injection treatment of nerve                      A   3.05   2.93     1.94    0.34   6.32  5.330010.10.80.1020000             25.0008 090 99      0.00   0.00   0.00
64632  N block inj common digit                          A   1.23   1.20     0.70    0.10   2.53  2.030010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
64633  Destroy cerv/thor facet jnt                       A   3.84   8.06     2.35    0.33  12.23  6.520010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
64634  Destroy c/th facet jnt addl                       A   1.32   4.11     0.53    0.11   5.54  1.960ZZZ.00.00.0001100             25.0008 090 99      0.00   0.00   0.00
64635  Destroy lumb/sac facet jnt                        A   3.78   7.91     2.33    0.32  12.01  6.430010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
64636  Destroy l/s facet jnt addl                        A   1.16   3.74     0.47    0.09   4.99  1.720ZZZ.00.00.0001100             25.0008 090 99      0.00   0.00   0.00
64640  Injection treatment of nerve                      A   1.23   2.72     1.48    0.11   4.06  2.820010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
64650  Chemodenerv eccrine glands                        A   0.70   2.94     0.40    0.11   3.75  1.210000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
64653  Chemodenerv eccrine glands                        A   0.88   3.40     0.45    0.24   4.52  1.570000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
64680  Injection treatment of nerve                      A   2.67   6.61     2.06    0.30   9.58  5.030010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
64681  Injection treatment of nerve                      A   3.78   6.69     1.75    0.30  10.77  5.830010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
64702  Revise finger/toe nerve                           A   6.26   7.60NA   7.60    1.06  14.92 14.920090.11.76.1320100             25.0008 090 99      0.00   0.00   0.00
64704  Revise hand/foot nerve                            A   4.69   4.18NA   4.18    0.54   9.41  9.410090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
64708  Revise arm/leg nerve                              A   6.36   7.33NA   7.33    1.16  14.85 14.850090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
64712  Revision of sciatic nerve                         A   8.07   7.46NA   7.46    1.33  16.86 16.860090.11.76.1321210             25.0008 090 99      0.00   0.00   0.00
64713  Revision of arm nerve(s)                          A  11.40   8.14NA   8.14    2.34  21.88 21.880090.11.76.1321210             25.0008 090 99      0.00   0.00   0.00
64714  Revise low back nerve(s)                          A  10.55   6.64NA   6.64    1.71  18.90 18.900090.11.76.1321210             25.0008 090 99      0.00   0.00   0.00
64716  Revision of cranial nerve                         A   6.99   7.91NA   7.91    1.13  16.03 16.030090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
64718  Revise ulnar nerve at elbow                       A   7.26   8.97NA   8.97    1.48  17.71 17.710090.11.76.1321000             25.0008 090 99      0.00   0.00   0.00
64719  Revise ulnar nerve at wrist                       A   4.97   5.97NA   5.97    0.93  11.87 11.870090.11.76.1321100             25.0008 090 99      0.00   0.00   0.00
64721  Carpal tunnel surgery                             A   4.97   6.86     6.78    0.98  12.81 12.730090.11.76.1321100             25.0008 090 99      0.00   0.00   0.00
64722  Relieve pressure on nerve(s)                      A   4.82   5.19NA   5.19    0.84  10.85 10.850090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
64726  Release foot/toe nerve                            A   4.27   3.45NA   3.45    0.39   8.11  8.110090.11.76.1320100             25.0008 090 99      0.00   0.00   0.00
64727  Internal nerve revision                           A   3.10   1.70NA   1.70    0.60   5.40  5.400ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
64732  Incision of brow nerve                            A   4.89   6.64NA   6.64    1.77  13.30 13.300090.11.76.1321200             25.0008 090 99      0.00   0.00   0.00
64734  Incision of cheek nerve                           A   5.55   5.31NA   5.31    0.71  11.57 11.570090.11.76.1321000             25.0008 090 99      0.00   0.00   0.00
64736  Incision of chin nerve                            A   5.23   5.73NA   5.73    1.88  12.84 12.840090.11.76.1321200             25.0008 090 99      0.00   0.00   0.00
64738  Incision of jaw nerve                             A   6.36   6.20NA   6.20    2.27  14.83 14.830090.11.76.1321200             25.0008 090 99      0.00   0.00   0.00
64740  Incision of tongue nerve                          A   6.22   6.72NA   6.72    0.80  13.74 13.740090.11.76.1321200             25.0008 090 99      0.00   0.00   0.00
64742  Incision of facial nerve                          A   6.85   7.25NA   7.25    0.87  14.97 14.970090.11.76.1321200             25.0008 090 99      0.00   0.00   0.00
64744  Incise nerve back of head                         A   5.72   7.06NA   7.06    2.04  14.82 14.820090.11.76.1321000             25.0008 090 99      0.00   0.00   0.00
64746  Incise diaphragm nerve                            A   6.56   4.85NA   4.85    1.54  12.95 12.950090.11.76.1321210             25.0008 090 99      0.00   0.00   0.00
64752  Incision of vagus nerve                           A   7.69   5.18NA   5.18    1.81  14.68 14.680090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
64755  Incision of stomach nerves                        A  15.05   8.86NA   8.86    3.21  27.12 27.120090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
64760  Incision of vagus nerve                           A   7.59   6.08NA   6.08    1.61  15.28 15.280090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
64761  Incision of pelvis nerve                          A   7.04   5.76NA   5.76    1.01  13.81 13.810090.11.76.1321200             25.0008 090 99      0.00   0.00   0.00
64763  Incise hip/thigh nerve                            A   7.56   7.40NA   7.40    1.61  16.57 16.570090.11.76.1321210             25.0008 090 99      0.00   0.00   0.00
64766  Incise hip/thigh nerve                            A   9.47   7.11NA   7.11    0.91  17.49 17.490090.11.76.1321200             25.0008 090 99      0.00   0.00   0.00
64771  Sever cranial nerve                               A   8.15   7.92NA   7.92    1.05  17.12 17.120090.11.76.1320200             25.0008 090 99      0.00   0.00   0.00
64772  Incision of spinal nerve                          A   7.84   7.54NA   7.54    1.81  17.19 17.190090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
64774  Remove skin nerve lesion                          A   5.80   5.66NA   5.66    1.05  12.51 12.510090.11.76.1320100             25.0008 090 99      0.00   0.00   0.00
64776  Remove digit nerve lesion                         A   5.60   5.07NA   5.07    0.84  11.51 11.510090.11.76.1320000             25.0008 090 99      0.00   0.00   0.00
64778  Digit nerve surgery add-on                        A   3.11   0.79NA   0.79    0.61   4.51  4.510ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
64782  Remove limb nerve lesion                          A   6.86   5.59NA   5.59    0.91  13.36 13.360090.11.76.1320110             25.0008 090 99      0.00   0.00   0.00
64783  Limb nerve surgery add-on                         A   3.71   2.18NA   2.18    0.45   6.34  6.340ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
64784  Remove nerve lesion                               A  10.62   9.28NA   9.28    2.00  21.90 21.900090.11.76.1320000             25.0008 090 99      0.00   0.00   0.00
64786  Remove sciatic nerve lesion                       A  16.25  12.49NA  12.49    3.21  31.95 31.950090.11.76.1321200             25.0008 090 99      0.00   0.00   0.00
64787  Implant nerve end                                 A   4.29   2.19NA   2.19    0.68   7.16  7.160ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
64788  Remove skin nerve lesion                          A   5.24   5.67NA   5.67    1.08  11.99 11.990090.11.76.1320100             25.0008 090 99      0.00   0.00   0.00
64790  Removal of nerve lesion                           A  12.10   9.66NA   9.66    2.75  24.51 24.510090.11.76.1320010             25.0008 090 99      0.00   0.00   0.00
64792  Removal of nerve lesion                           A  15.86  13.88NA  13.88    5.69  35.43 35.430090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
64795  Biopsy of nerve                                   A   3.01   1.94NA   1.94    0.82   5.77  5.770000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
64802  Sympathectomy cervical                            A  10.37   4.04NA   4.04    0.82  15.23 15.230090.11.76.1321210             25.0008 090 99      0.00   0.00   0.00
64804  Remove sympathetic nerves                         A  15.91   8.15NA   8.15    1.27  25.33 25.330090.11.76.1321210             25.0008 090 99      0.00   0.00   0.00
64809  Remove sympathetic nerves                         A  14.71   5.32NA   5.32    1.17  21.20 21.200090.11.76.1321210             25.0008 090 99      0.00   0.00   0.00
64818  Remove sympathetic nerves                         A  11.34   5.55NA   5.55    2.07  18.96 18.960090.11.76.1321210             25.0008 090 99      0.00   0.00   0.00
64820  Sympathectomy digital artery                      A  10.74   9.52NA   9.52    1.91  22.17 22.170090.11.76.1320100             25.0008 090 99      0.00   0.00   0.00
64821  Remove sympathetic nerves                         A   9.33   9.55NA   9.55    1.84  20.72 20.720090.11.76.1321100             25.0008 090 99      0.00   0.00   0.00
64822  Remove sympathetic nerves                         A   9.33   9.55NA   9.55    1.84  20.72 20.720090.11.76.1321100             25.0008 090 99      0.00   0.00   0.00
64823  Sympathectomy supfc palmar                        A  10.94  10.50NA  10.50    2.15  23.59 23.590090.11.76.1321100             25.0008 090 99      0.00   0.00   0.00
64831  Repair of digit nerve                             A   9.16   9.56NA   9.56    1.63  20.35 20.350090.11.76.1321100             25.0008 090 99      0.00   0.00   0.00
64832  Repair nerve add-on                               A   5.65   3.27NA   3.27    1.01   9.93  9.930ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
64834  Repair of hand or foot nerve                      A  10.81   9.35NA   9.35    1.85  22.01 22.010090.11.76.1321000             25.0008 090 99      0.00   0.00   0.00
64835  Repair of hand or foot nerve                      A  11.73  10.08NA  10.08    2.30  24.11 24.110090.11.76.1321200             25.0008 090 99      0.00   0.00   0.00
64836  Repair of hand or foot nerve                      A  11.73  10.67NA  10.67    2.30  24.70 24.700090.11.76.1321200             25.0008 090 99      0.00   0.00   0.00
64837  Repair nerve add-on                               A   6.25   3.94NA   3.94    0.76  10.95 10.950ZZZ.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
64840  Repair of leg nerve                               A  14.02  12.36NA  12.36    1.08  27.46 27.460090.11.76.1321200             25.0008 090 99      0.00   0.00   0.00
64856  Repair/transpose nerve                            A  15.07  12.13NA  12.13    2.84  30.04 30.040090.11.76.1320110             25.0008 090 99      0.00   0.00   0.00
64857  Repair arm/leg nerve                              A  15.82  12.46NA  12.46    2.91  31.19 31.190090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
64858  Repair sciatic nerve                              A  17.82  14.52NA  14.52    3.51  35.85 35.850090.11.76.1321210             25.0008 090 99      0.00   0.00   0.00
64859  Nerve surgery                                     A   4.25   2.50NA   2.50    0.83   7.58  7.580ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
64861  Repair of arm nerves                              A  20.89  13.63NA  13.63    4.12  38.64 38.640090.11.76.1321210             25.0008 090 99      0.00   0.00   0.00
64862  Repair of low back nerves                         A  21.09  12.03NA  12.03    7.57  40.69 40.690090.11.76.1321200             25.0008 090 99      0.00   0.00   0.00
64864  Repair of facial nerve                            A  13.41  10.91NA  10.91    1.70  26.02 26.020090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
64865  Repair of facial nerve                            A  16.09  15.19NA  15.19    2.04  33.32 33.320090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
64866  Fusion of facial/other nerve                      A  16.83  15.55NA  15.55    2.16  34.54 34.540090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
64868  Fusion of facial/other nerve                      A  14.90  13.69NA  13.69    1.91  30.50 30.500090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
64870  Fusion of facial/other nerve                      A  17.08  11.36NA  11.36    4.00  32.44 32.440090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
64872  Subsequent repair of nerve                        A   1.99   1.17NA   1.17    0.26   3.42  3.420ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
64874  Repair & revise nerve add-on                      A   2.98   1.88NA   1.88    0.37   5.23  5.230ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
64876  Repair nerve/shorten bone                         A   3.37   1.36NA   1.36    0.65   5.38  5.380ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
64885  Nerve graft head/neck </4 cm                      A  17.60  13.83NA  13.83    2.25  33.68 33.680090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
64886  Nerve graft head/neck >4 cm                       A  20.82  15.12NA  15.12    2.67  38.61 38.610090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
64890  Nerve graft hand/foot </4 cm                      A  16.24  12.49NA  12.49    3.20  31.93 31.930090.11.76.1320200             25.0008 090 99      0.00   0.00   0.00
64891  Nerve graft hand/foot >4 cm                       A  17.35  14.31NA  14.31    3.43  35.09 35.090090.11.76.1320200             25.0008 090 99      0.00   0.00   0.00
64892  Nerve graft arm/leg <4 cm                         A  15.74  13.19NA  13.19    3.12  32.05 32.050090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
64893  Nerve graft arm/leg >4 cm                         A  16.87  12.95NA  12.95    3.35  33.17 33.170090.11.76.1320200             25.0008 090 99      0.00   0.00   0.00
64895  Nerve graft hand/foot </4 cm                      A  20.39  15.62NA  15.62    4.01  40.02 40.020090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
64896  Nerve graft hand/foot >4 cm                       A  21.96  14.16NA  14.16    7.89  44.01 44.010090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
64897  Nerve graft arm/leg </4 cm                        A  19.38  15.02NA  15.02    3.82  38.22 38.220090.11.76.1320200             25.0008 090 99      0.00   0.00   0.00
64898  Nerve graft arm/leg >4 cm                         A  20.97  16.92NA  16.92    4.14  42.03 42.030090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
64901  Nerve graft add-on                                A  10.20   6.42NA   6.42    2.00  18.62 18.620ZZZ.00.00.0000210             25.0008 090 99      0.00   0.00   0.00
64902  Nerve graft add-on                                A  11.81   5.85NA   5.85    2.31  19.97 19.970ZZZ.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
64905  Nerve pedicle transfer                            A  15.11  12.79NA  12.79    2.98  30.88 30.880090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
64907  Nerve pedicle transfer                            A  20.03  15.47NA  15.47    1.42  36.92 36.920090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
64910  Nerve repair w/allograft                          A  11.39  11.04NA  11.04    1.97  24.40 24.400090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
64911  Neurorraphy w/vein autograft                      A  14.39  13.41NA  13.41    2.84  30.64 30.640090.11.76.1320210             25.0008 090 99      0.00   0.00   0.00
64999  Nervous system surgery                            C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 090 99      0.00   0.00   0.00
65091  Revise eye                                        A   7.26  11.06NA  11.06    1.44  19.76 19.760090.10.70.2021010             25.0008 090 99      0.00   0.00   0.00
65093  Revise eye with implant                           A   7.04  11.09NA  11.09    1.39  19.52 19.520090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
65101  Removal of eye                                    A   8.30  13.02NA  13.02    1.63  22.95 22.950090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
65103  Remove eye/insert implant                         A   8.84  13.37NA  13.37    1.74  23.95 23.950090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
65105  Remove eye/attach implant                         A   9.93  14.51NA  14.51    1.95  26.39 26.390090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
65110  Removal of eye                                    A  15.70  19.20NA  19.20    2.00  36.90 36.900090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
65112  Remove eye/revise socket                          A  18.51  21.90NA  21.90    2.35  42.76 42.760090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
65114  Remove eye/revise socket                          A  19.65  22.67NA  22.67    2.52  44.84 44.840090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
65125  Revise ocular implant                             A   3.27  10.30     5.20    0.64  14.21  9.110090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
65130  Insert ocular implant                             A   8.42  12.67NA  12.67    1.65  22.74 22.740090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
65135  Insert ocular implant                             A   8.60  12.80NA  12.80    1.67  23.07 23.070090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
65140  Attach ocular implant                             A   9.46  13.78NA  13.78    1.22  24.46 24.460090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
65150  Revise ocular implant                             A   6.43  10.27NA  10.27    0.45  17.15 17.150090.10.70.2021000             25.0008 090 99      0.00   0.00   0.00
65155  Reinsert ocular implant                           A  10.10  14.21NA  14.21    1.97  26.28 26.280090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
65175  Removal of ocular implant                         A   7.40  11.55NA  11.55    0.95  19.90 19.900090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
65205  Remove foreign body from eye                      A   0.71   0.89     0.53    0.10   1.70  1.340000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
65210  Remove foreign body from eye                      A   0.84   1.14     0.66    0.12   2.10  1.620000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
65220  Remove foreign body from eye                      A   0.71   0.93     0.45    0.11   1.75  1.270000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
65222  Remove foreign body from eye                      A   0.84   1.09     0.64    0.13   2.06  1.610000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
65235  Remove foreign body from eye                      A   9.01  11.37NA  11.37    1.24  21.62 21.620090.10.70.2021000             25.0008 090 99      0.00   0.00   0.00
65260  Remove foreign body from eye                      A  12.54  14.81NA  14.81    0.88  28.23 28.230090.10.70.2021200             25.0008 090 99      0.00   0.00   0.00
65265  Remove foreign body from eye                      A  14.34  16.42NA  16.42    3.08  33.84 33.840090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
65270  Repair of eye wound                               A   1.95   5.96     2.06    0.27   8.18  4.280010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
65272  Repair of eye wound                               A   4.62  10.09     5.40    0.33  15.04 10.350090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
65273  Repair of eye wound                               A   5.16   5.69NA   5.69    0.37  11.22 11.220090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
65275  Repair of eye wound                               A   6.29   9.97     6.45    0.86  17.12 13.600090.10.70.2021000             25.0008 090 99      0.00   0.00   0.00
65280  Repair of eye wound                               A   9.10  10.01NA  10.01    1.80  20.91 20.910090.10.70.2021000             25.0008 090 99      0.00   0.00   0.00
65285  Repair of eye wound                               A  15.36  16.13NA  16.13    2.71  34.20 34.200090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
65286  Repair of eye wound                               A   6.63  13.96     7.50    0.90  21.49 15.030090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
65290  Repair of eye socket wound                        A   6.53   7.45NA   7.45    1.28  15.26 15.260090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
65400  Removal of eye lesion                             A   7.50  12.16     9.81    1.03  20.69 18.340090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
65410  Biopsy of cornea                                  A   1.47   2.67     1.48    0.31   4.45  3.260000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
65420  Removal of eye lesion                             A   4.36  10.73     6.47    0.56  15.65 11.390090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
65426  Removal of eye lesion                             A   6.05  13.04     7.67    0.83  19.92 14.550090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
65430  Corneal smear                                     A   1.47   1.81     1.48    0.22   3.50  3.170000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
65435  Curette/treat cornea                              A   0.92   1.38     1.07    0.16   2.46  2.150000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
65436  Curette/treat cornea                              A   4.82   6.29     5.81    0.84  11.95 11.470090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
65450  Treatment of corneal lesion                       A   3.47   5.96     5.87    0.48   9.91  9.820090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
65600  Revision of cornea                                A   4.20   7.26     5.71    0.60  12.06 10.510090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
65710  Corneal transplant                                A  14.45  17.15NA  17.15    1.97  33.57 33.570090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
65730  Corneal transplant                                A  16.35  18.64NA  18.64    2.23  37.22 37.220090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
65750  Corneal transplant                                A  16.90  18.18NA  18.18    2.16  37.24 37.240090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
65755  Corneal transplant                                A  16.79  18.12NA  18.12    2.29  37.20 37.200090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
65756  Corneal trnspl endothelial                        A  16.84  16.73NA  16.73    1.20  34.77 34.770090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
65757  Prep corneal endo allograft                       C   0.00   0.00     0.00    0.00   0.00  0.000ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
65760  Revision of cornea                                N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
65765  Revision of cornea                                N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
65767  Corneal tissue transplant                         N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
65770  Revise cornea with implant                        A  19.74  20.19NA  20.19    7.08  47.01 47.010090.10.70.2021200             25.0008 090 99      0.00   0.00   0.00
65771  Radial keratotomy                                 N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
65772  Correction of astigmatism                         A   5.09   7.95     6.58    0.65  13.69 12.320090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
65775  Correction of astigmatism                         A   6.91   8.90NA   8.90    0.49  16.30 16.300090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
65778  Cover eye w/membrane                              A   1.19  41.78     0.79    0.18  43.15  2.160010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
65779  Cover eye w/membrane suture                       A   3.92  33.45     4.15    0.56  37.93  8.630010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
65780  Ocular reconst transplant                         A  10.73  14.84NA  14.84    1.39  26.96 26.960090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
65781  Ocular reconst transplant                         A  18.14  19.82NA  19.82    1.28  39.24 39.240090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
65782  Ocular reconst transplant                         A  15.43  17.37NA  17.37    3.06  35.86 35.860090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
65800  Drainage of eye                                   A   1.53   1.85     1.02    0.22   3.60  2.770000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
65810  Drainage of eye                                   A   5.82   7.51NA   7.51    0.84  14.17 14.170090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
65815  Drainage of eye                                   A   6.00  12.66     7.70    1.06  19.72 14.760090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
65820  Relieve inner eye pressure                        A   8.91  12.67NA  12.67    0.63  22.21 22.210090.10.70.2021000             25.0008 090 99      0.00   0.00   0.00
65850  Incision of eye                                   A  11.39  12.51NA  12.51    1.99  25.89 25.890090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
65855  Laser surgery of eye                              A   3.99   5.75     4.49    0.63  10.37  9.110010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
65860  Incise inner eye adhesions                        A   3.59   5.31     3.60    1.32  10.22  8.510090.10.70.2021000             25.0008 090 99      0.00   0.00   0.00
65865  Incise inner eye adhesions                        A   5.77   7.82NA   7.82    0.39  13.98 13.980090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
65870  Incise inner eye adhesions                        A   7.39   9.57NA   9.57    1.29  18.25 18.250090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
65875  Incise inner eye adhesions                        A   7.81  10.27NA  10.27    1.08  19.16 19.160090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
65880  Incise inner eye adhesions                        A   8.36  10.65NA  10.65    0.60  19.61 19.610090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
65900  Remove eye lesion                                 A  12.51  15.02NA  15.02    0.88  28.41 28.410090.10.70.2021200             25.0008 090 99      0.00   0.00   0.00
65920  Remove implant of eye                             A   9.99  12.59NA  12.59    1.29  23.87 23.870090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
65930  Remove blood clot from eye                        A   8.39   9.81NA   9.81    1.48  19.68 19.680090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
66020  Injection treatment of eye                        A   1.64   3.83     2.13    0.11   5.58  3.880010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
66030  Injection treatment of eye                        A   1.30   3.60     1.89    0.18   5.08  3.370010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
66130  Remove eye lesion                                 A   7.83  12.27     8.34    1.66  21.76 17.830090.10.70.2021000             25.0008 090 99      0.00   0.00   0.00
66150  Glaucoma surgery                                  A  10.53  14.68NA  14.68    0.73  25.94 25.940090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
66155  Glaucoma surgery                                  A  10.52  14.68NA  14.68    0.73  25.93 25.930090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
66160  Glaucoma surgery                                  A  12.39  15.93NA  15.93    0.87  29.19 29.190090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
66165  Glaucoma surgery                                  A  10.24  14.49NA  14.49    0.72  25.45 25.450090.10.70.2021200             25.0008 090 99      0.00   0.00   0.00
66170  Glaucoma surgery                                  A  15.02  19.40NA  19.40    1.92  36.34 36.340090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
66172  Incision of eye                                   A  18.86  24.60NA  24.60    2.41  45.87 45.870090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
66174  Translum dil eye canal                            A  12.85  14.13NA  14.13    2.27  29.25 29.250090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
66175  Trnslum dil eye canal w/stnt                      A  13.60  14.63NA  14.63    4.87  33.10 33.100090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
66180  Implant eye shunt                                 A  16.30  16.78NA  16.78    2.12  35.20 35.200090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
66185  Revise eye shunt                                  A   9.58  11.89NA  11.89    1.67  23.14 23.140090.10.70.2021200             25.0008 090 99      0.00   0.00   0.00
66220  Repair eye lesion                                 A   9.21  12.15NA  12.15    1.27  22.63 22.630090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
66225  Repair/graft eye lesion                           A  12.63  13.90NA  13.90    2.48  29.01 29.010090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
66250  Follow-up surgery of eye                          A   7.10  14.80     8.86    1.40  23.30 17.360090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
66500  Incision of iris                                  A   3.83   6.44NA   6.44    0.27  10.54 10.540090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
66505  Incision of iris                                  A   4.22   7.03NA   7.03    0.30  11.55 11.550090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
66600  Remove iris and lesion                            A  10.12  13.81NA  13.81    0.76  24.69 24.690090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
66605  Removal of iris                                   A  14.22  15.87NA  15.87    1.02  31.11 31.110090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
66625  Removal of iris                                   A   5.30   7.03NA   7.03    0.72  13.05 13.050090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
66630  Removal of iris                                   A   7.28   9.02NA   9.02    1.22  17.52 17.520090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
66635  Removal of iris                                   A   7.37   9.08NA   9.08    0.52  16.97 16.970090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
66680  Repair iris & ciliary body                        A   6.39   8.46NA   8.46    1.36  16.21 16.210090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
66682  Repair iris & ciliary body                        A   7.33  11.07NA  11.07    1.46  19.86 19.860090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
66700  Destruction ciliary body                          A   5.14   7.85     6.10    0.49  13.48 11.730090.10.70.2021000             25.0008 090 99      0.00   0.00   0.00
66710  Ciliary transsleral therapy                       A   5.14   7.54     6.10    1.02  13.70 12.260090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
66711  Ciliary endoscopic ablation                       A   7.93  10.50NA  10.50    0.56  18.99 18.990090.10.70.2031100       66710 25.0008 090 99      0.00   0.00   0.00
66720  Destruction ciliary body                          A   5.00   8.72     7.17    0.68  14.40 12.850090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
66740  Destruction ciliary body                          A   5.14   7.46     6.10    0.35  12.95 11.590090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
66761  Revision of iris                                  A   3.00   5.62     3.76    0.45   9.07  7.210010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
66762  Revision of iris                                  A   5.38   8.33     6.83    0.68  14.39 12.890090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
66770  Removal of inner eye lesion                       A   6.13   9.09     7.73    0.42  15.64 14.280090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
66820  Incision secondary cataract                       A   4.01   7.43NA   7.43    0.67  12.11 12.110090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
66821  After cataract laser surgery                      A   3.42   6.17     5.60    0.53  10.12  9.550090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
66825  Reposition intraocular lens                       A   9.01  12.87NA  12.87    1.17  23.05 23.050090.10.70.2021000             25.0008 090 99      0.00   0.00   0.00
66830  Removal of lens lesion                            A   9.47  10.85NA  10.85    0.67  20.99 20.990090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
66840  Removal of lens material                          A   9.18  10.71NA  10.71    1.81  21.70 21.700090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
66850  Removal of lens material                          A  10.55  12.06NA  12.06    1.46  24.07 24.070090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
66852  Removal of lens material                          A  11.41  12.64NA  12.64    2.00  26.05 26.050090.10.70.2021010             25.0008 090 99      0.00   0.00   0.00
66920  Extraction of lens                                A  10.13  11.36NA  11.36    0.71  22.20 22.200090.10.70.2021010             25.0008 090 99      0.00   0.00   0.00
66930  Extraction of lens                                A  11.61  12.79NA  12.79    0.82  25.22 25.220090.10.70.2021000             25.0008 090 99      0.00   0.00   0.00
66940  Extraction of lens                                A  10.37  11.93NA  11.93    1.74  24.04 24.040090.10.70.2021010             25.0008 090 99      0.00   0.00   0.00
66982  Cataract surgery complex                          A  11.08  11.51NA  11.51    1.72  24.31 24.310090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
66983  Cataract surg w/iol 1 stage                       A  10.43  10.92NA  10.92    0.83  22.18 22.180090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
66984  Cataract surg w/iol 1 stage                       A   8.52   9.74NA   9.74    1.34  19.60 19.600090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
66985  Insert lens prosthesis                            A   9.98  12.07NA  12.07    1.29  23.34 23.340090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
66986  Exchange lens prosthesis                          A  12.26  13.63NA  13.63    1.57  27.46 27.460090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
66990  Ophthalmic endoscope add-on                       A   1.51   1.01NA   1.01    0.10   2.62  2.620ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
66999  Eye surgery procedure                             C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021011             25.0008 090 99      0.00   0.00   0.00
67005  Partial removal of eye fluid                      A   5.89   7.66NA   7.66    1.25  14.80 14.800090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
67010  Partial removal of eye fluid                      A   7.06   8.44NA   8.44    0.98  16.48 16.480090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
67015  Release of eye fluid                              A   7.14   9.52NA   9.52    0.99  17.65 17.650090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
67025  Replace eye fluid                                 A   8.11  12.89    10.00    1.44  22.44 19.550090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
67027  Implant eye drug system                           A  11.62  12.62NA  12.62    2.03  26.27 26.270090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
67028  Injection eye drug                                A   1.44   1.44     1.39    0.20   3.08  3.030000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
67030  Incise inner eye strands                          A   6.11   9.26NA   9.26    0.42  15.79 15.790090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
67031  Laser surgery eye strands                         A   4.47   6.73     5.76    0.59  11.79 10.820090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67036  Removal of inner eye fluid                        A  13.32  13.92NA  13.92    1.82  29.06 29.060090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
67039  Laser treatment of retina                         A  16.74  18.38NA  18.38    2.97  38.09 38.090090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
67040  Laser treatment of retina                         A  19.61  20.72NA  20.72    2.69  43.02 43.020090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
67041  Vit for macular pucker                            A  19.25  18.20NA  18.20    2.64  40.09 40.090090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
67042  Vit for macular hole                              A  22.38  20.30NA  20.30    3.09  45.77 45.770090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
67043  Vit for membrane dissect                          A  23.24  21.72NA  21.72    4.10  49.06 49.060090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
67101  Repair detached retina                            A   8.80  13.84    10.46    1.55  24.19 20.810090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67105  Repair detached retina                            A   8.53  12.17     9.85    1.17  21.87 19.550090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67107  Repair detached retina                            A  16.71  17.84NA  17.84    2.95  37.50 37.500090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
67108  Repair detached retina                            A  22.89  22.57NA  22.57    3.14  48.60 48.600090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
67110  Repair detached retina                            A  10.25  14.77    11.87    1.31  26.33 23.430090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67112  Rerepair detached retina                          A  18.75  18.85NA  18.85    2.57  40.17 40.170090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
67113  Repair retinal detach cplx                        A  25.35  23.98NA  23.98    3.48  52.81 52.810090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
67115  Release encircling material                       A   6.11   8.24NA   8.24    0.78  15.13 15.130090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67120  Remove eye implant material                       A   7.10  11.97     8.90    1.40  20.47 17.400090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
67121  Remove eye implant material                       A  12.25  13.64NA  13.64    2.16  28.05 28.050090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
67141  Treatment of retina                               A   6.15   8.93     7.83    1.09  16.17 15.070090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67145  Treatment of retina                               A   6.32   8.83     7.95    0.86  16.01 15.130090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67208  Treatment of retinal lesion                       A   7.65   9.50     8.85    0.53  17.68 17.030090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67210  Treatment of retinal lesion                       A   6.36   8.51     7.97    0.94  15.81 15.270090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67218  Treatment of retinal lesion                       A  20.36  18.70NA  18.70    1.46  40.52 40.520090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67220  Treatment of choroid lesion                       A   6.36   9.01     7.97    1.13  16.50 15.460090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67221  Ocular photodynamic ther                          R   3.45   4.79     2.53    0.48   8.72  6.460000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
67225  Eye photodynamic ther add-on                      A   0.47   0.37     0.31    0.03   0.87  0.810ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
67227  Treatment of retinal lesion                       A   7.53   9.99     8.77    0.53  18.05 16.830090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67228  Treatment of retinal lesion                       A  13.82  14.58    12.96    2.10  30.50 28.880090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67229  Tr retinal les preterm inf                        A  16.30  16.80NA  16.80    1.17  34.27 34.270090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67250  Reinforce eye wall                                A   9.61  12.81NA  12.81    1.62  24.04 24.040090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
67255  Reinforce/graft eye wall                          A  10.17  14.04NA  14.04    1.99  26.20 26.200090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
67299  Eye surgery procedure                             C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021011             25.0008 090 99      0.00   0.00   0.00
67311  Revise eye muscle                                 A   7.77   9.33NA   9.33    1.31  18.41 18.410090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67312  Revise two eye muscles                            A   9.66  10.60NA  10.60    1.91  22.17 22.170090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
67314  Revise eye muscle                                 A   8.79  10.45NA  10.45    1.48  20.72 20.720090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67316  Revise two eye muscles                            A  10.93  11.88NA  11.88    2.15  24.96 24.960090.10.70.2021000             25.0008 090 99      0.00   0.00   0.00
67318  Revise eye muscle(s)                              A   9.12  10.99NA  10.99    0.64  20.75 20.750090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
67320  Revise eye muscle(s) add-on                       A   5.40   3.61NA   3.61    0.38   9.39  9.390ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
67331  Eye surgery follow-up add-on                      A   5.13   3.39NA   3.39    0.86   9.38  9.380ZZZ.00.00.0001110             25.0008 090 99      0.00   0.00   0.00
67332  Rerevise eye muscles add-on                       A   5.56   3.71NA   3.71    0.93  10.20 10.200ZZZ.00.00.0001110             25.0008 090 99      0.00   0.00   0.00
67334  Revise eye muscle w/suture                        A   5.05   3.38NA   3.38    0.35   8.78  8.780ZZZ.00.00.0001110             25.0008 090 99      0.00   0.00   0.00
67335  Eye suture during surgery                         A   2.49   1.66NA   1.66    0.41   4.56  4.560ZZZ.00.00.0001110             25.0008 090 99      0.00   0.00   0.00
67340  Revise eye muscle add-on                          A   6.00   4.01NA   4.01    0.42  10.43 10.430ZZZ.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
67343  Release eye tissue                                A   8.47  10.16NA  10.16    1.66  20.29 20.290090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
67345  Destroy nerve of eye muscle                       A   3.01   3.75     3.01    0.80   7.56  6.820010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
67346  Biopsy eye muscle                                 A   2.87   2.82NA   2.82    0.61   6.30  6.300000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
67399  Eye muscle surgery procedure                      C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021211             25.0008 090 99      0.00   0.00   0.00
67400  Explore/biopsy eye socket                         A  11.20  15.50NA  15.50    2.07  28.77 28.770090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
67405  Explore/drain eye socket                          A   9.20  13.54NA  13.54    1.18  23.92 23.920090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67412  Explore/treat eye socket                          A  10.30  14.11NA  14.11    1.86  26.27 26.270090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
67413  Explore/treat eye socket                          A  10.24  14.29NA  14.29    2.00  26.53 26.530090.10.70.2021200             25.0008 090 99      0.00   0.00   0.00
67414  Explr/decompress eye socket                       A  17.94  19.75NA  19.75    2.29  39.98 39.980090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
67415  Aspiration orbital contents                       A   1.76   1.15NA   1.15    0.24   3.15  3.150000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
67420  Explore/treat eye socket                          A  21.87  23.80NA  23.80    4.31  49.98 49.980090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
67430  Explore/treat eye socket                          A  15.29  20.50NA  20.50    1.09  36.88 36.880090.10.70.2021200             25.0008 090 99      0.00   0.00   0.00
67440  Explore/drain eye socket                          A  14.84  19.77NA  19.77    1.91  36.52 36.520090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
67445  Explr/decompress eye socket                       A  19.12  20.68NA  20.68    3.77  43.57 43.570090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
67450  Explore/biopsy eye socket                         A  15.41  20.58NA  20.58    1.97  37.96 37.960090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
67500  Inject/treat eye socket                           A   1.44   0.77     0.58    0.11   2.32  2.130000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
67505  Inject/treat eye socket                           A   1.27   1.25     1.02    0.26   2.78  2.550000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
67515  Inject/treat eye socket                           A   1.40   1.34     1.11    0.26   3.00  2.770000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
67550  Insert eye socket implant                         A  11.77  15.82NA  15.82    2.30  29.89 29.890090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
67560  Revise eye socket implant                         A  12.18  16.13NA  16.13    1.57  29.88 29.880090.10.70.2021000             25.0008 090 99      0.00   0.00   0.00
67570  Decompress optic nerve                            A  14.40  18.32NA  18.32    5.16  37.88 37.880090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
67599  Orbit surgery procedure                           C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021211             25.0008 090 99      0.00   0.00   0.00
67700  Drainage of eyelid abscess                        A   1.40   6.62     1.93    0.23   8.25  3.560010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
67710  Incision of eyelid                                A   1.07   5.66     1.75    0.22   6.95  3.040010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
67715  Incision of eyelid fold                           A   1.27   5.84     1.86    0.26   7.37  3.390010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
67800  Remove eyelid lesion                              A   1.41   2.26     1.54    0.24   3.91  3.190010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
67801  Remove eyelid lesions                             A   1.91   2.75     1.87    0.37   5.03  4.150010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
67805  Remove eyelid lesions                             A   2.27   3.55     2.41    0.44   6.26  5.120010.10.80.1020100             25.0008 090 99      0.00   0.00   0.00
67808  Remove eyelid lesion(s)                           A   4.60   5.96NA   5.96    0.90  11.46 11.460090.10.70.2020100             25.0008 090 99      0.00   0.00   0.00
67810  Biopsy eyelid & lid margin                        A   1.18   3.88     0.77    0.18   5.24  2.130000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
67820  Revise eyelashes                                  A   0.71   0.72     0.83    0.11   1.54  1.650000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
67825  Revise eyelashes                                  A   1.43   2.28     2.07    0.27   3.98  3.770010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
67830  Revise eyelashes                                  A   1.75   6.17     2.20    0.34   8.26  4.290010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
67835  Revise eyelashes                                  A   5.70   6.85NA   6.85    1.13  13.68 13.680090.10.70.2021000             25.0008 090 99      0.00   0.00   0.00
67840  Remove eyelid lesion                              A   2.09   6.04     2.43    0.34   8.47  4.860010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
67850  Treat eyelid lesion                               A   1.74   4.54     2.11    0.24   6.52  4.090010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
67875  Closure of eyelid by suture                       A   1.35   3.70     1.41    0.24   5.29  3.000000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
67880  Revision of eyelid                                A   4.60   8.74     5.97    0.82  14.16 11.390090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67882  Revision of eyelid                                A   6.02  10.32     7.50    1.18  17.52 14.700090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67900  Repair brow defect                                A   6.82  11.66     7.63    1.22  19.70 15.670090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67901  Repair eyelid defect                              A   7.59  14.38     8.84    1.50  23.47 17.930090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67902  Repair eyelid defect                              A   9.82  10.69NA  10.69    1.93  22.44 22.440090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
67903  Repair eyelid defect                              A   6.51  10.62     7.25    1.27  18.40 15.030090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
67904  Repair eyelid defect                              A   7.97  13.17     9.03    1.52  22.66 18.520090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
67906  Repair eyelid defect                              A   6.93   7.54NA   7.54    0.49  14.96 14.960090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67908  Repair eyelid defect                              A   5.30   8.99     6.87    1.05  15.34 13.220090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67909  Revise eyelid defect                              A   5.57   9.94     6.95    1.10  16.61 13.620090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67911  Revise eyelid defect                              A   7.50   8.51NA   8.51    1.40  17.41 17.410090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67912  Correction eyelid w/implant                       A   6.36  19.75     7.58    0.93  27.04 14.870090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67914  Repair eyelid defect                              A   3.75   7.54     4.47    0.68  11.97  8.900090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67915  Repair eyelid defect                              A   3.26   7.02     4.15    0.45  10.73  7.860090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67916  Repair eyelid defect                              A   5.48  10.15     6.87    0.95  16.58 13.300090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67917  Repair eyelid defect                              A   6.19  10.77     7.36    1.16  18.12 14.710090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67921  Repair eyelid defect                              A   3.47   7.36     4.29    0.68  11.51  8.440090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67922  Repair eyelid defect                              A   3.14   6.90     4.07    0.42  10.46  7.630090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67923  Repair eyelid defect                              A   6.05  10.39     7.27    1.13  17.57 14.450090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67924  Repair eyelid defect                              A   5.93  11.09     6.86    1.13  18.15 13.920090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67930  Repair eyelid wound                               A   3.65   6.94     3.12    0.71  11.30  7.480010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
67935  Repair eyelid wound                               A   6.36  10.77     6.09    1.25  18.38 13.700090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67938  Remove eyelid foreign body                        A   1.38   5.85     1.95    0.22   7.45  3.550010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
67950  Revision of eyelid                                A   5.99  10.56     7.21    1.10  17.65 14.300090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
67961  Revision of eyelid                                A   5.86  10.82     7.13    1.10  17.78 14.090090.10.70.2021000             25.0008 090 99      0.00   0.00   0.00
67966  Revision of eyelid                                A   8.97  13.10     9.70    1.70  23.77 20.370090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67971  Reconstruction of eyelid                          A  10.01  10.52NA  10.52    1.96  22.49 22.490090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
67973  Reconstruction of eyelid                          A  13.13  13.23NA  13.23    2.59  28.95 28.950090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
67974  Reconstruction of eyelid                          A  13.10  13.22NA  13.22    2.59  28.91 28.910090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
67975  Reconstruction of eyelid                          A   9.35  10.10NA  10.10    1.84  21.29 21.290090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
67999  Revision of eyelid                                C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021011             25.0008 090 99      0.00   0.00   0.00
68020  Incise/drain eyelid lining                        A   1.42   2.03     1.76    0.20   3.65  3.380010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
68040  Treatment of eyelid lesions                       A   0.85   0.99     0.62    0.16   2.00  1.630000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
68100  Biopsy of eyelid lining                           A   1.35   3.65     1.45    0.20   5.20  3.000000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
68110  Remove eyelid lining lesion                       A   1.82   4.82     2.46    0.35   6.99  4.630010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
68115  Remove eyelid lining lesion                       A   2.41   6.78     2.85    0.31   9.50  5.570010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
68130  Remove eyelid lining lesion                       A   5.10  10.63     6.74    0.35  16.08 12.190090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
68135  Remove eyelid lining lesion                       A   1.89   2.61     2.44    0.26   4.76  4.590010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
68200  Treat eyelid by injection                         A   0.49   0.69     0.50    0.08   1.26  1.070000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
68320  Revise/graft eyelid lining                        A   6.64  14.55     8.84    1.29  22.48 16.770090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
68325  Revise/graft eyelid lining                        A   8.63  10.15NA  10.15    1.69  20.47 20.470090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
68326  Revise/graft eyelid lining                        A   8.42  10.02NA  10.02    1.65  20.09 20.090090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
68328  Revise/graft eyelid lining                        A   9.45  10.71NA  10.71    1.86  22.02 22.020090.10.70.2021000             25.0008 090 99      0.00   0.00   0.00
68330  Revise eyelid lining                              A   5.78  11.85     7.44    1.14  18.77 14.360090.10.70.2021000             25.0008 090 99      0.00   0.00   0.00
68335  Revise/graft eyelid lining                        A   8.46  10.05NA  10.05    1.66  20.17 20.170090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
68340  Separate eyelid adhesions                         A   4.97  10.97     6.49    0.99  16.93 12.450090.10.70.2021000             25.0008 090 99      0.00   0.00   0.00
68360  Revise eyelid lining                              A   5.17  10.31     6.63    1.02  16.50 12.820090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
68362  Revise eyelid lining                              A   8.61  10.15NA  10.15    1.69  20.45 20.450090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
68371  Harvest eye tissue alograft                       A   5.09   6.78NA   6.78    0.35  12.22 12.220010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
68399  Eyelid lining surgery                             C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021011             25.0008 090 99      0.00   0.00   0.00
68400  Incise/drain tear gland                           A   1.74   6.75     2.03    0.34   8.83  4.110010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
68420  Incise/drain tear sac                             A   2.35   7.14     2.43    0.30   9.79  5.080010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
68440  Incise tear duct opening                          A   0.99   1.99     1.90    0.20   3.18  3.090010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
68500  Removal of tear gland                             A  12.77  15.09NA  15.09    2.99  30.85 30.850090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
68505  Partial removal tear gland                        A  12.69  15.04NA  15.04    2.48  30.21 30.210090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
68510  Biopsy of tear gland                              A   4.60   8.38     3.65    0.90  13.88  9.150000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
68520  Removal of tear sac                               A   8.78  10.88NA  10.88    1.14  20.80 20.800090.10.70.2021000             25.0008 090 99      0.00   0.00   0.00
68525  Biopsy of tear sac                                A   4.42   2.93NA   2.93    0.86   8.21  8.210000.00.00.0021110             25.0008 090 99      0.00   0.00   0.00
68530  Clearance of tear duct                            A   3.70   8.81     3.57    0.72  13.23  7.990010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
68540  Remove tear gland lesion                          A  12.18  14.36NA  14.36    1.57  28.11 28.110090.10.70.2021110             25.0008 090 99      0.00   0.00   0.00
68550  Remove tear gland lesion                          A  15.16  17.32NA  17.32    1.93  34.41 34.410090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
68700  Repair tear ducts                                 A   7.87   9.38NA   9.38    1.54  18.79 18.790090.10.70.2021100             25.0008 090 99      0.00   0.00   0.00
68705  Revise tear duct opening                          A   2.11   4.81     2.65    0.41   7.33  5.170010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
68720  Create tear sac drain                             A   9.96  11.59NA  11.59    1.66  23.21 23.210090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
68745  Create tear duct drain                            A   9.90  11.82NA  11.82    1.95  23.67 23.670090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
68750  Create tear duct drain                            A  10.10  12.36NA  12.36    1.97  24.43 24.430090.10.70.2021210             25.0008 090 99      0.00   0.00   0.00
68760  Close tear duct opening                           A   1.78   4.12     2.42    0.34   6.24  4.540010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
68761  Close tear duct opening                           A   1.41   2.92     2.04    0.22   4.55  3.670010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
68770  Close tear system fistula                         A   8.29   9.67NA   9.67    1.62  19.58 19.580090.10.70.2021000             25.0008 090 99      0.00   0.00   0.00
68801  Dilate tear duct opening                          A   1.00   2.68     2.16    0.16   3.84  3.320010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
68810  Probe nasolacrimal duct                           A   2.15   4.95     3.27    0.39   7.49  5.810010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
68811  Probe nasolacrimal duct                           A   2.45   3.49NA   3.49    0.48   6.42  6.420010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
68815  Probe nasolacrimal duct                           A   3.30   9.98     4.06    0.59  13.87  7.950010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
68816  Probe nl duct w/balloon                           A   3.06  19.39     4.14    0.60  23.05  7.800010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
68840  Explore/irrigate tear ducts                       A   1.30   2.43     2.09    0.24   3.97  3.630010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
68850  Injection for tear sac x-ray                      A   0.80   0.89     0.74    0.07   1.76  1.610000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
68899  Tear duct system surgery                          C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021011             25.0008 090 99      0.00   0.00   0.00
69000  Drain external ear lesion                         A   1.50   4.06     1.92    0.22   5.78  3.640010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
69005  Drain external ear lesion                         A   2.16   4.11     2.29    0.29   6.56  4.740010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
69020  Drain outer ear canal lesion                      A   1.53   5.49     2.62    0.20   7.22  4.350010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
69090  Pierce earlobes                                   N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
69100  Biopsy of external ear                            A   0.81   2.13     0.53    0.11   3.05  1.450000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
69105  Biopsy of external ear canal                      A   0.85   3.41     0.96    0.10   4.36  1.910000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
69110  Remove external ear partial                       A   3.53  10.05     5.82    0.53  14.11  9.880090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69120  Removal of external ear                           A   4.14   7.75NA   7.75    0.60  12.49 12.490090.07.79.1420100             25.0008 090 99      0.00   0.00   0.00
69140  Remove ear canal lesion(s)                        A   8.14  17.61NA  17.61    1.05  26.80 26.800090.07.79.1421000             25.0008 090 99      0.00   0.00   0.00
69145  Remove ear canal lesion(s)                        A   2.70   9.29     4.58    0.35  12.34  7.630090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69150  Extensive ear canal surgery                       A  13.61  15.92NA  15.92    1.95  31.48 31.480090.07.79.1420110             25.0008 090 99      0.00   0.00   0.00
69155  Extensive ear/neck surgery                        A  23.35  23.77NA  23.77    3.01  50.13 50.130090.07.79.1420210             25.0008 090 99      0.00   0.00   0.00
69200  Clear outer ear canal                             A   0.77   2.93     0.88    0.10   3.80  1.750000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
69205  Clear outer ear canal                             A   1.21   1.70NA   1.70    0.16   3.07  3.070010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
69210  Remove impacted ear wax                           A   0.61   0.88     0.28    0.07   1.56  0.960000.00.00.0022100             25.0008 090 99      0.00   0.00   0.00
69220  Clean out mastoid cavity                          A   0.83   3.35     0.94    0.10   4.28  1.870000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
69222  Clean out mastoid cavity                          A   1.45   5.20     2.55    0.18   6.83  4.180010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
69300  Revise external ear                               R   6.69  14.92     6.74    0.86  22.47 14.290YYY.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
69310  Rebuild outer ear canal                           A  10.97  20.90NA  20.90    1.44  33.31 33.310090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69320  Rebuild outer ear canal                           A  17.18  26.99NA  26.99    2.20  46.37 46.370090.07.79.1421200             25.0008 090 99      0.00   0.00   0.00
69399  Outer ear surgery procedure                       C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0020011             25.0008 090 99      0.00   0.00   0.00
69400  Inflate middle ear canal                          A   0.83   3.70     0.94    0.10   4.63  1.870000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
69401  Inflate middle ear canal                          A   0.63   2.04     0.81    0.07   2.74  1.510000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
69405  Catheterize middle ear canal                      A   2.68   4.97     2.76    0.34   7.99  5.780010.10.80.1021000             25.0008 090 99      0.00   0.00   0.00
69420  Incision of eardrum                               A   1.38   4.37     2.12    0.18   5.93  3.680010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
69421  Incision of eardrum                               A   1.78   2.51NA   2.51    0.23   4.52  4.520010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
69424  Remove ventilating tube                           A   0.85   3.02     0.92    0.10   3.97  1.870000.00.00.0021100             25.0008 090 99      0.00   0.00   0.00
69433  Create eardrum opening                            A   1.57   4.48     2.25    0.22   6.27  4.040010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
69436  Create eardrum opening                            A   2.01   2.59NA   2.59    0.26   4.86  4.860010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
69440  Exploration of middle ear                         A   7.71  12.38NA  12.38    0.99  21.08 21.080090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69450  Eardrum revision                                  A   5.69  10.28NA  10.28    0.72  16.69 16.690090.07.79.1421000             25.0008 090 99      0.00   0.00   0.00
69501  Mastoidectomy                                     A   9.21  11.81NA  11.81    1.18  22.20 22.200090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69502  Mastoidectomy                                     A  12.56  15.19NA  15.19    1.69  29.44 29.440090.07.79.1421000             25.0008 090 99      0.00   0.00   0.00
69505  Remove mastoid structures                         A  13.17  21.73NA  21.73    1.70  36.60 36.600090.07.79.1421000             25.0008 090 99      0.00   0.00   0.00
69511  Extensive mastoid surgery                         A  13.70  21.99NA  21.99    1.77  37.46 37.460090.07.79.1421000             25.0008 090 99      0.00   0.00   0.00
69530  Extensive mastoid surgery                         A  20.38  26.95NA  26.95    2.61  49.94 49.940090.07.79.1421200             25.0008 090 99      0.00   0.00   0.00
69535  Remove part of temporal bone                      A  37.42  37.63NA  37.63    5.23  80.28 80.280090.07.79.1421110             25.0008 090 99      0.00   0.00   0.00
69540  Remove ear lesion                                 A   1.25   5.09     2.49    0.16   6.50  3.900010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
69550  Remove ear lesion                                 A  11.15  19.10NA  19.10    1.44  31.69 31.690090.07.79.1421200             25.0008 090 99      0.00   0.00   0.00
69552  Remove ear lesion                                 A  19.81  25.02NA  25.02    2.55  47.38 47.380090.07.79.1421200             25.0008 090 99      0.00   0.00   0.00
69554  Remove ear lesion                                 A  35.97  34.98NA  34.98    4.61  75.56 75.560090.07.79.1421210             25.0008 090 99      0.00   0.00   0.00
69601  Mastoid surgery revision                          A  13.45  16.53NA  16.53    1.71  31.69 31.690090.07.79.1421000             25.0008 090 99      0.00   0.00   0.00
69602  Mastoid surgery revision                          A  13.76  17.48NA  17.48    1.77  33.01 33.010090.07.79.1421000             25.0008 090 99      0.00   0.00   0.00
69603  Mastoid surgery revision                          A  14.20  22.24NA  22.24    1.82  38.26 38.260090.07.79.1421000             25.0008 090 99      0.00   0.00   0.00
69604  Mastoid surgery revision                          A  14.20  17.70NA  17.70    1.82  33.72 33.720090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69605  Mastoid surgery revision                          A  18.69  26.11NA  26.11    2.40  47.20 47.200090.07.79.1421200             25.0008 090 99      0.00   0.00   0.00
69610  Repair of eardrum                                 A   4.47   6.61     3.66    0.59  11.67  8.720010.10.80.1021100             25.0008 090 99      0.00   0.00   0.00
69620  Repair of eardrum                                 A   6.03  14.49     8.00    0.76  21.28 14.790090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69631  Repair eardrum structures                         A  10.05  15.66NA  15.66    1.29  27.00 27.000090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69632  Rebuild eardrum structures                        A  12.96  18.16NA  18.16    1.66  32.78 32.780090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69633  Rebuild eardrum structures                        A  12.31  17.83NA  17.83    1.59  31.73 31.730090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69635  Repair eardrum structures                         A  13.51  22.10NA  22.10    1.74  37.35 37.350090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69636  Rebuild eardrum structures                        A  15.43  24.50NA  24.50    1.97  41.90 41.900090.07.79.1421000             25.0008 090 99      0.00   0.00   0.00
69637  Rebuild eardrum structures                        A  15.32  24.68NA  24.68    2.00  42.00 42.000090.07.79.1421000             25.0008 090 99      0.00   0.00   0.00
69641  Revise middle ear & mastoid                       A  12.89  17.05NA  17.05    1.67  31.61 31.610090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69642  Revise middle ear & mastoid                       A  17.06  21.29NA  21.29    2.19  40.54 40.540090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69643  Revise middle ear & mastoid                       A  15.59  19.48NA  19.48    2.00  37.07 37.070090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69644  Revise middle ear & mastoid                       A  17.23  25.39NA  25.39    2.22  44.84 44.840090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69645  Revise middle ear & mastoid                       A  16.71  25.09NA  25.09    2.18  43.98 43.980090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69646  Revise middle ear & mastoid                       A  18.37  25.95NA  25.95    2.35  46.67 46.670090.07.79.1421000             25.0008 090 99      0.00   0.00   0.00
69650  Release middle ear bone                           A   9.80  13.38NA  13.38    1.25  24.43 24.430090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69660  Revise middle ear bone                            A  12.03  14.47NA  14.47    1.55  28.05 28.050090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69661  Revise middle ear bone                            A  15.92  18.61NA  18.61    2.00  36.53 36.530090.07.79.1421000             25.0008 090 99      0.00   0.00   0.00
69662  Revise middle ear bone                            A  15.60  17.37NA  17.37    2.00  34.97 34.970090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69666  Repair middle ear structures                      A   9.89  13.38NA  13.38    1.28  24.55 24.550090.07.79.1421000             25.0008 090 99      0.00   0.00   0.00
69667  Repair middle ear structures                      A   9.90  13.40NA  13.40    1.28  24.58 24.580090.07.79.1421000             25.0008 090 99      0.00   0.00   0.00
69670  Remove mastoid air cells                          A  11.73  15.41NA  15.41    1.51  28.65 28.650090.07.79.1421200             25.0008 090 99      0.00   0.00   0.00
69676  Remove middle ear nerve                           A   9.69  14.40NA  14.40    1.24  25.33 25.330090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69700  Close mastoid fistula                             A   8.37  11.39NA  11.39    1.08  20.84 20.840090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69710  Implant/replace hearing aid                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
69711  Remove/repair hearing aid                         A  10.62  14.22NA  14.22    1.36  26.20 26.200090.07.79.1421200             25.0008 090 99      0.00   0.00   0.00
69714  Implant temple bone w/stimul                      A  14.45  16.22NA  16.22    1.86  32.53 32.530090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69715  Temple bne implnt w/stimulat                      A  18.96  18.59NA  18.59    2.42  39.97 39.970090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69717  Temple bone implant revision                      A  15.43  16.67NA  16.67    1.97  34.07 34.070090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69718  Revise temple bone implant                        A  19.21  18.71NA  18.71    2.45  40.37 40.370090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69720  Release facial nerve                              A  14.71  19.54NA  19.54    1.89  36.14 36.140090.07.79.1421010             25.0008 090 99      0.00   0.00   0.00
69725  Release facial nerve                              A  27.64  25.27NA  25.27    3.55  56.46 56.460090.07.79.1421200             25.0008 090 99      0.00   0.00   0.00
69740  Repair facial nerve                               A  16.27  16.82NA  16.82    2.08  35.17 35.170090.07.79.1421200             25.0008 090 99      0.00   0.00   0.00
69745  Repair facial nerve                               A  17.02  18.27NA  18.27    2.18  37.47 37.470090.07.79.1421200             25.0008 090 99      0.00   0.00   0.00
69799  Middle ear surgery procedure                      C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021011             25.0008 090 99      0.00   0.00   0.00
69801  Incise inner ear                                  A   2.06   3.65     1.42    0.27   5.98  3.750000.00.00.0021000             25.0008 090 99      0.00   0.00   0.00
69805  Explore inner ear                                 A  14.71  15.17NA  15.17    1.89  31.77 31.770090.07.79.1421200             25.0008 090 99      0.00   0.00   0.00
69806  Explore inner ear                                 A  12.63  14.27NA  14.27    1.63  28.53 28.530090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69820  Establish inner ear window                        A  10.52  14.17NA  14.17    1.36  26.05 26.050090.07.79.1421200             25.0008 090 99      0.00   0.00   0.00
69840  Revise inner ear window                           A  10.44  14.11NA  14.11    0.73  25.28 25.280090.07.79.1421200             25.0008 090 99      0.00   0.00   0.00
69905  Remove inner ear                                  A  11.26  15.18NA  15.18    1.46  27.90 27.900090.07.79.1421100             25.0008 090 99      0.00   0.00   0.00
69910  Remove inner ear & mastoid                        A  13.91  15.00NA  15.00    1.80  30.71 30.710090.07.79.1421000             25.0008 090 99      0.00   0.00   0.00
69915  Incise inner ear nerve                            A  22.77  20.48NA  20.48    2.97  46.22 46.220090.07.79.1421210             25.0008 090 99      0.00   0.00   0.00
69930  Implant cochlear device                           A  17.73  16.80NA  16.80    2.27  36.80 36.800090.07.79.1421000             25.0008 090 99      0.00   0.00   0.00
69949  Inner ear surgery procedure                       C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021011             25.0008 090 99      0.00   0.00   0.00
69950  Incise inner ear nerve                            A  27.63  22.13NA  22.13    3.55  53.31 53.310090.07.79.1421210             25.0008 090 99      0.00   0.00   0.00
69955  Release facial nerve                              A  29.42  26.17NA  26.17    3.78  59.37 59.370090.07.79.1421210             25.0008 090 99      0.00   0.00   0.00
69960  Release inner ear canal                           A  29.42  24.44NA  24.44    3.78  57.64 57.640090.07.79.1421210             25.0008 090 99      0.00   0.00   0.00
69970  Remove inner ear lesion                           A  32.41  27.63NA  27.63    4.16  64.20 64.200090.07.79.1421210             25.0008 090 99      0.00   0.00   0.00
69979  Temporal bone surgery                             C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0021011             25.0008 090 99      0.00   0.00   0.00
69990  Microsurgery add-on                               R   3.46   1.75NA   1.75    1.16   6.37  6.370ZZZ.00.00.0000200             25.0008 090 99      0.00   0.00   0.00
70010  Contrast x-ray of brain                           A   1.19   0.44NA   0.44    0.22   1.85  1.850XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70015  Contrast x-ray of brain                           A   1.19   3.40     3.40NA  0.08   4.67  4.671XXX.00.00.0000000             25.0008 090 99     20.69  20.69   0.14
70015TCContrast x-ray of brain                           A   0.00   2.94     2.94NA  0.01   2.95  2.951XXX.00.00.0000000             25.0008 030 99     20.23  20.23   0.07
7001526Contrast x-ray of brain                           A   1.19   0.46     0.46    0.07   1.72  1.721XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70030  X-ray eye for foreign body                        A   0.17   0.69     0.69NA  0.02   0.88  0.881XXX.00.00.0003000             25.0008 090 99      1.87   1.87   0.04
70030TCX-ray eye for foreign body                        A   0.00   0.63     0.63NA  0.01   0.64  0.641XXX.00.00.0003000             25.0008 010 99      1.81   1.81   0.03
7003026X-ray eye for foreign body                        A   0.17   0.06     0.06    0.01   0.24  0.241XXX.00.00.0003000             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
70100  X-ray exam of jaw <4views                         A   0.18   0.85     0.85NA  0.02   1.05  1.051XXX.00.00.0000000             25.0008 090 99      1.88   1.88   0.03
70100TCX-ray exam of jaw <4views                         A   0.00   0.78     0.78NA  0.01   0.79  0.791XXX.00.00.0000000             25.0008 010 99      1.81   1.81   0.02
7010026X-ray exam of jaw <4views                         A   0.18   0.07     0.07    0.01   0.26  0.261XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70110  X-ray exam of jaw 4/> views                       A   0.25   0.93     0.93NA  0.02   1.20  1.201XXX.00.00.0000000             25.0008 090 99      2.90   2.90   0.04
70110TCX-ray exam of jaw 4/> views                       A   0.00   0.83     0.83NA  0.01   0.84  0.841XXX.00.00.0000000             25.0008 010 99      2.80   2.80   0.03
7011026X-ray exam of jaw 4/> views                       A   0.25   0.10     0.10    0.01   0.36  0.361XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70120  X-ray exam of mastoids                            A   0.18   0.90     0.90NA  0.02   1.10  1.101XXX.00.00.0003000             25.0008 090 99      2.87   2.87   0.04
70120TCX-ray exam of mastoids                            A   0.00   0.83     0.83NA  0.01   0.84  0.841XXX.00.00.0003000             25.0008 010 99      2.80   2.80   0.03
7012026X-ray exam of mastoids                            A   0.18   0.07     0.07    0.01   0.26  0.261XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
70130  X-ray exam of mastoids                            A   0.34   1.43     1.43NA  0.02   1.79  1.791XXX.00.00.0003000             25.0008 090 99      1.96   1.96   0.02
70130TCX-ray exam of mastoids                            A   0.00   1.29     1.29NA  0.01   1.30  1.301XXX.00.00.0003000             25.0008 010 99      1.82   1.82   0.01
7013026X-ray exam of mastoids                            A   0.34   0.14     0.14    0.01   0.49  0.491XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
70134  X-ray exam of middle ear                          A   0.34   1.04     1.04NA  0.02   1.40  1.401XXX.00.00.0000000             25.0008 090 99      2.93   2.93   0.04
70134TCX-ray exam of middle ear                          A   0.00   0.91     0.91NA  0.01   0.92  0.921XXX.00.00.0000000             25.0008 010 99      2.80   2.80   0.03
7013426X-ray exam of middle ear                          A   0.34   0.13     0.13    0.01   0.48  0.481XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70140  X-ray exam of facial bones                        A   0.19   0.70     0.70NA  0.02   0.91  0.911XXX.00.00.0000000             25.0008 090 99      1.90   1.90   0.04
70140TCX-ray exam of facial bones                        A   0.00   0.61     0.61NA  0.01   0.62  0.621XXX.00.00.0000000             25.0008 010 99      1.81   1.81   0.03
7014026X-ray exam of facial bones                        A   0.19   0.09     0.09    0.01   0.29  0.291XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70150  X-ray exam of facial bones                        A   0.26   1.02     1.02NA  0.02   1.30  1.301XXX.00.00.0000000             25.0008 090 99      2.91   2.91   0.04
70150TCX-ray exam of facial bones                        A   0.00   0.91     0.91NA  0.01   0.92  0.921XXX.00.00.0000000             25.0008 010 99      2.80   2.80   0.03
7015026X-ray exam of facial bones                        A   0.26   0.11     0.11    0.01   0.38  0.381XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70160  X-ray exam of nasal bones                         A   0.17   0.83     0.83NA  0.02   1.02  1.021XXX.00.00.0000000             25.0008 090 99      1.88   1.88   0.03
70160TCX-ray exam of nasal bones                         A   0.00   0.76     0.76NA  0.01   0.77  0.771XXX.00.00.0000000             25.0008 010 99      1.81   1.81   0.02
7016026X-ray exam of nasal bones                         A   0.17   0.07     0.07    0.01   0.25  0.251XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70170  X-ray exam of tear duct                           C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99     10.32  10.32   0.04
70170TCX-ray exam of tear duct                           C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99     10.21  10.21   0.01
7017026X-ray exam of tear duct                           A   0.30   0.11     0.11    0.03   0.44  0.441XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70190  X-ray exam of eye sockets                         A   0.21   0.87     0.87NA  0.02   1.10  1.101XXX.00.00.0003000             25.0008 090 99      1.90   1.90   0.03
70190TCX-ray exam of eye sockets                         A   0.00   0.78     0.78NA  0.01   0.79  0.791XXX.00.00.0003000             25.0008 010 99      1.81   1.81   0.02
7019026X-ray exam of eye sockets                         A   0.21   0.09     0.09    0.01   0.31  0.311XXX.00.00.0003000             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
70200  X-ray exam of eye sockets                         A   0.28   1.03     1.03NA  0.02   1.33  1.331XXX.00.00.0000000             25.0008 090 99      2.91   2.91   0.04
70200TCX-ray exam of eye sockets                         A   0.00   0.92     0.92NA  0.01   0.93  0.931XXX.00.00.0000000             25.0008 010 99      2.80   2.80   0.03
7020026X-ray exam of eye sockets                         A   0.28   0.11     0.11    0.01   0.40  0.401XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70210  X-ray exam of sinuses                             A   0.17   0.75     0.75NA  0.02   0.94  0.941XXX.00.00.0000000             25.0008 090 99      1.88   1.88   0.04
70210TCX-ray exam of sinuses                             A   0.00   0.68     0.68NA  0.01   0.69  0.691XXX.00.00.0000000             25.0008 010 99      1.81   1.81   0.03
7021026X-ray exam of sinuses                             A   0.17   0.07     0.07    0.01   0.25  0.251XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70220  X-ray exam of sinuses                             A   0.25   0.91     0.91NA  0.02   1.18  1.181XXX.00.00.0000000             25.0008 090 99      2.90   2.90   0.04
70220TCX-ray exam of sinuses                             A   0.00   0.81     0.81NA  0.01   0.82  0.821XXX.00.00.0000000             25.0008 010 99      2.80   2.80   0.03
7022026X-ray exam of sinuses                             A   0.25   0.10     0.10    0.01   0.36  0.361XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70240  X-ray exam pituitary saddle                       A   0.19   0.70     0.70NA  0.02   0.91  0.911XXX.00.00.0000000             25.0008 090 99      1.89   1.89   0.04
70240TCX-ray exam pituitary saddle                       A   0.00   0.62     0.62NA  0.01   0.63  0.631XXX.00.00.0000000             25.0008 010 99      1.81   1.81   0.03
7024026X-ray exam pituitary saddle                       A   0.19   0.08     0.08    0.01   0.28  0.281XXX.00.00.0000000             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
70250  X-ray exam of skull                               A   0.24   0.87     0.87NA  0.02   1.13  1.131XXX.00.00.0000000             25.0008 090 99      1.92   1.92   0.03
70250TCX-ray exam of skull                               A   0.00   0.76     0.76NA  0.01   0.77  0.771XXX.00.00.0000000             25.0008 010 99      1.81   1.81   0.02
7025026X-ray exam of skull                               A   0.24   0.11     0.11    0.01   0.36  0.361XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70260  X-ray exam of skull                               A   0.34   1.07     1.07NA  0.02   1.43  1.431XXX.00.00.0000000             25.0008 090 99      2.94   2.94   0.04
70260TCX-ray exam of skull                               A   0.00   0.93     0.93NA  0.01   0.94  0.941XXX.00.00.0000000             25.0008 010 99      2.80   2.80   0.03
7026026X-ray exam of skull                               A   0.34   0.14     0.14    0.01   0.49  0.491XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70300  X-ray exam of teeth                               A   0.10   0.33     0.33NA  0.02   0.45  0.451XXX.00.00.0000000             25.0008 090 99      1.44   1.44   0.06
70300TCX-ray exam of teeth                               A   0.00   0.27     0.27NA  0.01   0.28  0.281XXX.00.00.0000000             25.0008 010 99      1.38   1.38   0.05
7030026X-ray exam of teeth                               A   0.10   0.06     0.06    0.01   0.17  0.171XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70310  X-ray exam of teeth                               A   0.16   0.99     0.99NA  0.02   1.17  1.171XXX.00.00.0000000             25.0008 090 99      1.48   1.48   0.03
70310TCX-ray exam of teeth                               A   0.00   0.93     0.93NA  0.01   0.94  0.941XXX.00.00.0000000             25.0008 010 99      1.42   1.42   0.02
7031026X-ray exam of teeth                               A   0.16   0.06     0.06    0.01   0.23  0.231XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70320  Full mouth x-ray of teeth                         A   0.22   1.40     1.40NA  0.02   1.64  1.641XXX.00.00.0000000             25.0008 090 99      1.53   1.53   0.02
70320TCFull mouth x-ray of teeth                         A   0.00   1.29     1.29NA  0.01   1.30  1.301XXX.00.00.0000000             25.0008 010 99      1.42   1.42   0.01
7032026Full mouth x-ray of teeth                         A   0.22   0.11     0.11    0.01   0.34  0.341XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70328  X-ray exam of jaw joint                           A   0.18   0.77     0.77NA  0.02   0.97  0.971XXX.00.00.0000000             25.0008 090 99      1.89   1.89   0.04
70328TCX-ray exam of jaw joint                           A   0.00   0.69     0.69NA  0.01   0.70  0.701XXX.00.00.0000000             25.0008 010 99      1.81   1.81   0.03
7032826X-ray exam of jaw joint                           A   0.18   0.08     0.08    0.01   0.27  0.271XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70330  X-ray exam of jaw joints                          A   0.24   1.21     1.21NA  0.02   1.47  1.471XXX.00.00.0002000             25.0008 090 99      1.93   1.93   0.03
70330TCX-ray exam of jaw joints                          A   0.00   1.10     1.10NA  0.01   1.11  1.111XXX.00.00.0002000             25.0008 010 99      1.82   1.82   0.02
7033026X-ray exam of jaw joints                          A   0.24   0.11     0.11    0.01   0.36  0.361XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
70332  X-ray exam of jaw joint                           A   0.54   1.58     1.58NA  0.04   2.16  2.161XXX.00.00.0003000             25.0008 090 99     12.06  12.06   0.12
70332TCX-ray exam of jaw joint                           A   0.00   1.38     1.38NA  0.01   1.39  1.391XXX.00.00.0003000             25.0008 030 99     11.86  11.86   0.09
7033226X-ray exam of jaw joint                           A   0.54   0.20     0.20    0.03   0.77  0.771XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
70336  Magnetic image jaw joint                          A   1.48   9.27     9.27NA  0.09  10.84 10.841XXX.00.00.0040000             25.0008 090 88     14.05  14.05   0.10
70336TCMagnetic image jaw joint                          A   0.00   8.74     8.74NA  0.01   8.75  8.751XXX.00.00.0040000             25.0008 010 88     13.52  13.52   0.02
7033626Magnetic image jaw joint                          A   1.48   0.53     0.53    0.08   2.09  2.091XXX.00.00.0043000             25.0008 090 88      0.00   0.00   0.00
70350  X-ray head for orthodontia                        A   0.17   0.46     0.46NA  0.02   0.65  0.651XXX.00.00.0000000             25.0008 090 99      1.90   1.90   0.06
70350TCX-ray head for orthodontia                        A   0.00   0.35     0.35NA  0.01   0.36  0.361XXX.00.00.0000000             25.0008 010 99      1.79   1.79   0.05
7035026X-ray head for orthodontia                        A   0.17   0.11     0.11    0.01   0.29  0.291XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70355  Panoramic x-ray of jaws                           A   0.20   0.41     0.41NA  0.02   0.63  0.631XXX.00.00.0000000             25.0008 090 99      1.50   1.50   0.06
70355TCPanoramic x-ray of jaws                           A   0.00   0.30     0.30NA  0.01   0.31  0.311XXX.00.00.0000000             25.0008 010 99      1.39   1.39   0.05
7035526Panoramic x-ray of jaws                           A   0.20   0.11     0.11    0.01   0.32  0.321XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70360  X-ray exam of neck                                A   0.17   0.66     0.66NA  0.02   0.85  0.851XXX.00.00.0000000             25.0008 090 99      1.87   1.87   0.04
70360TCX-ray exam of neck                                A   0.00   0.60     0.60NA  0.01   0.61  0.611XXX.00.00.0000000             25.0008 010 99      1.81   1.81   0.03
7036026X-ray exam of neck                                A   0.17   0.06     0.06    0.01   0.24  0.241XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70370  Throat x-ray & fluoroscopy                        A   0.32   2.12     2.12NA  0.02   2.46  2.461XXX.00.00.0000000             25.0008 090 99      4.67   4.67   0.03
70370TCThroat x-ray & fluoroscopy                        A   0.00   2.00     2.00NA  0.01   2.01  2.011XXX.00.00.0000000             25.0008 030 99      4.55   4.55   0.02
7037026Throat x-ray & fluoroscopy                        A   0.32   0.12     0.12    0.01   0.45  0.451XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70371  Speech evaluation complex                         A   0.84   1.87     1.87NA  0.04   2.75  2.751XXX.00.00.0000000             25.0008 090 99      4.87   4.87   0.06
70371TCSpeech evaluation complex                         A   0.00   1.54     1.54NA  0.01   1.55  1.551XXX.00.00.0000000             25.0008 030 99      4.54   4.54   0.03
7037126Speech evaluation complex                         A   0.84   0.33     0.33    0.03   1.20  1.201XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70373  Contrast x-ray of larynx                          A   0.44   1.94     1.94NA  0.02   2.40  2.401XXX.00.00.0000000             25.0008 090 99     10.33  10.33   0.07
70373TCContrast x-ray of larynx                          A   0.00   1.77     1.77NA  0.01   1.78  1.781XXX.00.00.0000000             25.0008 030 99     10.16  10.16   0.06
7037326Contrast x-ray of larynx                          A   0.44   0.17     0.17    0.01   0.62  0.621XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70380  X-ray exam of salivary gland                      A   0.17   1.00     1.00NA  0.02   1.19  1.191XXX.00.00.0000000             25.0008 090 99      1.91   1.91   0.03
70380TCX-ray exam of salivary gland                      A   0.00   0.91     0.91NA  0.01   0.92  0.921XXX.00.00.0000000             25.0008 010 99      1.82   1.82   0.02
7038026X-ray exam of salivary gland                      A   0.17   0.09     0.09    0.01   0.27  0.271XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70390  X-ray exam of salivary duct                       A   0.38   2.67     2.67NA  0.04   3.09  3.091XXX.00.00.0000000             25.0008 090 99     10.32  10.32   0.07
70390TCX-ray exam of salivary duct                       A   0.00   2.53     2.53NA  0.01   2.54  2.541XXX.00.00.0000000             25.0008 030 99     10.18  10.18   0.04
7039026X-ray exam of salivary duct                       A   0.38   0.14     0.14    0.03   0.55  0.551XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70450  Ct head/brain w/o dye                             A   0.85   4.05     4.05NA  0.05   4.95  4.951XXX.00.00.0040000             25.0008 090 88      7.23   7.23   0.06
70450TCCt head/brain w/o dye                             A   0.00   3.74     3.74NA  0.01   3.75  3.751XXX.00.00.0040000             25.0008 010 88      6.92   6.92   0.02
7045026Ct head/brain w/o dye                             A   0.85   0.31     0.31    0.04   1.20  1.201XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
70460  Ct head/brain w/dye                               A   1.13   5.31     5.31NA  0.06   6.50  6.501XXX.00.00.0040000             25.0008 090 88     12.28  12.28   0.07
70460TCCt head/brain w/dye                               A   0.00   4.89     4.89NA  0.01   4.90  4.901XXX.00.00.0040000             25.0008 020 88     11.86  11.86   0.02
7046026Ct head/brain w/dye                               A   1.13   0.42     0.42    0.05   1.60  1.601XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
70470  Ct head/brain w/o & w/dye                         A   1.27   5.21     5.21NA  0.08   6.56  6.561XXX.00.00.0040000             25.0008 090 88     13.62  13.62   0.10
70470TCCt head/brain w/o & w/dye                         A   0.00   4.74     4.74NA  0.01   4.75  4.751XXX.00.00.0040000             25.0008 020 88     13.15  13.15   0.03
7047026Ct head/brain w/o & w/dye                         A   1.27   0.47     0.47    0.07   1.81  1.811XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
70480  Ct orbit/ear/fossa w/o dye                        A   1.28   6.96     6.96NA  0.08   8.32  8.321XXX.00.00.0040000             25.0008 090 88      7.41   7.41   0.08
70480TCCt orbit/ear/fossa w/o dye                        A   0.00   6.48     6.48NA  0.01   6.49  6.491XXX.00.00.0040000             25.0008 010 88      6.93   6.93   0.01
7048026Ct orbit/ear/fossa w/o dye                        A   1.28   0.48     0.48    0.07   1.83  1.831XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
70481  Ct orbit/ear/fossa w/dye                          A   1.38   8.17     8.17NA  0.09   9.64  9.641XXX.00.00.0040000             25.0008 090 88     12.37  12.37   0.10
70481TCCt orbit/ear/fossa w/dye                          A   0.00   7.67     7.67NA  0.01   7.68  7.681XXX.00.00.0040000             25.0008 020 88     11.87  11.87   0.02
7048126Ct orbit/ear/fossa w/dye                          A   1.38   0.50     0.50    0.08   1.96  1.961XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
70482  Ct orbit/ear/fossa w/o&w/dye                      A   1.45   9.15     9.15NA  0.09  10.69 10.691XXX.00.00.0040000             25.0008 090 88     13.69  13.69   0.10
70482TCCt orbit/ear/fossa w/o&w/dye                      A   0.00   8.62     8.62NA  0.01   8.63  8.631XXX.00.00.0040000             25.0008 020 88     13.16  13.16   0.02
7048226Ct orbit/ear/fossa w/o&w/dye                      A   1.45   0.53     0.53    0.08   2.06  2.061XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
70486  Ct maxillofacial w/o dye                          A   1.14   5.64     5.64NA  0.06   6.84  6.841XXX.00.00.0040000             25.0008 090 88      7.36   7.36   0.06
70486TCCt maxillofacial w/o dye                          A   0.00   5.21     5.21NA  0.01   5.22  5.221XXX.00.00.0040000             25.0008 010 88      6.93   6.93   0.01
7048626Ct maxillofacial w/o dye                          A   1.14   0.43     0.43    0.05   1.62  1.621XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
70487  Ct maxillofacial w/dye                            A   1.30   6.87     6.87NA  0.08   8.25  8.251XXX.00.00.0040000             25.0008 090 88     12.35  12.35   0.09
70487TCCt maxillofacial w/dye                            A   0.00   6.39     6.39NA  0.01   6.40  6.401XXX.00.00.0040000             25.0008 020 88     11.87  11.87   0.02
7048726Ct maxillofacial w/dye                            A   1.30   0.48     0.48    0.07   1.85  1.851XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
70488  Ct maxillofacial w/o & w/dye                      A   1.42   8.42     8.42NA  0.09   9.93  9.931XXX.00.00.0040000             25.0008 090 88     13.68  13.68   0.10
70488TCCt maxillofacial w/o & w/dye                      A   0.00   7.90     7.90NA  0.01   7.91  7.911XXX.00.00.0040000             25.0008 020 88     13.16  13.16   0.02
7048826Ct maxillofacial w/o & w/dye                      A   1.42   0.52     0.52    0.08   2.02  2.021XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
70490  Ct soft tissue neck w/o dye                       A   1.28   5.30     5.30NA  0.08   6.66  6.661XXX.00.00.0040000             25.0008 090 88      7.40   7.40   0.08
70490TCCt soft tissue neck w/o dye                       A   0.00   4.83     4.83NA  0.01   4.84  4.841XXX.00.00.0040000             25.0008 010 88      6.93   6.93   0.01
7049026Ct soft tissue neck w/o dye                       A   1.28   0.47     0.47    0.07   1.82  1.821XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
70491  Ct soft tissue neck w/dye                         A   1.38   6.57     6.57NA  0.08   8.03  8.031XXX.00.00.0040000             25.0008 090 88     12.38  12.38   0.09
70491TCCt soft tissue neck w/dye                         A   0.00   6.06     6.06NA  0.01   6.07  6.071XXX.00.00.0040000             25.0008 020 88     11.87  11.87   0.02
7049126Ct soft tissue neck w/dye                         A   1.38   0.51     0.51    0.07   1.96  1.961XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
70492  Ct sft tsue nck w/o & w/dye                       A   1.45   8.06     8.06NA  0.09   9.60  9.601XXX.00.00.0040000             25.0008 090 88     13.69  13.69   0.10
70492TCCt sft tsue nck w/o & w/dye                       A   0.00   7.53     7.53NA  0.01   7.54  7.541XXX.00.00.0040000             25.0008 020 88     13.16  13.16   0.02
7049226Ct sft tsue nck w/o & w/dye                       A   1.45   0.53     0.53    0.08   2.06  2.061XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
70496  Ct angiography head                               A   1.75  13.19    13.19NA  0.11  15.05 15.051XXX.00.00.0040000             25.0008 090 88     14.20  14.20   0.11
70496TCCt angiography head                               A   0.00  12.55    12.55NA  0.01  12.56 12.561XXX.00.00.0040000             25.0008 020 88     13.56  13.56   0.01
7049626Ct angiography head                               A   1.75   0.64     0.64    0.10   2.49  2.491XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
70498  Ct angiography neck                               A   1.75  13.69    13.69NA  0.11  15.55 15.551XXX.00.00.0040000             25.0008 090 88     14.20  14.20   0.11
70498TCCt angiography neck                               A   0.00  13.05    13.05NA  0.01  13.06 13.061XXX.00.00.0040000             25.0008 020 88     13.56  13.56   0.01
7049826Ct angiography neck                               A   1.75   0.64     0.64    0.10   2.49  2.491XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
70540  Mri orbit/face/neck w/o dye                       A   1.35  10.81    10.81NA  0.09  12.25 12.251XXX.00.00.0040000             25.0008 090 88     14.02  14.02   0.09
70540TCMri orbit/face/neck w/o dye                       A   0.00  10.32    10.32NA  0.01  10.33 10.331XXX.00.00.0040000             25.0008 010 88     13.53  13.53   0.01
7054026Mri orbit/face/neck w/o dye                       A   1.35   0.49     0.49    0.08   1.92  1.921XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
70542  Mri orbit/face/neck w/dye                         A   1.62  12.06    12.06NA  0.11  13.79 13.791XXX.00.00.0040000             25.0008 090 88     18.76  18.76   0.12
70542TCMri orbit/face/neck w/dye                         A   0.00  11.47    11.47NA  0.01  11.48 11.481XXX.00.00.0040000             25.0008 020 88     18.17  18.17   0.02
7054226Mri orbit/face/neck w/dye                         A   1.62   0.59     0.59    0.10   2.31  2.311XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
70543  Mri orbt/fac/nck w/o &w/dye                       A   2.15  14.66    14.66NA  0.13  16.94 16.941XXX.00.00.0040000             25.0008 090 88     22.74  22.74   0.14
70543TCMri orbt/fac/nck w/o &w/dye                       A   0.00  13.88    13.88NA  0.01  13.89 13.891XXX.00.00.0040000             25.0008 020 88     21.96  21.96   0.02
7054326Mri orbt/fac/nck w/o &w/dye                       A   2.15   0.78     0.78    0.12   3.05  3.051XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
70544  Mr angiography head w/o dye                       A   1.20  12.53    12.53NA  0.08  13.81 13.811XXX.00.00.0040000             25.0008 090 88     13.97  13.97   0.08
70544TCMr angiography head w/o dye                       A   0.00  12.09    12.09NA  0.01  12.10 12.101XXX.00.00.0040000             25.0008 010 88     13.53  13.53   0.01
7054426Mr angiography head w/o dye                       A   1.20   0.44     0.44    0.07   1.71  1.711XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
70545  Mr angiography head w/dye                         A   1.20  12.30    12.30NA  0.08  13.58 13.581XXX.00.00.0040000             25.0008 090 88     18.60  18.60   0.09
70545TCMr angiography head w/dye                         A   0.00  11.87    11.87NA  0.01  11.88 11.881XXX.00.00.0040000             25.0008 020 88     18.17  18.17   0.02
7054526Mr angiography head w/dye                         A   1.20   0.43     0.43    0.07   1.70  1.701XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
70546  Mr angiograph head w/o&w/dye                      A   1.80  18.95    18.95NA  0.12  20.87 20.871XXX.00.00.0040000             25.0008 090 88     22.63  22.63   0.12
70546TCMr angiograph head w/o&w/dye                      A   0.00  18.29    18.29NA  0.01  18.30 18.301XXX.00.00.0040000             25.0008 020 88     21.97  21.97   0.01
7054626Mr angiograph head w/o&w/dye                      A   1.80   0.66     0.66    0.11   2.57  2.571XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
70547  Mr angiography neck w/o dye                       A   1.20  12.54    12.54NA  0.08  13.82 13.821XXX.00.00.0040000             25.0008 090 88     13.97  13.97   0.08
70547TCMr angiography neck w/o dye                       A   0.00  12.10    12.10NA  0.01  12.11 12.111XXX.00.00.0040000             25.0008 010 88     13.53  13.53   0.01
7054726Mr angiography neck w/o dye                       A   1.20   0.44     0.44    0.07   1.71  1.711XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
70548  Mr angiography neck w/dye                         A   1.20  13.34    13.34NA  0.08  14.62 14.621XXX.00.00.0040000             25.0008 090 88     18.61  18.61   0.08
70548TCMr angiography neck w/dye                         A   0.00  12.90    12.90NA  0.01  12.91 12.911XXX.00.00.0040000             25.0008 020 88     18.17  18.17   0.01
7054826Mr angiography neck w/dye                         A   1.20   0.44     0.44    0.07   1.71  1.711XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
70549  Mr angiograph neck w/o&w/dye                      A   1.80  19.00    19.00NA  0.11  20.91 20.911XXX.00.00.0040000             25.0008 090 88     22.63  22.63   0.11
70549TCMr angiograph neck w/o&w/dye                      A   0.00  18.34    18.34NA  0.01  18.35 18.351XXX.00.00.0040000             25.0008 020 88     21.97  21.97   0.01
7054926Mr angiograph neck w/o&w/dye                      A   1.80   0.66     0.66    0.10   2.56  2.561XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
70551  Mri brain stem w/o dye                            A   1.48  11.36    11.36NA  0.09  12.93 12.931XXX.00.00.0040000             25.0008 090 88     14.07  14.07   0.09
70551TCMri brain stem w/o dye                            A   0.00  10.82    10.82NA  0.01  10.83 10.831XXX.00.00.0040000             25.0008 010 88     13.53  13.53   0.01
7055126Mri brain stem w/o dye                            A   1.48   0.54     0.54    0.08   2.10  2.101XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
70552  Mri brain stem w/dye                              A   1.78  12.56    12.56NA  0.12  14.46 14.461XXX.00.00.0040000             25.0008 090 88     18.83  18.83   0.13
70552TCMri brain stem w/dye                              A   0.00  11.90    11.90NA  0.01  11.91 11.911XXX.00.00.0040000             25.0008 020 88     18.17  18.17   0.02
7055226Mri brain stem w/dye                              A   1.78   0.66     0.66    0.11   2.55  2.551XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
70553  Mri brain stem w/o & w/dye                        A   2.36  14.41    14.41NA  0.15  16.92 16.921XXX.00.00.0040000             25.0008 090 88     22.82  22.82   0.16
70553TCMri brain stem w/o & w/dye                        A   0.00  13.55    13.55NA  0.01  13.56 13.561XXX.00.00.0040000             25.0008 020 88     21.96  21.96   0.02
7055326Mri brain stem w/o & w/dye                        A   2.36   0.86     0.86    0.14   3.36  3.361XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
70554  Fmri brain by tech                                A   2.11  12.48    12.48NA  0.13  14.72 14.721XXX.00.00.0043000             25.0008 090 88      0.00   0.00   0.00
70554TCFmri brain by tech                                A   0.00  11.69    11.69NA  0.01  11.70 11.701XXX.00.00.0043000             25.0008 020 88      0.00   0.00   0.00
7055426Fmri brain by tech                                A   2.11   0.79     0.79    0.12   3.02  3.021XXX.00.00.0043000             25.0008 090 88      0.00   0.00   0.00
70555  Fmri brain by phys/psych                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
70555TCFmri brain by phys/psych                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0003000             25.0008 020 99      0.00   0.00   0.00
7055526Fmri brain by phys/psych                          A   2.54   0.94     0.94    0.24   3.72  3.721XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
70557  Mri brain w/o dye                                 C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99     14.60  14.60   1.06
70557TCMri brain w/o dye                                 C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 010 99     13.53  13.53   0.01
7055726Mri brain w/o dye                                 A   2.90   1.07     1.07    1.05   5.02  5.021XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70558  Mri brain w/dye                                   C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99     19.35  19.35   0.31
70558TCMri brain w/dye                                   C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 020 99     18.17  18.17   0.01
7055826Mri brain w/dye                                   A   3.20   1.18     1.18    0.30   4.68  4.681XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
70559  Mri brain w/o & w/dye                             C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99     23.17  23.17   0.31
70559TCMri brain w/o & w/dye                             C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 020 99     21.97  21.97   0.01
7055926Mri brain w/o & w/dye                             A   3.20   1.20     1.20    0.30   4.70  4.701XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
71010  Chest x-ray 1 view frontal                        A   0.18   0.50     0.50NA  0.02   0.70  0.701XXX.00.00.0000000             25.0008 090 99      1.87   1.87   0.05
71010TCChest x-ray 1 view frontal                        A   0.00   0.43     0.43NA  0.01   0.44  0.441XXX.00.00.0000000             25.0008 010 99      1.80   1.80   0.04
7101026Chest x-ray 1 view frontal                        A   0.18   0.07     0.07    0.01   0.26  0.261XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
71015  Chest x-ray stereo frontal                        A   0.21   0.70     0.70NA  0.02   0.93  0.931XXX.00.00.0000000             25.0008 090 99      1.89   1.89   0.04
71015TCChest x-ray stereo frontal                        A   0.00   0.62     0.62NA  0.01   0.63  0.631XXX.00.00.0000000             25.0008 010 99      1.81   1.81   0.03
7101526Chest x-ray stereo frontal                        A   0.21   0.08     0.08    0.01   0.30  0.301XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
71020  Chest x-ray 2vw frontal&latl                      A   0.22   0.67     0.67NA  0.02   0.91  0.911XXX.00.00.0000000             25.0008 090 99      1.89   1.89   0.04
71020TCChest x-ray 2vw frontal&latl                      A   0.00   0.59     0.59NA  0.01   0.60  0.601XXX.00.00.0000000             25.0008 010 99      1.81   1.81   0.03
7102026Chest x-ray 2vw frontal&latl                      A   0.22   0.08     0.08    0.01   0.31  0.311XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
71021  Chest x-ray frnt lat lordotc                      A   0.27   0.84     0.84NA  0.02   1.13  1.131XXX.00.00.0000000             25.0008 090 99      1.92   1.92   0.03
71021TCChest x-ray frnt lat lordotc                      A   0.00   0.73     0.73NA  0.01   0.74  0.741XXX.00.00.0000000             25.0008 010 99      1.81   1.81   0.02
7102126Chest x-ray frnt lat lordotc                      A   0.27   0.11     0.11    0.01   0.39  0.391XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
71022  Chest x-ray frnt lat oblique                      A   0.31   1.12     1.12NA  0.02   1.45  1.451XXX.00.00.0000000             25.0008 090 99      1.95   1.95   0.03
71022TCChest x-ray frnt lat oblique                      A   0.00   0.99     0.99NA  0.01   1.00  1.001XXX.00.00.0000000             25.0008 010 99      1.82   1.82   0.02
7102226Chest x-ray frnt lat oblique                      A   0.31   0.13     0.13    0.01   0.45  0.451XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
71023  Chest x-ray and fluoroscopy                       A   0.38   1.58     1.58NA  0.02   1.98  1.981XXX.00.00.0000000             25.0008 090 99      4.68   4.68   0.04
71023TCChest x-ray and fluoroscopy                       A   0.00   1.44     1.44NA  0.01   1.45  1.451XXX.00.00.0000000             25.0008 030 99      4.54   4.54   0.03
7102326Chest x-ray and fluoroscopy                       A   0.38   0.14     0.14    0.01   0.53  0.531XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
71030  Chest x-ray 4/> views                             A   0.31   1.06     1.06NA  0.02   1.39  1.391XXX.00.00.0000000             25.0008 090 99      2.91   2.91   0.04
71030TCChest x-ray 4/> views                             A   0.00   0.95     0.95NA  0.01   0.96  0.961XXX.00.00.0000000             25.0008 010 99      2.80   2.80   0.03
7103026Chest x-ray 4/> views                             A   0.31   0.11     0.11    0.01   0.43  0.431XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
71034  Chest x-ray&fluoro 4/> views                      A   0.46   2.10     2.10NA  0.02   2.58  2.581XXX.00.00.0000000             25.0008 090 99      4.72   4.72   0.03
71034TCChest x-ray&fluoro 4/> views                      A   0.00   1.93     1.93NA  0.01   1.94  1.941XXX.00.00.0000000             25.0008 030 99      4.55   4.55   0.02
7103426Chest x-ray&fluoro 4/> views                      A   0.46   0.17     0.17    0.01   0.64  0.641XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
71035  Chest x-ray special views                         A   0.18   0.90     0.90NA  0.02   1.10  1.101XXX.00.00.0000000             25.0008 090 99      1.89   1.89   0.03
71035TCChest x-ray special views                         A   0.00   0.83     0.83NA  0.01   0.84  0.841XXX.00.00.0000000             25.0008 010 99      1.82   1.82   0.02
7103526Chest x-ray special views                         A   0.18   0.07     0.07    0.01   0.26  0.261XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
71100  X-ray exam ribs uni 2 views                       A   0.22   0.75     0.75NA  0.02   0.99  0.991XXX.00.00.0000000             25.0008 090 99      1.90   1.90   0.04
71100TCX-ray exam ribs uni 2 views                       A   0.00   0.66     0.66NA  0.01   0.67  0.671XXX.00.00.0000000             25.0008 010 99      1.81   1.81   0.03
7110026X-ray exam ribs uni 2 views                       A   0.22   0.09     0.09    0.01   0.32  0.321XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
71101  X-ray exam unilat ribs/chest                      A   0.27   0.91     0.91NA  0.02   1.20  1.201XXX.00.00.0000000             25.0008 090 99      2.90   2.90   0.04
71101TCX-ray exam unilat ribs/chest                      A   0.00   0.81     0.81NA  0.01   0.82  0.821XXX.00.00.0000000             25.0008 010 99      2.80   2.80   0.03
7110126X-ray exam unilat ribs/chest                      A   0.27   0.10     0.10    0.01   0.38  0.381XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
71110  X-ray exam ribs bil 3 views                       A   0.27   0.94     0.94NA  0.02   1.23  1.231XXX.00.00.0002000             25.0008 090 99      2.91   2.91   0.04
71110TCX-ray exam ribs bil 3 views                       A   0.00   0.83     0.83NA  0.01   0.84  0.841XXX.00.00.0002000             25.0008 010 99      2.80   2.80   0.03
7111026X-ray exam ribs bil 3 views                       A   0.27   0.11     0.11    0.01   0.39  0.391XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
71111  X-ray exam ribs/chest4/> vws                      A   0.32   1.28     1.28NA  0.02   1.62  1.621XXX.00.00.0002000             25.0008 090 99      2.94   2.94   0.03
71111TCX-ray exam ribs/chest4/> vws                      A   0.00   1.15     1.15NA  0.01   1.16  1.161XXX.00.00.0002000             25.0008 010 99      2.81   2.81   0.02
7111126X-ray exam ribs/chest4/> vws                      A   0.32   0.13     0.13    0.01   0.46  0.461XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
71120  X-ray exam breastbone 2/>vws                      A   0.20   0.74     0.74NA  0.02   0.96  0.961XXX.00.00.0000000             25.0008 090 99      1.89   1.89   0.04
71120TCX-ray exam breastbone 2/>vws                      A   0.00   0.66     0.66NA  0.01   0.67  0.671XXX.00.00.0000000             25.0008 010 99      1.81   1.81   0.03
7112026X-ray exam breastbone 2/>vws                      A   0.20   0.08     0.08    0.01   0.29  0.291XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
71130  X-ray strenoclavic jt 3/>vws                      A   0.22   0.89     0.89NA  0.02   1.13  1.131XXX.00.00.0000000             25.0008 090 99      1.91   1.91   0.03
71130TCX-ray strenoclavic jt 3/>vws                      A   0.00   0.80     0.80NA  0.01   0.81  0.811XXX.00.00.0000000             25.0008 010 99      1.82   1.82   0.02
7113026X-ray strenoclavic jt 3/>vws                      A   0.22   0.09     0.09    0.01   0.32  0.321XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
71250  Ct thorax w/o dye                                 A   1.02   5.22     5.22NA  0.06   6.30  6.301XXX.00.00.0040000             25.0008 090 88      7.30   7.30   0.06
71250TCCt thorax w/o dye                                 A   0.00   4.85     4.85NA  0.01   4.86  4.861XXX.00.00.0040000             25.0008 010 88      6.93   6.93   0.01
7125026Ct thorax w/o dye                                 A   1.02   0.37     0.37    0.05   1.44  1.441XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
71260  Ct thorax w/dye                                   A   1.24   6.56     6.56NA  0.08   7.88  7.881XXX.00.00.0040000             25.0008 090 88     12.33  12.33   0.09
71260TCCt thorax w/dye                                   A   0.00   6.10     6.10NA  0.01   6.11  6.111XXX.00.00.0040000             25.0008 020 88     11.87  11.87   0.02
7126026Ct thorax w/dye                                   A   1.24   0.46     0.46    0.07   1.77  1.771XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
71270  Ct thorax w/o & w/dye                             A   1.38   8.09     8.09NA  0.08   9.55  9.551XXX.00.00.0040000             25.0008 090 88     13.66  13.66   0.09
71270TCCt thorax w/o & w/dye                             A   0.00   7.59     7.59NA  0.01   7.60  7.601XXX.00.00.0040000             25.0008 020 88     13.16  13.16   0.02
7127026Ct thorax w/o & w/dye                             A   1.38   0.50     0.50    0.07   1.95  1.951XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
71275  Ct angiography chest                              A   1.92  10.09    10.09NA  0.12  12.13 12.131XXX.00.00.0040000             25.0008 090 88     14.25  14.25   0.12
71275TCCt angiography chest                              A   0.00   9.39     9.39NA  0.01   9.40  9.401XXX.00.00.0040000             25.0008 020 88     13.55  13.55   0.01
7127526Ct angiography chest                              A   1.92   0.70     0.70    0.11   2.73  2.731XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
71550  Mri chest w/o dye                                 A   1.46  12.58    12.58NA  0.09  14.13 14.131XXX.00.00.0040000             25.0008 090 88     14.06  14.06   0.09
71550TCMri chest w/o dye                                 A   0.00  12.05    12.05NA  0.01  12.06 12.061XXX.00.00.0040000             25.0008 010 88     13.53  13.53   0.01
7155026Mri chest w/o dye                                 A   1.46   0.53     0.53    0.08   2.07  2.071XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
71551  Mri chest w/dye                                   A   1.73  13.85    13.85NA  0.11  15.69 15.691XXX.00.00.0040000             25.0008 090 88     18.80  18.80   0.11
71551TCMri chest w/dye                                   A   0.00  13.22    13.22NA  0.01  13.23 13.231XXX.00.00.0040000             25.0008 020 88     18.17  18.17   0.01
7155126Mri chest w/dye                                   A   1.73   0.63     0.63    0.10   2.46  2.461XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
71552  Mri chest w/o & w/dye                             A   2.26  17.59    17.59NA  0.13  19.98 19.981XXX.00.00.0040000             25.0008 090 88     22.79  22.79   0.13
71552TCMri chest w/o & w/dye                             A   0.00  16.77    16.77NA  0.01  16.78 16.781XXX.00.00.0040000             25.0008 020 88     21.97  21.97   0.01
7155226Mri chest w/o & w/dye                             A   2.26   0.82     0.82    0.12   3.20  3.201XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
71555  Mri angio chest w or w/o dye                      R   1.81  11.98    11.98NA  0.11  13.90 13.901XXX.00.00.0040000             25.0008 090 88     22.61  22.61   0.12
71555TCMri angio chest w or w/o dye                      R   0.00  11.33    11.33NA  0.01  11.34 11.341XXX.00.00.0040000             25.0008 020 88     21.96  21.96   0.02
7155526Mri angio chest w or w/o dye                      R   1.81   0.65     0.65    0.10   2.56  2.561XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72010  X-ray exam spine ap&lat                           A   0.45   1.91     1.91NA  0.04   2.40  2.401XXX.00.00.0000000             25.0008 090 99      3.01   3.01   0.05
72010TCX-ray exam spine ap&lat                           A   0.00   1.72     1.72NA  0.01   1.73  1.731XXX.00.00.0000000             25.0008 010 99      2.82   2.82   0.02
7201026X-ray exam spine ap&lat                           A   0.45   0.19     0.19    0.03   0.67  0.671XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72020  X-ray exam of spine 1 view                        A   0.15   0.54     0.54NA  0.02   0.71  0.711XXX.00.00.0000000             25.0008 090 99      1.86   1.86   0.05
72020TCX-ray exam of spine 1 view                        A   0.00   0.48     0.48NA  0.01   0.49  0.491XXX.00.00.0000000             25.0008 010 99      1.80   1.80   0.04
7202026X-ray exam of spine 1 view                        A   0.15   0.06     0.06    0.01   0.22  0.221XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72040  X-ray exam neck spine 3/<vws                      A   0.22   1.05     1.05NA  0.04   1.31  1.311XXX.00.00.0000000             25.0008 090 99      1.91   1.91   0.05
72040TCX-ray exam neck spine 3/<vws                      A   0.00   0.96     0.96NA  0.01   0.97  0.971XXX.00.00.0000000             25.0008 010 99      1.82   1.82   0.02
7204026X-ray exam neck spine 3/<vws                      A   0.22   0.09     0.09    0.03   0.34  0.341XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72050  X-ray exam neck spine 4/5vws                      A   0.31   1.31     1.31NA  0.04   1.66  1.661XXX.00.00.0000000             25.0008 090 99      2.93   2.93   0.05
72050TCX-ray exam neck spine 4/5vws                      A   0.00   1.19     1.19NA  0.01   1.20  1.201XXX.00.00.0000000             25.0008 010 99      2.81   2.81   0.02
7205026X-ray exam neck spine 4/5vws                      A   0.31   0.12     0.12    0.03   0.46  0.461XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72052  X-ray exam neck spine 6/>vws                      A   0.36   1.73     1.73NA  0.04   2.13  2.131XXX.00.00.0000000             25.0008 090 99      2.96   2.96   0.05
72052TCX-ray exam neck spine 6/>vws                      A   0.00   1.59     1.59NA  0.01   1.60  1.601XXX.00.00.0000000             25.0008 010 99      2.82   2.82   0.02
7205226X-ray exam neck spine 6/>vws                      A   0.36   0.14     0.14    0.03   0.53  0.531XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72069  X-ray exam trunk spine stand                      A   0.22   0.93     0.93NA  0.04   1.19  1.191XXX.00.00.0000000             25.0008 090 99      1.91   1.91   0.05
72069TCX-ray exam trunk spine stand                      A   0.00   0.84     0.84NA  0.01   0.85  0.851XXX.00.00.0000000             25.0008 010 99      1.82   1.82   0.02
7206926X-ray exam trunk spine stand                      A   0.22   0.09     0.09    0.03   0.34  0.341XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72070  X-ray exam thorac spine 2vws                      A   0.22   0.78     0.78NA  0.02   1.02  1.021XXX.00.00.0000000             25.0008 090 99      1.90   1.90   0.04
72070TCX-ray exam thorac spine 2vws                      A   0.00   0.69     0.69NA  0.01   0.70  0.701XXX.00.00.0000000             25.0008 010 99      1.81   1.81   0.03
7207026X-ray exam thorac spine 2vws                      A   0.22   0.09     0.09    0.01   0.32  0.321XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72072  X-ray exam thorac spine 3vws                      A   0.22   0.89     0.89NA  0.02   1.13  1.131XXX.00.00.0000000             25.0008 090 99      2.88   2.88   0.04
72072TCX-ray exam thorac spine 3vws                      A   0.00   0.81     0.81NA  0.01   0.82  0.821XXX.00.00.0000000             25.0008 010 99      2.80   2.80   0.03
7207226X-ray exam thorac spine 3vws                      A   0.22   0.08     0.08    0.01   0.31  0.311XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72074  X-ray exam thorac spine4/>vw                      A   0.22   1.10     1.10NA  0.02   1.34  1.341XXX.00.00.0000000             25.0008 090 99      1.90   1.90   0.03
72074TCX-ray exam thorac spine4/>vw                      A   0.00   1.02     1.02NA  0.01   1.03  1.031XXX.00.00.0000000             25.0008 010 99      1.82   1.82   0.02
7207426X-ray exam thorac spine4/>vw                      A   0.22   0.08     0.08    0.01   0.31  0.311XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72080  X-ray exam trunk spine 2 vws                      A   0.22   0.85     0.85NA  0.04   1.11  1.111XXX.00.00.0000000             25.0008 090 99      1.90   1.90   0.05
72080TCX-ray exam trunk spine 2 vws                      A   0.00   0.76     0.76NA  0.01   0.77  0.771XXX.00.00.0000000             25.0008 010 99      1.81   1.81   0.02
7208026X-ray exam trunk spine 2 vws                      A   0.22   0.09     0.09    0.03   0.34  0.341XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72090  X-ray exam scloiosis erect                        A   0.28   1.26     1.26NA  0.05   1.59  1.591XXX.00.00.0000000             25.0008 090 99      2.93   2.93   0.06
72090TCX-ray exam scloiosis erect                        A   0.00   1.14     1.14NA  0.01   1.15  1.151XXX.00.00.0000000             25.0008 010 99      2.81   2.81   0.02
7209026X-ray exam scloiosis erect                        A   0.28   0.12     0.12    0.04   0.44  0.441XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72100  X-ray exam l-s spine 2/3 vws                      A   0.22   0.84     0.84NA  0.04   1.10  1.101XXX.00.00.0000000             25.0008 090 99      1.90   1.90   0.05
72100TCX-ray exam l-s spine 2/3 vws                      A   0.00   0.75     0.75NA  0.01   0.76  0.761XXX.00.00.0000000             25.0008 010 99      1.81   1.81   0.02
7210026X-ray exam l-s spine 2/3 vws                      A   0.22   0.09     0.09    0.03   0.34  0.341XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72110  X-ray exam l-2 spine 4/>vws                       A   0.31   1.14     1.14NA  0.04   1.49  1.491XXX.00.00.0000000             25.0008 090 99      2.93   2.93   0.06
72110TCX-ray exam l-2 spine 4/>vws                       A   0.00   1.02     1.02NA  0.01   1.03  1.031XXX.00.00.0000000             25.0008 010 99      2.81   2.81   0.03
7211026X-ray exam l-2 spine 4/>vws                       A   0.31   0.12     0.12    0.03   0.46  0.461XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72114  X-ray exam l-s spine bending                      A   0.32   1.58     1.58NA  0.05   1.95  1.951XXX.00.00.0000000             25.0008 090 99      2.94   2.94   0.06
72114TCX-ray exam l-s spine bending                      A   0.00   1.45     1.45NA  0.01   1.46  1.461XXX.00.00.0000000             25.0008 010 99      2.81   2.81   0.02
7211426X-ray exam l-s spine bending                      A   0.32   0.13     0.13    0.04   0.49  0.491XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72120  X-ray bend only l-s spine                         A   0.22   1.04     1.04NA  0.04   1.30  1.301XXX.00.00.0000000             25.0008 090 99      2.90   2.90   0.06
72120TCX-ray bend only l-s spine                         A   0.00   0.94     0.94NA  0.01   0.95  0.951XXX.00.00.0000000             25.0008 010 99      2.80   2.80   0.03
7212026X-ray bend only l-s spine                         A   0.22   0.10     0.10    0.03   0.35  0.351XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72125  Ct neck spine w/o dye                             A   1.07   5.31     5.31NA  0.06   6.44  6.441XXX.00.00.0040000             25.0008 090 88      7.32   7.32   0.06
72125TCCt neck spine w/o dye                             A   0.00   4.92     4.92NA  0.01   4.93  4.931XXX.00.00.0040000             25.0008 010 88      6.93   6.93   0.01
7212526Ct neck spine w/o dye                             A   1.07   0.39     0.39    0.05   1.51  1.511XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72126  Ct neck spine w/dye                               A   1.22   6.58     6.58NA  0.08   7.88  7.881XXX.00.00.0040000             25.0008 090 88     12.32  12.32   0.09
72126TCCt neck spine w/dye                               A   0.00   6.13     6.13NA  0.01   6.14  6.141XXX.00.00.0040000             25.0008 020 88     11.87  11.87   0.02
7212626Ct neck spine w/dye                               A   1.22   0.45     0.45    0.07   1.74  1.741XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72127  Ct neck spine w/o & w/dye                         A   1.27   8.06     8.06NA  0.08   9.41  9.411XXX.00.00.0040000             25.0008 090 88     13.62  13.62   0.09
72127TCCt neck spine w/o & w/dye                         A   0.00   7.60     7.60NA  0.01   7.61  7.611XXX.00.00.0040000             25.0008 020 88     13.16  13.16   0.02
7212726Ct neck spine w/o & w/dye                         A   1.27   0.46     0.46    0.07   1.80  1.801XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72128  Ct chest spine w/o dye                            A   1.00   5.26     5.26NA  0.06   6.32  6.321XXX.00.00.0040000             25.0008 090 88      7.30   7.30   0.06
72128TCCt chest spine w/o dye                            A   0.00   4.89     4.89NA  0.01   4.90  4.901XXX.00.00.0040000             25.0008 010 88      6.93   6.93   0.01
7212826Ct chest spine w/o dye                            A   1.00   0.37     0.37    0.05   1.42  1.421XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72129  Ct chest spine w/dye                              A   1.22   6.61     6.61NA  0.08   7.91  7.911XXX.00.00.0040000             25.0008 090 88     12.32  12.32   0.09
72129TCCt chest spine w/dye                              A   0.00   6.16     6.16NA  0.01   6.17  6.171XXX.00.00.0040000             25.0008 020 88     11.87  11.87   0.02
7212926Ct chest spine w/dye                              A   1.22   0.45     0.45    0.07   1.74  1.741XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72130  Ct chest spine w/o & w/dye                        A   1.27   8.12     8.12NA  0.08   9.47  9.471XXX.00.00.0040000             25.0008 090 88     13.62  13.62   0.09
72130TCCt chest spine w/o & w/dye                        A   0.00   7.66     7.66NA  0.01   7.67  7.671XXX.00.00.0040000             25.0008 020 88     13.16  13.16   0.02
7213026Ct chest spine w/o & w/dye                        A   1.27   0.46     0.46    0.07   1.80  1.801XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72131  Ct lumbar spine w/o dye                           A   1.00   5.23     5.23NA  0.06   6.29  6.291XXX.00.00.0040000             25.0008 090 88      7.30   7.30   0.06
72131TCCt lumbar spine w/o dye                           A   0.00   4.86     4.86NA  0.01   4.87  4.871XXX.00.00.0040000             25.0008 010 88      6.93   6.93   0.01
7213126Ct lumbar spine w/o dye                           A   1.00   0.37     0.37    0.05   1.42  1.421XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72132  Ct lumbar spine w/dye                             A   1.22   6.59     6.59NA  0.08   7.89  7.891XXX.00.00.0040000             25.0008 090 88     12.32  12.32   0.09
72132TCCt lumbar spine w/dye                             A   0.00   6.14     6.14NA  0.01   6.15  6.151XXX.00.00.0040000             25.0008 020 88     11.87  11.87   0.02
7213226Ct lumbar spine w/dye                             A   1.22   0.45     0.45    0.07   1.74  1.741XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72133  Ct lumbar spine w/o & w/dye                       A   1.27   8.07     8.07NA  0.08   9.42  9.421XXX.00.00.0040000             25.0008 090 88     13.62  13.62   0.09
72133TCCt lumbar spine w/o & w/dye                       A   0.00   7.61     7.61NA  0.01   7.62  7.621XXX.00.00.0040000             25.0008 020 88     13.16  13.16   0.02
7213326Ct lumbar spine w/o & w/dye                       A   1.27   0.46     0.46    0.07   1.80  1.801XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72141  Mri neck spine w/o dye                            A   1.60   9.74     9.74NA  0.11  11.45 11.451XXX.00.00.0040000             25.0008 090 88     14.11  14.11   0.11
72141TCMri neck spine w/o dye                            A   0.00   9.15     9.15NA  0.01   9.16  9.161XXX.00.00.0040000             25.0008 010 88     13.52  13.52   0.01
7214126Mri neck spine w/o dye                            A   1.60   0.59     0.59    0.10   2.29  2.291XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72142  Mri neck spine w/dye                              A   1.92  12.69    12.69NA  0.12  14.73 14.731XXX.00.00.0040000             25.0008 090 88     18.89  18.89   0.13
72142TCMri neck spine w/dye                              A   0.00  11.97    11.97NA  0.01  11.98 11.981XXX.00.00.0040000             25.0008 020 88     18.17  18.17   0.02
7214226Mri neck spine w/dye                              A   1.92   0.72     0.72    0.11   2.75  2.751XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72146  Mri chest spine w/o dye                           A   1.60   9.76     9.76NA  0.11  11.47 11.471XXX.00.00.0040000             25.0008 090 88     14.11  14.11   0.11
72146TCMri chest spine w/o dye                           A   0.00   9.17     9.17NA  0.01   9.18  9.181XXX.00.00.0040000             25.0008 010 88     13.52  13.52   0.01
7214626Mri chest spine w/o dye                           A   1.60   0.59     0.59    0.10   2.29  2.291XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72147  Mri chest spine w/dye                             A   1.92  10.98    10.98NA  0.12  13.02 13.021XXX.00.00.0040000             25.0008 090 88     18.87  18.87   0.13
72147TCMri chest spine w/dye                             A   0.00  10.27    10.27NA  0.01  10.28 10.281XXX.00.00.0040000             25.0008 020 88     18.16  18.16   0.02
7214726Mri chest spine w/dye                             A   1.92   0.71     0.71    0.11   2.74  2.741XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72148  Mri lumbar spine w/o dye                          A   1.48   9.71     9.71NA  0.11  11.30 11.301XXX.00.00.0040000             25.0008 090 88     14.07  14.07   0.11
72148TCMri lumbar spine w/o dye                          A   0.00   9.16     9.16NA  0.01   9.17  9.171XXX.00.00.0040000             25.0008 010 88     13.52  13.52   0.01
7214826Mri lumbar spine w/o dye                          A   1.48   0.55     0.55    0.10   2.13  2.131XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72149  Mri lumbar spine w/dye                            A   1.78  12.34    12.34NA  0.12  14.24 14.241XXX.00.00.0040000             25.0008 090 88     18.83  18.83   0.13
72149TCMri lumbar spine w/dye                            A   0.00  11.68    11.68NA  0.01  11.69 11.691XXX.00.00.0040000             25.0008 020 88     18.17  18.17   0.02
7214926Mri lumbar spine w/dye                            A   1.78   0.66     0.66    0.11   2.55  2.551XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72156  Mri neck spine w/o & w/dye                        A   2.57  14.19    14.19NA  0.17  16.93 16.931XXX.00.00.0040000             25.0008 090 88     22.90  22.90   0.18
72156TCMri neck spine w/o & w/dye                        A   0.00  13.25    13.25NA  0.01  13.26 13.261XXX.00.00.0040000             25.0008 020 88     21.96  21.96   0.02
7215626Mri neck spine w/o & w/dye                        A   2.57   0.94     0.94    0.16   3.67  3.671XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72157  Mri chest spine w/o & w/dye                       A   2.57  13.00    13.00NA  0.17  15.74 15.741XXX.00.00.0040000             25.0008 090 88     22.90  22.90   0.18
72157TCMri chest spine w/o & w/dye                       A   0.00  12.06    12.06NA  0.01  12.07 12.071XXX.00.00.0040000             25.0008 020 88     21.96  21.96   0.02
7215726Mri chest spine w/o & w/dye                       A   2.57   0.94     0.94    0.16   3.67  3.671XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72158  Mri lumbar spine w/o & w/dye                      A   2.36  14.04    14.04NA  0.17  16.57 16.571XXX.00.00.0040000             25.0008 090 88     22.83  22.83   0.18
72158TCMri lumbar spine w/o & w/dye                      A   0.00  13.17    13.17NA  0.01  13.18 13.181XXX.00.00.0040000             25.0008 020 88     21.96  21.96   0.02
7215826Mri lumbar spine w/o & w/dye                      A   2.36   0.87     0.87    0.16   3.39  3.391XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72159  Mr angio spine w/o&w/dye                          R   1.80  12.38    12.38NA  0.08  14.26 14.261XXX.00.00.0040000             25.0008 090 88     22.62  22.62   0.09
72159TCMr angio spine w/o&w/dye                          R   0.00  11.72    11.72NA  0.01  11.73 11.731XXX.00.00.0040900             25.0008 020 88     21.96  21.96   0.02
7215926Mr angio spine w/o&w/dye                          R   1.80   0.66     0.66    0.07   2.53  2.531XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72170  X-ray exam of pelvis                              A   0.17   0.67     0.67NA  0.04   0.88  0.881XXX.00.00.0000000             25.0008 090 99      1.88   1.88   0.06
72170TCX-ray exam of pelvis                              A   0.00   0.60     0.60NA  0.01   0.61  0.611XXX.00.00.0000000             25.0008 010 99      1.81   1.81   0.03
7217026X-ray exam of pelvis                              A   0.17   0.07     0.07    0.03   0.27  0.271XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72190  X-ray exam of pelvis                              A   0.21   1.07     1.07NA  0.04   1.32  1.321XXX.00.00.0000000             25.0008 090 99      1.91   1.91   0.05
72190TCX-ray exam of pelvis                              A   0.00   0.98     0.98NA  0.01   0.99  0.991XXX.00.00.0000000             25.0008 010 99      1.82   1.82   0.02
7219026X-ray exam of pelvis                              A   0.21   0.09     0.09    0.03   0.33  0.331XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72191  Ct angiograph pelv w/o&w/dye                      A   1.81  10.11    10.11NA  0.13  12.05 12.051XXX.00.00.0040000             25.0008 090 88     14.20  14.20   0.13
72191TCCt angiograph pelv w/o&w/dye                      A   0.00   9.46     9.46NA  0.01   9.47  9.471XXX.00.00.0040000             25.0008 020 88     13.55  13.55   0.01
7219126Ct angiograph pelv w/o&w/dye                      A   1.81   0.65     0.65    0.12   2.58  2.581XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72192  Ct pelvis w/o dye                                 A   1.09   4.07     4.07NA  0.06   5.22  5.221XXX.00.00.0040000             25.0008 090 88      7.32   7.32   0.07
72192TCCt pelvis w/o dye                                 A   0.00   3.67     3.67NA  0.01   3.68  3.681XXX.00.00.0040000             25.0008 010 88      6.92   6.92   0.02
7219226Ct pelvis w/o dye                                 A   1.09   0.40     0.40    0.05   1.54  1.541XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72193  Ct pelvis w/dye                                   A   1.16   6.68     6.68NA  0.08   7.92  7.921XXX.00.00.0040000             25.0008 090 88     12.30  12.30   0.09
72193TCCt pelvis w/dye                                   A   0.00   6.25     6.25NA  0.01   6.26  6.261XXX.00.00.0040000             25.0008 020 88     11.87  11.87   0.02
7219326Ct pelvis w/dye                                   A   1.16   0.43     0.43    0.07   1.66  1.661XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72194  Ct pelvis w/o & w/dye                             A   1.22   7.76     7.76NA  0.08   9.06  9.061XXX.00.00.0040000             25.0008 090 88     13.60  13.60   0.09
72194TCCt pelvis w/o & w/dye                             A   0.00   7.32     7.32NA  0.01   7.33  7.331XXX.00.00.0040000             25.0008 020 88     13.16  13.16   0.02
7219426Ct pelvis w/o & w/dye                             A   1.22   0.44     0.44    0.07   1.73  1.731XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72195  Mri pelvis w/o dye                                A   1.46  11.21    11.21NA  0.11  12.78 12.781XXX.00.00.0040000             25.0008 090 88     14.07  14.07   0.11
72195TCMri pelvis w/o dye                                A   0.00  10.67    10.67NA  0.01  10.68 10.681XXX.00.00.0040000             25.0008 010 88     13.53  13.53   0.01
7219526Mri pelvis w/o dye                                A   1.46   0.54     0.54    0.10   2.10  2.101XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72196  Mri pelvis w/dye                                  A   1.73  12.37    12.37NA  0.11  14.21 14.211XXX.00.00.0040000             25.0008 090 88     18.81  18.81   0.12
72196TCMri pelvis w/dye                                  A   0.00  11.73    11.73NA  0.01  11.74 11.741XXX.00.00.0040000             25.0008 020 88     18.17  18.17   0.02
7219626Mri pelvis w/dye                                  A   1.73   0.64     0.64    0.10   2.47  2.471XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72197  Mri pelvis w/o & w/dye                            A   2.26  14.95    14.95NA  0.13  17.34 17.341XXX.00.00.0040000             25.0008 090 88     22.78  22.78   0.14
72197TCMri pelvis w/o & w/dye                            A   0.00  14.13    14.13NA  0.01  14.14 14.141XXX.00.00.0040000             25.0008 020 88     21.96  21.96   0.02
7219726Mri pelvis w/o & w/dye                            A   2.26   0.82     0.82    0.12   3.20  3.201XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72198  Mr angio pelvis w/o & w/dye                       A   1.80  12.15    12.15NA  0.11  14.06 14.061XXX.00.00.0040000             25.0008 090 88     22.61  22.61   0.12
72198TCMr angio pelvis w/o & w/dye                       A   0.00  11.50    11.50NA  0.01  11.51 11.511XXX.00.00.0040000             25.0008 020 88     21.96  21.96   0.02
7219826Mr angio pelvis w/o & w/dye                       A   1.80   0.65     0.65    0.10   2.55  2.551XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
72200  X-ray exam si joints                              A   0.17   0.71     0.71NA  0.02   0.90  0.901XXX.00.00.0000000             25.0008 090 99      1.88   1.88   0.04
72200TCX-ray exam si joints                              A   0.00   0.64     0.64NA  0.01   0.65  0.651XXX.00.00.0000000             25.0008 010 99      1.81   1.81   0.03
7220026X-ray exam si joints                              A   0.17   0.07     0.07    0.01   0.25  0.251XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72202  X-ray exam si joints 3/> vws                      A   0.19   0.84     0.84NA  0.02   1.05  1.051XXX.00.00.0000000             25.0008 090 99      1.88   1.88   0.03
72202TCX-ray exam si joints 3/> vws                      A   0.00   0.77     0.77NA  0.01   0.78  0.781XXX.00.00.0000000             25.0008 010 99      1.81   1.81   0.02
7220226X-ray exam si joints 3/> vws                      A   0.19   0.07     0.07    0.01   0.27  0.271XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72220  X-ray exam sacrum tailbone                        A   0.17   0.69     0.69NA  0.02   0.88  0.881XXX.00.00.0000000             25.0008 090 99      1.88   1.88   0.04
72220TCX-ray exam sacrum tailbone                        A   0.00   0.62     0.62NA  0.01   0.63  0.631XXX.00.00.0000000             25.0008 010 99      1.81   1.81   0.03
7222026X-ray exam sacrum tailbone                        A   0.17   0.07     0.07    0.01   0.25  0.251XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72240  Myelography neck spine                            A   0.91   2.92     2.92NA  0.06   3.89  3.891XXX.00.00.0000000             25.0008 090 99     20.57  20.57   0.13
72240TCMyelography neck spine                            A   0.00   2.58     2.58NA  0.01   2.59  2.591XXX.00.00.0000000             25.0008 030 99     20.23  20.23   0.08
7224026Myelography neck spine                            A   0.91   0.34     0.34    0.05   1.30  1.301XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72255  Myelography thoracic spine                        A   0.91   2.73     2.73NA  0.05   3.69  3.691XXX.00.00.0000000             25.0008 090 99     20.57  20.57   0.12
72255TCMyelography thoracic spine                        A   0.00   2.38     2.38NA  0.01   2.39  2.391XXX.00.00.0000000             25.0008 030 99     20.22  20.22   0.08
7225526Myelography thoracic spine                        A   0.91   0.35     0.35    0.04   1.30  1.301XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72265  Myelography l-s spine                             A   0.83   2.93     2.93NA  0.05   3.81  3.811XXX.00.00.0000000             25.0008 090 99     20.54  20.54   0.12
72265TCMyelography l-s spine                             A   0.00   2.62     2.62NA  0.01   2.63  2.631XXX.00.00.0000000             25.0008 030 99     20.23  20.23   0.08
7226526Myelography l-s spine                             A   0.83   0.31     0.31    0.04   1.18  1.181XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72270  Myelogphy 2/> spine regions                       A   1.33   4.53     4.53NA  0.08   5.94  5.941XXX.00.00.0000000             25.0008 090 99     20.75  20.75   0.12
72270TCMyelogphy 2/> spine regions                       A   0.00   4.03     4.03NA  0.01   4.04  4.041XXX.00.00.0000000             25.0008 030 99     20.25  20.25   0.05
7227026Myelogphy 2/> spine regions                       A   1.33   0.50     0.50    0.07   1.90  1.901XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72275  Epidurography                                     A   0.76   2.79     2.79NA  0.05   3.60  3.601XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
72275TCEpidurography                                     A   0.00   2.45     2.45NA  0.01   2.46  2.461XXX.00.00.0099999             25.0008 030 99      0.00   0.00   0.00
7227526Epidurography                                     A   0.76   0.34     0.34    0.04   1.14  1.141XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
72285  Discography cerv/thor spine                       A   1.16   2.28     2.28NA  0.06   3.50  3.501XXX.00.00.0000000             25.0008 090 99     69.38  69.38   0.45
72285TCDiscography cerv/thor spine                       A   0.00   1.74     1.74NA  0.01   1.75  1.751XXX.00.00.0000000             25.0008 030 99     68.84  68.84   0.40
7228526Discography cerv/thor spine                       A   1.16   0.54     0.54    0.05   1.75  1.751XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72291  Perq verte/sacroplsty fluor                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72291TCPerq verte/sacroplsty fluor                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7229126Perq verte/sacroplsty fluor                       A   1.31   0.56     0.56    0.22   2.09  2.091XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72292  Perq verte/sacroplsty ct                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72292TCPerq verte/sacroplsty ct                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7229226Perq verte/sacroplsty ct                          A   1.38   0.55     0.55    0.20   2.13  2.131XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
72295  X-ray of lower spine disk                         A   0.83   2.18     2.18NA  0.05   3.06  3.061XXX.00.00.0000000             25.0008 090 99     69.24  69.24   0.42
72295TCX-ray of lower spine disk                         A   0.00   1.79     1.79NA  0.01   1.80  1.801XXX.00.00.0000000             25.0008 030 99     68.85  68.85   0.38
7229526X-ray of lower spine disk                         A   0.83   0.39     0.39    0.04   1.26  1.261XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
73000  X-ray exam of collar bone                         A   0.16   0.71     0.71NA  0.02   0.89  0.891XXX.00.00.0003000             25.0008 090 99      1.88   1.88   0.04
73000TCX-ray exam of collar bone                         A   0.00   0.64     0.64NA  0.01   0.65  0.651XXX.00.00.0003000             25.0008 010 99      1.81   1.81   0.03
7300026X-ray exam of collar bone                         A   0.16   0.07     0.07    0.01   0.24  0.241XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73010  X-ray exam of shoulder blade                      A   0.17   0.77     0.77NA  0.04   0.98  0.981XXX.00.00.0003000             25.0008 090 99      1.89   1.89   0.06
73010TCX-ray exam of shoulder blade                      A   0.00   0.69     0.69NA  0.01   0.70  0.701XXX.00.00.0003000             25.0008 010 99      1.81   1.81   0.03
7301026X-ray exam of shoulder blade                      A   0.17   0.08     0.08    0.03   0.28  0.281XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73020  X-ray exam of shoulder                            A   0.15   0.55     0.55NA  0.02   0.72  0.721XXX.00.00.0003000             25.0008 090 99      1.86   1.86   0.05
73020TCX-ray exam of shoulder                            A   0.00   0.49     0.49NA  0.01   0.50  0.501XXX.00.00.0003000             25.0008 010 99      1.80   1.80   0.04
7302026X-ray exam of shoulder                            A   0.15   0.06     0.06    0.01   0.22  0.221XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73030  X-ray exam of shoulder                            A   0.18   0.72     0.72NA  0.04   0.94  0.941XXX.00.00.0003000             25.0008 090 99      1.89   1.89   0.06
73030TCX-ray exam of shoulder                            A   0.00   0.64     0.64NA  0.01   0.65  0.651XXX.00.00.0003000             25.0008 010 99      1.81   1.81   0.03
7303026X-ray exam of shoulder                            A   0.18   0.08     0.08    0.03   0.29  0.291XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73040  Contrast x-ray of shoulder                        A   0.54   2.64     2.64NA  0.05   3.23  3.231XXX.00.00.0003000             25.0008 090 99     12.12  12.12   0.09
73040TCContrast x-ray of shoulder                        A   0.00   2.42     2.42NA  0.01   2.43  2.431XXX.00.00.0003000             25.0008 030 99     11.90  11.90   0.05
7304026Contrast x-ray of shoulder                        A   0.54   0.22     0.22    0.04   0.80  0.801XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73050  X-ray exam of shoulders                           A   0.20   0.99     0.99NA  0.04   1.23  1.231XXX.00.00.0002000             25.0008 090 99      1.91   1.91   0.05
73050TCX-ray exam of shoulders                           A   0.00   0.90     0.90NA  0.01   0.91  0.911XXX.00.00.0002000             25.0008 010 99      1.82   1.82   0.02
7305026X-ray exam of shoulders                           A   0.20   0.09     0.09    0.03   0.32  0.321XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
73060  X-ray exam of humerus                             A   0.17   0.70     0.70NA  0.02   0.89  0.891XXX.00.00.0003000             25.0008 090 99      1.88   1.88   0.04
73060TCX-ray exam of humerus                             A   0.00   0.63     0.63NA  0.01   0.64  0.641XXX.00.00.0003000             25.0008 010 99      1.81   1.81   0.03
7306026X-ray exam of humerus                             A   0.17   0.07     0.07    0.01   0.25  0.251XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73070  X-ray exam of elbow                               A   0.15   0.70     0.70NA  0.02   0.87  0.871XXX.00.00.0003000             25.0008 090 99      1.88   1.88   0.04
73070TCX-ray exam of elbow                               A   0.00   0.63     0.63NA  0.01   0.64  0.641XXX.00.00.0003000             25.0008 010 99      1.81   1.81   0.03
7307026X-ray exam of elbow                               A   0.15   0.07     0.07    0.01   0.23  0.231XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73080  X-ray exam of elbow                               A   0.17   0.83     0.83NA  0.02   1.02  1.021XXX.00.00.0003000             25.0008 090 99      1.88   1.88   0.03
73080TCX-ray exam of elbow                               A   0.00   0.76     0.76NA  0.01   0.77  0.771XXX.00.00.0003000             25.0008 010 99      1.81   1.81   0.02
7308026X-ray exam of elbow                               A   0.17   0.07     0.07    0.01   0.25  0.251XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73085  Contrast x-ray of elbow                           A   0.54   2.51     2.51NA  0.04   3.09  3.091XXX.00.00.0003000             25.0008 090 99     12.15  12.15   0.08
73085TCContrast x-ray of elbow                           A   0.00   2.25     2.25NA  0.01   2.26  2.261XXX.00.00.0003000             25.0008 030 99     11.89  11.89   0.05
7308526Contrast x-ray of elbow                           A   0.54   0.26     0.26    0.03   0.83  0.831XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73090  X-ray exam of forearm                             A   0.16   0.67     0.67NA  0.02   0.85  0.851XXX.00.00.0003000             25.0008 090 99      1.88   1.88   0.04
73090TCX-ray exam of forearm                             A   0.00   0.60     0.60NA  0.01   0.61  0.611XXX.00.00.0003000             25.0008 010 99      1.81   1.81   0.03
7309026X-ray exam of forearm                             A   0.16   0.07     0.07    0.01   0.24  0.241XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73092  X-ray exam of arm infant                          A   0.16   0.81     0.81NA  0.02   0.99  0.991XXX.00.00.0003000             25.0008 090 99      1.88   1.88   0.03
73092TCX-ray exam of arm infant                          A   0.00   0.74     0.74NA  0.01   0.75  0.751XXX.00.00.0003000             25.0008 010 99      1.81   1.81   0.02
7309226X-ray exam of arm infant                          A   0.16   0.07     0.07    0.01   0.24  0.241XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73100  X-ray exam of wrist                               A   0.16   0.78     0.78NA  0.04   0.98  0.981XXX.00.00.0003000             25.0008 090 99      1.89   1.89   0.06
73100TCX-ray exam of wrist                               A   0.00   0.70     0.70NA  0.01   0.71  0.711XXX.00.00.0003000             25.0008 010 99      1.81   1.81   0.03
7310026X-ray exam of wrist                               A   0.16   0.08     0.08    0.03   0.27  0.271XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73110  X-ray exam of wrist                               A   0.17   0.96     0.96NA  0.02   1.15  1.151XXX.00.00.0003000             25.0008 090 99      1.89   1.89   0.03
73110TCX-ray exam of wrist                               A   0.00   0.89     0.89NA  0.01   0.90  0.901XXX.00.00.0003000             25.0008 010 99      1.82   1.82   0.02
7311026X-ray exam of wrist                               A   0.17   0.07     0.07    0.01   0.25  0.251XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73115  Contrast x-ray of wrist                           A   0.54   2.81     2.81NA  0.05   3.40  3.401XXX.00.00.0003000             25.0008 090 99     12.14  12.14   0.09
73115TCContrast x-ray of wrist                           A   0.00   2.57     2.57NA  0.01   2.58  2.581XXX.00.00.0003000             25.0008 030 99     11.90  11.90   0.05
7311526Contrast x-ray of wrist                           A   0.54   0.24     0.24    0.04   0.82  0.821XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73120  X-ray exam of hand                                A   0.16   0.66     0.66NA  0.02   0.84  0.841XXX.00.00.0003000             25.0008 090 99      1.88   1.88   0.04
73120TCX-ray exam of hand                                A   0.00   0.59     0.59NA  0.01   0.60  0.601XXX.00.00.0003000             25.0008 010 99      1.81   1.81   0.03
7312026X-ray exam of hand                                A   0.16   0.07     0.07    0.01   0.24  0.241XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73130  X-ray exam of hand                                A   0.17   0.80     0.80NA  0.02   0.99  0.991XXX.00.00.0003000             25.0008 090 99      1.88   1.88   0.03
73130TCX-ray exam of hand                                A   0.00   0.73     0.73NA  0.01   0.74  0.741XXX.00.00.0003000             25.0008 010 99      1.81   1.81   0.02
7313026X-ray exam of hand                                A   0.17   0.07     0.07    0.01   0.25  0.251XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73140  X-ray exam of finger(s)                           A   0.13   0.88     0.88NA  0.02   1.03  1.031XXX.00.00.0003000             25.0008 090 99      1.88   1.88   0.03
73140TCX-ray exam of finger(s)                           A   0.00   0.82     0.82NA  0.01   0.83  0.831XXX.00.00.0003000             25.0008 010 99      1.82   1.82   0.02
7314026X-ray exam of finger(s)                           A   0.13   0.06     0.06    0.01   0.20  0.201XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73200  Ct upper extremity w/o dye                        A   1.00   5.20     5.20NA  0.08   6.28  6.281XXX.00.00.0043000             25.0008 090 88      7.30   7.30   0.08
73200TCCt upper extremity w/o dye                        A   0.00   4.83     4.83NA  0.01   4.84  4.841XXX.00.00.0043000             25.0008 010 88      6.93   6.93   0.01
7320026Ct upper extremity w/o dye                        A   1.00   0.37     0.37    0.07   1.44  1.441XXX.00.00.0043000             25.0008 090 88      0.00   0.00   0.00
73201  Ct upper extremity w/dye                          A   1.16   6.46     6.46NA  0.08   7.70  7.701XXX.00.00.0043000             25.0008 090 88     12.29  12.29   0.09
73201TCCt upper extremity w/dye                          A   0.00   6.04     6.04NA  0.01   6.05  6.051XXX.00.00.0043000             25.0008 020 88     11.87  11.87   0.02
7320126Ct upper extremity w/dye                          A   1.16   0.42     0.42    0.07   1.65  1.651XXX.00.00.0043000             25.0008 090 88      0.00   0.00   0.00
73202  Ct uppr extremity w/o&w/dye                       A   1.22   8.50     8.50NA  0.08   9.80  9.801XXX.00.00.0043000             25.0008 090 88     13.60  13.60   0.09
73202TCCt uppr extremity w/o&w/dye                       A   0.00   8.06     8.06NA  0.01   8.07  8.071XXX.00.00.0043000             25.0008 020 88     13.16  13.16   0.02
7320226Ct uppr extremity w/o&w/dye                       A   1.22   0.44     0.44    0.07   1.73  1.731XXX.00.00.0043000             25.0008 090 88      0.00   0.00   0.00
73206  Ct angio upr extrm w/o&w/dye                      A   1.81   9.09     9.09NA  0.09  10.99 10.991XXX.00.00.0040000             25.0008 090 88     14.21  14.21   0.10
73206TCCt angio upr extrm w/o&w/dye                      A   0.00   8.43     8.43NA  0.01   8.44  8.441XXX.00.00.0040000             25.0008 020 88     13.55  13.55   0.02
7320626Ct angio upr extrm w/o&w/dye                      A   1.81   0.66     0.66    0.08   2.55  2.551XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
73218  Mri upper extremity w/o dye                       A   1.35  11.12    11.12NA  0.08  12.55 12.551XXX.00.00.0043000             25.0008 090 88     14.03  14.03   0.08
73218TCMri upper extremity w/o dye                       A   0.00  10.62    10.62NA  0.01  10.63 10.631XXX.00.00.0043000             25.0008 010 88     13.53  13.53   0.01
7321826Mri upper extremity w/o dye                       A   1.35   0.50     0.50    0.07   1.92  1.921XXX.00.00.0043000             25.0008 090 88      0.00   0.00   0.00
73219  Mri upper extremity w/dye                         A   1.62  12.22    12.22NA  0.11  13.95 13.951XXX.00.00.0043000             25.0008 090 88     18.77  18.77   0.12
73219TCMri upper extremity w/dye                         A   0.00  11.62    11.62NA  0.01  11.63 11.631XXX.00.00.0043000             25.0008 020 88     18.17  18.17   0.02
7321926Mri upper extremity w/dye                         A   1.62   0.60     0.60    0.10   2.32  2.321XXX.00.00.0043000             25.0008 090 88      0.00   0.00   0.00
73220  Mri uppr extremity w/o&w/dye                      A   2.15  14.91    14.91NA  0.13  17.19 17.191XXX.00.00.0043000             25.0008 090 88     22.75  22.75   0.14
73220TCMri uppr extremity w/o&w/dye                      A   0.00  14.12    14.12NA  0.01  14.13 14.131XXX.00.00.0043000             25.0008 020 88     21.96  21.96   0.02
7322026Mri uppr extremity w/o&w/dye                      A   2.15   0.79     0.79    0.12   3.06  3.061XXX.00.00.0043000             25.0008 090 88      0.00   0.00   0.00
73221  Mri joint upr extrem w/o dye                      A   1.35   6.87     6.87NA  0.11   8.33  8.331XXX.00.00.0043000             25.0008 090 88     14.03  14.03   0.12
73221TCMri joint upr extrem w/o dye                      A   0.00   6.36     6.36NA  0.01   6.37  6.371XXX.00.00.0043000             25.0008 010 88     13.52  13.52   0.02
7322126Mri joint upr extrem w/o dye                      A   1.35   0.51     0.51    0.10   1.96  1.961XXX.00.00.0043000             25.0008 090 88      0.00   0.00   0.00
73222  Mri joint upr extrem w/dye                        A   1.62  11.37    11.37NA  0.11  13.10 13.101XXX.00.00.0043000             25.0008 090 88     18.76  18.76   0.12
73222TCMri joint upr extrem w/dye                        A   0.00  10.77    10.77NA  0.01  10.78 10.781XXX.00.00.0043000             25.0008 020 88     18.16  18.16   0.02
7322226Mri joint upr extrem w/dye                        A   1.62   0.60     0.60    0.10   2.32  2.321XXX.00.00.0043000             25.0008 090 88      0.00   0.00   0.00
73223  Mri joint upr extr w/o&w/dye                      A   2.15  13.92    13.92NA  0.13  16.20 16.201XXX.00.00.0043000             25.0008 090 88     22.75  22.75   0.14
73223TCMri joint upr extr w/o&w/dye                      A   0.00  13.13    13.13NA  0.01  13.14 13.141XXX.00.00.0043000             25.0008 020 88     21.96  21.96   0.02
7322326Mri joint upr extr w/o&w/dye                      A   2.15   0.79     0.79    0.12   3.06  3.061XXX.00.00.0043000             25.0008 090 88      0.00   0.00   0.00
73225  Mr angio upr extr w/o&w/dye                       R   1.73  12.47    12.47NA  0.08  14.28 14.281XXX.00.00.0040000             25.0008 090 88     22.58  22.58   0.09
73225TCMr angio upr extr w/o&w/dye                       R   0.00  11.85    11.85NA  0.01  11.86 11.861XXX.00.00.0040900             25.0008 020 88     21.96  21.96   0.02
7322526Mr angio upr extr w/o&w/dye                       R   1.73   0.62     0.62    0.07   2.42  2.421XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
73500  X-ray exam of hip                                 A   0.17   0.63     0.63NA  0.04   0.84  0.841XXX.00.00.0000000             25.0008 090 99      1.89   1.89   0.06
73500TCX-ray exam of hip                                 A   0.00   0.55     0.55NA  0.01   0.56  0.561XXX.00.00.0000000             25.0008 010 99      1.81   1.81   0.03
7350026X-ray exam of hip                                 A   0.17   0.08     0.08    0.03   0.28  0.281XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
73510  X-ray exam of hip                                 A   0.21   0.95     0.95NA  0.04   1.20  1.201XXX.00.00.0000000             25.0008 090 99      1.91   1.91   0.05
73510TCX-ray exam of hip                                 A   0.00   0.86     0.86NA  0.01   0.87  0.871XXX.00.00.0000000             25.0008 010 99      1.82   1.82   0.02
7351026X-ray exam of hip                                 A   0.21   0.09     0.09    0.03   0.33  0.331XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
73520  X-ray exam of hips                                A   0.26   0.96     0.96NA  0.04   1.26  1.261XXX.00.00.0002000             25.0008 090 99      2.91   2.91   0.06
73520TCX-ray exam of hips                                A   0.00   0.85     0.85NA  0.01   0.86  0.861XXX.00.00.0002000             25.0008 010 99      2.80   2.80   0.03
7352026X-ray exam of hips                                A   0.26   0.11     0.11    0.03   0.40  0.401XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
73525  Contrast x-ray of hip                             A   0.54   2.62     2.62NA  0.05   3.21  3.211XXX.00.00.0003000             25.0008 090 99     12.16  12.16   0.09
73525TCContrast x-ray of hip                             A   0.00   2.36     2.36NA  0.01   2.37  2.371XXX.00.00.0003000             25.0008 030 99     11.90  11.90   0.05
7352526Contrast x-ray of hip                             A   0.54   0.26     0.26    0.04   0.84  0.841XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73530  X-ray exam of hip                                 C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73530TCX-ray exam of hip                                 C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0003000             25.0008 030 99      0.00   0.00   0.00
7353026X-ray exam of hip                                 A   0.29   0.11     0.11    0.03   0.43  0.431XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73540  X-ray exam of pelvis & hips                       A   0.20   1.13     1.13NA  0.04   1.37  1.371XXX.00.00.0000000             25.0008 090 99      1.91   1.91   0.05
73540TCX-ray exam of pelvis & hips                       A   0.00   1.04     1.04NA  0.01   1.05  1.051XXX.00.00.0000000             25.0008 010 99      1.82   1.82   0.02
7354026X-ray exam of pelvis & hips                       A   0.20   0.09     0.09    0.03   0.32  0.321XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
73550  X-ray exam of thigh                               A   0.17   0.66     0.66NA  0.04   0.87  0.871XXX.00.00.0003000             25.0008 090 99      1.88   1.88   0.06
73550TCX-ray exam of thigh                               A   0.00   0.59     0.59NA  0.01   0.60  0.601XXX.00.00.0003000             25.0008 010 99      1.81   1.81   0.03
7355026X-ray exam of thigh                               A   0.17   0.07     0.07    0.03   0.27  0.271XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73560  X-ray exam of knee 1 or 2                         A   0.17   0.74     0.74NA  0.04   0.95  0.951XXX.00.00.0003000             25.0008 090 99      1.89   1.89   0.06
73560TCX-ray exam of knee 1 or 2                         A   0.00   0.66     0.66NA  0.01   0.67  0.671XXX.00.00.0003000             25.0008 010 99      1.81   1.81   0.03
7356026X-ray exam of knee 1 or 2                         A   0.17   0.08     0.08    0.03   0.28  0.281XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73562  X-ray exam of knee 3                              A   0.18   0.93     0.93NA  0.04   1.15  1.151XXX.00.00.0003000             25.0008 090 99      1.90   1.90   0.05
73562TCX-ray exam of knee 3                              A   0.00   0.85     0.85NA  0.01   0.86  0.861XXX.00.00.0003000             25.0008 010 99      1.82   1.82   0.02
7356226X-ray exam of knee 3                              A   0.18   0.08     0.08    0.03   0.29  0.291XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73564  X-ray exam knee 4 or more                         A   0.22   1.08     1.08NA  0.04   1.34  1.341XXX.00.00.0003000             25.0008 090 99      2.90   2.90   0.06
73564TCX-ray exam knee 4 or more                         A   0.00   0.98     0.98NA  0.01   0.99  0.991XXX.00.00.0003000             25.0008 010 99      2.80   2.80   0.03
7356426X-ray exam knee 4 or more                         A   0.22   0.10     0.10    0.03   0.35  0.351XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73565  X-ray exam of knees                               A   0.17   0.88     0.88NA  0.04   1.09  1.091XXX.00.00.0002000             25.0008 090 99      1.90   1.90   0.05
73565TCX-ray exam of knees                               A   0.00   0.80     0.80NA  0.01   0.81  0.811XXX.00.00.0002000             25.0008 010 99      1.82   1.82   0.02
7356526X-ray exam of knees                               A   0.17   0.08     0.08    0.03   0.28  0.281XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
73580  Contrast x-ray of knee joint                      A   0.54   3.37     3.37NA  0.06   3.97  3.971XXX.00.00.0003000             25.0008 090 99     12.16  12.16   0.09
73580TCContrast x-ray of knee joint                      A   0.00   3.12     3.12NA  0.01   3.13  3.131XXX.00.00.0003000             25.0008 030 99     11.91  11.91   0.04
7358026Contrast x-ray of knee joint                      A   0.54   0.25     0.25    0.05   0.84  0.841XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73590  X-ray exam of lower leg                           A   0.17   0.65     0.65NA  0.02   0.84  0.841XXX.00.00.0003000             25.0008 090 99      1.88   1.88   0.04
73590TCX-ray exam of lower leg                           A   0.00   0.58     0.58NA  0.01   0.59  0.591XXX.00.00.0003000             25.0008 010 99      1.81   1.81   0.03
7359026X-ray exam of lower leg                           A   0.17   0.07     0.07    0.01   0.25  0.251XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73592  X-ray exam of leg infant                          A   0.16   0.67     0.67NA  0.02   0.85  0.851XXX.00.00.0003000             25.0008 090 99      1.87   1.87   0.04
73592TCX-ray exam of leg infant                          A   0.00   0.61     0.61NA  0.01   0.62  0.621XXX.00.00.0003000             25.0008 010 99      1.81   1.81   0.03
7359226X-ray exam of leg infant                          A   0.16   0.06     0.06    0.01   0.23  0.231XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73600  X-ray exam of ankle                               A   0.16   0.70     0.70NA  0.02   0.88  0.881XXX.00.00.0003000             25.0008 090 99      1.88   1.88   0.04
73600TCX-ray exam of ankle                               A   0.00   0.63     0.63NA  0.01   0.64  0.641XXX.00.00.0003000             25.0008 010 99      1.81   1.81   0.03
7360026X-ray exam of ankle                               A   0.16   0.07     0.07    0.01   0.24  0.241XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73610  X-ray exam of ankle                               A   0.17   0.83     0.83NA  0.02   1.02  1.021XXX.00.00.0003000             25.0008 090 99      1.88   1.88   0.03
73610TCX-ray exam of ankle                               A   0.00   0.76     0.76NA  0.01   0.77  0.771XXX.00.00.0003000             25.0008 010 99      1.81   1.81   0.02
7361026X-ray exam of ankle                               A   0.17   0.07     0.07    0.01   0.25  0.251XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73615  Contrast x-ray of ankle                           A   0.54   2.61     2.61NA  0.05   3.20  3.201XXX.00.00.0003000             25.0008 090 99     12.15  12.15   0.09
73615TCContrast x-ray of ankle                           A   0.00   2.36     2.36NA  0.01   2.37  2.371XXX.00.00.0003000             25.0008 030 99     11.90  11.90   0.05
7361526Contrast x-ray of ankle                           A   0.54   0.25     0.25    0.04   0.83  0.831XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73620  X-ray exam of foot                                A   0.16   0.66     0.66NA  0.02   0.84  0.841XXX.00.00.0003000             25.0008 090 99      1.86   1.86   0.04
73620TCX-ray exam of foot                                A   0.00   0.61     0.61NA  0.01   0.62  0.621XXX.00.00.0003000             25.0008 010 99      1.81   1.81   0.03
7362026X-ray exam of foot                                A   0.16   0.05     0.05    0.01   0.22  0.221XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73630  X-ray exam of foot                                A   0.17   0.77     0.77NA  0.02   0.96  0.961XXX.00.00.0003000             25.0008 090 99      1.87   1.87   0.04
73630TCX-ray exam of foot                                A   0.00   0.71     0.71NA  0.01   0.72  0.721XXX.00.00.0003000             25.0008 010 99      1.81   1.81   0.03
7363026X-ray exam of foot                                A   0.17   0.06     0.06    0.01   0.24  0.241XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73650  X-ray exam of heel                                A   0.16   0.69     0.69NA  0.02   0.87  0.871XXX.00.00.0003000             25.0008 090 99      1.87   1.87   0.04
73650TCX-ray exam of heel                                A   0.00   0.63     0.63NA  0.01   0.64  0.641XXX.00.00.0003000             25.0008 010 99      1.81   1.81   0.03
7365026X-ray exam of heel                                A   0.16   0.06     0.06    0.01   0.23  0.231XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73660  X-ray exam of toe(s)                              A   0.13   0.78     0.78NA  0.02   0.93  0.931XXX.00.00.0003000             25.0008 090 99      1.86   1.86   0.03
73660TCX-ray exam of toe(s)                              A   0.00   0.73     0.73NA  0.01   0.74  0.741XXX.00.00.0003000             25.0008 010 99      1.81   1.81   0.02
7366026X-ray exam of toe(s)                              A   0.13   0.05     0.05    0.01   0.19  0.191XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
73700  Ct lower extremity w/o dye                        A   1.00   5.22     5.22NA  0.08   6.30  6.301XXX.00.00.0043000             25.0008 090 88      7.30   7.30   0.08
73700TCCt lower extremity w/o dye                        A   0.00   4.85     4.85NA  0.01   4.86  4.861XXX.00.00.0043000             25.0008 010 88      6.93   6.93   0.01
7370026Ct lower extremity w/o dye                        A   1.00   0.37     0.37    0.07   1.44  1.441XXX.00.00.0043000             25.0008 090 88      0.00   0.00   0.00
73701  Ct lower extremity w/dye                          A   1.16   6.58     6.58NA  0.08   7.82  7.821XXX.00.00.0043000             25.0008 090 88     12.30  12.30   0.09
73701TCCt lower extremity w/dye                          A   0.00   6.15     6.15NA  0.01   6.16  6.161XXX.00.00.0043000             25.0008 020 88     11.87  11.87   0.02
7370126Ct lower extremity w/dye                          A   1.16   0.43     0.43    0.07   1.66  1.661XXX.00.00.0043000             25.0008 090 88      0.00   0.00   0.00
73702  Ct lwr extremity w/o&w/dye                        A   1.22   8.47     8.47NA  0.08   9.77  9.771XXX.00.00.0043000             25.0008 090 88     13.60  13.60   0.09
73702TCCt lwr extremity w/o&w/dye                        A   0.00   8.03     8.03NA  0.01   8.04  8.041XXX.00.00.0043000             25.0008 020 88     13.16  13.16   0.02
7370226Ct lwr extremity w/o&w/dye                        A   1.22   0.44     0.44    0.07   1.73  1.731XXX.00.00.0043000             25.0008 090 88      0.00   0.00   0.00
73706  Ct angio lwr extr w/o&w/dye                       A   1.90  10.13    10.13NA  0.12  12.15 12.151XXX.00.00.0043000             25.0008 090 88     14.23  14.23   0.12
73706TCCt angio lwr extr w/o&w/dye                       A   0.00   9.45     9.45NA  0.01   9.46  9.461XXX.00.00.0043000             25.0008 020 88     13.55  13.55   0.01
7370626Ct angio lwr extr w/o&w/dye                       A   1.90   0.68     0.68    0.11   2.69  2.691XXX.00.00.0043000             25.0008 090 88      0.00   0.00   0.00
73718  Mri lower extremity w/o dye                       A   1.35  11.04    11.04NA  0.09  12.48 12.481XXX.00.00.0043000             25.0008 090 88     14.02  14.02   0.09
73718TCMri lower extremity w/o dye                       A   0.00  10.55    10.55NA  0.01  10.56 10.561XXX.00.00.0043000             25.0008 010 88     13.53  13.53   0.01
7371826Mri lower extremity w/o dye                       A   1.35   0.49     0.49    0.08   1.92  1.921XXX.00.00.0043000             25.0008 090 88      0.00   0.00   0.00
73719  Mri lower extremity w/dye                         A   1.62  12.46    12.46NA  0.11  14.19 14.191XXX.00.00.0043000             25.0008 090 88     18.77  18.77   0.12
73719TCMri lower extremity w/dye                         A   0.00  11.86    11.86NA  0.01  11.87 11.871XXX.00.00.0043000             25.0008 020 88     18.17  18.17   0.02
7371926Mri lower extremity w/dye                         A   1.62   0.60     0.60    0.10   2.32  2.321XXX.00.00.0043000             25.0008 090 88      0.00   0.00   0.00
73720  Mri lwr extremity w/o&w/dye                       A   2.15  15.04    15.04NA  0.13  17.32 17.321XXX.00.00.0043000             25.0008 090 88     22.74  22.74   0.14
73720TCMri lwr extremity w/o&w/dye                       A   0.00  14.26    14.26NA  0.01  14.27 14.271XXX.00.00.0043000             25.0008 020 88     21.96  21.96   0.02
7372026Mri lwr extremity w/o&w/dye                       A   2.15   0.78     0.78    0.12   3.05  3.051XXX.00.00.0043000             25.0008 090 88      0.00   0.00   0.00
73721  Mri jnt of lwr extre w/o dye                      A   1.35   6.87     6.87NA  0.11   8.33  8.331XXX.00.00.0043000             25.0008 090 88     14.03  14.03   0.12
73721TCMri jnt of lwr extre w/o dye                      A   0.00   6.36     6.36NA  0.01   6.37  6.371XXX.00.00.0043000             25.0008 010 88     13.52  13.52   0.02
7372126Mri jnt of lwr extre w/o dye                      A   1.35   0.51     0.51    0.10   1.96  1.961XXX.00.00.0043000             25.0008 090 88      0.00   0.00   0.00
73722  Mri joint of lwr extr w/dye                       A   1.62  11.54    11.54NA  0.12  13.28 13.281XXX.00.00.0043000             25.0008 090 88     18.78  18.78   0.13
73722TCMri joint of lwr extr w/dye                       A   0.00  10.93    10.93NA  0.01  10.94 10.941XXX.00.00.0043000             25.0008 020 88     18.17  18.17   0.02
7372226Mri joint of lwr extr w/dye                       A   1.62   0.61     0.61    0.11   2.34  2.341XXX.00.00.0043000             25.0008 090 88      0.00   0.00   0.00
73723  Mri joint lwr extr w/o&w/dye                      A   2.15  13.92    13.92NA  0.13  16.20 16.201XXX.00.00.0043000             25.0008 090 88     22.74  22.74   0.14
73723TCMri joint lwr extr w/o&w/dye                      A   0.00  13.14    13.14NA  0.01  13.15 13.151XXX.00.00.0043000             25.0008 020 88     21.96  21.96   0.02
7372326Mri joint lwr extr w/o&w/dye                      A   2.15   0.78     0.78    0.12   3.05  3.051XXX.00.00.0043000             25.0008 090 88      0.00   0.00   0.00
73725  Mr ang lwr ext w or w/o dye                       R   1.82  12.21    12.21NA  0.11  14.14 14.141XXX.00.00.0043000             25.0008 090 88     22.61  22.61   0.12
73725TCMr ang lwr ext w or w/o dye                       R   0.00  11.56    11.56NA  0.01  11.57 11.571XXX.00.00.0043000             25.0008 020 88     21.96  21.96   0.02
7372526Mr ang lwr ext w or w/o dye                       R   1.82   0.65     0.65    0.10   2.57  2.571XXX.00.00.0043000             25.0008 090 88      0.00   0.00   0.00
74000  X-ray exam of abdomen                             A   0.18   0.54     0.54NA  0.02   0.74  0.741XXX.00.00.0000000             25.0008 090 99      1.87   1.87   0.05
74000TCX-ray exam of abdomen                             A   0.00   0.47     0.47NA  0.01   0.48  0.481XXX.00.00.0000000             25.0008 010 99      1.80   1.80   0.04
7400026X-ray exam of abdomen                             A   0.18   0.07     0.07    0.01   0.26  0.261XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74010  X-ray exam of abdomen                             A   0.23   0.92     0.92NA  0.02   1.17  1.171XXX.00.00.0000000             25.0008 090 99      1.91   1.91   0.03
74010TCX-ray exam of abdomen                             A   0.00   0.83     0.83NA  0.01   0.84  0.841XXX.00.00.0000000             25.0008 010 99      1.82   1.82   0.02
7401026X-ray exam of abdomen                             A   0.23   0.09     0.09    0.01   0.33  0.331XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74020  X-ray exam of abdomen                             A   0.27   0.94     0.94NA  0.02   1.23  1.231XXX.00.00.0000000             25.0008 090 99      1.92   1.92   0.03
74020TCX-ray exam of abdomen                             A   0.00   0.84     0.84NA  0.01   0.85  0.851XXX.00.00.0000000             25.0008 010 99      1.82   1.82   0.02
7402026X-ray exam of abdomen                             A   0.27   0.10     0.10    0.01   0.38  0.381XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74022  X-ray exam series abdomen                         A   0.32   1.14     1.14NA  0.02   1.48  1.481XXX.00.00.0000000             25.0008 090 99      2.93   2.93   0.04
74022TCX-ray exam series abdomen                         A   0.00   1.02     1.02NA  0.01   1.03  1.031XXX.00.00.0000000             25.0008 010 99      2.81   2.81   0.03
7402226X-ray exam series abdomen                         A   0.32   0.12     0.12    0.01   0.45  0.451XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74150  Ct abdomen w/o dye                                A   1.19   4.06     4.06NA  0.08   5.33  5.331XXX.00.00.0040000             25.0008 090 88      7.36   7.36   0.09
74150TCCt abdomen w/o dye                                A   0.00   3.62     3.62NA  0.01   3.63  3.631XXX.00.00.0040000             25.0008 010 88      6.92   6.92   0.02
7415026Ct abdomen w/o dye                                A   1.19   0.44     0.44    0.07   1.70  1.701XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
74160  Ct abdomen w/dye                                  A   1.27   6.70     6.70NA  0.08   8.05  8.051XXX.00.00.0040000             25.0008 090 88     12.34  12.34   0.09
74160TCCt abdomen w/dye                                  A   0.00   6.23     6.23NA  0.01   6.24  6.241XXX.00.00.0040000             25.0008 020 88     11.87  11.87   0.02
7416026Ct abdomen w/dye                                  A   1.27   0.47     0.47    0.07   1.81  1.811XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
74170  Ct abdomen w/o & w/dye                            A   1.40   7.83     7.83NA  0.09   9.32  9.321XXX.00.00.0040000             25.0008 090 88     13.68  13.68   0.10
74170TCCt abdomen w/o & w/dye                            A   0.00   7.31     7.31NA  0.01   7.32  7.321XXX.00.00.0040000             25.0008 020 88     13.16  13.16   0.02
7417026Ct abdomen w/o & w/dye                            A   1.40   0.52     0.52    0.08   2.00  2.001XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
74174  Ct angio abd&pelv w/o&w/dye                       A   2.20  12.65    12.65NA  0.15  15.00 15.001XXX.00.00.0040000             25.0008 090 88     20.08  20.08   0.16
74174TCCt angio abd&pelv w/o&w/dye                       A   0.00  11.86    11.86NA  0.01  11.87 11.871XXX.00.00.0040000             25.0008 020 88     19.29  19.29   0.02
7417426Ct angio abd&pelv w/o&w/dye                       A   2.20   0.79     0.79    0.14   3.13  3.131XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
74175  Ct angio abdom w/o & w/dye                        A   1.90  10.15    10.15NA  0.13  12.18 12.181XXX.00.00.0040000             25.0008 090 88     14.23  14.23   0.13
74175TCCt angio abdom w/o & w/dye                        A   0.00   9.47     9.47NA  0.01   9.48  9.481XXX.00.00.0040000             25.0008 020 88     13.55  13.55   0.01
7417526Ct angio abdom w/o & w/dye                        A   1.90   0.68     0.68    0.12   2.70  2.701XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
74176  Ct abd & pelvis                                   A   1.74   5.03     5.03NA  0.11   6.88  6.881XXX.00.00.0040900             25.0008 090 88     12.85  12.85   0.13
74176TCCt abd & pelvis                                   A   0.00   4.39     4.39NA  0.01   4.40  4.401XXX.00.00.0040900             25.0008 010 88     12.21  12.21   0.03
7417626Ct abd & pelvis                                   A   1.74   0.64     0.64    0.10   2.48  2.481XXX.00.00.0040900             25.0008 090 88      0.00   0.00   0.00
74177  Ct abd & pelv w/contrast                          A   1.82   8.10     8.10NA  0.11  10.03 10.031XXX.00.00.0040900             25.0008 090 88     19.95  19.95   0.13
74177TCCt abd & pelv w/contrast                          A   0.00   7.43     7.43NA  0.01   7.44  7.441XXX.00.00.0040900             25.0008 020 88     19.28  19.28   0.03
7417726Ct abd & pelv w/contrast                          A   1.82   0.67     0.67    0.10   2.59  2.591XXX.00.00.0040900             25.0008 090 88      0.00   0.00   0.00
74178  Ct abd & pelv 1/> regns                           A   2.01   9.66     9.66NA  0.13  11.80 11.801XXX.00.00.0040900             25.0008 090 88     20.02  20.02   0.14
74178TCCt abd & pelv 1/> regns                           A   0.00   8.92     8.92NA  0.01   8.93  8.931XXX.00.00.0040900             25.0008 020 88     19.28  19.28   0.02
7417826Ct abd & pelv 1/> regns                           A   2.01   0.74     0.74    0.12   2.87  2.871XXX.00.00.0040900             25.0008 090 88      0.00   0.00   0.00
74181  Mri abdomen w/o dye                               A   1.46   9.77     9.77NA  0.09  11.32 11.321XXX.00.00.0040000             25.0008 090 88     14.05  14.05   0.09
74181TCMri abdomen w/o dye                               A   0.00   9.24     9.24NA  0.01   9.25  9.251XXX.00.00.0040000             25.0008 010 88     13.52  13.52   0.01
7418126Mri abdomen w/o dye                               A   1.46   0.53     0.53    0.08   2.07  2.071XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
74182  Mri abdomen w/dye                                 A   1.73  13.79    13.79NA  0.11  15.63 15.631XXX.00.00.0040000             25.0008 090 88     18.80  18.80   0.11
74182TCMri abdomen w/dye                                 A   0.00  13.16    13.16NA  0.01  13.17 13.171XXX.00.00.0040000             25.0008 020 88     18.17  18.17   0.01
7418226Mri abdomen w/dye                                 A   1.73   0.63     0.63    0.10   2.46  2.461XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
74183  Mri abdomen w/o & w/dye                           A   2.26  15.01    15.01NA  0.13  17.40 17.401XXX.00.00.0040000             25.0008 090 88     22.78  22.78   0.14
74183TCMri abdomen w/o & w/dye                           A   0.00  14.19    14.19NA  0.01  14.20 14.201XXX.00.00.0040000             25.0008 020 88     21.96  21.96   0.02
7418326Mri abdomen w/o & w/dye                           A   2.26   0.82     0.82    0.12   3.20  3.201XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
74185  Mri angio abdom w orw/o dye                       R   1.80  12.14    12.14NA  0.11  14.05 14.051XXX.00.00.0040000             25.0008 090 88     22.61  22.61   0.12
74185TCMri angio abdom w orw/o dye                       R   0.00  11.49    11.49NA  0.01  11.50 11.501XXX.00.00.0040000             25.0008 020 88     21.96  21.96   0.02
7418526Mri angio abdom w orw/o dye                       R   1.80   0.65     0.65    0.10   2.55  2.551XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
74190  X-ray exam of peritoneum                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99     10.38  10.38   0.05
74190TCX-ray exam of peritoneum                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99     10.21  10.21   0.01
7419026X-ray exam of peritoneum                          A   0.48   0.17     0.17    0.04   0.69  0.691XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74210  Contrst x-ray exam of throat                      A   0.36   2.00     2.00NA  0.02   2.38  2.381XXX.00.00.0000000             25.0008 090 99      3.42   3.42   0.03
74210TCContrst x-ray exam of throat                      A   0.00   1.87     1.87NA  0.01   1.88  1.881XXX.00.00.0000000             25.0008 030 99      3.29   3.29   0.02
7421026Contrst x-ray exam of throat                      A   0.36   0.13     0.13    0.01   0.50  0.501XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74220  Contrast x-ray esophagus                          A   0.46   2.28     2.28NA  0.04   2.78  2.781XXX.00.00.0000000             25.0008 090 99      3.46   3.46   0.05
74220TCContrast x-ray esophagus                          A   0.00   2.11     2.11NA  0.01   2.12  2.121XXX.00.00.0000000             25.0008 030 99      3.29   3.29   0.02
7422026Contrast x-ray esophagus                          A   0.46   0.17     0.17    0.03   0.66  0.661XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74230  Cine/vid x-ray throat/esoph                       A   0.53   2.19     2.19NA  0.04   2.76  2.761XXX.00.00.0000000             25.0008 090 99      3.48   3.48   0.05
74230TCCine/vid x-ray throat/esoph                       A   0.00   2.00     2.00NA  0.01   2.01  2.011XXX.00.00.0000000             25.0008 030 99      3.29   3.29   0.02
7423026Cine/vid x-ray throat/esoph                       A   0.53   0.19     0.19    0.03   0.75  0.751XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74235  Remove esophagus obstruction                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74235TCRemove esophagus obstruction                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7423526Remove esophagus obstruction                      A   1.19   0.63     0.63    0.10   1.92  1.921XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74240  X-ray upper gi delay w/o kub                      A   0.69   2.71     2.71NA  0.05   3.45  3.451XXX.00.00.0000000             25.0008 090 99      5.15   5.15   0.06
74240TCX-ray upper gi delay w/o kub                      A   0.00   2.45     2.45NA  0.01   2.46  2.461XXX.00.00.0000000             25.0008 030 99      4.89   4.89   0.02
7424026X-ray upper gi delay w/o kub                      A   0.69   0.26     0.26    0.04   0.99  0.991XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74241  X-rayupper gi delay w/kub                         A   0.69   2.90     2.90NA  0.04   3.63  3.631XXX.00.00.0000000             25.0008 090 99      5.14   5.14   0.05
74241TCX-rayupper gi delay w/kub                         A   0.00   2.65     2.65NA  0.01   2.66  2.661XXX.00.00.0000000             25.0008 030 99      4.89   4.89   0.02
7424126X-rayupper gi delay w/kub                         A   0.69   0.25     0.25    0.03   0.97  0.971XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74245  X-ray upper gi&small intest                       A   0.91   4.44     4.44NA  0.06   5.41  5.411XXX.00.00.0000000             25.0008 090 99      5.23   5.23   0.06
74245TCX-ray upper gi&small intest                       A   0.00   4.11     4.11NA  0.01   4.12  4.121XXX.00.00.0000000             25.0008 030 99      4.90   4.90   0.01
7424526X-ray upper gi&small intest                       A   0.91   0.33     0.33    0.05   1.29  1.291XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74246  Contrst x-ray uppr gi tract                       A   0.69   3.16     3.16NA  0.05   3.90  3.901XXX.00.00.0000000             25.0008 090 99      5.15   5.15   0.06
74246TCContrst x-ray uppr gi tract                       A   0.00   2.91     2.91NA  0.01   2.92  2.921XXX.00.00.0000000             25.0008 030 99      4.90   4.90   0.02
7424626Contrst x-ray uppr gi tract                       A   0.69   0.25     0.25    0.04   0.98  0.981XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74247  Contrst x-ray uppr gi tract                       A   0.69   3.61     3.61NA  0.05   4.35  4.351XXX.00.00.0000000             25.0008 090 99      5.15   5.15   0.05
74247TCContrst x-ray uppr gi tract                       A   0.00   3.36     3.36NA  0.01   3.37  3.371XXX.00.00.0000000             25.0008 030 99      4.90   4.90   0.01
7424726Contrst x-ray uppr gi tract                       A   0.69   0.25     0.25    0.04   0.98  0.981XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74249  Contrst x-ray uppr gi tract                       A   0.91   4.87     4.87NA  0.06   5.84  5.841XXX.00.00.0000000             25.0008 090 99      5.23   5.23   0.06
74249TCContrst x-ray uppr gi tract                       A   0.00   4.54     4.54NA  0.01   4.55  4.551XXX.00.00.0000000             25.0008 030 99      4.90   4.90   0.01
7424926Contrst x-ray uppr gi tract                       A   0.91   0.33     0.33    0.05   1.29  1.291XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74250  X-ray exam of small bowel                         A   0.47   2.79     2.79NA  0.04   3.30  3.301XXX.00.00.0000000             25.0008 090 99      3.47   3.47   0.04
74250TCX-ray exam of small bowel                         A   0.00   2.62     2.62NA  0.01   2.63  2.631XXX.00.00.0000000             25.0008 020 99      3.30   3.30   0.01
7425026X-ray exam of small bowel                         A   0.47   0.17     0.17    0.03   0.67  0.671XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74251  X-ray exam of small bowel                         A   0.69  12.03    12.03NA  0.05  12.77 12.771XXX.00.00.0000000             25.0008 090 99      5.16   5.16   0.04
74251TCX-ray exam of small bowel                         A   0.00  11.78    11.78NA  0.01  11.79 11.791XXX.00.00.0000000             25.0008 030 99      4.91   4.91   0.00
7425126X-ray exam of small bowel                         A   0.69   0.25     0.25    0.04   0.98  0.981XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74260  X-ray exam of small bowel                         A   0.50   9.98     9.98NA  0.04  10.52 10.521XXX.00.00.0000000             25.0008 090 99      3.49   3.49   0.03
74260TCX-ray exam of small bowel                         A   0.00   9.80     9.80NA  0.01   9.81  9.811XXX.00.00.0000000             25.0008 030 99      3.31   3.31   0.00
7426026X-ray exam of small bowel                         A   0.50   0.18     0.18    0.03   0.71  0.711XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74261  Ct colonography dx                                A   2.40  13.52    13.52NA  0.13  16.05 16.051XXX.00.00.0040000             25.0008 090 88      7.83   7.83   0.13
74261TCCt colonography dx                                A   0.00  12.63    12.63NA  0.01  12.64 12.641XXX.00.00.0040000             25.0008 020 88      6.94   6.94   0.01
7426126Ct colonography dx                                A   2.40   0.89     0.89    0.12   3.41  3.411XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
74262  Ct colonography dx w/dye                          A   2.50  15.07    15.07NA  0.15  17.72 17.721XXX.00.00.0040000             25.0008 090 88     12.79  12.79   0.15
74262TCCt colonography dx w/dye                          A   0.00  14.16    14.16NA  0.01  14.17 14.171XXX.00.00.0040000             25.0008 020 88     11.88  11.88   0.01
7426226Ct colonography dx w/dye                          A   2.50   0.91     0.91    0.14   3.55  3.551XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
74263  Ct colonography screening                         N+  2.28  20.71    20.71NA  0.13  23.12 23.121XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
74263TCCt colonography screening                         N+  0.00  19.79    19.79NA  0.01  19.80 19.801XXX.00.00.0099999             25.0008 020 99      0.00   0.00   0.00
7426326Ct colonography screening                         N+  2.28   0.92     0.92    0.12   3.32  3.321XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
74270  Contrast x-ray exam of colon                      A   0.69   4.05     4.05NA  0.05   4.79  4.791XXX.00.00.0000000             25.0008 090 99      5.15   5.15   0.05
74270TCContrast x-ray exam of colon                      A   0.00   3.80     3.80NA  0.01   3.81  3.811XXX.00.00.0000000             25.0008 030 99      4.90   4.90   0.01
7427026Contrast x-ray exam of colon                      A   0.69   0.25     0.25    0.04   0.98  0.981XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74280  Contrast x-ray exam of colon                      A   0.99   5.65     5.65NA  0.06   6.70  6.701XXX.00.00.0000000             25.0008 090 99      5.26   5.26   0.06
74280TCContrast x-ray exam of colon                      A   0.00   5.29     5.29NA  0.01   5.30  5.301XXX.00.00.0000000             25.0008 030 99      4.90   4.90   0.01
7428026Contrast x-ray exam of colon                      A   0.99   0.36     0.36    0.05   1.40  1.401XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74283  Contrast x-ray exam of colon                      A   2.02   3.97     3.97NA  0.06   6.05  6.051XXX.00.00.0000000             25.0008 090 99      5.65   5.65   0.07
74283TCContrast x-ray exam of colon                      A   0.00   3.22     3.22NA  0.01   3.23  3.231XXX.00.00.0000000             25.0008 030 99      4.90   4.90   0.02
7428326Contrast x-ray exam of colon                      A   2.02   0.75     0.75    0.05   2.82  2.821XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74290  Contrast x-ray gallbladder                        A   0.32   1.78     1.78NA  0.02   2.12  2.121XXX.00.00.0000000             25.0008 090 99      3.41   3.41   0.03
74290TCContrast x-ray gallbladder                        A   0.00   1.66     1.66NA  0.01   1.67  1.671XXX.00.00.0000000             25.0008 010 99      3.29   3.29   0.02
7429026Contrast x-ray gallbladder                        A   0.32   0.12     0.12    0.01   0.45  0.451XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74291  Contrast x-rays gallbladder                       A   0.20   1.86     1.86NA  0.02   2.08  2.081XXX.00.00.0000000             25.0008 090 99      3.37   3.37   0.03
74291TCContrast x-rays gallbladder                       A   0.00   1.78     1.78NA  0.01   1.79  1.791XXX.00.00.0000000             25.0008 010 99      3.29   3.29   0.02
7429126Contrast x-rays gallbladder                       A   0.20   0.08     0.08    0.01   0.29  0.291XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74300  X-ray bile ducts/pancreas                         C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74300TCX-ray bile ducts/pancreas                         C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7430026X-ray bile ducts/pancreas                         A   0.36   0.13     0.13    0.03   0.52  0.521XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74301  X-rays at surgery add-on                          C   0.00   0.00     0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74301TCX-rays at surgery add-on                          C   0.00   0.00     0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7430126X-rays at surgery add-on                          A   0.21   0.08     0.08    0.03   0.32  0.321ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74305  X-ray bile ducts/pancreas                         C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99     10.36  10.36   0.05
74305TCX-ray bile ducts/pancreas                         C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99     10.21  10.21   0.01
7430526X-ray bile ducts/pancreas                         A   0.42   0.15     0.15    0.04   0.61  0.611XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74320  Contrast x-ray of bile ducts                      A   0.54   2.39     2.39NA  0.04   2.97  2.971XXX.00.00.0000000             25.0008 090 99     13.01  13.01   0.09
74320TCContrast x-ray of bile ducts                      A   0.00   2.20     2.20NA  0.01   2.21  2.211XXX.00.00.0000000             25.0008 030 99     12.82  12.82   0.06
7432026Contrast x-ray of bile ducts                      A   0.54   0.19     0.19    0.03   0.76  0.761XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74327  X-ray bile stone removal                          A   0.70   3.43     3.43NA  0.13   4.26  4.261XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74327TCX-ray bile stone removal                          A   0.00   3.18     3.18NA  0.01   3.19  3.191XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7432726X-ray bile stone removal                          A   0.70   0.25     0.25    0.12   1.07  1.071XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74328  X-ray bile duct endoscopy                         C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74328TCX-ray bile duct endoscopy                         C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7432826X-ray bile duct endoscopy                         A   0.70   0.28     0.28    0.05   1.03  1.031XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74329  X-ray for pancreas endoscopy                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74329TCX-ray for pancreas endoscopy                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7432926X-ray for pancreas endoscopy                      A   0.70   0.29     0.29    0.05   1.04  1.041XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74330  X-ray bile/panc endoscopy                         C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74330TCX-ray bile/panc endoscopy                         C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7433026X-ray bile/panc endoscopy                         A   0.90   0.35     0.35    0.07   1.32  1.321XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74340  X-ray guide for GI tube                           C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74340TCX-ray guide for GI tube                           C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7434026X-ray guide for GI tube                           A   0.54   0.20     0.20    0.04   0.78  0.781XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74355  X-ray guide intestinal tube                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74355TCX-ray guide intestinal tube                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7435526X-ray guide intestinal tube                       A   0.76   0.28     0.28    0.07   1.11  1.111XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74360  X-ray guide gi dilation                           C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74360TCX-ray guide gi dilation                           C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7436026X-ray guide gi dilation                           A   0.54   0.25     0.25    0.04   0.83  0.831XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74363  X-ray bile duct dilation                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74363TCX-ray bile duct dilation                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7436326X-ray bile duct dilation                          A   0.88   0.31     0.31    0.08   1.27  1.271XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74400  Contrst x-ray urinary tract                       A   0.49   2.91     2.91NA  0.04   3.44  3.441XXX.00.00.0000000             25.0008 090 99      8.53   8.53   0.06
74400TCContrst x-ray urinary tract                       A   0.00   2.73     2.73NA  0.01   2.74  2.741XXX.00.00.0000000             25.0008 020 99      8.35   8.35   0.03
7440026Contrst x-ray urinary tract                       A   0.49   0.18     0.18    0.03   0.70  0.701XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74410  Contrst x-ray urinary tract                       A   0.49   2.87     2.87NA  0.04   3.40  3.401XXX.00.00.0000000             25.0008 090 99      8.53   8.53   0.06
74410TCContrst x-ray urinary tract                       A   0.00   2.69     2.69NA  0.01   2.70  2.701XXX.00.00.0000000             25.0008 020 99      8.35   8.35   0.03
7441026Contrst x-ray urinary tract                       A   0.49   0.18     0.18    0.03   0.70  0.701XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74415  Contrst x-ray urinary tract                       A   0.49   3.68     3.68NA  0.04   4.21  4.211XXX.00.00.0000000             25.0008 090 99      8.54   8.54   0.05
74415TCContrst x-ray urinary tract                       A   0.00   3.50     3.50NA  0.01   3.51  3.511XXX.00.00.0000000             25.0008 020 99      8.36   8.36   0.02
7441526Contrst x-ray urinary tract                       A   0.49   0.18     0.18    0.03   0.70  0.701XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74420  Contrst x-ray urinary tract                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      8.50   8.50   0.04
74420TCContrst x-ray urinary tract                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      8.37   8.37   0.01
7442026Contrst x-ray urinary tract                       A   0.36   0.13     0.13    0.03   0.52  0.521XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74425  Contrst x-ray urinary tract                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      8.50   8.50   0.04
74425TCContrst x-ray urinary tract                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      8.37   8.37   0.01
7442526Contrst x-ray urinary tract                       A   0.36   0.13     0.13    0.03   0.52  0.521XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74430  Contrast x-ray bladder                            A   0.32   0.90     0.90NA  0.02   1.24  1.241XXX.00.00.0000000             25.0008 090 99      8.40   8.40   0.12
74430TCContrast x-ray bladder                            A   0.00   0.78     0.78NA  0.01   0.79  0.791XXX.00.00.0000000             25.0008 030 99      8.28   8.28   0.11
7443026Contrast x-ray bladder                            A   0.32   0.12     0.12    0.01   0.45  0.451XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74440  X-ray male genital tract                          A   0.38   2.13     2.13NA  0.04   2.55  2.551XXX.00.00.0000000             25.0008 090 99      8.48   8.48   0.07
74440TCX-ray male genital tract                          A   0.00   1.99     1.99NA  0.01   2.00  2.001XXX.00.00.0000000             25.0008 030 99      8.34   8.34   0.04
7444026X-ray male genital tract                          A   0.38   0.14     0.14    0.03   0.55  0.551XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74445  X-ray exam of penis                               C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      8.78   8.78   0.11
74445TCX-ray exam of penis                               C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      8.37   8.37   0.01
7444526X-ray exam of penis                               A   1.14   0.41     0.41    0.10   1.65  1.651XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74450  X-ray urethra/bladder                             C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      8.49   8.49   0.04
74450TCX-ray urethra/bladder                             C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      8.37   8.37   0.01
7445026X-ray urethra/bladder                             A   0.33   0.12     0.12    0.03   0.48  0.481XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74455  X-ray urethra/bladder                             A   0.33   2.22     2.22NA  0.02   2.57  2.571XXX.00.00.0000000             25.0008 090 99      8.46   8.46   0.05
74455TCX-ray urethra/bladder                             A   0.00   2.10     2.10NA  0.01   2.11  2.111XXX.00.00.0000000             25.0008 030 99      8.34   8.34   0.04
7445526X-ray urethra/bladder                             A   0.33   0.12     0.12    0.01   0.46  0.461XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74470  X-ray exam of kidney lesion                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99     10.40  10.40   0.05
74470TCX-ray exam of kidney lesion                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99     10.21  10.21   0.01
7447026X-ray exam of kidney lesion                       A   0.54   0.19     0.19    0.04   0.77  0.771XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74475  X-ray control cath insert                         A   0.54   2.36     2.36NA  0.04   2.94  2.941XXX.00.00.0000000             25.0008 090 99     45.23  45.23   0.24
74475TCX-ray control cath insert                         A   0.00   2.17     2.17NA  0.01   2.18  2.181XXX.00.00.0000000             25.0008 030 99     45.04  45.04   0.21
7447526X-ray control cath insert                         A   0.54   0.19     0.19    0.03   0.76  0.761XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74480  X-ray control cath insert                         A   0.54   2.36     2.36NA  0.04   2.94  2.941XXX.00.00.0000000             25.0008 090 99     45.23  45.23   0.24
74480TCX-ray control cath insert                         A   0.00   2.17     2.17NA  0.01   2.18  2.181XXX.00.00.0000000             25.0008 030 99     45.04  45.04   0.21
7448026X-ray control cath insert                         A   0.54   0.19     0.19    0.03   0.76  0.761XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74485  X-ray guide gu dilation                           A   0.54   2.37     2.37NA  0.04   2.95  2.951XXX.00.00.0000000             25.0008 090 99     45.23  45.23   0.24
74485TCX-ray guide gu dilation                           A   0.00   2.18     2.18NA  0.01   2.19  2.191XXX.00.00.0000000             25.0008 030 99     45.04  45.04   0.21
7448526X-ray guide gu dilation                           A   0.54   0.19     0.19    0.03   0.76  0.761XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74710  X-ray measurement of pelvis                       A   0.34   0.63     0.63NA  0.02   0.99  0.991XXX.00.00.0000000             25.0008 090 99      2.87   2.87   0.06
74710TCX-ray measurement of pelvis                       A   0.00   0.54     0.54NA  0.01   0.55  0.551XXX.00.00.0000000             25.0008 010 99      2.78   2.78   0.05
7471026X-ray measurement of pelvis                       A   0.34   0.09     0.09    0.01   0.44  0.441XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74740  X-ray female genital tract                        A   0.38   1.94     1.94NA  0.02   2.34  2.341XXX.00.00.0000000             25.0008 090 99     10.30  10.30   0.07
74740TCX-ray female genital tract                        A   0.00   1.80     1.80NA  0.01   1.81  1.811XXX.00.00.0000000             25.0008 030 99     10.16  10.16   0.06
7474026X-ray female genital tract                        A   0.38   0.14     0.14    0.01   0.53  0.531XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74742  X-ray fallopian tube                              C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74742TCX-ray fallopian tube                              C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7474226X-ray fallopian tube                              A   0.61   0.23     0.23    0.05   0.89  0.891XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
74775  X-ray exam of perineum                            C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      8.60   8.60   0.06
74775TCX-ray exam of perineum                            C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      8.37   8.37   0.01
7477526X-ray exam of perineum                            A   0.62   0.23     0.23    0.05   0.90  0.901XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75557  Cardiac mri for morph                             A   2.35   8.35     8.35NA  0.11  10.81 10.811XXX.00.00.0040000             25.0008 090 88     14.38  14.38   0.12
75557TCCardiac mri for morph                             A   0.00   7.49     7.49NA  0.01   7.50  7.501XXX.00.00.0040000             25.0008 010 88     13.52  13.52   0.02
7555726Cardiac mri for morph                             A   2.35   0.86     0.86    0.10   3.31  3.311XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
75559  Cardiac mri w/stress img                          A   2.95  11.69    11.69NA  0.13  14.77 14.771XXX.00.00.0040000             25.0008 090 88     14.60  14.60   0.13
75559TCCardiac mri w/stress img                          A   0.00  10.62    10.62NA  0.01  10.63 10.631XXX.00.00.0040000             25.0008 020 88     13.53  13.53   0.01
7555926Cardiac mri w/stress img                          A   2.95   1.07     1.07    0.12   4.14  4.141XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
75561  Cardiac mri for morph w/dye                       A   2.60  11.72    11.72NA  0.12  14.44 14.441XXX.00.00.0040000             25.0008 090 88     22.91  22.91   0.13
75561TCCardiac mri for morph w/dye                       A   0.00  10.77    10.77NA  0.01  10.78 10.781XXX.00.00.0040000             25.0008 010 88     21.96  21.96   0.02
7556126Cardiac mri for morph w/dye                       A   2.60   0.95     0.95    0.11   3.66  3.661XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
75563  Card mri w/stress img & dye                       A   3.00  13.90    13.90NA  0.12  17.02 17.021XXX.00.00.0040000             25.0008 090 88     23.05  23.05   0.13
75563TCCard mri w/stress img & dye                       A   0.00  12.81    12.81NA  0.01  12.82 12.821XXX.00.00.0040000             25.0008 010 88     21.96  21.96   0.02
7556326Card mri w/stress img & dye                       A   3.00   1.09     1.09    0.11   4.20  4.201XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
75565  Card mri veloc flow mapping                       A   0.25   1.62     1.62NA  0.02   1.89  1.891ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75565TCCard mri veloc flow mapping                       A   0.00   1.53     1.53NA  0.01   1.54  1.541ZZZ.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
7556526Card mri veloc flow mapping                       A   0.25   0.09     0.09    0.01   0.35  0.351ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75571  Ct hrt w/o dye w/ca test                          A   0.58   2.77     2.77NA  0.02   3.37  3.371XXX.00.00.0040000             25.0008 090 88      2.19   2.19   0.02
75571TCCt hrt w/o dye w/ca test                          A   0.00   2.56     2.56NA  0.01   2.57  2.571XXX.00.00.0040000             25.0008 020 88      1.98   1.98   0.01
7557126Ct hrt w/o dye w/ca test                          A   0.58   0.21     0.21    0.01   0.80  0.801XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
75572  Ct hrt w/3d image                                 A   1.75   7.44     7.44NA  0.06   9.25  9.251XXX.00.00.0040000             25.0008 090 88     11.31  11.31   0.07
75572TCCt hrt w/3d image                                 A   0.00   6.80     6.80NA  0.01   6.81  6.811XXX.00.00.0040000             25.0008 020 88     10.67  10.67   0.02
7557226Ct hrt w/3d image                                 A   1.75   0.64     0.64    0.05   2.44  2.441XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
75573  Ct hrt w/3d image congen                          A   2.55  10.01    10.01NA  0.09  12.65 12.651XXX.00.00.0040000             25.0008 090 88     11.61  11.61   0.09
75573TCCt hrt w/3d image congen                          A   0.00   9.08     9.08NA  0.01   9.09  9.091XXX.00.00.0040000             25.0008 020 88     10.68  10.68   0.01
7557326Ct hrt w/3d image congen                          A   2.55   0.93     0.93    0.08   3.56  3.561XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
75574  Ct angio hrt w/3d image                           A   2.40  11.15    11.15NA  0.09  13.64 13.641XXX.00.00.0040000             25.0008 090 88     11.55  11.55   0.09
75574TCCt angio hrt w/3d image                           A   0.00  10.28    10.28NA  0.01  10.29 10.291XXX.00.00.0040000             25.0008 020 88     10.68  10.68   0.01
7557426Ct angio hrt w/3d image                           A   2.40   0.87     0.87    0.08   3.35  3.351XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
75600  Contrast exam thoracic aorta                      A   0.49   5.85     5.85NA  0.04   6.38  6.381XXX.00.00.0060000             25.0008 090 99     88.80  88.80   0.19
75600TCContrast exam thoracic aorta                      A   0.00   5.68     5.68NA  0.01   5.69  5.691XXX.00.00.0060000             25.0008 030 99     88.63  88.63   0.16
7560026Contrast exam thoracic aorta                      A   0.49   0.17     0.17    0.03   0.69  0.691XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75605  Contrast exam thoracic aorta                      A   1.14   3.40     3.40NA  0.08   4.62  4.621XXX.00.00.0060000             25.0008 090 99     88.89  88.89   0.36
75605TCContrast exam thoracic aorta                      A   0.00   3.01     3.01NA  0.01   3.02  3.021XXX.00.00.0060000             25.0008 030 99     88.50  88.50   0.29
7560526Contrast exam thoracic aorta                      A   1.14   0.39     0.39    0.07   1.60  1.601XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75625  Contrast exam abdominl aorta                      A   1.14   3.37     3.37NA  0.11   4.62  4.621XXX.00.00.0060000             25.0008 090 99     88.86  88.86   0.39
75625TCContrast exam abdominl aorta                      A   0.00   3.01     3.01NA  0.01   3.02  3.021XXX.00.00.0060000             25.0008 030 99     88.50  88.50   0.29
7562526Contrast exam abdominl aorta                      A   1.14   0.36     0.36    0.10   1.60  1.601XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75630  X-ray aorta leg arteries                          A   1.79   3.58     3.58NA  0.11   5.48  5.481XXX.00.00.0060000             25.0008 090 99     89.09  89.09   0.40
75630TCX-ray aorta leg arteries                          A   0.00   2.98     2.98NA  0.01   2.99  2.991XXX.00.00.0060000             25.0008 030 99     88.49  88.49   0.30
7563026X-ray aorta leg arteries                          A   1.79   0.60     0.60    0.10   2.49  2.491XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75635  Ct angio abdominal arteries                       A   2.40  10.92    10.92NA  0.15  13.47 13.471XXX.00.00.0040000             25.0008 090 88     14.40  14.40   0.16
75635TCCt angio abdominal arteries                       A   0.00  10.05    10.05NA  0.03  10.08 10.081XXX.00.00.0040000             25.0008 020 88     13.53  13.53   0.04
7563526Ct angio abdominal arteries                       A   2.40   0.87     0.87    0.12   3.39  3.391XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
75658  Artery x-rays arm                                 A   1.31   4.07     4.07NA  0.09   5.47  5.471XXX.00.00.0060000             25.0008 090 99     88.96  88.96   0.32
75658TCArtery x-rays arm                                 A   0.00   3.66     3.66NA  0.01   3.67  3.671XXX.00.00.0060000             25.0008 030 99     88.55  88.55   0.24
7565826Artery x-rays arm                                 A   1.31   0.41     0.41    0.08   1.80  1.801XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75705  Artery x-rays spine                               A   2.18   5.12     5.12NA  0.08   7.38  7.381XXX.00.00.0060000             25.0008 090 99     89.42  89.42   0.28
75705TCArtery x-rays spine                               A   0.00   4.28     4.28NA  0.01   4.29  4.291XXX.00.00.0060000             25.0008 030 99     88.58  88.58   0.21
7570526Artery x-rays spine                               A   2.18   0.84     0.84    0.07   3.09  3.091XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75710  Artery x-rays arm/leg                             A   1.14   4.16     4.16NA  0.06   5.36  5.361XXX.00.00.0060000             25.0008 090 99     88.94  88.94   0.28
75710TCArtery x-rays arm/leg                             A   0.00   3.78     3.78NA  0.01   3.79  3.791XXX.00.00.0060000             25.0008 030 99     88.56  88.56   0.23
7571026Artery x-rays arm/leg                             A   1.14   0.38     0.38    0.05   1.57  1.571XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75716  Artery x-rays arms/legs                           A   1.31   4.99     4.99NA  0.13   6.43  6.431XXX.00.00.0062000             25.0008 090 99     88.64  88.64   0.68
75716TCArtery x-rays arms/legs                           A   0.00   4.56     4.56NA  0.03   4.59  4.591XXX.00.00.0062000             25.0008 030 99     88.21  88.21   0.58
7571626Artery x-rays arms/legs                           A   1.31   0.43     0.43    0.10   1.84  1.841XXX.00.00.0062000             25.0008 090 99      0.00   0.00   0.00
75726  Artery x-rays abdomen                             A   1.14   4.18     4.18NA  0.09   5.41  5.411XXX.00.00.0060000             25.0008 090 99     88.95  88.95   0.31
75726TCArtery x-rays abdomen                             A   0.00   3.79     3.79NA  0.01   3.80  3.801XXX.00.00.0060000             25.0008 030 99     88.56  88.56   0.23
7572626Artery x-rays abdomen                             A   1.14   0.39     0.39    0.08   1.61  1.611XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75731  Artery x-rays adrenal gland                       A   1.14   3.78     3.78NA  0.05   4.97  4.971XXX.00.00.0060000             25.0008 090 99     88.94  88.94   0.30
75731TCArtery x-rays adrenal gland                       A   0.00   3.37     3.37NA  0.01   3.38  3.381XXX.00.00.0060000             25.0008 030 99     88.53  88.53   0.26
7573126Artery x-rays adrenal gland                       A   1.14   0.41     0.41    0.04   1.59  1.591XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75733  Artery x-rays adrenals                            A   1.31   4.81     4.81NA  0.07   6.19  6.191XXX.00.00.0062000             25.0008 090 99     88.66  88.66   0.65
75733TCArtery x-rays adrenals                            A   0.00   4.33     4.33NA  0.03   4.36  4.361XXX.00.00.0062000             25.0008 030 99     88.18  88.18   0.61
7573326Artery x-rays adrenals                            A   1.31   0.48     0.48    0.04   1.83  1.831XXX.00.00.0062000             25.0008 090 99      0.00   0.00   0.00
75736  Artery x-rays pelvis                              A   1.14   4.03     4.03NA  0.06   5.23  5.231XXX.00.00.0060000             25.0008 090 99     88.93  88.93   0.29
75736TCArtery x-rays pelvis                              A   0.00   3.65     3.65NA  0.01   3.66  3.661XXX.00.00.0060000             25.0008 030 99     88.55  88.55   0.24
7573626Artery x-rays pelvis                              A   1.14   0.38     0.38    0.05   1.57  1.571XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75741  Artery x-rays lung                                A   1.31   3.46     3.46NA  0.09   4.86  4.861XXX.00.00.0060000             25.0008 090 99     88.95  88.95   0.37
75741TCArtery x-rays lung                                A   0.00   3.01     3.01NA  0.01   3.02  3.021XXX.00.00.0060000             25.0008 030 99     88.50  88.50   0.29
7574126Artery x-rays lung                                A   1.31   0.45     0.45    0.08   1.84  1.841XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75743  Artery x-rays lungs                               A   1.66   3.89     3.89NA  0.11   5.66  5.661XXX.00.00.0062000             25.0008 090 99     89.09  89.09   0.37
75743TCArtery x-rays lungs                               A   0.00   3.32     3.32NA  0.01   3.33  3.331XXX.00.00.0062000             25.0008 030 99     88.52  88.52   0.27
7574326Artery x-rays lungs                               A   1.66   0.57     0.57    0.10   2.33  2.331XXX.00.00.0062000             25.0008 090 99      0.00   0.00   0.00
75746  Artery x-rays lung                                A   1.14   3.86     3.86NA  0.08   5.08  5.081XXX.00.00.0060000             25.0008 090 99     28.97  28.97   0.15
75746TCArtery x-rays lung                                A   0.00   3.45     3.45NA  0.01   3.46  3.461XXX.00.00.0060000             25.0008 030 99     28.56  28.56   0.08
7574626Artery x-rays lung                                A   1.14   0.41     0.41    0.07   1.62  1.621XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75756  Artery x-rays chest                               A   1.14   4.33     4.33NA  0.23   5.70  5.701XXX.00.00.0060000             25.0008 090 99     28.94  28.94   0.29
75756TCArtery x-rays chest                               A   0.00   3.96     3.96NA  0.01   3.97  3.971XXX.00.00.0060000             25.0008 030 99     28.57  28.57   0.07
7575626Artery x-rays chest                               A   1.14   0.37     0.37    0.22   1.73  1.731XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75774  Artery x-ray each vessel                          A   0.36   2.63     2.63NA  0.04   3.03  3.031ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75774TCArtery x-ray each vessel                          A   0.00   2.51     2.51NA  0.01   2.52  2.521ZZZ.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7577426Artery x-ray each vessel                          A   0.36   0.12     0.12    0.03   0.51  0.511ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75791  Av dialysis shunt imaging                         A   1.71   8.25     8.25NA  0.11  10.07 10.071XXX.00.00.0060000             25.0008 090 99     29.16  29.16   0.14
75791TCAv dialysis shunt imaging                         A   0.00   7.69     7.69NA  0.01   7.70  7.701XXX.00.00.0060000             25.0008 030 99     28.60  28.60   0.04
7579126Av dialysis shunt imaging                         A   1.71   0.56     0.56    0.10   2.37  2.371XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75801  Lymph vessel x-ray arm/leg                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99     13.19  13.19   0.19
75801TCLymph vessel x-ray arm/leg                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99     12.87  12.87   0.01
7580126Lymph vessel x-ray arm/leg                        A   0.81   0.32     0.32    0.18   1.31  1.311XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75803  Lymph vessel x-ray arms/legs                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0002000             25.0008 090 99     13.30  13.30   0.11
75803TCLymph vessel x-ray arms/legs                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0002000             25.0008 030 99     12.87  12.87   0.01
7580326Lymph vessel x-ray arms/legs                      A   1.17   0.43     0.43    0.10   1.70  1.701XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
75805  Lymph vessel x-ray trunk                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99     13.17  13.17   0.08
75805TCLymph vessel x-ray trunk                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99     12.87  12.87   0.01
7580526Lymph vessel x-ray trunk                          A   0.81   0.30     0.30    0.07   1.18  1.181XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75807  Lymph vessel x-ray trunk                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0002000             25.0008 090 99     13.30  13.30   0.11
75807TCLymph vessel x-ray trunk                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0002000             25.0008 030 99     12.87  12.87   0.01
7580726Lymph vessel x-ray trunk                          A   1.17   0.43     0.43    0.10   1.70  1.701XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
75809  Nonvascular shunt x-ray                           A   0.47   2.63     2.63NA  0.04   3.14  3.141XXX.00.00.0060000             25.0008 090 99      3.01   3.01   0.04
75809TCNonvascular shunt x-ray                           A   0.00   2.44     2.44NA  0.01   2.45  2.451XXX.00.00.0060000             25.0008 030 99      2.82   2.82   0.01
7580926Nonvascular shunt x-ray                           A   0.47   0.19     0.19    0.03   0.69  0.691XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75810  Vein x-ray spleen/liver                           C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99     89.20  89.20   0.11
75810TCVein x-ray spleen/liver                           C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99     88.78  88.78   0.01
7581026Vein x-ray spleen/liver                           A   1.14   0.42     0.42    0.10   1.66  1.661XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75820  Vein x-ray arm/leg                                A   0.70   3.04     3.04NA  0.05   3.79  3.791XXX.00.00.0060000             25.0008 090 99     28.79  28.79   0.14
75820TCVein x-ray arm/leg                                A   0.00   2.79     2.79NA  0.01   2.80  2.801XXX.00.00.0060000             25.0008 030 99     28.54  28.54   0.10
7582026Vein x-ray arm/leg                                A   0.70   0.25     0.25    0.04   0.99  0.991XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75822  Vein x-ray arms/legs                              A   1.06   3.59     3.59NA  0.08   4.73  4.731XXX.00.00.0062000             25.0008 090 99     28.92  28.92   0.16
75822TCVein x-ray arms/legs                              A   0.00   3.22     3.22NA  0.01   3.23  3.231XXX.00.00.0062000             25.0008 030 99     28.55  28.55   0.09
7582226Vein x-ray arms/legs                              A   1.06   0.37     0.37    0.07   1.50  1.501XXX.00.00.0062000             25.0008 090 99      0.00   0.00   0.00
75825  Vein x-ray trunk                                  A   1.14   3.24     3.24NA  0.09   4.47  4.471XXX.00.00.0060000             25.0008 090 99     88.86  88.86   0.39
75825TCVein x-ray trunk                                  A   0.00   2.86     2.86NA  0.01   2.87  2.871XXX.00.00.0060000             25.0008 030 99     88.48  88.48   0.31
7582526Vein x-ray trunk                                  A   1.14   0.38     0.38    0.08   1.60  1.601XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75827  Vein x-ray chest                                  A   1.14   3.35     3.35NA  0.08   4.57  4.571XXX.00.00.0060000             25.0008 090 99     28.92  28.92   0.17
75827TCVein x-ray chest                                  A   0.00   2.97     2.97NA  0.01   2.98  2.981XXX.00.00.0060000             25.0008 030 99     28.54  28.54   0.10
7582726Vein x-ray chest                                  A   1.14   0.38     0.38    0.07   1.59  1.591XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75831  Vein x-ray kidney                                 A   1.14   3.42     3.42NA  0.25   4.81  4.811XXX.00.00.0060000             25.0008 090 99     88.88  88.88   0.53
75831TCVein x-ray kidney                                 A   0.00   3.04     3.04NA  0.01   3.05  3.051XXX.00.00.0060000             25.0008 030 99     88.50  88.50   0.29
7583126Vein x-ray kidney                                 A   1.14   0.38     0.38    0.24   1.76  1.761XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75833  Vein x-ray kidneys                                A   1.49   4.00     4.00NA  0.09   5.58  5.581XXX.00.00.0062000             25.0008 090 99     89.00  89.00   0.33
75833TCVein x-ray kidneys                                A   0.00   3.54     3.54NA  0.01   3.55  3.551XXX.00.00.0062000             25.0008 030 99     88.54  88.54   0.25
7583326Vein x-ray kidneys                                A   1.49   0.46     0.46    0.08   2.03  2.031XXX.00.00.0062000             25.0008 090 99      0.00   0.00   0.00
75840  Vein x-ray adrenal gland                          A   1.14   3.44     3.44NA  0.25   4.83  4.831XXX.00.00.0060000             25.0008 090 99     88.92  88.92   0.53
75840TCVein x-ray adrenal gland                          A   0.00   3.02     3.02NA  0.01   3.03  3.031XXX.00.00.0060000             25.0008 030 99     88.50  88.50   0.29
7584026Vein x-ray adrenal gland                          A   1.14   0.42     0.42    0.24   1.80  1.801XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75842  Vein x-ray adrenal glands                         A   1.49   4.17     4.17NA  0.09   5.75  5.751XXX.00.00.0062000             25.0008 090 99     89.10  89.10   0.32
75842TCVein x-ray adrenal glands                         A   0.00   3.62     3.62NA  0.01   3.63  3.631XXX.00.00.0062000             25.0008 030 99     88.55  88.55   0.24
7584226Vein x-ray adrenal glands                         A   1.49   0.55     0.55    0.08   2.12  2.121XXX.00.00.0062000             25.0008 090 99      0.00   0.00   0.00
75860  Vein x-ray neck                                   A   1.14   3.40     3.40NA  0.09   4.63  4.631XXX.00.00.0060000             25.0008 090 99     28.93  28.93   0.17
75860TCVein x-ray neck                                   A   0.00   3.01     3.01NA  0.01   3.02  3.021XXX.00.00.0060000             25.0008 030 99     28.54  28.54   0.09
7586026Vein x-ray neck                                   A   1.14   0.39     0.39    0.08   1.61  1.611XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75870  Vein x-ray skull                                  A   1.14   3.42     3.42NA  0.08   4.64  4.641XXX.00.00.0060000             25.0008 090 99     28.96  28.96   0.16
75870TCVein x-ray skull                                  A   0.00   3.00     3.00NA  0.01   3.01  3.011XXX.00.00.0060000             25.0008 030 99     28.54  28.54   0.09
7587026Vein x-ray skull                                  A   1.14   0.42     0.42    0.07   1.63  1.631XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75872  Vein x-ray skull epidural                         A   1.14   3.42     3.42NA  0.08   4.64  4.641XXX.00.00.0060000             25.0008 090 99     28.96  28.96   0.16
75872TCVein x-ray skull epidural                         A   0.00   3.00     3.00NA  0.01   3.01  3.011XXX.00.00.0060000             25.0008 030 99     28.54  28.54   0.09
7587226Vein x-ray skull epidural                         A   1.14   0.42     0.42    0.07   1.63  1.631XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75880  Vein x-ray eye socket                             A   0.70   6.34     6.34NA  0.05   7.09  7.091XXX.00.00.0060000             25.0008 090 99     28.93  28.93   0.09
75880TCVein x-ray eye socket                             A   0.00   6.00     6.00NA  0.01   6.01  6.011XXX.00.00.0060000             25.0008 030 99     28.59  28.59   0.05
7588026Vein x-ray eye socket                             A   0.70   0.34     0.34    0.04   1.08  1.081XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75885  Vein x-ray liver w/hemodynam                      A   1.44   3.54     3.54NA  0.09   5.07  5.071XXX.00.00.0060000             25.0008 090 99     89.00  89.00   0.37
75885TCVein x-ray liver w/hemodynam                      A   0.00   3.04     3.04NA  0.01   3.05  3.051XXX.00.00.0060000             25.0008 030 99     88.50  88.50   0.29
7588526Vein x-ray liver w/hemodynam                      A   1.44   0.50     0.50    0.08   2.02  2.021XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75887  Vein x-ray liver w/o hemodyn                      A   1.44   3.54     3.54NA  0.06   5.04  5.041XXX.00.00.0060000             25.0008 090 99     29.06  29.06   0.14
75887TCVein x-ray liver w/o hemodyn                      A   0.00   3.03     3.03NA  0.01   3.04  3.041XXX.00.00.0060000             25.0008 030 99     28.55  28.55   0.09
7588726Vein x-ray liver w/o hemodyn                      A   1.44   0.51     0.51    0.05   2.00  2.001XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75889  Vein x-ray liver w/hemodynam                      A   1.14   3.45     3.45NA  0.08   4.67  4.671XXX.00.00.0060000             25.0008 090 99     88.89  88.89   0.36
75889TCVein x-ray liver w/hemodynam                      A   0.00   3.06     3.06NA  0.01   3.07  3.071XXX.00.00.0060000             25.0008 030 99     88.50  88.50   0.29
7588926Vein x-ray liver w/hemodynam                      A   1.14   0.39     0.39    0.07   1.60  1.601XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75891  Vein x-ray liver                                  A   1.14   3.46     3.46NA  0.08   4.68  4.681XXX.00.00.0060000             25.0008 090 99     88.90  88.90   0.36
75891TCVein x-ray liver                                  A   0.00   3.06     3.06NA  0.01   3.07  3.071XXX.00.00.0060000             25.0008 030 99     88.50  88.50   0.29
7589126Vein x-ray liver                                  A   1.14   0.40     0.40    0.07   1.61  1.611XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75893  Venous sampling by catheter                       A   0.54   3.25     3.25NA  0.02   3.81  3.811XXX.00.00.0060000             25.0008 090 99     88.70  88.70   0.30
75893TCVenous sampling by catheter                       A   0.00   3.05     3.05NA  0.01   3.06  3.061XXX.00.00.0060000             25.0008 030 99     88.50  88.50   0.29
7589326Venous sampling by catheter                       A   0.54   0.20     0.20    0.01   0.75  0.751XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
75894  X-rays transcath therapy                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75894TCX-rays transcath therapy                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7589426X-rays transcath therapy                          A   1.31   0.46     0.46    0.16   1.93  1.931XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75896  X-rays transcath therapy                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75896TCX-rays transcath therapy                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7589626X-rays transcath therapy                          A   1.31   0.44     0.44    0.16   1.91  1.911XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75898  Follow-up angiography                             C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99     13.82  13.82   0.21
75898TCFollow-up angiography                             C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99     13.23  13.23   0.01
7589826Follow-up angiography                             A   1.65   0.59     0.59    0.20   2.44  2.441XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75901  Remove cva device obstruct                        A   0.49   4.75     4.75NA  0.04   5.28  5.281XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75901TCRemove cva device obstruct                        A   0.00   4.58     4.58NA  0.01   4.59  4.591XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7590126Remove cva device obstruct                        A   0.49   0.17     0.17    0.03   0.69  0.691XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75902  Remove cva lumen obstruct                         A   0.39   1.84     1.84NA  0.05   2.28  2.281XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75902TCRemove cva lumen obstruct                         A   0.00   1.71     1.71NA  0.01   1.72  1.721XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7590226Remove cva lumen obstruct                         A   0.39   0.13     0.13    0.04   0.56  0.561XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75945  Intravascular us                                  C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      6.30   6.30   0.06
75945TCIntravascular us                                  C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      6.18   6.18   0.01
7594526Intravascular us                                  A   0.40   0.12     0.12    0.05   0.57  0.571XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75946  Intravascular us add-on                           C   0.00   0.00     0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75946TCIntravascular us add-on                           C   0.00   0.00     0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7594626Intravascular us add-on                           A   0.40   0.11     0.11    0.07   0.58  0.581ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75952  Endovasc repair abdom aorta                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75952TCEndovasc repair abdom aorta                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7595226Endovasc repair abdom aorta                       A   4.49   1.32     1.32    0.86   6.67  6.671XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75953  Abdom aneurysm endovas rpr                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75953TCAbdom aneurysm endovas rpr                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7595326Abdom aneurysm endovas rpr                        A   1.36   0.40     0.40    0.27   2.03  2.031XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75954  Iliac aneurysm endovas rpr                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75954TCIliac aneurysm endovas rpr                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7595426Iliac aneurysm endovas rpr                        A   2.25   0.67     0.67    0.41   3.33  3.331XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75956  Xray endovasc thor ao repr                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75956TCXray endovasc thor ao repr                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7595626Xray endovasc thor ao repr                        A   7.00   2.04     2.04    1.44  10.48 10.481XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75957  Xray endovasc thor ao repr                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75957TCXray endovasc thor ao repr                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7595726Xray endovasc thor ao repr                        A   6.00   1.73     1.73    1.21   8.94  8.941XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75958  Xray place prox ext thor ao                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75958TCXray place prox ext thor ao                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7595826Xray place prox ext thor ao                       A   4.00   1.14     1.14    0.82   5.96  5.961XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75959  Xray place dist ext thor ao                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75959TCXray place dist ext thor ao                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7595926Xray place dist ext thor ao                       A   3.50   0.85     0.85    0.83   5.18  5.181XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75960  Transcath iv stent rs&i                           A   0.82   2.86     2.86NA  0.06   3.74  3.741XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75960TCTranscath iv stent rs&i                           A   0.00   2.59     2.59NA  0.01   2.60  2.601XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7596026Transcath iv stent rs&i                           A   0.82   0.27     0.27    0.05   1.14  1.141XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75962  Repair arterial blockage                          A   0.54   3.93     3.93NA  0.04   4.51  4.511XXX.00.00.0000000             25.0008 090 99    160.67 160.67   0.46
75962TCRepair arterial blockage                          A   0.00   3.75     3.75NA  0.01   3.76  3.761XXX.00.00.0000000             25.0008 030 99    160.49 160.49   0.43
7596226Repair arterial blockage                          A   0.54   0.18     0.18    0.03   0.75  0.751XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75964  Repair artery blockage each                       A   0.36   2.51     2.51NA  0.05   2.92  2.921ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75964TCRepair artery blockage each                       A   0.00   2.39     2.39NA  0.01   2.40  2.401ZZZ.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7596426Repair artery blockage each                       A   0.36   0.12     0.12    0.04   0.52  0.521ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75966  Repair arterial blockage                          A   1.31   3.90     3.90NA  0.08   5.29  5.291XXX.00.00.0000000             25.0008 090 99    160.89 160.89   0.53
75966TCRepair arterial blockage                          A   0.00   3.47     3.47NA  0.01   3.48  3.481XXX.00.00.0000000             25.0008 030 99    160.46 160.46   0.46
7596626Repair arterial blockage                          A   1.31   0.43     0.43    0.07   1.81  1.811XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75968  Repair artery blockage each                       A   0.36   2.26     2.26NA  0.02   2.64  2.641ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75968TCRepair artery blockage each                       A   0.00   2.14     2.14NA  0.01   2.15  2.151ZZZ.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7596826Repair artery blockage each                       A   0.36   0.12     0.12    0.01   0.49  0.491ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75970  Vascular biopsy                                   C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75970TCVascular biopsy                                   C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7597026Vascular biopsy                                   A   0.83   0.29     0.29    0.07   1.19  1.191XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75978  Repair venous blockage                            A   0.54   3.89     3.89NA  0.04   4.47  4.471XXX.00.00.0000000             25.0008 090 99     85.92  85.92   0.26
75978TCRepair venous blockage                            A   0.00   3.71     3.71NA  0.01   3.72  3.721XXX.00.00.0000000             25.0008 030 99     85.74  85.74   0.23
7597826Repair venous blockage                            A   0.54   0.18     0.18    0.03   0.75  0.751XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75980  Contrast xray exam bile duct                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75980TCContrast xray exam bile duct                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7598026Contrast xray exam bile duct                      A   1.44   0.51     0.51    0.12   2.07  2.071XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75982  Contrast xray exam bile duct                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75982TCContrast xray exam bile duct                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7598226Contrast xray exam bile duct                      A   1.44   0.50     0.50    0.12   2.06  2.061XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75984  Xray control catheter change                      A   0.72   2.59     2.59NA  0.05   3.36  3.361XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75984TCXray control catheter change                      A   0.00   2.34     2.34NA  0.01   2.35  2.351XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7598426Xray control catheter change                      A   0.72   0.25     0.25    0.04   1.01  1.011XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75989  Abscess drainage under x-ray                      A   1.19   2.48     2.48NA  0.06   3.73  3.731XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
75989TCAbscess drainage under x-ray                      A   0.00   2.06     2.06NA  0.01   2.07  2.071XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7598926Abscess drainage under x-ray                      A   1.19   0.42     0.42    0.05   1.66  1.661XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76000  Fluoroscope examination                           A   0.17   1.37     1.37NA  0.02   1.56  1.561XXX.00.00.0000000             25.0008 090 99      4.61   4.61   0.04
76000TCFluoroscope examination                           A   0.00   1.30     1.30NA  0.01   1.31  1.311XXX.00.00.0000000             25.0008 030 99      4.54   4.54   0.03
7600026Fluoroscope examination                           A   0.17   0.07     0.07    0.01   0.25  0.251XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76001  Fluoroscope exam extensive                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76001TCFluoroscope exam extensive                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7600126Fluoroscope exam extensive                        A   0.67   0.28     0.28    0.08   1.03  1.031XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76010  X-ray nose to rectum                              A   0.18   0.62     0.62NA  0.02   0.82  0.821XXX.00.00.0000000             25.0008 090 99      1.88   1.88   0.04
76010TCX-ray nose to rectum                              A   0.00   0.55     0.55NA  0.01   0.56  0.561XXX.00.00.0000000             25.0008 010 99      1.81   1.81   0.03
7601026X-ray nose to rectum                              A   0.18   0.07     0.07    0.01   0.26  0.261XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76080  X-ray exam of fistula                             A   0.54   1.24     1.24NA  0.04   1.82  1.821XXX.00.00.0000000             25.0008 090 99     10.31  10.31   0.13
76080TCX-ray exam of fistula                             A   0.00   1.05     1.05NA  0.01   1.06  1.061XXX.00.00.0000000             25.0008 030 99     10.12  10.12   0.10
7608026X-ray exam of fistula                             A   0.54   0.19     0.19    0.03   0.76  0.761XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76098  X-ray exam breast specimen                        A   0.16   0.38     0.38NA  0.02   0.56  0.561XXX.00.00.0000000             25.0008 090 99     12.55  12.55   0.40
76098TCX-ray exam breast specimen                        A   0.00   0.32     0.32NA  0.01   0.33  0.331XXX.00.00.0000000             25.0008 010 99     12.49  12.49   0.39
7609826X-ray exam breast specimen                        A   0.16   0.06     0.06    0.01   0.23  0.231XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76100  X-ray exam of body section                        A   0.58   2.42     2.42NA  0.06   3.06  3.061XXX.00.00.0000000             25.0008 090 99      3.10   3.10   0.06
76100TCX-ray exam of body section                        A   0.00   2.14     2.14NA  0.01   2.15  2.151XXX.00.00.0000000             25.0008 010 99      2.82   2.82   0.01
7610026X-ray exam of body section                        A   0.58   0.28     0.28    0.05   0.91  0.911XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76101  Complex body section x-ray                        A   0.58   3.93     3.93NA  0.09   4.60  4.601XXX.00.00.0000000             25.0008 090 99     10.56  10.56   0.11
76101TCComplex body section x-ray                        A   0.00   3.56     3.56NA  0.01   3.57  3.571XXX.00.00.0000000             25.0008 020 99     10.19  10.19   0.03
7610126Complex body section x-ray                        A   0.58   0.37     0.37    0.08   1.03  1.031XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76102  Complex body section x-rays                       A   0.58   5.46     5.46NA  0.11   6.15  6.151XXX.00.00.0002000             25.0008 090 99     10.57  10.57   0.12
76102TCComplex body section x-rays                       A   0.00   5.09     5.09NA  0.01   5.10  5.101XXX.00.00.0002000             25.0008 020 99     10.20  10.20   0.02
7610226Complex body section x-rays                       A   0.58   0.37     0.37    0.10   1.05  1.051XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
76120  Cine/video x-rays                                 A   0.38   1.85     1.85NA  0.04   2.27  2.271XXX.00.00.0000000             25.0008 090 99      4.68   4.68   0.06
76120TCCine/video x-rays                                 A   0.00   1.71     1.71NA  0.01   1.72  1.721XXX.00.00.0000000             25.0008 020 99      4.54   4.54   0.03
7612026Cine/video x-rays                                 A   0.38   0.14     0.14    0.03   0.55  0.551XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76125  Cine/video x-rays add-on                          C   0.00   0.00     0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76125TCCine/video x-rays add-on                          C   0.00   0.00     0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
7612526Cine/video x-rays add-on                          A   0.27   0.11     0.11    0.03   0.41  0.411ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76140  X-ray consultation                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
76376  3d render w/intrp postproces                      A   0.20   1.56     1.56NA  0.02   1.78  1.781XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76376TC3d render w/intrp postproces                      A   0.00   1.49     1.49NA  0.01   1.50  1.501XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
76376263d render w/intrp postproces                      A   0.20   0.07     0.07    0.01   0.28  0.281XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76377  3d render w/intrp postproces                      A   0.79   1.60     1.60NA  0.05   2.44  2.441XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76377TC3d render w/intrp postproces                      A   0.00   1.31     1.31NA  0.01   1.32  1.321XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
76377263d render w/intrp postproces                      A   0.79   0.29     0.29    0.04   1.12  1.121XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76380  CAT scan follow-up study                          A   0.98   3.94     3.94NA  0.05   4.97  4.971XXX.00.00.0000000             25.0008 090 99      4.31   4.31   0.05
76380TCCAT scan follow-up study                          A   0.00   3.57     3.57NA  0.01   3.58  3.581XXX.00.00.0000000             25.0008 010 99      3.94   3.94   0.01
7638026CAT scan follow-up study                          A   0.98   0.37     0.37    0.04   1.39  1.391XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76390  Mr spectroscopy                                   N+  1.40  12.20    12.20NA  0.06  13.66 13.661XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
76390TCMr spectroscopy                                   N+  0.00  11.64    11.64NA  0.01  11.65 11.651XXX.00.00.0099999             25.0008 010 99      0.00   0.00   0.00
7639026Mr spectroscopy                                   N+  1.40   0.56     0.56    0.05   2.01  2.011XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
76496  Fluoroscopic procedure                            C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
76496TCFluoroscopic procedure                            C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      4.56   4.56   0.01
7649626Fluoroscopic procedure                            C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76497  Ct procedure                                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
76497TCCt procedure                                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 020 99      3.94   3.94   0.01
7649726Ct procedure                                      C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76498  Mri procedure                                     C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
76498TCMri procedure                                     C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 020 99     13.53  13.53   0.01
7649826Mri procedure                                     C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76499  Radiographic procedure                            C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76499TCRadiographic procedure                            C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      1.83   1.83   0.01
7649926Radiographic procedure                            C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76506  Echo exam of head                                 A   0.63   3.10     3.10NA  0.05   3.78  3.781XXX.00.00.0000000             25.0008 090 99      2.81   2.81   0.05
76506TCEcho exam of head                                 A   0.00   2.86     2.86NA  0.01   2.87  2.871XXX.00.00.0000000             25.0008 010 99      2.57   2.57   0.01
7650626Echo exam of head                                 A   0.63   0.24     0.24    0.04   0.91  0.911XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76510  Ophth us b & quant a                              A   1.55   3.54     3.54NA  0.27   5.36  5.361XXX.00.00.0073000             25.0008 090 99      6.79   6.79   0.28
76510TCOphth us b & quant a                              A   0.00   2.52     2.52NA  0.01   2.53  2.531XXX.00.00.0073000             25.0008 020 99      5.77   5.77   0.02
7651026Ophth us b & quant a                              A   1.55   1.02     1.02    0.26   2.83  2.831XXX.00.00.0073000             25.0008 090 99      0.00   0.00   0.00
76511  Ophth us quant a only                             A   0.94   2.08     2.08NA  0.02   3.04  3.041XXX.00.00.0073000             25.0008 090 99      4.54   4.54   0.04
76511TCOphth us quant a only                             A   0.00   1.49     1.49NA  0.01   1.50  1.501XXX.00.00.0073000             25.0008 020 99      3.95   3.95   0.03
7651126Ophth us quant a only                             A   0.94   0.59     0.59    0.01   1.54  1.541XXX.00.00.0073000             25.0008 090 99      0.00   0.00   0.00
76512  Ophth us b w/non-quant a                          A   0.94   1.83     1.83NA  0.05   2.82  2.821XXX.00.00.0073000             25.0008 090 99      4.54   4.54   0.07
76512TCOphth us b w/non-quant a                          A   0.00   1.23     1.23NA  0.01   1.24  1.241XXX.00.00.0073000             25.0008 020 99      3.94   3.94   0.03
7651226Ophth us b w/non-quant a                          A   0.94   0.60     0.60    0.04   1.58  1.581XXX.00.00.0073000             25.0008 090 99      0.00   0.00   0.00
76513  Echo exam of eye water bath                       A   0.66   2.25     2.25NA  0.02   2.93  2.931XXX.00.00.0073000             25.0008 090 99      4.33   4.33   0.03
76513TCEcho exam of eye water bath                       A   0.00   1.87     1.87NA  0.01   1.88  1.881XXX.00.00.0073000             25.0008 020 99      3.95   3.95   0.02
7651326Echo exam of eye water bath                       A   0.66   0.38     0.38    0.01   1.05  1.051XXX.00.00.0073000             25.0008 090 99      0.00   0.00   0.00
76514  Echo exam of eye thickness                        A   0.17   0.26     0.26NA  0.02   0.45  0.451XXX.00.00.0072000             25.0008 090 99      0.98   0.98   0.07
76514TCEcho exam of eye thickness                        A   0.00   0.16     0.16NA  0.01   0.17  0.171XXX.00.00.0072000             25.0008 010 99      0.88   0.88   0.06
7651426Echo exam of eye thickness                        A   0.17   0.10     0.10    0.01   0.28  0.281XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
76516  Echo exam of eye                                  A   0.54   1.82     1.82NA  0.02   2.38  2.381XXX.00.00.0072000             25.0008 090 99      2.92   2.92   0.03
76516TCEcho exam of eye                                  A   0.00   1.47     1.47NA  0.01   1.48  1.481XXX.00.00.0072000             25.0008 010 99      2.57   2.57   0.02
7651626Echo exam of eye                                  A   0.54   0.35     0.35    0.01   0.90  0.901XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
76519  Echo exam of eye                                  A   0.54   2.00     2.00NA  0.04   2.58  2.581XXX.00.00.0072000             25.0008 090 99      4.31   4.31   0.05
76519TCEcho exam of eye                                  A   0.00   1.64     1.64NA  0.01   1.65  1.651XXX.00.00.0072000             25.0008 010 99      3.95   3.95   0.02
7651926Echo exam of eye                                  A   0.54   0.36     0.36    0.03   0.93  0.931XXX.00.00.0073000             25.0008 090 99      0.00   0.00   0.00
76529  Echo exam of eye                                  A   0.57   1.81     1.81NA  0.04   2.42  2.421XXX.00.00.0003000             25.0008 090 99      2.93   2.93   0.05
76529TCEcho exam of eye                                  A   0.00   1.44     1.44NA  0.01   1.45  1.451XXX.00.00.0003000             25.0008 010 99      2.56   2.56   0.02
7652926Echo exam of eye                                  A   0.57   0.37     0.37    0.03   0.97  0.971XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
76536  Us exam of head and neck                          A   0.56   3.09     3.09NA  0.04   3.69  3.691XXX.00.00.0000000             25.0008 090 99      4.17   4.17   0.04
76536TCUs exam of head and neck                          A   0.00   2.88     2.88NA  0.01   2.89  2.891XXX.00.00.0000000             25.0008 010 99      3.96   3.96   0.01
7653626Us exam of head and neck                          A   0.56   0.21     0.21    0.03   0.80  0.801XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76604  Us exam chest                                     A   0.55   2.06     2.06NA  0.04   2.65  2.651XXX.00.00.0040000             25.0008 090 88      2.77   2.77   0.04
76604TCUs exam chest                                     A   0.00   1.86     1.86NA  0.01   1.87  1.871XXX.00.00.0040000             25.0008 010 88      2.57   2.57   0.01
7660426Us exam chest                                     A   0.55   0.20     0.20    0.03   0.78  0.781XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
76645  Us exam breast(s)                                 A   0.54   2.37     2.37NA  0.05   2.96  2.961XXX.00.00.0002000             25.0008 090 99      2.77   2.77   0.05
76645TCUs exam breast(s)                                 A   0.00   2.17     2.17NA  0.01   2.18  2.181XXX.00.00.0002000             25.0008 010 99      2.57   2.57   0.01
7664526Us exam breast(s)                                 A   0.54   0.20     0.20    0.04   0.78  0.781XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
76700  Us exam abdom complete                            A   0.81   3.37     3.37NA  0.05   4.23  4.231XXX.00.00.0040000             25.0008 090 88      4.26   4.26   0.05
76700TCUs exam abdom complete                            A   0.00   3.07     3.07NA  0.01   3.08  3.081XXX.00.00.0040000             25.0008 010 88      3.96   3.96   0.01
7670026Us exam abdom complete                            A   0.81   0.30     0.30    0.04   1.15  1.151XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
76705  Echo exam of abdomen                              A   0.59   2.64     2.64NA  0.04   3.27  3.271XXX.00.00.0040000             25.0008 090 88      4.18   4.18   0.05
76705TCEcho exam of abdomen                              A   0.00   2.42     2.42NA  0.01   2.43  2.431XXX.00.00.0040000             25.0008 010 88      3.96   3.96   0.02
7670526Echo exam of abdomen                              A   0.59   0.22     0.22    0.03   0.84  0.841XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
76770  Us exam abdo back wall comp                       A   0.74   3.21     3.21NA  0.05   4.00  4.001XXX.00.00.0040000             25.0008 090 88      4.23   4.23   0.05
76770TCUs exam abdo back wall comp                       A   0.00   2.94     2.94NA  0.01   2.95  2.951XXX.00.00.0040000             25.0008 010 88      3.96   3.96   0.01
7677026Us exam abdo back wall comp                       A   0.74   0.27     0.27    0.04   1.05  1.051XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
76775  Us exam abdo back wall lim                        A   0.58   2.66     2.66NA  0.04   3.28  3.281XXX.00.00.0040000             25.0008 090 88      4.17   4.17   0.05
76775TCUs exam abdo back wall lim                        A   0.00   2.45     2.45NA  0.01   2.46  2.461XXX.00.00.0040000             25.0008 010 88      3.96   3.96   0.02
7677526Us exam abdo back wall lim                        A   0.58   0.21     0.21    0.03   0.82  0.821XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
76776  Us exam k transpl w/doppler                       A   0.76   3.83     3.83NA  0.05   4.64  4.641XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
76776TCUs exam k transpl w/doppler                       A   0.00   3.55     3.55NA  0.01   3.56  3.561XXX.00.00.0040000             25.0008 010 88      0.00   0.00   0.00
7677626Us exam k transpl w/doppler                       A   0.76   0.28     0.28    0.04   1.08  1.081XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
76800  Us exam spinal canal                              A   1.13   2.74     2.74NA  0.05   3.92  3.921XXX.00.00.0000000             25.0008 090 99      4.38   4.38   0.06
76800TCUs exam spinal canal                              A   0.00   2.32     2.32NA  0.01   2.33  2.331XXX.00.00.0000000             25.0008 010 99      3.96   3.96   0.02
7680026Us exam spinal canal                              A   1.13   0.42     0.42    0.04   1.59  1.591XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76801  Ob us < 14 wks single fetus                       A   0.99   2.78     2.78NA  0.04   3.81  3.811XXX.00.00.0000000             25.0008 010 99      4.35   4.35   0.05
76801TCOb us < 14 wks single fetus                       A   0.00   2.39     2.39NA  0.01   2.40  2.401XXX.00.00.0000000             25.0008 010 99      3.96   3.96   0.02
7680126Ob us < 14 wks single fetus                       A   0.99   0.39     0.39    0.03   1.41  1.411XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76802  Ob us < 14 wks addl fetus                         A   0.83   1.10     1.10NA  0.04   1.97  1.971ZZZ.00.00.0000000             25.0008 010 99      2.88   2.88   0.06
76802TCOb us < 14 wks addl fetus                         A   0.00   0.77     0.77NA  0.01   0.78  0.781ZZZ.00.00.0000000             25.0008 010 99      2.55   2.55   0.03
7680226Ob us < 14 wks addl fetus                         A   0.83   0.33     0.33    0.03   1.19  1.191ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76805  Ob us >/= 14 wks sngl fetus                       A   0.99   3.41     3.41NA  0.04   4.44  4.441XXX.00.00.0000000             25.0008 090 99      4.36   4.36   0.04
76805TCOb us >/= 14 wks sngl fetus                       A   0.00   3.01     3.01NA  0.01   3.02  3.021XXX.00.00.0000000             25.0008 010 99      3.96   3.96   0.01
7680526Ob us >/= 14 wks sngl fetus                       A   0.99   0.40     0.40    0.03   1.42  1.421XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76810  Ob us >/= 14 wks addl fetus                       A   0.98   1.87     1.87NA  0.04   2.89  2.891ZZZ.00.00.0000000             25.0008 090 99      4.34   4.34   0.06
76810TCOb us >/= 14 wks addl fetus                       A   0.00   1.48     1.48NA  0.01   1.49  1.491ZZZ.00.00.0000000             25.0008 010 99      3.95   3.95   0.03
7681026Ob us >/= 14 wks addl fetus                       A   0.98   0.39     0.39    0.03   1.40  1.401ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76811  Ob us detailed sngl fetus                         A   1.90   3.62     3.62NA  0.06   5.58  5.581XXX.00.00.0000000             25.0008 010 99      6.97   6.97   0.07
76811TCOb us detailed sngl fetus                         A   0.00   2.82     2.82NA  0.01   2.83  2.831XXX.00.00.0000000             25.0008 010 99      6.17   6.17   0.02
7681126Ob us detailed sngl fetus                         A   1.90   0.80     0.80    0.05   2.75  2.751XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76812  Ob us detailed addl fetus                         A   1.78   4.53     4.53NA  0.06   6.37  6.371ZZZ.00.00.0000000             25.0008 010 99      3.34   3.34   0.06
76812TCOb us detailed addl fetus                         A   0.00   3.77     3.77NA  0.01   3.78  3.781ZZZ.00.00.0000000             25.0008 010 99      2.58   2.58   0.01
7681226Ob us detailed addl fetus                         A   1.78   0.76     0.76    0.05   2.59  2.591ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76813  Ob us nuchal meas 1 gest                          A   1.18   2.42     2.42NA  0.05   3.65  3.651XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
76813TCOb us nuchal meas 1 gest                          A   0.00   1.93     1.93NA  0.01   1.94  1.941XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
7681326Ob us nuchal meas 1 gest                          A   1.18   0.49     0.49    0.04   1.71  1.711XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76814  Ob us nuchal meas add-on                          A   0.99   1.34     1.34NA  0.04   2.37  2.371XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
76814TCOb us nuchal meas add-on                          A   0.00   0.92     0.92NA  0.01   0.93  0.931XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
7681426Ob us nuchal meas add-on                          A   0.99   0.42     0.42    0.03   1.44  1.441XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76815  Ob us limited fetus(s)                            A   0.65   2.04     2.04NA  0.02   2.71  2.711XXX.00.00.0000000             25.0008 090 99      2.82   2.82   0.02
76815TCOb us limited fetus(s)                            A   0.00   1.79     1.79NA  0.01   1.80  1.801XXX.00.00.0000000             25.0008 010 99      2.57   2.57   0.01
7681526Ob us limited fetus(s)                            A   0.65   0.25     0.25    0.01   0.91  0.911XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76816  Ob us follow-up per fetus                         A   0.85   2.66     2.66NA  0.04   3.55  3.551XXX.00.00.0000000             25.0008 090 99      2.92   2.92   0.04
76816TCOb us follow-up per fetus                         A   0.00   2.31     2.31NA  0.01   2.32  2.321XXX.00.00.0000000             25.0008 010 99      2.57   2.57   0.01
7681626Ob us follow-up per fetus                         A   0.85   0.35     0.35    0.03   1.23  1.231XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76817  Transvaginal us obstetric                         A   0.75   2.28     2.28NA  0.04   3.07  3.071XXX.00.00.0000000             25.0008 010 99      2.87   2.87   0.04
76817TCTransvaginal us obstetric                         A   0.00   1.98     1.98NA  0.01   1.99  1.991XXX.00.00.0000000             25.0008 010 99      2.57   2.57   0.01
7681726Transvaginal us obstetric                         A   0.75   0.30     0.30    0.03   1.08  1.081XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76818  Fetal biophys profile w/nst                       A   1.05   2.61     2.61NA  0.04   3.70  3.701XXX.00.00.0000000             25.0008 090 99      4.39   4.39   0.05
76818TCFetal biophys profile w/nst                       A   0.00   2.17     2.17NA  0.01   2.18  2.181XXX.00.00.0000000             25.0008 010 99      3.95   3.95   0.02
7681826Fetal biophys profile w/nst                       A   1.05   0.44     0.44    0.03   1.52  1.521XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76819  Fetal biophys profil w/o nst                      A   0.77   1.88     1.88NA  0.04   2.69  2.691XXX.00.00.0000000             25.0008 090 99      4.26   4.26   0.06
76819TCFetal biophys profil w/o nst                      A   0.00   1.57     1.57NA  0.01   1.58  1.581XXX.00.00.0000000             25.0008 010 99      3.95   3.95   0.03
7681926Fetal biophys profil w/o nst                      A   0.77   0.31     0.31    0.03   1.11  1.111XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76820  Umbilical artery echo                             A   0.50   0.68     0.68NA  0.02   1.20  1.201XXX.00.00.0000000             25.0008 090 99      2.74   2.74   0.06
76820TCUmbilical artery echo                             A   0.00   0.47     0.47NA  0.01   0.48  0.481XXX.00.00.0000000             25.0008 010 99      2.53   2.53   0.05
7682026Umbilical artery echo                             A   0.50   0.21     0.21    0.01   0.72  0.721XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76821  Middle cerebral artery echo                       A   0.70   2.11     2.11NA  0.04   2.85  2.851XXX.00.00.0000000             25.0008 090 99      2.86   2.86   0.04
76821TCMiddle cerebral artery echo                       A   0.00   1.82     1.82NA  0.01   1.83  1.831XXX.00.00.0000000             25.0008 010 99      2.57   2.57   0.01
7682126Middle cerebral artery echo                       A   0.70   0.29     0.29    0.03   1.02  1.021XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76825  Echo exam of fetal heart                          A   1.67   4.80     4.80NA  0.05   6.52  6.521XXX.00.00.0000000             25.0008 090 99      9.16   9.16   0.06
76825TCEcho exam of fetal heart                          A   0.00   4.13     4.13NA  0.01   4.14  4.141XXX.00.00.0000000             25.0008 010 99      8.49   8.49   0.02
7682526Echo exam of fetal heart                          A   1.67   0.67     0.67    0.04   2.38  2.381XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76826  Echo exam of fetal heart                          A   0.83   3.06     3.06NA  0.04   3.93  3.931XXX.00.00.0000000             25.0008 090 99      8.81   8.81   0.06
76826TCEcho exam of fetal heart                          A   0.00   2.73     2.73NA  0.01   2.74  2.741XXX.00.00.0000000             25.0008 010 99      8.48   8.48   0.03
7682626Echo exam of fetal heart                          A   0.83   0.33     0.33    0.03   1.19  1.191XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76827  Echo exam of fetal heart                          A   0.58   1.19     1.19NA  0.02   1.79  1.791XXX.00.00.0000000             25.0008 090 99      2.79   2.79   0.04
76827TCEcho exam of fetal heart                          A   0.00   0.96     0.96NA  0.01   0.97  0.971XXX.00.00.0000000             25.0008 010 99      2.56   2.56   0.03
7682726Echo exam of fetal heart                          A   0.58   0.23     0.23    0.01   0.82  0.821XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76828  Echo exam of fetal heart                          A   0.56   0.74     0.74NA  0.02   1.32  1.321XXX.00.00.0000000             25.0008 090 99      2.76   2.76   0.06
76828TCEcho exam of fetal heart                          A   0.00   0.51     0.51NA  0.01   0.52  0.521XXX.00.00.0000000             25.0008 010 99      2.53   2.53   0.05
7682826Echo exam of fetal heart                          A   0.56   0.23     0.23    0.01   0.80  0.801XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76830  Transvaginal us non-ob                            A   0.69   1.54     1.54NA  0.04   2.27  2.271XXX.00.00.0000000             25.0008 090 99      4.21   4.21   0.06
76830TCTransvaginal us non-ob                            A   0.00   1.27     1.27NA  0.01   1.28  1.281XXX.00.00.0000000             25.0008 010 99      3.94   3.94   0.03
7683026Transvaginal us non-ob                            A   0.69   0.27     0.27    0.03   0.99  0.991XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76831  Echo exam uterus                                  A   0.72   3.04     3.04NA  0.04   3.80  3.801XXX.00.00.0040000             25.0008 090 88      6.47   6.47   0.05
76831TCEcho exam uterus                                  A   0.00   2.74     2.74NA  0.01   2.75  2.751XXX.00.00.0040000             25.0008 030 88      6.17   6.17   0.02
7683126Echo exam uterus                                  A   0.72   0.30     0.30    0.03   1.05  1.051XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
76856  Us exam pelvic complete                           A   0.69   3.03     3.03NA  0.04   3.76  3.761XXX.00.00.0040000             25.0008 090 88      4.22   4.22   0.04
76856TCUs exam pelvic complete                           A   0.00   2.77     2.77NA  0.01   2.78  2.781XXX.00.00.0040000             25.0008 010 88      3.96   3.96   0.01
7685626Us exam pelvic complete                           A   0.69   0.26     0.26    0.03   0.98  0.981XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
76857  Us exam pelvic limited                            A   0.38   2.46     2.46NA  0.04   2.88  2.881XXX.00.00.0040000             25.0008 090 88      2.71   2.71   0.04
76857TCUs exam pelvic limited                            A   0.00   2.32     2.32NA  0.01   2.33  2.331XXX.00.00.0040000             25.0008 010 88      2.57   2.57   0.01
7685726Us exam pelvic limited                            A   0.38   0.14     0.14    0.03   0.55  0.551XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
76870  Us exam scrotum                                   A   0.64   3.06     3.06NA  0.05   3.75  3.751XXX.00.00.0040000             25.0008 090 88      4.19   4.19   0.05
76870TCUs exam scrotum                                   A   0.00   2.83     2.83NA  0.01   2.84  2.841XXX.00.00.0040000             25.0008 010 88      3.96   3.96   0.01
7687026Us exam scrotum                                   A   0.64   0.23     0.23    0.04   0.91  0.911XXX.00.00.0040000             25.0008 090 88      0.00   0.00   0.00
76872  Us transrectal                                    A   0.69   1.94     1.94NA  0.05   2.68  2.681XXX.00.00.0000000             25.0008 090 99      4.20   4.20   0.06
76872TCUs transrectal                                    A   0.00   1.69     1.69NA  0.01   1.70  1.701XXX.00.00.0000000             25.0008 010 99      3.95   3.95   0.02
7687226Us transrectal                                    A   0.69   0.25     0.25    0.04   0.98  0.981XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76873  Echograp trans r pros study                       A   1.55   3.47     3.47NA  0.09   5.11  5.111XXX.00.00.0099999             25.0008 090 99      6.77   6.77   0.10
76873TCEchograp trans r pros study                       A   0.00   2.87     2.87NA  0.01   2.88  2.881XXX.00.00.0099999             25.0008 020 99      6.17   6.17   0.02
7687326Echograp trans r pros study                       A   1.55   0.60     0.60    0.08   2.23  2.231XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
76881  Us xtr non-vasc complete                          A   0.63   2.98     2.98NA  0.05   3.66  3.661XXX.00.00.0000900             25.0008 090 99      4.20   4.20   0.05
76881TCUs xtr non-vasc complete                          A   0.00   2.74     2.74NA  0.01   2.75  2.751XXX.00.00.0000900             25.0008 010 99      3.96   3.96   0.01
7688126Us xtr non-vasc complete                          A   0.63   0.24     0.24    0.04   0.91  0.911XXX.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
76882  Us xtr non-vasc lmtd                              A   0.49   0.50     0.50NA  0.05   1.04  1.041XXX.00.00.0000900             25.0008 090 99      2.68   2.68   0.12
76882TCUs xtr non-vasc lmtd                              A   0.00   0.33     0.33NA  0.01   0.34  0.341XXX.00.00.0000900             25.0008 010 99      2.51   2.51   0.08
7688226Us xtr non-vasc lmtd                              A   0.49   0.17     0.17    0.04   0.70  0.701XXX.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
76885  Us exam infant hips dynamic                       A   0.74   3.72     3.72NA  0.05   4.51  4.511XXX.00.00.0000000             25.0008 090 99      2.86   2.86   0.05
76885TCUs exam infant hips dynamic                       A   0.00   3.44     3.44NA  0.01   3.45  3.451XXX.00.00.0000000             25.0008 010 99      2.58   2.58   0.01
7688526Us exam infant hips dynamic                       A   0.74   0.28     0.28    0.04   1.06  1.061XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76886  Us exam infant hips static                        A   0.62   2.54     2.54NA  0.02   3.18  3.181XXX.00.00.0000000             25.0008 090 99      2.80   2.80   0.02
76886TCUs exam infant hips static                        A   0.00   2.31     2.31NA  0.01   2.32  2.321XXX.00.00.0000000             25.0008 010 99      2.57   2.57   0.01
7688626Us exam infant hips static                        A   0.62   0.23     0.23    0.01   0.86  0.861XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76930  Echo guide cardiocentesis                         A   0.67   1.83     1.83NA  0.02   2.52  2.521XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76930TCEcho guide cardiocentesis                         A   0.00   1.59     1.59NA  0.01   1.60  1.601XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7693026Echo guide cardiocentesis                         A   0.67   0.24     0.24    0.01   0.92  0.921XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76932  Echo guide for heart biopsy                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76932TCEcho guide for heart biopsy                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7693226Echo guide for heart biopsy                       A   0.67   0.24     0.24    0.04   0.95  0.951XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76936  Echo guide for artery repair                      A   1.99   6.22     6.22NA  0.24   8.45  8.451XXX.00.00.0000000             25.0008 090 99      4.96   4.96   0.24
76936TCEcho guide for artery repair                      A   0.00   5.60     5.60NA  0.01   5.61  5.611XXX.00.00.0000000             25.0008 030 99      4.34   4.34   0.01
7693626Echo guide for artery repair                      A   1.99   0.62     0.62    0.23   2.84  2.841XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76937  Us guide vascular access                          A   0.30   0.74     0.74NA  0.04   1.08  1.081ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76937TCUs guide vascular access                          A   0.00   0.64     0.64NA  0.01   0.65  0.651ZZZ.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7693726Us guide vascular access                          A   0.30   0.10     0.10    0.03   0.43  0.431ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76940  Us guide tissue ablation                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76940TCUs guide tissue ablation                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7694026Us guide tissue ablation                          A   2.00   0.74     0.74    0.29   3.03  3.031XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76941  Echo guide for transfusion                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76941TCEcho guide for transfusion                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7694126Echo guide for transfusion                        A   1.34   0.57     0.57    0.11   2.02  2.021XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76942  Echo guide for biopsy                             A   0.67   5.43     5.43NA  0.05   6.15  6.151XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76942TCEcho guide for biopsy                             A   0.00   5.18     5.18NA  0.01   5.19  5.191XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7694226Echo guide for biopsy                             A   0.67   0.25     0.25    0.04   0.96  0.961XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76945  Echo guide villus sampling                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76945TCEcho guide villus sampling                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7694526Echo guide villus sampling                        A   0.67   0.29     0.29    0.04   1.00  1.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76946  Echo guide for amniocentesis                      A   0.38   0.56     0.56NA  0.02   0.96  0.961XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76946TCEcho guide for amniocentesis                      A   0.00   0.40     0.40NA  0.01   0.41  0.411XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7694626Echo guide for amniocentesis                      A   0.38   0.16     0.16    0.01   0.55  0.551XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76948  Echo guide ova aspiration                         A   0.38   0.57     0.57NA  0.04   0.99  0.991XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76948TCEcho guide ova aspiration                         A   0.00   0.41     0.41NA  0.01   0.42  0.421XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7694826Echo guide ova aspiration                         A   0.38   0.16     0.16    0.03   0.57  0.571XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76950  Echo guidance radiotherapy                        A   0.58   0.87     0.87NA  0.04   1.49  1.491XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76950TCEcho guidance radiotherapy                        A   0.00   0.64     0.64NA  0.01   0.65  0.651XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
7695026Echo guidance radiotherapy                        A   0.58   0.23     0.23    0.03   0.84  0.841XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76965  Echo guidance radiotherapy                        A   1.34   1.21     1.21NA  0.09   2.64  2.641XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76965TCEcho guidance radiotherapy                        A   0.00   0.71     0.71NA  0.01   0.72  0.721XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7696526Echo guidance radiotherapy                        A   1.34   0.50     0.50    0.08   1.92  1.921XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76970  Ultrasound exam follow-up                         A   0.40   2.57     2.57NA  0.05   3.02  3.021XXX.00.00.0000000             25.0008 090 99      2.72   2.72   0.05
76970TCUltrasound exam follow-up                         A   0.00   2.42     2.42NA  0.01   2.43  2.431XXX.00.00.0000000             25.0008 010 99      2.57   2.57   0.01
7697026Ultrasound exam follow-up                         A   0.40   0.15     0.15    0.04   0.59  0.591XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76975  GI endoscopic ultrasound                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      6.56   6.56   0.09
76975TCGI endoscopic ultrasound                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      6.18   6.18   0.01
7697526GI endoscopic ultrasound                          A   0.81   0.38     0.38    0.08   1.27  1.271XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76977  Us bone density measure                           A   0.05   0.14     0.14NA  0.02   0.21  0.211XXX.00.00.0000000             25.0008 090 99      1.85   1.85   0.16
76977TCUs bone density measure                           A   0.00   0.12     0.12NA  0.01   0.13  0.131XXX.00.00.0000000             25.0008 010 99      1.83   1.83   0.15
7697726Us bone density measure                           A   0.05   0.02     0.02    0.01   0.08  0.081XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76998  Us guide intraop                                  C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76998TCUs guide intraop                                  C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
7699826Us guide intraop                                  A   1.20   0.42     0.42    0.26   1.88  1.881XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76999  Echo examination procedure                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
76999TCEcho examination procedure                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7699926Echo examination procedure                        C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77001  Fluoroguide for vein device                       A   0.38   3.16     3.16NA  0.04   3.58  3.581ZZZ.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77001TCFluoroguide for vein device                       A   0.00   3.03     3.03NA  0.01   3.04  3.041ZZZ.00.00.0000900             25.0008 030 99      0.00   0.00   0.00
7700126Fluoroguide for vein device                       A   0.38   0.13     0.13    0.03   0.54  0.541ZZZ.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77002  Needle localization by xray                       A   0.54   1.78     1.78NA  0.04   2.36  2.361XXX.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77002TCNeedle localization by xray                       A   0.00   1.55     1.55NA  0.01   1.56  1.561XXX.00.00.0000900             25.0008 030 99      0.00   0.00   0.00
7700226Needle localization by xray                       A   0.54   0.23     0.23    0.03   0.80  0.801XXX.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77003  Fluoroguide for spine inject                      A   0.60   2.16     2.16NA  0.04   2.80  2.801XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
77003TCFluoroguide for spine inject                      A   0.00   1.91     1.91NA  0.01   1.92  1.921XXX.00.00.0099999             25.0008 030 99      0.00   0.00   0.00
7700326Fluoroguide for spine inject                      A   0.60   0.25     0.25    0.03   0.88  0.881XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
77011  Ct scan for localization                          A   1.21   5.41     5.41NA  0.05   6.67  6.671XXX.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77011TCCt scan for localization                          A   0.00   4.90     4.90NA  0.01   4.91  4.911XXX.00.00.0000900             25.0008 030 99      0.00   0.00   0.00
7701126Ct scan for localization                          A   1.21   0.51     0.51    0.04   1.76  1.761XXX.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77012  Ct scan for needle biopsy                         A   1.16   2.60     2.60NA  0.05   3.81  3.811XXX.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77012TCCt scan for needle biopsy                         A   0.00   2.18     2.18NA  0.01   2.19  2.191XXX.00.00.0000900             25.0008 030 99      0.00   0.00   0.00
7701226Ct scan for needle biopsy                         A   1.16   0.42     0.42    0.04   1.62  1.621XXX.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77013  Ct guide for tissue ablation                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77013TCCt guide for tissue ablation                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7701326Ct guide for tissue ablation                      A   3.99   1.40     1.40    0.37   5.76  5.761XXX.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77014  Ct scan for therapy guide                         A   0.85   2.76     2.76NA  0.05   3.66  3.661XXX.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77014TCCt scan for therapy guide                         A   0.00   2.42     2.42NA  0.01   2.43  2.431XXX.00.00.0000900             25.0008 020 99      0.00   0.00   0.00
7701426Ct scan for therapy guide                         A   0.85   0.34     0.34    0.04   1.23  1.231XXX.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77021  Mr guidance for needle place                      A   1.50   9.95     9.95NA  0.13  11.58 11.581XXX.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77021TCMr guidance for needle place                      A   0.00   9.41     9.41NA  0.01   9.42  9.421XXX.00.00.0000900             25.0008 030 99      0.00   0.00   0.00
7702126Mr guidance for needle place                      A   1.50   0.54     0.54    0.12   2.16  2.161XXX.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77022  Mri for tissue ablation                           C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77022TCMri for tissue ablation                           C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7702226Mri for tissue ablation                           A   4.24   1.46     1.46    0.38   6.08  6.081XXX.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77031  Stereotact guide for brst bx                      A   1.59   2.12     2.12NA  0.13   3.84  3.841XXX.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77031TCStereotact guide for brst bx                      A   0.00   1.53     1.53NA  0.01   1.54  1.541XXX.00.00.0000900             25.0008 030 99      0.00   0.00   0.00
7703126Stereotact guide for brst bx                      A   1.59   0.59     0.59    0.12   2.30  2.301XXX.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77032  Guidance for needle breast                        A   0.56   0.96     0.96NA  0.04   1.56  1.561XXX.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77032TCGuidance for needle breast                        A   0.00   0.75     0.75NA  0.01   0.76  0.761XXX.00.00.0000900             25.0008 030 99      0.00   0.00   0.00
7703226Guidance for needle breast                        A   0.56   0.21     0.21    0.03   0.80  0.801XXX.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77051  Computer dx mammogram add-on                      A   0.06   0.23     0.23NA  0.02   0.31  0.311ZZZ.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77051TCComputer dx mammogram add-on                      A   0.00   0.21     0.21NA  0.01   0.22  0.221ZZZ.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
7705126Computer dx mammogram add-on                      A   0.06   0.02     0.02    0.01   0.09  0.091ZZZ.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77052  Comp screen mammogram add-on                      A   0.06   0.23     0.23NA  0.02   0.31  0.311ZZZ.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77052TCComp screen mammogram add-on                      A   0.00   0.21     0.21NA  0.01   0.22  0.221ZZZ.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
7705226Comp screen mammogram add-on                      A   0.06   0.02     0.02    0.01   0.09  0.091ZZZ.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77053  X-ray of mammary duct                             A   0.36   1.39     1.39NA  0.02   1.77  1.771XXX.00.00.0000900             25.0008 090 99     10.27  10.27   0.09
77053TCX-ray of mammary duct                             A   0.00   1.26     1.26NA  0.01   1.27  1.271XXX.00.00.0000900             25.0008 030 99     10.14  10.14   0.08
7705326X-ray of mammary duct                             A   0.36   0.13     0.13    0.01   0.50  0.501XXX.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77054  X-ray of mammary ducts                            A   0.45   1.91     1.91NA  0.04   2.40  2.401XXX.00.00.0000900             25.0008 090 99     10.33  10.33   0.09
77054TCX-ray of mammary ducts                            A   0.00   1.74     1.74NA  0.01   1.75  1.751XXX.00.00.0000900             25.0008 030 99     10.16  10.16   0.06
7705426X-ray of mammary ducts                            A   0.45   0.17     0.17    0.03   0.65  0.651XXX.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77055  Mammogram one breast                              A   0.70   1.89     1.89NA  0.05   2.64  2.641XXX.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77055TCMammogram one breast                              A   0.00   1.63     1.63NA  0.01   1.64  1.641XXX.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
7705526Mammogram one breast                              A   0.70   0.26     0.26    0.04   1.00  1.001XXX.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77056  Mammogram both breasts                            A   0.87   2.46     2.46NA  0.06   3.39  3.391XXX.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77056TCMammogram both breasts                            A   0.00   2.14     2.14NA  0.01   2.15  2.151XXX.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
7705626Mammogram both breasts                            A   0.87   0.32     0.32    0.05   1.24  1.241XXX.00.00.0000900             25.0008 090 99      0.00   0.00   0.00
77057  Mammogram screening                               A   0.70   1.67     1.67NA  0.05   2.42  2.421XXX.00.00.0002900             25.0008 090 99      0.00   0.00   0.00
77057TCMammogram screening                               A   0.00   1.41     1.41NA  0.01   1.42  1.421XXX.00.00.0002900             25.0008 090 99      0.00   0.00   0.00
7705726Mammogram screening                               A   0.70   0.26     0.26    0.04   1.00  1.001XXX.00.00.0002900             25.0008 090 99      0.00   0.00   0.00
77058  Mri one breast                                    A   1.63  16.94    16.94NA  0.11  18.68 18.681XXX.00.00.0040900             25.0008 090 88     22.55  22.55   0.11
77058TCMri one breast                                    A   0.00  16.35    16.35NA  0.01  16.36 16.361XXX.00.00.0040900             25.0008 020 88     21.96  21.96   0.01
7705826Mri one breast                                    A   1.63   0.59     0.59    0.10   2.32  2.321XXX.00.00.0040900             25.0008 090 88      0.00   0.00   0.00
77059  Mri both breasts                                  A   1.63  16.80    16.80NA  0.11  18.54 18.541XXX.00.00.0042900             25.0008 090 88     22.55  22.55   0.11
77059TCMri both breasts                                  A   0.00  16.21    16.21NA  0.01  16.22 16.221XXX.00.00.0042900             25.0008 020 88     21.96  21.96   0.01
7705926Mri both breasts                                  A   1.63   0.59     0.59    0.10   2.32  2.321XXX.00.00.0042900             25.0008 090 88      0.00   0.00   0.00
77071  X-ray stress view                                 A   0.41   1.06     1.06    0.07   1.54  1.542XXX.00.00.0002000             25.0008 030 99      0.00   0.00   0.00
77072  X-rays for bone age                               A   0.19   0.49     0.49NA  0.02   0.70  0.701XXX.00.00.0000000             25.0008 090 99      1.87   1.87   0.05
77072TCX-rays for bone age                               A   0.00   0.42     0.42NA  0.01   0.43  0.431XXX.00.00.0000000             25.0008 010 99      1.80   1.80   0.04
7707226X-rays for bone age                               A   0.19   0.07     0.07    0.01   0.27  0.271XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77073  X-rays bone length studies                        A   0.27   0.84     0.84NA  0.05   1.16  1.161XXX.00.00.0000000             25.0008 090 99      2.91   2.91   0.08
77073TCX-rays bone length studies                        A   0.00   0.72     0.72NA  0.01   0.73  0.731XXX.00.00.0000000             25.0008 010 99      2.79   2.79   0.04
7707326X-rays bone length studies                        A   0.27   0.12     0.12    0.04   0.43  0.431XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77074  X-rays bone survey limited                        A   0.45   1.64     1.64NA  0.04   2.13  2.131XXX.00.00.0000000             25.0008 090 99      2.98   2.98   0.05
77074TCX-rays bone survey limited                        A   0.00   1.47     1.47NA  0.01   1.48  1.481XXX.00.00.0000000             25.0008 010 99      2.81   2.81   0.02
7707426X-rays bone survey limited                        A   0.45   0.17     0.17    0.03   0.65  0.651XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77075  X-rays bone survey complete                       A   0.54   2.62     2.62NA  0.04   3.20  3.201XXX.00.00.0000000             25.0008 090 99      3.02   3.02   0.04
77075TCX-rays bone survey complete                       A   0.00   2.42     2.42NA  0.01   2.43  2.431XXX.00.00.0000000             25.0008 010 99      2.82   2.82   0.01
7707526X-rays bone survey complete                       A   0.54   0.20     0.20    0.03   0.77  0.771XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77076  X-rays bone survey infant                         A   0.70   2.46     2.46NA  0.05   3.21  3.211XXX.00.00.0000000             25.0008 090 99      3.08   3.08   0.05
77076TCX-rays bone survey infant                         A   0.00   2.20     2.20NA  0.01   2.21  2.211XXX.00.00.0000000             25.0008 010 99      2.82   2.82   0.01
7707626X-rays bone survey infant                         A   0.70   0.26     0.26    0.04   1.00  1.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77077  Joint survey single view                          A   0.31   0.86     0.86NA  0.05   1.22  1.221XXX.00.00.0000000             25.0008 090 99      1.95   1.95   0.07
77077TCJoint survey single view                          A   0.00   0.72     0.72NA  0.01   0.73  0.731XXX.00.00.0000000             25.0008 010 99      1.81   1.81   0.03
7707726Joint survey single view                          A   0.31   0.14     0.14    0.04   0.49  0.491XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77078  Ct bone density axial                             A   0.25   3.68     3.68NA  0.02   3.95  3.951XXX.00.00.0000000             25.0008 090 99      3.04   3.04   0.02
77078TCCt bone density axial                             A   0.00   3.59     3.59NA  0.01   3.60  3.601XXX.00.00.0000000             25.0008 010 99      2.95   2.95   0.01
7707826Ct bone density axial                             A   0.25   0.09     0.09    0.01   0.35  0.351XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77080  Dxa bone density axial                            A   0.20   1.26     1.26NA  0.02   1.48  1.481XXX.00.00.0000000             25.0008 090 99      3.01   3.01   0.03
77080TCDxa bone density axial                            A   0.00   1.18     1.18NA  0.01   1.19  1.191XXX.00.00.0000000             25.0008 010 99      2.93   2.93   0.02
7708026Dxa bone density axial                            A   0.20   0.08     0.08    0.01   0.29  0.291XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77081  Dxa bone density/peripheral                       A   0.22   0.60     0.60NA  0.02   0.84  0.841XXX.00.00.0000000             25.0008 090 99      1.47   1.47   0.04
77081TCDxa bone density/peripheral                       A   0.00   0.51     0.51NA  0.01   0.52  0.521XXX.00.00.0000000             25.0008 010 99      1.38   1.38   0.03
7708126Dxa bone density/peripheral                       A   0.22   0.09     0.09    0.01   0.32  0.321XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77082  Dxa bone density vert fx                          A   0.17   0.65     0.65NA  0.02   0.84  0.841XXX.00.00.0000000             25.0008 090 99      1.88   1.88   0.04
77082TCDxa bone density vert fx                          A   0.00   0.58     0.58NA  0.01   0.59  0.591XXX.00.00.0000000             25.0008 010 99      1.81   1.81   0.03
7708226Dxa bone density vert fx                          A   0.17   0.07     0.07    0.01   0.25  0.251XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77084  Magnetic image bone marrow                        A   1.60  11.52    11.52NA  0.11  13.23 13.231XXX.00.00.0000000             25.0008 090 99     14.12  14.12   0.11
77084TCMagnetic image bone marrow                        A   0.00  10.93    10.93NA  0.01  10.94 10.941XXX.00.00.0000000             25.0008 010 99     13.53  13.53   0.01
7708426Magnetic image bone marrow                        A   1.60   0.59     0.59    0.10   2.29  2.291XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77261  Radiation therapy planning                        A   1.39   0.61     0.61    0.10   2.10  2.102XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77262  Radiation therapy planning                        A   2.11   0.86     0.86    0.18   3.15  3.152XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77263  Radiation therapy planning                        A   3.14   1.27     1.27    0.26   4.67  4.672XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77280  Set radiation therapy field                       A   0.70   4.58     4.58NA  0.04   5.32  5.321XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77280TCSet radiation therapy field                       A   0.00   4.30     4.30NA  0.01   4.31  4.311XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7728026Set radiation therapy field                       A   0.70   0.28     0.28    0.03   1.01  1.011XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77285  Set radiation therapy field                       A   1.05   8.31     8.31NA  0.06   9.42  9.421XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77285TCSet radiation therapy field                       A   0.00   7.89     7.89NA  0.01   7.90  7.901XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7728526Set radiation therapy field                       A   1.05   0.42     0.42    0.05   1.52  1.521XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77290  Set radiation therapy field                       A   1.56  13.98    13.98NA  0.08  15.62 15.621XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77290TCSet radiation therapy field                       A   0.00  13.35    13.35NA  0.01  13.36 13.361XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7729026Set radiation therapy field                       A   1.56   0.63     0.63    0.07   2.26  2.261XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77295  Set radiation therapy field                       A   4.56   8.24     8.24NA  0.28  13.08 13.081XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77295TCSet radiation therapy field                       A   0.00   6.40     6.40NA  0.04   6.44  6.441XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7729526Set radiation therapy field                       A   4.56   1.84     1.84    0.24   6.64  6.641XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77299  Radiation therapy planning                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77299TCRadiation therapy planning                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7729926Radiation therapy planning                        C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77300  Radiation therapy dose plan                       A   0.62   1.30     1.30NA  0.04   1.96  1.961XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77300TCRadiation therapy dose plan                       A   0.00   1.05     1.05NA  0.01   1.06  1.061XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7730026Radiation therapy dose plan                       A   0.62   0.25     0.25    0.03   0.90  0.901XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77301  Radiotherapy dose plan imrt                       A   7.99  49.98    49.98NA  0.63  58.60 58.601XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77301TCRadiotherapy dose plan imrt                       A   0.00  46.75    46.75NA  0.22  46.97 46.971XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7730126Radiotherapy dose plan imrt                       A   7.99   3.23     3.23    0.41  11.63 11.631XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77305  Teletx isodose plan simple                        A   0.70   0.98     0.98NA  0.04   1.72  1.721XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77305TCTeletx isodose plan simple                        A   0.00   0.70     0.70NA  0.01   0.71  0.711XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7730526Teletx isodose plan simple                        A   0.70   0.28     0.28    0.03   1.01  1.011XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77310  Teletx isodose plan intermed                      A   1.05   1.38     1.38NA  0.06   2.49  2.491XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77310TCTeletx isodose plan intermed                      A   0.00   0.96     0.96NA  0.01   0.97  0.971XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7731026Teletx isodose plan intermed                      A   1.05   0.42     0.42    0.05   1.52  1.521XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77315  Teletx isodose plan complex                       A   1.56   2.29     2.29NA  0.08   3.93  3.931XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77315TCTeletx isodose plan complex                       A   0.00   1.66     1.66NA  0.01   1.67  1.671XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7731526Teletx isodose plan complex                       A   1.56   0.63     0.63    0.07   2.26  2.261XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77321  Special teletx port plan                          A   0.95   1.66     1.66NA  0.05   2.66  2.661XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77321TCSpecial teletx port plan                          A   0.00   1.28     1.28NA  0.01   1.29  1.291XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7732126Special teletx port plan                          A   0.95   0.38     0.38    0.04   1.37  1.371XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77326  Brachytx isodose calc simp                        A   0.93   3.30     3.30NA  0.07   4.30  4.301XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77326TCBrachytx isodose calc simp                        A   0.00   2.92     2.92NA  0.03   2.95  2.951XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7732626Brachytx isodose calc simp                        A   0.93   0.38     0.38    0.04   1.35  1.351XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77327  Brachytx isodose calc interm                      A   1.39   4.51     4.51NA  0.10   6.00  6.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77327TCBrachytx isodose calc interm                      A   0.00   3.95     3.95NA  0.03   3.98  3.981XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7732726Brachytx isodose calc interm                      A   1.39   0.56     0.56    0.07   2.02  2.021XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77328  Brachytx isodose plan compl                       A   2.09   5.77     5.77NA  0.14   8.00  8.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77328TCBrachytx isodose plan compl                       A   0.00   4.93     4.93NA  0.04   4.97  4.971XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7732826Brachytx isodose plan compl                       A   2.09   0.84     0.84    0.10   3.03  3.031XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77331  Special radiation dosimetry                       A   0.87   0.90     0.90NA  0.05   1.82  1.821XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77331TCSpecial radiation dosimetry                       A   0.00   0.55     0.55NA  0.01   0.56  0.561XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7733126Special radiation dosimetry                       A   0.87   0.35     0.35    0.04   1.26  1.261XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77332  Radiation treatment aid(s)                        A   0.54   1.78     1.78NA  0.04   2.36  2.361XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77332TCRadiation treatment aid(s)                        A   0.00   1.56     1.56NA  0.01   1.57  1.571XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7733226Radiation treatment aid(s)                        A   0.54   0.22     0.22    0.03   0.79  0.791XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77333  Radiation treatment aid(s)                        A   0.84   0.61     0.61NA  0.05   1.50  1.501XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77333TCRadiation treatment aid(s)                        A   0.00   0.27     0.27NA  0.01   0.28  0.281XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7733326Radiation treatment aid(s)                        A   0.84   0.34     0.34    0.04   1.22  1.221XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77334  Radiation treatment aid(s)                        A   1.24   3.11     3.11NA  0.06   4.41  4.411XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77334TCRadiation treatment aid(s)                        A   0.00   2.61     2.61NA  0.01   2.62  2.621XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7733426Radiation treatment aid(s)                        A   1.24   0.50     0.50    0.05   1.79  1.791XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77336  Radiation physics consult                         A   0.00   1.28     1.28NA  0.01   1.29  1.293XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77338  Design mlc device for imrt                        A   4.29  10.16    10.16NA  0.27  14.72 14.721XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77338TCDesign mlc device for imrt                        A   0.00   8.43     8.43NA  0.04   8.47  8.471XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
7733826Design mlc device for imrt                        A   4.29   1.73     1.73    0.23   6.25  6.251XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77370  Radiation physics consult                         A   0.00   3.43     3.43NA  0.04   3.47  3.473XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77371  Srs multisource                                   C   0.00   0.00     0.00    0.00   0.00  0.003XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77372  Srs linear based                                  A   0.00  23.03    23.03NA  0.05  23.08 23.083XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77373  Sbrt delivery                                     A   0.00  37.23    37.23NA  0.07  37.30 37.303XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77399  External radiation dosimetry                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77399TCExternal radiation dosimetry                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7739926External radiation dosimetry                      C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77401  Radiation treatment delivery                      A   0.00   0.60     0.60NA  0.01   0.61  0.613XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77402  Radiation treatment delivery                      A   0.00   4.55     4.55NA  0.01   4.56  4.563XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77403  Radiation treatment delivery                      A   0.00   3.76     3.76NA  0.01   3.77  3.773XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77404  Radiation treatment delivery                      A   0.00   4.18     4.18NA  0.01   4.19  4.193XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77406  Radiation treatment delivery                      A   0.00   4.17     4.17NA  0.01   4.18  4.183XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77407  Radiation treatment delivery                      A   0.00   6.63     6.63NA  0.01   6.64  6.643XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77408  Radiation treatment delivery                      A   0.00   5.18     5.18NA  0.01   5.19  5.193XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77409  Radiation treatment delivery                      A   0.00   5.76     5.76NA  0.01   5.77  5.773XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77411  Radiation treatment delivery                      A   0.00   5.79     5.79NA  0.01   5.80  5.803XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77412  Radiation treatment delivery                      A   0.00   7.05     7.05NA  0.01   7.06  7.063XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77413  Radiation treatment delivery                      A   0.00   6.79     6.79NA  0.01   6.80  6.803XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77414  Radiation treatment delivery                      A   0.00   7.65     7.65NA  0.01   7.66  7.663XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77416  Radiation treatment delivery                      A   0.00   7.64     7.64NA  0.01   7.65  7.653XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77417  Radiology port film(s)                            A   0.00   0.41     0.41NA  0.01   0.42  0.423XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
77418  Radiation tx delivery imrt                        A   0.00  11.91    11.91NA  0.01  11.92 11.923XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77421  Stereoscopic x-ray guidance                       A   0.39   1.78     1.78NA  0.02   2.19  2.191XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77421TCStereoscopic x-ray guidance                       A   0.00   1.62     1.62NA  0.01   1.63  1.631XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
7742126Stereoscopic x-ray guidance                       A   0.39   0.16     0.16    0.01   0.56  0.561XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77422  Neutron beam tx simple                            A   0.00   8.29     8.29NA  0.01   8.30  8.303XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77423  Neutron beam tx complex                           A   0.00   8.47     8.47NA  0.01   8.48  8.483XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77424  Io rad tx delivery by x-ray                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
77425  Io rad tx deliver by elctrns                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
77427  Radiation tx management x5                        A   3.37   1.60     1.60    0.27   5.24  5.242XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
77431  Radiation therapy management                      A   1.81   0.93     0.93    0.14   2.88  2.882XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77432  Stereotactic radiation trmt                       A   7.92   3.21     3.21    0.65  11.78 11.782XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77435  Sbrt management                                   A  11.87   4.92     4.92    0.99  17.78 17.782XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77469  Io radiation tx management                        A   5.75   2.62NA   2.62    0.47   8.84  8.840XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77470  Special radiation treatment                       A   2.09   2.25     2.25NA  0.11   4.45  4.451XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77470TCSpecial radiation treatment                       A   0.00   1.40     1.40NA  0.01   1.41  1.411XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7747026Special radiation treatment                       A   2.09   0.85     0.85    0.10   3.04  3.041XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77499  Radiation therapy management                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77499TCRadiation therapy management                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7749926Radiation therapy management                      C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 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  0.003XXX.00.00.0000000             25.0008 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  0.003XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77523  Proton trmt intermediate                          C   0.00   0.00     0.00    0.00   0.00  0.003XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77525  Proton treatment complex                          C   0.00   0.00     0.00    0.00   0.00  0.003XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77600  Hyperthermia treatment                            R   1.56  11.02    11.02NA  0.10  12.68 12.681XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77600TCHyperthermia treatment                            R   0.00  10.39    10.39NA  0.03  10.42 10.421XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7760026Hyperthermia treatment                            R   1.56   0.63     0.63    0.07   2.26  2.261XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77605  Hyperthermia treatment                            R   2.09  31.65    31.65NA  0.41  34.15 34.151XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77605TCHyperthermia treatment                            R   0.00  30.82    30.82NA  0.03  30.85 30.851XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7760526Hyperthermia treatment                            R   2.09   0.83     0.83    0.38   3.30  3.301XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77610  Hyperthermia treatment                            R   1.56  30.52    30.52NA  0.10  32.18 32.181XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77610TCHyperthermia treatment                            R   0.00  29.90    29.90NA  0.03  29.93 29.931XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7761026Hyperthermia treatment                            R   1.56   0.62     0.62    0.07   2.25  2.251XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77615  Hyperthermia treatment                            R   2.09  27.69    27.69NA  0.17  29.95 29.951XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77615TCHyperthermia treatment                            R   0.00  26.84    26.84NA  0.07  26.91 26.911XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7761526Hyperthermia treatment                            R   2.09   0.85     0.85    0.10   3.04  3.041XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77620  Hyperthermia treatment                            R   1.56  15.64    15.64NA  0.08  17.28 17.281XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77620TCHyperthermia treatment                            R   0.00  15.02    15.02NA  0.04  15.06 15.061XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7762026Hyperthermia treatment                            R   1.56   0.62     0.62    0.04   2.22  2.221XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77750  Infuse radioactive materials                      A   5.00   5.30     5.30NA  0.29  10.59 10.591090.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77750TCInfuse radioactive materials                      A   0.00   3.29     3.29NA  0.03   3.32  3.321090.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7775026Infuse radioactive materials                      A   5.00   2.01     2.01    0.26   7.27  7.271090.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77761  Apply intrcav radiat simple                       A   3.85   7.18     7.18NA  0.24  11.27 11.271090.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77761TCApply intrcav radiat simple                       A   0.00   5.65     5.65NA  0.04   5.69  5.691090.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7776126Apply intrcav radiat simple                       A   3.85   1.53     1.53    0.20   5.58  5.581090.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77762  Apply intrcav radiat interm                       A   5.76   8.79     8.79NA  0.35  14.90 14.901090.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77762TCApply intrcav radiat interm                       A   0.00   6.49     6.49NA  0.05   6.54  6.541090.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7776226Apply intrcav radiat interm                       A   5.76   2.30     2.30    0.30   8.36  8.361090.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77763  Apply intrcav radiat compl                        A   8.66  11.85    11.85NA  0.51  21.02 21.021090.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77763TCApply intrcav radiat compl                        A   0.00   8.36     8.36NA  0.07   8.43  8.431090.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7776326Apply intrcav radiat compl                        A   8.66   3.49     3.49    0.44  12.59 12.591090.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77776  Apply interstit radiat simpl                      A   4.70   7.56     7.56NA  0.36  12.62 12.621090.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77776TCApply interstit radiat simpl                      A   0.00   5.66     5.66NA  0.05   5.71  5.711090.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7777626Apply interstit radiat simpl                      A   4.70   1.90     1.90    0.31   6.91  6.911090.00.00.0000020             25.0008 090 99      0.00   0.00   0.00
77777  Apply interstit radiat inter                      A   7.52   9.05     9.05NA  0.54  17.11 17.111090.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77777TCApply interstit radiat inter                      A   0.00   6.07     6.07NA  0.05   6.12  6.121090.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7777726Apply interstit radiat inter                      A   7.52   2.98     2.98    0.49  10.99 10.991090.00.00.0000020             25.0008 090 99      0.00   0.00   0.00
77778  Apply interstit radiat compl                      A  11.32  13.09    13.09NA  0.68  25.09 25.091090.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77778TCApply interstit radiat compl                      A   0.00   8.55     8.55NA  0.08   8.63  8.631090.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7777826Apply interstit radiat compl                      A  11.32   4.54     4.54    0.60  16.46 16.461090.00.00.0000020             25.0008 090 99      0.00   0.00   0.00
77785  Hdr brachytx 1 channel                            A   1.42   5.84     5.84NA  0.10   7.36  7.361XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77785TCHdr brachytx 1 channel                            A   0.00   5.27     5.27NA  0.03   5.30  5.301XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7778526Hdr brachytx 1 channel                            A   1.42   0.57     0.57    0.07   2.06  2.061XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77786  Hdr brachytx 2-12 channel                         A   3.25  12.90    12.90NA  0.21  16.36 16.361XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77786TCHdr brachytx 2-12 channel                         A   0.00  11.59    11.59NA  0.05  11.64 11.641XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7778626Hdr brachytx 2-12 channel                         A   3.25   1.31     1.31    0.16   4.72  4.721XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77787  Hdr brachytx over 12 chan                         A   4.89  22.85    22.85NA  0.34  28.08 28.081XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77787TCHdr brachytx over 12 chan                         A   0.00  20.87    20.87NA  0.08  20.95 20.951XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7778726Hdr brachytx over 12 chan                         A   4.89   1.98     1.98    0.26   7.13  7.131XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77789  Apply surface radiation                           A   1.14   2.27     2.27NA  0.06   3.47  3.471000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77789TCApply surface radiation                           A   0.00   1.80     1.80NA  0.01   1.81  1.811000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7778926Apply surface radiation                           A   1.14   0.47     0.47    0.05   1.66  1.661000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77790  Radiation handling                                A   1.05   1.68     1.68NA  0.05   2.78  2.781XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77790TCRadiation handling                                A   0.00   1.26     1.26NA  0.01   1.27  1.271XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7779026Radiation handling                                A   1.05   0.42     0.42    0.04   1.51  1.511XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77799  Radium/radioisotope therapy                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
77799TCRadium/radioisotope therapy                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7779926Radium/radioisotope therapy                       C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78012  Thyroid uptake measurement                        A   0.19   2.24     2.24NA  0.02   2.45  2.451XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78012TCThyroid uptake measurement                        A   0.00   2.17     2.17NA  0.01   2.18  2.181XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7801226Thyroid uptake measurement                        A   0.19   0.07     0.07    0.01   0.27  0.271XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78013  Thyroid imaging w/blood flow                      A   0.37   5.78     5.78NA  0.04   6.19  6.191XXX.00.00.0000000             25.0008 090 99      6.11   6.11   0.04
78013TCThyroid imaging w/blood flow                      A   0.00   5.64     5.64NA  0.03   5.67  5.671XXX.00.00.0000000             25.0008 090 99      5.97   5.97   0.03
7801326Thyroid imaging w/blood flow                      A   0.37   0.14     0.14    0.01   0.52  0.521XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78014  Thyroid imaging w/blood flow                      A   0.50   6.61     6.61NA  0.06   7.17  7.171XXX.00.00.0000000             25.0008 090 99      9.44   9.44   0.07
78014TCThyroid imaging w/blood flow                      A   0.00   6.44     6.44NA  0.03   6.47  6.471XXX.00.00.0000000             25.0008 090 99      9.27   9.27   0.04
7801426Thyroid imaging w/blood flow                      A   0.50   0.17     0.17    0.03   0.70  0.701XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78015  Thyroid met imaging                               A   0.67   5.85     5.85NA  0.07   6.59  6.591XXX.00.00.0000000             25.0008 090 99     12.15  12.15   0.10
78015TCThyroid met imaging                               A   0.00   5.64     5.64NA  0.03   5.67  5.671XXX.00.00.0000000             25.0008 010 99     11.94  11.94   0.06
7801526Thyroid met imaging                               A   0.67   0.21     0.21    0.04   0.92  0.921XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78016  Thyroid met imaging/studies                       A   0.82   7.63     7.63NA  0.06   8.51  8.511XXX.00.00.0000000             25.0008 090 99     12.10  12.10   0.08
78016TCThyroid met imaging/studies                       A   0.00   7.49     7.49NA  0.03   7.52  7.521XXX.00.00.0000000             25.0008 010 99     11.96  11.96   0.05
7801626Thyroid met imaging/studies                       A   0.82   0.14     0.14    0.03   0.99  0.991XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78018  Thyroid met imaging body                          A   0.86   8.60     8.60NA  0.07   9.53  9.531XXX.00.00.0000000             25.0008 090 99     12.23  12.23   0.08
78018TCThyroid met imaging body                          A   0.00   8.33     8.33NA  0.03   8.36  8.361XXX.00.00.0000000             25.0008 010 99     11.96  11.96   0.04
7801826Thyroid met imaging body                          A   0.86   0.27     0.27    0.04   1.17  1.171XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78020  Thyroid met uptake                                A   0.60   1.87     1.87NA  0.04   2.51  2.511ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78020TCThyroid met uptake                                A   0.00   1.70     1.70NA  0.01   1.71  1.711ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7802026Thyroid met uptake                                A   0.60   0.17     0.17    0.03   0.80  0.801ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78070  Parathyroid planar imaging                        A   0.80   8.22     8.22NA  0.07   9.09  9.091XXX.00.00.0000000             25.0008 090 99      9.55   9.55   0.07
78070TCParathyroid planar imaging                        A   0.00   7.95     7.95NA  0.03   7.98  7.981XXX.00.00.0000000             25.0008 010 99      9.28   9.28   0.03
7807026Parathyroid planar imaging                        A   0.80   0.27     0.27    0.04   1.11  1.111XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78071  Parathyrd planar w/wo subtrj                      A   1.20   9.39     9.39NA  0.09  10.68 10.681XXX.00.00.0000000             25.0008 090 99     13.24  13.24   0.10
78071TCParathyrd planar w/wo subtrj                      A   0.00   8.99     8.99NA  0.03   9.02  9.021XXX.00.00.0000000             25.0008 090 99     12.84  12.84   0.04
7807126Parathyrd planar w/wo subtrj                      A   1.20   0.40     0.40    0.06   1.66  1.661XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78072  Parathyrd planar w/spect&ct                       C   0.00   0.00     0.00NA  0.00   0.00  0.001YYY.00.00.0000000             25.0008 090 99     13.52  13.52   0.06
78072TCParathyrd planar w/spect&ct                       C   0.00   0.00     0.00NA  0.00   0.00  0.001YYY.00.00.0000000             25.0008 090 99     12.87  12.87   0.01
7807226Parathyrd planar w/spect&ct                       A   1.60   0.65     0.65    0.05   2.30  2.301XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78075  Adrenal cortex & medulla img                      A   0.74  12.23    12.23NA  0.08  13.05 13.051XXX.00.00.0000000             25.0008 090 99     38.32  38.32   0.17
78075TCAdrenal cortex & medulla img                      A   0.00  12.01    12.01NA  0.04  12.05 12.051XXX.00.00.0000000             25.0008 010 99     38.10  38.10   0.13
7807526Adrenal cortex & medulla img                      A   0.74   0.22     0.22    0.04   1.00  1.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78099  Endocrine nuclear procedure                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78099TCEndocrine nuclear procedure                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7809926Endocrine nuclear procedure                       C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78102  Bone marrow imaging ltd                           A   0.55   4.55     4.55NA  0.06   5.16  5.161XXX.00.00.0000000             25.0008 090 99     11.29  11.29   0.11
78102TCBone marrow imaging ltd                           A   0.00   4.38     4.38NA  0.03   4.41  4.411XXX.00.00.0000000             25.0008 010 99     11.12  11.12   0.08
7810226Bone marrow imaging ltd                           A   0.55   0.17     0.17    0.03   0.75  0.751XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78103  Bone marrow imaging mult                          A   0.75   5.65     5.65NA  0.07   6.47  6.471XXX.00.00.0000000             25.0008 090 99     11.36  11.36   0.10
78103TCBone marrow imaging mult                          A   0.00   5.43     5.43NA  0.03   5.46  5.461XXX.00.00.0000000             25.0008 010 99     11.14  11.14   0.06
7810326Bone marrow imaging mult                          A   0.75   0.22     0.22    0.04   1.01  1.011XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78104  Bone marrow imaging body                          A   0.80   6.81     6.81NA  0.07   7.68  7.681XXX.00.00.0000000             25.0008 090 99     11.41  11.41   0.09
78104TCBone marrow imaging body                          A   0.00   6.55     6.55NA  0.03   6.58  6.581XXX.00.00.0000000             25.0008 010 99     11.15  11.15   0.05
7810426Bone marrow imaging body                          A   0.80   0.26     0.26    0.04   1.10  1.101XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78110  Plasma volume single                              A   0.19   2.57     2.57NA  0.04   2.80  2.801XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78110TCPlasma volume single                              A   0.00   2.50     2.50NA  0.03   2.53  2.531XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
7811026Plasma volume single                              A   0.19   0.07     0.07    0.01   0.27  0.271XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78111  Plasma volume multiple                            A   0.22   2.29     2.29NA  0.04   2.55  2.551XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78111TCPlasma volume multiple                            A   0.00   2.24     2.24NA  0.03   2.27  2.271XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
7811126Plasma volume multiple                            A   0.22   0.05     0.05    0.01   0.28  0.281XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78120  Red cell mass single                              A   0.23   2.52     2.52NA  0.04   2.79  2.791XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78120TCRed cell mass single                              A   0.00   2.43     2.43NA  0.03   2.46  2.461XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
7812026Red cell mass single                              A   0.23   0.09     0.09    0.01   0.33  0.331XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78121  Red cell mass multiple                            A   0.32   1.97     1.97NA  0.04   2.33  2.331XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78121TCRed cell mass multiple                            A   0.00   1.92     1.92NA  0.03   1.95  1.951XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
7812126Red cell mass multiple                            A   0.32   0.05     0.05    0.01   0.38  0.381XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78122  Blood volume                                      A   0.45   2.50     2.50NA  0.04   2.99  2.991XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78122TCBlood volume                                      A   0.00   2.36     2.36NA  0.03   2.39  2.391XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
7812226Blood volume                                      A   0.45   0.14     0.14    0.01   0.60  0.601XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78130  Red cell survival study                           A   0.61   4.19     4.19NA  0.08   4.88  4.881XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78130TCRed cell survival study                           A   0.00   3.96     3.96NA  0.04   4.00  4.001XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
7813026Red cell survival study                           A   0.61   0.23     0.23    0.04   0.88  0.881XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78135  Red cell survival kinetics                        A   0.64  10.16    10.16NA  0.07  10.87 10.871XXX.00.00.0000000             25.0008 090 99     17.62  17.62   0.09
78135TCRed cell survival kinetics                        A   0.00   9.92     9.92NA  0.03   9.95  9.951XXX.00.00.0000000             25.0008 010 99     17.38  17.38   0.05
7813526Red cell survival kinetics                        A   0.64   0.24     0.24    0.04   0.92  0.921XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78140  Red cell sequestration                            A   0.61   3.42     3.42NA  0.07   4.10  4.101XXX.00.00.0000000             25.0008 090 99     17.49  17.49   0.20
78140TCRed cell sequestration                            A   0.00   3.20     3.20NA  0.03   3.23  3.231XXX.00.00.0000000             25.0008 010 99     17.27  17.27   0.16
7814026Red cell sequestration                            A   0.61   0.22     0.22    0.04   0.87  0.871XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78185  Spleen imaging                                    A   0.40   6.03     6.03NA  0.04   6.47  6.471XXX.00.00.0000000             25.0008 090 99     11.29  11.29   0.07
78185TCSpleen imaging                                    A   0.00   5.88     5.88NA  0.03   5.91  5.911XXX.00.00.0000000             25.0008 010 99     11.14  11.14   0.06
7818526Spleen imaging                                    A   0.40   0.15     0.15    0.01   0.56  0.561XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78190  Platelet survival kinetics                        A   1.09  11.23    11.23NA  0.07  12.39 12.391XXX.00.00.0000000             25.0008 090 99      8.28   8.28   0.06
78190TCPlatelet survival kinetics                        A   0.00  10.79    10.79NA  0.03  10.82 10.821XXX.00.00.0000000             25.0008 010 99      7.84   7.84   0.02
7819026Platelet survival kinetics                        A   1.09   0.44     0.44    0.04   1.57  1.571XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78191  Platelet survival                                 A   0.61   4.20     4.20NA  0.08   4.89  4.891XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78191TCPlatelet survival                                 A   0.00   3.97     3.97NA  0.04   4.01  4.011XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
7819126Platelet survival                                 A   0.61   0.23     0.23    0.04   0.88  0.881XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78195  Lymph system imaging                              A   1.20   9.58     9.58NA  0.10  10.88 10.881XXX.00.00.0000000             25.0008 090 99     11.56  11.56   0.11
78195TCLymph system imaging                              A   0.00   9.18     9.18NA  0.03   9.21  9.211XXX.00.00.0000000             25.0008 010 99     11.16  11.16   0.04
7819526Lymph system imaging                              A   1.20   0.40     0.40    0.07   1.67  1.671XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78199  Blood/lymph nuclear exam                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78199TCBlood/lymph nuclear exam                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7819926Blood/lymph nuclear exam                          C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78201  Liver imaging                                     A   0.44   5.17     5.17NA  0.07   5.68  5.681XXX.00.00.0000000             25.0008 090 99     12.63  12.63   0.11
78201TCLiver imaging                                     A   0.00   5.04     5.04NA  0.03   5.07  5.071XXX.00.00.0000000             25.0008 010 99     12.50  12.50   0.07
7820126Liver imaging                                     A   0.44   0.13     0.13    0.04   0.61  0.611XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78202  Liver imaging with flow                           A   0.51   5.68     5.68NA  0.04   6.23  6.231XXX.00.00.0000000             25.0008 090 99     12.66  12.66   0.08
78202TCLiver imaging with flow                           A   0.00   5.53     5.53NA  0.03   5.56  5.561XXX.00.00.0000000             25.0008 010 99     12.51  12.51   0.07
7820226Liver imaging with flow                           A   0.51   0.15     0.15    0.01   0.67  0.671XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78205  Liver imaging (3D)                                A   0.71   5.69     5.69NA  0.07   6.47  6.471XXX.00.00.0000000             25.0008 090 99     12.73  12.73   0.11
78205TCLiver imaging (3D)                                A   0.00   5.47     5.47NA  0.03   5.50  5.501XXX.00.00.0000000             25.0008 010 99     12.51  12.51   0.07
7820526Liver imaging (3D)                                A   0.71   0.22     0.22    0.04   0.97  0.971XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78206  Liver image (3d) with flow                        A   0.96   9.31     9.31NA  0.07  10.34 10.341XXX.00.00.0000000             25.0008 090 99     12.84  12.84   0.08
78206TCLiver image (3d) with flow                        A   0.00   9.00     9.00NA  0.03   9.03  9.031XXX.00.00.0000000             25.0008 010 99     12.53  12.53   0.04
7820626Liver image (3d) with flow                        A   0.96   0.31     0.31    0.04   1.31  1.311XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78215  Liver and spleen imaging                          A   0.49   5.40     5.40NA  0.06   5.95  5.951XXX.00.00.0000000             25.0008 090 99     12.67  12.67   0.10
78215TCLiver and spleen imaging                          A   0.00   5.23     5.23NA  0.03   5.26  5.261XXX.00.00.0000000             25.0008 010 99     12.50  12.50   0.07
7821526Liver and spleen imaging                          A   0.49   0.17     0.17    0.03   0.69  0.691XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78216  Liver & spleen image/flow                         A   0.57   3.12     3.12NA  0.06   3.75  3.751XXX.00.00.0000000             25.0008 090 99     12.63  12.63   0.16
78216TCLiver & spleen image/flow                         A   0.00   2.94     2.94NA  0.03   2.97  2.971XXX.00.00.0000000             25.0008 010 99     12.45  12.45   0.13
7821626Liver & spleen image/flow                         A   0.57   0.18     0.18    0.03   0.78  0.781XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78226  Hepatobiliary system imaging                      A   0.74  10.63    10.63NA  0.07  11.44 11.441XXX.00.00.0000000             25.0008 090 99     12.84  12.84   0.08
78226TCHepatobiliary system imaging                      A   0.00  10.33    10.33NA  0.03  10.36 10.361XXX.00.00.0000000             25.0008 010 99     12.54  12.54   0.04
7822626Hepatobiliary system imaging                      A   0.74   0.30     0.30    0.04   1.08  1.081XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78227  Hepatobil syst image w/drug                       A   0.90  14.52    14.52NA  0.08  15.50 15.501XXX.00.00.0000000             25.0008 090 99     12.90  12.90   0.08
78227TCHepatobil syst image w/drug                       A   0.00  14.16    14.16NA  0.04  14.20 14.201XXX.00.00.0000000             25.0008 010 99     12.54  12.54   0.04
7822726Hepatobil syst image w/drug                       A   0.90   0.36     0.36    0.04   1.30  1.301XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78230  Salivary gland imaging                            A   0.45   4.78     4.78NA  0.06   5.29  5.291XXX.00.00.0000000             25.0008 090 99     10.37  10.37   0.10
78230TCSalivary gland imaging                            A   0.00   4.61     4.61NA  0.03   4.64  4.641XXX.00.00.0000000             25.0008 010 99     10.20  10.20   0.07
7823026Salivary gland imaging                            A   0.45   0.17     0.17    0.03   0.65  0.651XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78231  Serial salivary imaging                           A   0.52   3.35     3.35NA  0.04   3.91  3.911XXX.00.00.0000000             25.0008 090 99     10.36  10.36   0.11
78231TCSerial salivary imaging                           A   0.00   3.16     3.16NA  0.03   3.19  3.191XXX.00.00.0000000             25.0008 010 99     10.17  10.17   0.10
7823126Serial salivary imaging                           A   0.52   0.19     0.19    0.01   0.72  0.721XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78232  Salivary gland function exam                      A   0.47   2.40     2.40NA  0.06   2.93  2.931XXX.00.00.0000000             25.0008 090 99     10.21  10.21   0.16
78232TCSalivary gland function exam                      A   0.00   2.33     2.33NA  0.03   2.36  2.361XXX.00.00.0000000             25.0008 010 99     10.14  10.14   0.13
7823226Salivary gland function exam                      A   0.47   0.07     0.07    0.03   0.57  0.571XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78258  Esophageal motility study                         A   0.74   6.03     6.03NA  0.06   6.83  6.831XXX.00.00.0000000             25.0008 090 99     10.47  10.47   0.08
78258TCEsophageal motility study                         A   0.00   5.78     5.78NA  0.03   5.81  5.811XXX.00.00.0000000             25.0008 010 99     10.22  10.22   0.05
7825826Esophageal motility study                         A   0.74   0.25     0.25    0.03   1.02  1.021XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78261  Gastric mucosa imaging                            A   0.69   6.95     6.95NA  0.07   7.71  7.711XXX.00.00.0000000             25.0008 090 99     10.48  10.48   0.09
78261TCGastric mucosa imaging                            A   0.00   6.69     6.69NA  0.03   6.72  6.721XXX.00.00.0000000             25.0008 010 99     10.22  10.22   0.05
7826126Gastric mucosa imaging                            A   0.69   0.26     0.26    0.04   0.99  0.991XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78262  Gastroesophageal reflux exam                      A   0.68   6.91     6.91NA  0.04   7.63  7.631XXX.00.00.0000000             25.0008 090 99     10.47  10.47   0.06
78262TCGastroesophageal reflux exam                      A   0.00   6.66     6.66NA  0.03   6.69  6.691XXX.00.00.0000000             25.0008 010 99     10.22  10.22   0.05
7826226Gastroesophageal reflux exam                      A   0.68   0.25     0.25    0.01   0.94  0.941XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78264  Gastric emptying study                            A   0.80   7.94     7.94NA  0.07   8.81  8.811XXX.00.00.0000000             25.0008 090 99     10.51  10.51   0.08
78264TCGastric emptying study                            A   0.00   7.66     7.66NA  0.03   7.69  7.691XXX.00.00.0000000             25.0008 010 99     10.23  10.23   0.04
7826426Gastric emptying study                            A   0.80   0.28     0.28    0.04   1.12  1.121XXX.00.00.0000000             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
78270  Vit B-12 absorption exam                          A   0.20   2.39     2.39NA  0.02   2.61  2.611XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78270TCVit B-12 absorption exam                          A   0.00   2.31     2.31NA  0.01   2.32  2.321XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
7827026Vit B-12 absorption exam                          A   0.20   0.08     0.08    0.01   0.29  0.291XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78271  Vit b-12 absrp exam int fac                       A   0.20   2.60     2.60NA  0.02   2.82  2.821XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78271TCVit b-12 absrp exam int fac                       A   0.00   2.52     2.52NA  0.01   2.53  2.531XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
7827126Vit b-12 absrp exam int fac                       A   0.20   0.08     0.08    0.01   0.29  0.291XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78272  Vit b-12 absorp combined                          A   0.27   2.55     2.55NA  0.04   2.86  2.861XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78272TCVit b-12 absorp combined                          A   0.00   2.45     2.45NA  0.03   2.48  2.481XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
7827226Vit b-12 absorp combined                          A   0.27   0.10     0.10    0.01   0.38  0.381XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78278  Acute GI blood loss imaging                       A   0.99   9.56     9.56NA  0.08  10.63 10.631XXX.00.00.0000000             25.0008 090 99     10.58  10.58   0.08
78278TCAcute GI blood loss imaging                       A   0.00   9.22     9.22NA  0.03   9.25  9.251XXX.00.00.0000000             25.0008 010 99     10.24  10.24   0.03
7827826Acute GI blood loss imaging                       A   0.99   0.34     0.34    0.05   1.38  1.381XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78282  GI protein loss exam                              C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99     10.40  10.40   0.04
78282TCGI protein loss exam                              C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 010 99     10.26  10.26   0.01
7828226GI protein loss exam                              A   0.38   0.14     0.14    0.03   0.55  0.551XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78290  Meckels divert exam                               A   0.68   9.49     9.49NA  0.07  10.24 10.241XXX.00.00.0000000             25.0008 090 99     10.48  10.48   0.07
78290TCMeckels divert exam                               A   0.00   9.25     9.25NA  0.03   9.28  9.281XXX.00.00.0000000             25.0008 010 99     10.24  10.24   0.03
7829026Meckels divert exam                               A   0.68   0.24     0.24    0.04   0.96  0.961XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78291  Leveen/shunt patency exam                         A   0.88   6.84     6.84NA  0.08   7.80  7.801XXX.00.00.0000000             25.0008 090 99     10.52  10.52   0.10
78291TCLeveen/shunt patency exam                         A   0.00   6.54     6.54NA  0.03   6.57  6.571XXX.00.00.0000000             25.0008 010 99     10.22  10.22   0.05
7829126Leveen/shunt patency exam                         A   0.88   0.30     0.30    0.05   1.23  1.231XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78299  GI nuclear procedure                              C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78299TCGI nuclear procedure                              C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7829926GI nuclear procedure                              C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78300  Bone imaging limited area                         A   0.62   4.81     4.81NA  0.06   5.49  5.491XXX.00.00.0000000             25.0008 090 99     10.62  10.62   0.10
78300TCBone imaging limited area                         A   0.00   4.59     4.59NA  0.03   4.62  4.621XXX.00.00.0000000             25.0008 010 99     10.40  10.40   0.07
7830026Bone imaging limited area                         A   0.62   0.22     0.22    0.03   0.87  0.871XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78305  Bone imaging multiple areas                       A   0.83   6.31     6.31NA  0.07   7.21  7.211XXX.00.00.0000000             25.0008 090 99     10.71  10.71   0.09
78305TCBone imaging multiple areas                       A   0.00   6.02     6.02NA  0.03   6.05  6.051XXX.00.00.0000000             25.0008 010 99     10.42  10.42   0.05
7830526Bone imaging multiple areas                       A   0.83   0.29     0.29    0.04   1.16  1.161XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78306  Bone imaging whole body                           A   0.86   6.72     6.72NA  0.07   7.65  7.651XXX.00.00.0020000             25.0008 090 99     10.72  10.72   0.09
78306TCBone imaging whole body                           A   0.00   6.42     6.42NA  0.03   6.45  6.451XXX.00.00.0020000             25.0008 010 99     10.42  10.42   0.05
7830626Bone imaging whole body                           A   0.86   0.30     0.30    0.04   1.20  1.201XXX.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
78315  Bone imaging 3 phase                              A   1.02   9.52     9.52NA  0.08  10.62 10.621XXX.00.00.0000000             25.0008 090 99     10.78  10.78   0.08
78315TCBone imaging 3 phase                              A   0.00   9.17     9.17NA  0.03   9.20  9.201XXX.00.00.0000000             25.0008 010 99     10.43  10.43   0.03
7831526Bone imaging 3 phase                              A   1.02   0.35     0.35    0.05   1.42  1.421XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78320  Bone imaging (3D)                                 A   1.04   5.77     5.77NA  0.08   6.89  6.891XXX.00.00.0020000             25.0008 090 99     10.74  10.74   0.11
78320TCBone imaging (3D)                                 A   0.00   5.44     5.44NA  0.03   5.47  5.471XXX.00.00.0020000             25.0008 010 99     10.41  10.41   0.06
7832026Bone imaging (3D)                                 A   1.04   0.33     0.33    0.05   1.42  1.421XXX.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
78350  Bone mineral single photon                        N+  0.22   0.75     0.75NA  0.02   0.99  0.991XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
78350TCBone mineral single photon                        N+  0.00   0.66     0.66NA  0.01   0.67  0.671XXX.00.00.0099999             25.0008 010 99      0.00   0.00   0.00
7835026Bone mineral single photon                        N+  0.22   0.09     0.09    0.01   0.32  0.321XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
78351  Bone mineral dual photon                          N+  0.30   0.12NA   0.12    0.01   0.43  0.439XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
78399  Musculoskeletal nuclear exam                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78399TCMusculoskeletal nuclear exam                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7839926Musculoskeletal nuclear exam                      C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78414  Non-imaging heart function                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78414TCNon-imaging heart function                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
7841426Non-imaging heart function                        A   0.45   0.18     0.18    0.03   0.66  0.661XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78428  Cardiac shunt imaging                             A   0.78   4.74     4.74NA  0.06   5.58  5.581XXX.00.00.0060000             25.0008 090 99     12.54  12.54   0.11
78428TCCardiac shunt imaging                             A   0.00   4.48     4.48NA  0.03   4.51  4.511XXX.00.00.0060000             25.0008 010 99     12.28  12.28   0.08
7842826Cardiac shunt imaging                             A   0.78   0.26     0.26    0.03   1.07  1.071XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
78445  Vascular flow imaging                             A   0.49   4.72     4.72NA  0.04   5.25  5.251XXX.00.00.0060000             25.0008 090 99     13.30  13.30   0.10
78445TCVascular flow imaging                             A   0.00   4.57     4.57NA  0.03   4.60  4.601XXX.00.00.0060000             25.0008 010 99     13.15  13.15   0.09
7844526Vascular flow imaging                             A   0.49   0.15     0.15    0.01   0.65  0.651XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
78451  Ht muscle image spect sing                        A   1.38   9.15     9.15NA  0.08  10.61 10.611XXX.00.00.0060000             25.0008 090 99     27.58  27.58   0.14
78451TCHt muscle image spect sing                        A   0.00   8.66     8.66NA  0.03   8.69  8.691XXX.00.00.0060000             25.0008 010 99     27.09  27.09   0.09
7845126Ht muscle image spect sing                        A   1.38   0.49     0.49    0.05   1.92  1.921XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
78452  Ht muscle image spect mult                        A   1.62  13.06    13.06NA  0.09  14.77 14.771XXX.00.00.0060000             25.0008 090 99     27.68  27.68   0.14
78452TCHt muscle image spect mult                        A   0.00  12.48    12.48NA  0.04  12.52 12.521XXX.00.00.0060000             25.0008 010 99     27.10  27.10   0.09
7845226Ht muscle image spect mult                        A   1.62   0.58     0.58    0.05   2.25  2.251XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
78453  Ht muscle image planar sing                       A   1.00   8.18     8.18NA  0.08   9.26  9.261XXX.00.00.0060000             25.0008 090 99     27.43  27.43   0.15
78453TCHt muscle image planar sing                       A   0.00   7.83     7.83NA  0.03   7.86  7.861XXX.00.00.0060000             25.0008 010 99     27.08  27.08   0.10
7845326Ht muscle image planar sing                       A   1.00   0.35     0.35    0.05   1.40  1.401XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
78454  Ht musc image planar mult                         A   1.34  11.89    11.89NA  0.09  13.32 13.321XXX.00.00.0060000             25.0008 090 99     27.57  27.57   0.14
78454TCHt musc image planar mult                         A   0.00  11.41    11.41NA  0.04  11.45 11.451XXX.00.00.0060000             25.0008 010 99     27.09  27.09   0.09
7845426Ht musc image planar mult                         A   1.34   0.48     0.48    0.05   1.87  1.871XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
78456  Acute venous thrombus image                       A   1.00   9.78     9.78NA  0.06  10.84 10.841XXX.00.00.0069999             25.0008 090 99     13.57  13.57   0.07
78456TCAcute venous thrombus image                       A   0.00   9.41     9.41NA  0.03   9.44  9.441XXX.00.00.0069999             25.0008 090 99     13.20  13.20   0.04
7845626Acute venous thrombus image                       A   1.00   0.37     0.37    0.03   1.40  1.401XXX.00.00.0069999             25.0008 090 99      0.00   0.00   0.00
78457  Venous thrombosis imaging                         A   0.77   5.35     5.35NA  0.07   6.19  6.191XXX.00.00.0060000             25.0008 090 99     13.43  13.43   0.12
78457TCVenous thrombosis imaging                         A   0.00   5.08     5.08NA  0.03   5.11  5.111XXX.00.00.0060000             25.0008 010 99     13.16  13.16   0.08
7845726Venous thrombosis imaging                         A   0.77   0.27     0.27    0.04   1.08  1.081XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
78458  Ven thrombosis images bilat                       A   0.90   4.70     4.70NA  0.08   5.68  5.681XXX.00.00.0062000             25.0008 090 99     13.38  13.38   0.14
78458TCVen thrombosis images bilat                       A   0.00   4.47     4.47NA  0.03   4.50  4.501XXX.00.00.0062000             25.0008 010 99     13.15  13.15   0.09
7845826Ven thrombosis images bilat                       A   0.90   0.23     0.23    0.05   1.18  1.181XXX.00.00.0062000             25.0008 090 99      0.00   0.00   0.00
78459  Heart muscle imaging (PET)                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99     42.70  42.70   0.11
78459TCHeart muscle imaging (PET)                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99     42.23  42.23   0.01
7845926Heart muscle imaging (PET)                        A   1.50   0.47     0.47    0.10   2.07  2.071XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78466  Heart infarct image                               A   0.69   5.21     5.21NA  0.06   5.96  5.961XXX.00.00.0060000             25.0008 090 99     12.56  12.56   0.10
78466TCHeart infarct image                               A   0.00   4.93     4.93NA  0.03   4.96  4.961XXX.00.00.0060000             25.0008 010 99     12.28  12.28   0.07
7846626Heart infarct image                               A   0.69   0.28     0.28    0.03   1.00  1.001XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
78468  Heart infarct image (ef)                          A   0.80   5.20     5.20NA  0.06   6.06  6.061XXX.00.00.0060000             25.0008 090 99     12.57  12.57   0.10
78468TCHeart infarct image (ef)                          A   0.00   4.91     4.91NA  0.03   4.94  4.941XXX.00.00.0060000             25.0008 010 99     12.28  12.28   0.07
7846826Heart infarct image (ef)                          A   0.80   0.29     0.29    0.03   1.12  1.121XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
78469  Heart infarct image (3D)                          A   0.92   5.90     5.90NA  0.06   6.88  6.881XXX.00.00.0060000             25.0008 090 99     12.64  12.64   0.10
78469TCHeart infarct image (3D)                          A   0.00   5.55     5.55NA  0.03   5.58  5.581XXX.00.00.0060000             25.0008 010 99     12.29  12.29   0.07
7846926Heart infarct image (3D)                          A   0.92   0.35     0.35    0.03   1.30  1.301XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
78472  Gated heart planar single                         A   0.98   5.98     5.98NA  0.07   7.03  7.031XXX.00.00.0060000             25.0008 090 99     12.63  12.63   0.11
78472TCGated heart planar single                         A   0.00   5.64     5.64NA  0.03   5.67  5.671XXX.00.00.0060000             25.0008 010 99     12.29  12.29   0.07
7847226Gated heart planar single                         A   0.98   0.34     0.34    0.04   1.36  1.361XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
78473  Gated heart multiple                              A   1.47   7.35     7.35NA  0.08   8.90  8.901XXX.00.00.0060000             25.0008 090 99     12.83  12.83   0.10
78473TCGated heart multiple                              A   0.00   6.83     6.83NA  0.03   6.86  6.861XXX.00.00.0060000             25.0008 010 99     12.31  12.31   0.05
7847326Gated heart multiple                              A   1.47   0.52     0.52    0.05   2.04  2.041XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
78481  Heart first pass single                           A   0.98   4.51     4.51NA  0.04   5.53  5.531XXX.00.00.0060000             25.0008 090 99     12.68  12.68   0.06
78481TCHeart first pass single                           A   0.00   4.16     4.16NA  0.01   4.17  4.171XXX.00.00.0060000             25.0008 010 99     12.33  12.33   0.03
7848126Heart first pass single                           A   0.98   0.35     0.35    0.03   1.36  1.361XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
78483  Heart first pass multiple                         A   1.47   5.82     5.82NA  0.08   7.37  7.371XXX.00.00.0060000             25.0008 090 99     12.82  12.82   0.12
78483TCHeart first pass multiple                         A   0.00   5.29     5.29NA  0.03   5.32  5.321XXX.00.00.0060000             25.0008 010 99     12.29  12.29   0.07
7848326Heart first pass multiple                         A   1.47   0.53     0.53    0.05   2.05  2.051XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
78491  Heart image (pet) single                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99     42.73  42.73   0.11
78491TCHeart image (pet) single                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 010 99     42.23  42.23   0.01
7849126Heart image (pet) single                          A   1.50   0.50     0.50    0.10   2.10  2.101XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78492  Heart image (pet) multiple                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99     42.85  42.85   0.13
78492TCHeart image (pet) multiple                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 010 99     42.23  42.23   0.01
7849226Heart image (pet) multiple                        A   1.87   0.62     0.62    0.12   2.61  2.611XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78494  Heart image spect                                 A   1.19   5.70     5.70NA  0.07   6.96  6.961XXX.00.00.0060000             25.0008 090 99     12.71  12.71   0.11
78494TCHeart image spect                                 A   0.00   5.28     5.28NA  0.03   5.31  5.311XXX.00.00.0060000             25.0008 010 99     12.29  12.29   0.07
7849426Heart image spect                                 A   1.19   0.42     0.42    0.04   1.65  1.651XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
78496  Heart first pass add-on                           A   0.50   0.81     0.81NA  0.02   1.33  1.331ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78496TCHeart first pass add-on                           A   0.00   0.63     0.63NA  0.01   0.64  0.641ZZZ.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
7849626Heart first pass add-on                           A   0.50   0.18     0.18    0.01   0.69  0.691ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78499  Cardiovascular nuclear exam                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78499TCCardiovascular nuclear exam                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7849926Cardiovascular nuclear exam                       C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78579  Lung ventilation imaging                          A   0.49   6.01     6.01NA  0.05   6.55  6.551XXX.00.00.0000000             25.0008 090 99      9.01   9.01   0.06
78579TCLung ventilation imaging                          A   0.00   5.81     5.81NA  0.02   5.83  5.831XXX.00.00.0000000             25.0008 010 99      8.81   8.81   0.03
7857926Lung ventilation imaging                          A   0.49   0.20     0.20    0.03   0.72  0.721XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78580  Lung perfusion imaging                            A   0.74   6.44     6.44NA  0.06   7.24  7.241XXX.00.00.0000000             25.0008 090 99      9.05   9.05   0.07
78580TCLung perfusion imaging                            A   0.00   6.19     6.19NA  0.03   6.22  6.221XXX.00.00.0000000             25.0008 010 99      8.80   8.80   0.04
7858026Lung perfusion imaging                            A   0.74   0.25     0.25    0.03   1.02  1.021XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78582  Lung ventilat&perfus imaging                      A   1.07  10.37    10.37NA  0.08  11.52 11.521XXX.00.00.0000000             25.0008 090 99     13.85  13.85   0.09
78582TCLung ventilat&perfus imaging                      A   0.00   9.94     9.94NA  0.03   9.97  9.971XXX.00.00.0000000             25.0008 010 99     13.42  13.42   0.04
7858226Lung ventilat&perfus imaging                      A   1.07   0.43     0.43    0.05   1.55  1.551XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78597  Lung perfusion differential                       A   0.75   6.37     6.37NA  0.04   7.16  7.161XXX.00.00.0000000             25.0008 090 99      9.11   9.11   0.05
78597TCLung perfusion differential                       A   0.00   6.07     6.07NA  0.02   6.09  6.091XXX.00.00.0000000             25.0008 010 99      8.81   8.81   0.03
7859726Lung perfusion differential                       A   0.75   0.30     0.30    0.02   1.07  1.071XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78598  Lung perf&ventilat diferentl                      A   0.85   9.79     9.79NA  0.06  10.70 10.701XXX.00.00.0000000             25.0008 090 99     13.75  13.75   0.07
78598TCLung perf&ventilat diferentl                      A   0.00   9.45     9.45NA  0.03   9.48  9.481XXX.00.00.0000000             25.0008 010 99     13.41  13.41   0.04
7859826Lung perf&ventilat diferentl                      A   0.85   0.34     0.34    0.03   1.22  1.221XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78599  Respiratory nuclear exam                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78599TCRespiratory nuclear exam                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7859926Respiratory nuclear exam                          C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78600  Brain image < 4 views                             A   0.44   5.11     5.11NA  0.04   5.59  5.591XXX.00.00.0000000             25.0008 090 99     10.66  10.66   0.07
78600TCBrain image < 4 views                             A   0.00   4.95     4.95NA  0.03   4.98  4.981XXX.00.00.0000000             25.0008 010 99     10.50  10.50   0.06
7860026Brain image < 4 views                             A   0.44   0.16     0.16    0.01   0.61  0.611XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78601  Brain image w/flow < 4 views                      A   0.51   6.04     6.04NA  0.06   6.61  6.611XXX.00.00.0000000             25.0008 090 99     18.42  18.42   0.12
78601TCBrain image w/flow < 4 views                      A   0.00   5.86     5.86NA  0.03   5.89  5.891XXX.00.00.0000000             25.0008 010 99     18.24  18.24   0.09
7860126Brain image w/flow < 4 views                      A   0.51   0.18     0.18    0.03   0.72  0.721XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78605  Brain image 4+ views                              A   0.53   5.44     5.44NA  0.06   6.03  6.031XXX.00.00.0000000             25.0008 090 99     10.70  10.70   0.09
78605TCBrain image 4+ views                              A   0.00   5.24     5.24NA  0.03   5.27  5.271XXX.00.00.0000000             25.0008 010 99     10.50  10.50   0.06
7860526Brain image 4+ views                              A   0.53   0.20     0.20    0.03   0.76  0.761XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78606  Brain image w/flow 4 + views                      A   0.64   9.46     9.46NA  0.04  10.14 10.141XXX.00.00.0000000             25.0008 090 99     18.49  18.49   0.07
78606TCBrain image w/flow 4 + views                      A   0.00   9.24     9.24NA  0.03   9.27  9.271XXX.00.00.0000000             25.0008 010 99     18.27  18.27   0.06
7860626Brain image w/flow 4 + views                      A   0.64   0.22     0.22    0.01   0.87  0.871XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78607  Brain imaging (3D)                                A   1.23   9.38     9.38NA  0.08  10.69 10.691XXX.00.00.0000000             25.0008 090 99     18.64  18.64   0.11
78607TCBrain imaging (3D)                                A   0.00   9.01     9.01NA  0.03   9.04  9.041XXX.00.00.0000000             25.0008 010 99     18.27  18.27   0.06
7860726Brain imaging (3D)                                A   1.23   0.37     0.37    0.05   1.65  1.651XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78608  Brain imaging (PET)                               C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99     42.70  42.70   0.12
78608TCBrain imaging (PET)                               C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 010 99     42.23  42.23   0.01
7860826Brain imaging (PET)                               A   1.50   0.47     0.47    0.11   2.08  2.081XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78609  Brain imaging (PET)                               N+  1.50   0.60     0.60NA  0.10   2.20  2.201XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
78609TCBrain imaging (PET)                               N   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0099999             25.0008 010 99      0.00   0.00   0.00
7860926Brain imaging (PET)                               N+  1.50   0.60     0.60    0.10   2.20  2.201XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
78610  Brain flow imaging only                           A   0.30   5.05     5.05NA  0.04   5.39  5.391XXX.00.00.0000000             25.0008 090 99     10.61  10.61   0.07
78610TCBrain flow imaging only                           A   0.00   4.94     4.94NA  0.03   4.97  4.971XXX.00.00.0000000             25.0008 010 99     10.50  10.50   0.06
7861026Brain flow imaging only                           A   0.30   0.11     0.11    0.01   0.42  0.421XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78630  Cerebrospinal fluid scan                          A   0.68   9.79     9.79NA  0.06  10.53 10.531XXX.00.00.0000000             25.0008 090 99     18.52  18.52   0.09
78630TCCerebrospinal fluid scan                          A   0.00   9.55     9.55NA  0.03   9.58  9.581XXX.00.00.0000000             25.0008 010 99     18.28  18.28   0.06
7863026Cerebrospinal fluid scan                          A   0.68   0.24     0.24    0.03   0.95  0.951XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78635  CSF ventriculography                              A   0.61   9.69     9.69NA  0.04  10.34 10.341XXX.00.00.0000000             25.0008 090 99     18.50  18.50   0.07
78635TCCSF ventriculography                              A   0.00   9.47     9.47NA  0.03   9.50  9.501XXX.00.00.0000000             25.0008 010 99     18.28  18.28   0.06
7863526CSF ventriculography                              A   0.61   0.22     0.22    0.01   0.84  0.841XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78645  CSF shunt evaluation                              A   0.57   9.18     9.18NA  0.06   9.81  9.811XXX.00.00.0000000             25.0008 090 99     10.71  10.71   0.06
78645TCCSF shunt evaluation                              A   0.00   9.00     9.00NA  0.03   9.03  9.031XXX.00.00.0000000             25.0008 010 99     10.53  10.53   0.03
7864526CSF shunt evaluation                              A   0.57   0.18     0.18    0.03   0.78  0.781XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78647  Cerebrospinal fluid scan                          A   0.90  10.16    10.16NA  0.08  11.14 11.141XXX.00.00.0000000             25.0008 090 99     18.58  18.58   0.11
78647TCCerebrospinal fluid scan                          A   0.00   9.86     9.86NA  0.03   9.89  9.891XXX.00.00.0000000             25.0008 010 99     18.28  18.28   0.06
7864726Cerebrospinal fluid scan                          A   0.90   0.30     0.30    0.05   1.25  1.251XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78650  CSF leakage imaging                               A   0.61   9.50     9.50NA  0.07  10.18 10.181XXX.00.00.0000000             25.0008 090 99     18.48  18.48   0.10
78650TCCSF leakage imaging                               A   0.00   9.29     9.29NA  0.03   9.32  9.321XXX.00.00.0000000             25.0008 010 99     18.27  18.27   0.06
7865026CSF leakage imaging                               A   0.61   0.21     0.21    0.04   0.86  0.861XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78660  Nuclear exam of tear flow                         A   0.53   5.16     5.16NA  0.06   5.75  5.751XXX.00.00.0000000             25.0008 090 99     10.72  10.72   0.09
78660TCNuclear exam of tear flow                         A   0.00   4.94     4.94NA  0.03   4.97  4.971XXX.00.00.0000000             25.0008 010 99     10.50  10.50   0.06
7866026Nuclear exam of tear flow                         A   0.53   0.22     0.22    0.03   0.78  0.781XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78699  Nervous system nuclear exam                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78699TCNervous system nuclear exam                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7869926Nervous system nuclear exam                       C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78700  Kidney imaging morphol                            A   0.45   4.88     4.88NA  0.06   5.39  5.391XXX.00.00.0000000             25.0008 090 99     13.39  13.39   0.11
78700TCKidney imaging morphol                            A   0.00   4.72     4.72NA  0.03   4.75  4.751XXX.00.00.0000000             25.0008 010 99     13.23  13.23   0.08
7870026Kidney imaging morphol                            A   0.45   0.16     0.16    0.03   0.64  0.641XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78701  Kidney imaging with flow                          A   0.49   5.95     5.95NA  0.06   6.50  6.501XXX.00.00.0000000             25.0008 090 99     13.42  13.42   0.10
78701TCKidney imaging with flow                          A   0.00   5.78     5.78NA  0.03   5.81  5.811XXX.00.00.0000000             25.0008 010 99     13.25  13.25   0.07
7870126Kidney imaging with flow                          A   0.49   0.17     0.17    0.03   0.69  0.691XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78707  K flow/funct image w/o drug                       A   0.96   5.99     5.99NA  0.07   7.02  7.021XXX.00.00.0000000             25.0008 090 99     13.57  13.57   0.11
78707TCK flow/funct image w/o drug                       A   0.00   5.67     5.67NA  0.03   5.70  5.701XXX.00.00.0000000             25.0008 010 99     13.25  13.25   0.07
7870726K flow/funct image w/o drug                       A   0.96   0.32     0.32    0.04   1.32  1.321XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78708  K flow/funct image w/drug                         A   1.21   3.90     3.90NA  0.08   5.19  5.191XXX.00.00.0000000             25.0008 090 99     13.61  13.61   0.16
78708TCK flow/funct image w/drug                         A   0.00   3.49     3.49NA  0.03   3.52  3.521XXX.00.00.0000000             25.0008 010 99     13.20  13.20   0.11
7870826K flow/funct image w/drug                         A   1.21   0.41     0.41    0.05   1.67  1.671XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78709  K flow/funct image multiple                       A   1.41   9.69     9.69NA  0.10  11.20 11.201XXX.00.00.0000000             25.0008 090 99     13.74  13.74   0.11
78709TCK flow/funct image multiple                       A   0.00   9.22     9.22NA  0.03   9.25  9.251XXX.00.00.0000000             25.0008 010 99     13.27  13.27   0.04
7870926K flow/funct image multiple                       A   1.41   0.47     0.47    0.07   1.95  1.951XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78710  Kidney imaging (3D)                               A   0.66   5.51     5.51NA  0.04   6.21  6.211XXX.00.00.0000000             25.0008 090 99     13.42  13.42   0.08
78710TCKidney imaging (3D)                               A   0.00   5.33     5.33NA  0.03   5.36  5.361XXX.00.00.0000000             25.0008 010 99     13.24  13.24   0.07
7871026Kidney imaging (3D)                               A   0.66   0.18     0.18    0.01   0.85  0.851XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78725  Kidney function study                             A   0.38   2.94     2.94NA  0.04   3.36  3.361XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78725TCKidney function study                             A   0.00   2.81     2.81NA  0.03   2.84  2.841XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
7872526Kidney function study                             A   0.38   0.13     0.13    0.01   0.52  0.521XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78730  Urinary bladder retention                         A   0.15   1.85     1.85NA  0.02   2.02  2.021ZZZ.00.00.0000000             25.0008 090 99      4.60   4.60   0.04
78730TCUrinary bladder retention                         A   0.00   1.79     1.79NA  0.01   1.80  1.801ZZZ.00.00.0000000             25.0008 010 99      4.54   4.54   0.03
7873026Urinary bladder retention                         A   0.15   0.06     0.06    0.01   0.22  0.221ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78740  Ureteral reflux study                             A   0.57   6.43     6.43NA  0.06   7.06  7.061XXX.00.00.0000000             25.0008 090 99     13.46  13.46   0.09
78740TCUreteral reflux study                             A   0.00   6.22     6.22NA  0.03   6.25  6.251XXX.00.00.0000000             25.0008 010 99     13.25  13.25   0.06
7874026Ureteral reflux study                             A   0.57   0.21     0.21    0.03   0.81  0.811XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78761  Testicular imaging w/flow                         A   0.71   5.80     5.80NA  0.07   6.58  6.581XXX.00.00.0000000             25.0008 090 99     13.50  13.50   0.11
78761TCTesticular imaging w/flow                         A   0.00   5.54     5.54NA  0.03   5.57  5.571XXX.00.00.0000000             25.0008 010 99     13.24  13.24   0.07
7876126Testicular imaging w/flow                         A   0.71   0.26     0.26    0.04   1.01  1.011XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78799  Genitourinary nuclear exam                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78799TCGenitourinary nuclear exam                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7879926Genitourinary nuclear exam                        C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78800  Tumor imaging limited area                        A   0.66   5.03     5.03NA  0.07   5.76  5.761XXX.00.00.0000000             25.0008 090 99     12.17  12.17   0.11
78800TCTumor imaging limited area                        A   0.00   4.79     4.79NA  0.03   4.82  4.821XXX.00.00.0000000             25.0008 010 99     11.93  11.93   0.07
7880026Tumor imaging limited area                        A   0.66   0.24     0.24    0.04   0.94  0.941XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78801  Tumor imaging mult areas                          A   0.79   6.56     6.56NA  0.07   7.42  7.421XXX.00.00.0000000             25.0008 090 99     20.29  20.29   0.14
78801TCTumor imaging mult areas                          A   0.00   6.28     6.28NA  0.03   6.31  6.311XXX.00.00.0000000             25.0008 010 99     20.01  20.01   0.10
7880126Tumor imaging mult areas                          A   0.79   0.28     0.28    0.04   1.11  1.111XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78802  Tumor imaging whole body                          A   0.86   8.91     8.91NA  0.07   9.84  9.841XXX.00.00.0020000             25.0008 090 99     20.31  20.31   0.11
78802TCTumor imaging whole body                          A   0.00   8.63     8.63NA  0.03   8.66  8.661XXX.00.00.0020000             25.0008 010 99     20.03  20.03   0.07
7880226Tumor imaging whole body                          A   0.86   0.28     0.28    0.04   1.18  1.181XXX.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
78803  Tumor imaging (3D)                                A   1.09   9.19     9.19NA  0.08  10.36 10.361XXX.00.00.0020000             25.0008 090 99     20.36  20.36   0.12
78803TCTumor imaging (3D)                                A   0.00   8.86     8.86NA  0.03   8.89  8.891XXX.00.00.0020000             25.0008 010 99     20.03  20.03   0.07
7880326Tumor imaging (3D)                                A   1.09   0.33     0.33    0.05   1.47  1.471XXX.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
78804  Tumor imaging whole body                          A   1.07  16.18    16.18NA  0.10  17.35 17.351XXX.00.00.0000000             25.0008 090 99     38.45  38.45   0.17
78804TCTumor imaging whole body                          A   0.00  15.83    15.83NA  0.05  15.88 15.881XXX.00.00.0000000             25.0008 010 99     38.10  38.10   0.12
7880426Tumor imaging whole body                          A   1.07   0.35     0.35    0.05   1.47  1.471XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78805  Abscess imaging ltd area                          A   0.73   4.76     4.76NA  0.07   5.56  5.561XXX.00.00.0000000             25.0008 090 99     20.22  20.22   0.17
78805TCAbscess imaging ltd area                          A   0.00   4.51     4.51NA  0.03   4.54  4.541XXX.00.00.0000000             25.0008 010 99     19.97  19.97   0.13
7880526Abscess imaging ltd area                          A   0.73   0.25     0.25    0.04   1.02  1.021XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78806  Abscess imaging whole body                        A   0.86   9.17     9.17NA  0.07  10.10 10.101XXX.00.00.0020000             25.0008 090 99     20.31  20.31   0.11
78806TCAbscess imaging whole body                        A   0.00   8.89     8.89NA  0.03   8.92  8.921XXX.00.00.0020000             25.0008 010 99     20.03  20.03   0.07
7880626Abscess imaging whole body                        A   0.86   0.28     0.28    0.04   1.18  1.181XXX.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
78807  Nuclear localization/abscess                      A   1.09   9.11     9.11NA  0.07  10.27 10.271XXX.00.00.0020000             25.0008 090 99     20.35  20.35   0.11
78807TCNuclear localization/abscess                      A   0.00   8.79     8.79NA  0.03   8.82  8.821XXX.00.00.0020000             25.0008 010 99     20.03  20.03   0.07
7880726Nuclear localization/abscess                      A   1.09   0.32     0.32    0.04   1.45  1.451XXX.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
78808  Iv inj ra drug dx study                           A   0.18   1.14     1.14NA  0.03   1.35  1.355XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78811  Pet image ltd area                                C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99     42.76  42.76   0.19
78811TCPet image ltd area                                C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 010 99     42.23  42.23   0.01
7881126Pet image ltd area                                A   1.54   0.53     0.53    0.18   2.25  2.251XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78812  Pet image skull-thigh                             C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99     42.88  42.88   0.17
78812TCPet image skull-thigh                             C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 010 99     42.23  42.23   0.01
7881226Pet image skull-thigh                             A   1.93   0.65     0.65    0.16   2.74  2.741XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78813  Pet image full body                               C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99     42.90  42.90   0.19
78813TCPet image full body                               C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 010 99     42.23  42.23   0.01
7881326Pet image full body                               A   2.00   0.67     0.67    0.18   2.85  2.851XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78814  Pet image w/ct lmtd                               C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99     42.98  42.98   0.21
78814TCPet image w/ct lmtd                               C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 010 99     42.23  42.23   0.01
7881426Pet image w/ct lmtd                               A   2.20   0.75     0.75    0.20   3.15  3.151XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78815  Pet image w/ct skull-thigh                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99     43.05  43.05   0.23
78815TCPet image w/ct skull-thigh                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 010 99     42.23  42.23   0.01
7881526Pet image w/ct skull-thigh                        A   2.44   0.82     0.82    0.22   3.48  3.481XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78816  Pet image w/ct full body                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99     43.02  43.02   0.23
78816TCPet image w/ct full body                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 010 99     42.23  42.23   0.01
7881626Pet image w/ct full body                          A   2.50   0.79     0.79    0.22   3.51  3.511XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78999  Nuclear diagnostic exam                           C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
78999TCNuclear diagnostic exam                           C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7899926Nuclear diagnostic exam                           C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
79005  Nuclear rx oral admin                             A   1.80   2.08     2.08NA  0.08   3.96  3.961XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
79005TCNuclear rx oral admin                             A   0.00   1.46     1.46NA  0.01   1.47  1.471XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7900526Nuclear rx oral admin                             A   1.80   0.62     0.62    0.07   2.49  2.491XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
79101  Nuclear rx iv admin                               A   1.96   2.18     2.18NA  0.08   4.22  4.221XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
79101TCNuclear rx iv admin                               A   0.00   1.51     1.51NA  0.01   1.52  1.521XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7910126Nuclear rx iv admin                               A   1.96   0.67     0.67    0.07   2.70  2.701XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
79200  Nuclear rx intracav admin                         A   1.99   2.47     2.47NA  0.12   4.58  4.581XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
79200TCNuclear rx intracav admin                         A   0.00   1.66     1.66NA  0.01   1.67  1.671XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7920026Nuclear rx intracav admin                         A   1.99   0.81     0.81    0.11   2.91  2.911XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
79300  Nuclr rx interstit colloid                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
79300TCNuclr rx interstit colloid                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7930026Nuclr rx interstit colloid                        A   1.60   0.59     0.59    0.14   2.33  2.331XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
79403  Hematopoietic nuclear tx                          A   2.25   3.20     3.20NA  0.14   5.59  5.591XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
79403TCHematopoietic nuclear tx                          A   0.00   2.39     2.39NA  0.03   2.42  2.421XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7940326Hematopoietic nuclear tx                          A   2.25   0.81     0.81    0.11   3.17  3.171XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
79440  Nuclear rx intra-articular                        A   1.99   2.17     2.17NA  0.06   4.22  4.221XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
79440TCNuclear rx intra-articular                        A   0.00   1.43     1.43NA  0.01   1.44  1.441XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7944026Nuclear rx intra-articular                        A   1.99   0.74     0.74    0.05   2.78  2.781XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
79445  Nuclear rx intra-arterial                         C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
79445TCNuclear rx intra-arterial                         C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7944526Nuclear rx intra-arterial                         A   2.40   0.73     0.73    0.20   3.33  3.331XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
79999  Nuclear medicine therapy                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
79999TCNuclear medicine therapy                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
7999926Nuclear medicine therapy                          C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
80047  Metabolic panel ionized ca                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80048  Metabolic panel total ca                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80050  General health panel                              N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80051  Electrolyte panel                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80053  Comprehen metabolic panel                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80055  Obstetric panel                                   I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80061  Lipid panel                                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80069  Renal function panel                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80074  Acute hepatitis panel                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80076  Hepatic function panel                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80100  Drug screen qualitate/multi                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80101  Drug screen single                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80102  Drug confirmation                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80103  Drug analysis tissue prep                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80150  Assay of amikacin                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80152  Assay of amitriptyline                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80154  Assay of benzodiazepines                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80156  Assay carbamazepine total                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80157  Assay carbamazepine free                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80158  Assay of cyclosporine                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80160  Assay of desipramine                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80162  Assay of digoxin                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80164  Assay dipropylacetic acid                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80166  Assay of doxepin                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80168  Assay of ethosuximide                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80170  Assay of gentamicin                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80172  Assay of gold                                     X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80173  Assay of haloperidol                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80174  Assay of imipramine                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80176  Assay of lidocaine                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80178  Assay of lithium                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80182  Assay of nortriptyline                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80184  Assay of phenobarbital                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80185  Assay of phenytoin total                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80186  Assay of phenytoin free                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80188  Assay of primidone                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80190  Assay of procainamide                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80192  Assay of procainamide                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80194  Assay of quinidine                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80195  Assay of sirolimus                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80196  Assay of salicylate                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80197  Assay of tacrolimus                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80198  Assay of theophylline                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80200  Assay of tobramycin                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80201  Assay of topiramate                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80202  Assay of vancomycin                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80299  Quantitative assay drug                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80400  Acth stimulation panel                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80402  Acth stimulation panel                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80406  Acth stimulation panel                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80408  Aldosterone suppression eval                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80410  Calcitonin stimul panel                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80412  CRH stimulation panel                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80414  Testosterone response                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80415  Estradiol response panel                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80416  Renin stimulation panel                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80417  Renin stimulation panel                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80418  Pituitary evaluation panel                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80420  Dexamethasone panel                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80422  Glucagon tolerance panel                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80424  Glucagon tolerance panel                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80426  Gonadotropin hormone panel                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80428  Growth hormone panel                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80430  Growth hormone panel                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80432  Insulin suppression panel                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80434  Insulin tolerance panel                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80435  Insulin tolerance panel                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80436  Metyrapone panel                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80438  TRH stimulation panel                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80439  TRH stimulation panel                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80440  TRH stimulation panel                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
80500  Lab pathology consultation                        A   0.37   0.20     0.13    0.03   0.60  0.530XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
80502  Lab pathology consultation                        A   1.33   0.52     0.45    0.07   1.92  1.850XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
81000  Urinalysis nonauto w/scope                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81001  Urinalysis auto w/scope                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81005  Urinalysis                                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81007  Urine screen for bacteria                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81015  Microscopic exam of urine                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81020  Urinalysis glass test                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81025  Urine pregnancy test                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81050  Urinalysis volume measure                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81099  Urinalysis test procedure                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81200  Aspa gene                                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81201  Apc gene full sequence                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81202  Apc gene known fam variants                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81203  Apc gene dup/delet variants                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81205  Bckdhb gene                                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81206  Bcr/abl1 gene major bp                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81207  Bcr/abl1 gene minor bp                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81208  Bcr/abl1 gene other bp                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81209  Blm gene                                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81210  Braf gene                                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81211  Brca1&2 seq & com dup/del                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81212  Brca1&2 185&5385&6174 var                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81213  Brca1&2 uncom dup/del var                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81214  Brca1 full seq & com dup/del                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81215  Brca1 gene known fam variant                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81216  Brca2 gene full sequence                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81217  Brca2 gene known fam variant                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81220  Cftr gene com variants                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81221  Cftr gene known fam variants                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81222  Cftr gene dup/delet variants                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81223  Cftr gene full sequence                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81224  Cftr gene intron poly t                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81225  Cyp2c19 gene com variants                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81226  Cyp2d6 gene com variants                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81227  Cyp2c9 gene com variants                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81228  Cytogen micrarray copy nmbr                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81229  Cytogen m array copy no&snp                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81235  Egfr gene com variants                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81240  F2 gene                                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81241  F5 gene                                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81242  Fancc gene                                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81243  Fmr1 gene detection                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81244  Fmr1 gene characterization                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81245  Flt3 gene                                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81250  G6pc gene                                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81251  Gba gene                                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81252  Gjb2 gene full sequence                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81253  Gjb2 gene known fam variants                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81254  Gjb6 gene com variants                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81255  Hexa gene                                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81256  Hfe gene                                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81257  Hba1/hba2 gene                                    X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81260  Ikbkap gene                                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81261  Igh gene rearrange amp meth                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81262  Igh gene rearrang dir probe                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81263  Igh vari regional mutation                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81264  Igk rearrangeabn clonal pop                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81265  Str markers specimen anal                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81266  Str markers spec anal addl                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81267  Chimerism anal no cell selec                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81268  Chimerism anal w/cell select                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81270  Jak2 gene                                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81275  Kras gene                                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81280  Long qt synd gene full seq                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81281  Long qt synd known fam var                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81282  Long qt syn gene dup/dlt var                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81290  Mcoln1 gene                                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81291  Mthfr gene                                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81292  Mlh1 gene full seq                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81293  Mlh1 gene known variants                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81294  Mlh1 gene dup/delete variant                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81295  Msh2 gene full seq                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81296  Msh2 gene known variants                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81297  Msh2 gene dup/delete variant                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81298  Msh6 gene full seq                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81299  Msh6 gene known variants                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81300  Msh6 gene dup/delete variant                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81301  Microsatellite instability                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81302  Mecp2 gene full seq                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81303  Mecp2 gene known variant                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81304  Mecp2 gene dup/delet variant                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81310  Npm1 gene                                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81315  Pml/raralpha com breakpoints                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81316  Pml/raralpha 1 breakpoint                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81317  Pms2 gene full seq analysis                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81318  Pms2 known familial variants                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81319  Pms2 gene dup/delet variants                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81321  Pten gene full sequence                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81322  Pten gene known fam variant                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81323  Pten gene dup/delet variant                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81324  Pmp22 gene dup/delet                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81325  Pmp22 gene full sequence                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81326  Pmp22 gene known fam variant                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81330  Smpd1 gene common variants                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81331  Snrpn/ube3a gene                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81332  Serpina1 gene                                     X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81340  Trb@ gene rearrange amplify                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81341  Trb@ gene rearrange dirprobe                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81342  Trg gene rearrangement anal                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81350  Ugt1a1 gene                                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81355  Vkorc1 gene                                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81370  Hla i & ii typing lr                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81371  Hla i & ii type verify lr                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81372  Hla i typing complete lr                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81373  Hla i typing 1 locus lr                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81374  Hla i typing 1 antigen lr                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81375  Hla ii typing ag equiv lr                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81376  Hla ii typing 1 locus lr                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81377  Hla ii type 1 ag equiv lr                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81378  Hla i & ii typing hr                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81379  Hla i typing complete hr                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81380  Hla i typing 1 locus hr                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81381  Hla i typing 1 allele hr                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81382  Hla ii typing 1 loc hr                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81383  Hla ii typing 1 allele hr                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81400  Mopath procedure level 1                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81401  Mopath procedure level 2                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81402  Mopath procedure level 3                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81403  Mopath procedure level 4                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81404  Mopath procedure level 5                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81405  Mopath procedure level 6                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81406  Mopath procedure level 7                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81407  Mopath procedure level 8                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81408  Mopath procedure level 9                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81479  Unlisted molecular pathology                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81500  Onco (ovar) two proteins                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81503  Onco (ovar) five proteins                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81506  Endo assay seven anal                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81508  Ftl cgen abnor two proteins                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81509  Ftl cgen abnor 3 proteins                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81510  Ftl cgen abnor three anal                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81511  Ftl cgen abnor four anal                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81512  Ftl cgen abnor five anal                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
81599  Unlisted maaa                                     I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82000  Assay of blood acetaldehyde                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82003  Assay of acetaminophen                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82009  Test for acetone/ketones                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82010  Acetone assay                                     X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82013  Acetylcholinesterase assay                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82016  Acylcarnitines qual                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82017  Acylcarnitines quant                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82024  Assay of acth                                     X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82030  Assay of adp & amp                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82040  Assay of serum albumin                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82042  Assay of urine albumin                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82043  Microalbumin quantitative                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82044  Microalbumin semiquant                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82045  Albumin ischemia modified                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82055  Assay of ethanol                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82075  Assay of breath ethanol                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82085  Assay of aldolase                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82088  Assay of aldosterone                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82101  Assay of urine alkaloids                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82103  Alpha-1-antitrypsin total                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82104  Alpha-1-antitrypsin pheno                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82105  Alpha-fetoprotein serum                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82106  Alpha-fetoprotein amniotic                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82107  Alpha-fetoprotein l3                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82108  Assay of aluminum                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82120  Amines vaginal fluid qual                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82127  Amino acid single qual                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82128  Amino acids mult qual                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82131  Amino acids single quant                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82135  Assay aminolevulinic acid                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82140  Assay of ammonia                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82143  Amniotic fluid scan                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82145  Assay of amphetamines                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82150  Assay of amylase                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82154  Androstanediol glucuronide                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82157  Assay of androstenedione                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82160  Assay of androsterone                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82163  Assay of angiotensin II                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82164  Angiotensin I enzyme test                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82172  Assay of apolipoprotein                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82175  Assay of arsenic                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82180  Assay of ascorbic acid                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82190  Atomic absorption                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82205  Assay of barbiturates                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82239  Bile acids total                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82240  Bile acids cholylglycine                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82247  Bilirubin total                                   X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82248  Bilirubin direct                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82252  Fecal bilirubin test                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82261  Assay of biotinidase                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82270  Occult blood feces                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82271  Occult blood other sources                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82286  Assay of bradykinin                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82300  Assay of cadmium                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82306  Vitamin d 25 hydroxy                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82308  Assay of calcitonin                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82310  Assay of calcium                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82330  Assay of calcium                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82331  Calcium infusion test                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82355  Calculus analysis qual                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82360  Calculus assay quant                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82365  Calculus spectroscopy                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82370  X-ray assay calculus                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82374  Assay blood carbon dioxide                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82375  Assay carboxyhb quant                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82376  Assay carboxyhb qual                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82378  Carcinoembryonic antigen                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82379  Assay of carnitine                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82380  Assay of carotene                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82382  Assay urine catecholamines                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82383  Assay blood catecholamines                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82384  Assay three catecholamines                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82387  Assay of cathepsin-d                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82390  Assay of ceruloplasmin                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82397  Chemiluminescent assay                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82415  Assay of chloramphenicol                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82435  Assay of blood chloride                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82436  Assay of urine chloride                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82438  Assay other fluid chlorides                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82441  Test for chlorohydrocarbons                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82465  Assay bld/serum cholesterol                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82480  Assay serum cholinesterase                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82482  Assay rbc cholinesterase                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82485  Assay chondroitin sulfate                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82486  Gas/liquid chromatography                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82487  Paper chromatography                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82488  Paper chromatography                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82489  Thin layer chromatography                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82491  Chromotography quant sing                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82492  Chromotography quant mult                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82495  Assay of chromium                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82507  Assay of citrate                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82520  Assay of cocaine                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82523  Collagen crosslinks                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82525  Assay of copper                                   X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82528  Assay of corticosterone                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82530  Cortisol free                                     X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82533  Total cortisol                                    X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82540  Assay of creatine                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82541  Column chromotography qual                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82542  Column chromotography quant                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82543  Column chromotograph/isotope                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82544  Column chromotograph/isotope                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82550  Assay of ck (cpk)                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82553  Creatine mb fraction                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82554  Creatine isoforms                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82565  Assay of creatinine                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82570  Assay of urine creatinine                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82575  Creatinine clearance test                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82585  Assay of cryofibrinogen                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82595  Assay of cryoglobulin                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82600  Assay of cyanide                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82607  Vitamin B-12                                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82608  B-12 binding capacity                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82610  Cystatin c                                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82615  Test for urine cystines                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82626  Dehydroepiandrosterone                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82627  Dehydroepiandrosterone                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82633  Desoxycorticosterone                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82634  Deoxycortisol                                     X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82638  Assay of dibucaine number                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82646  Assay of dihydrocodeinone                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82649  Assay of dihydromorphinone                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82651  Assay of dihydrotestosterone                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82654  Assay of dimethadione                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82656  Pancreatic elastase fecal                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82657  Enzyme cell activity                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82658  Enzyme cell activity ra                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82664  Electrophoretic test                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82666  Assay of epiandrosterone                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82668  Assay of erythropoietin                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82670  Assay of estradiol                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82671  Assay of estrogens                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82672  Assay of estrogen                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82677  Assay of estriol                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82679  Assay of estrone                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82690  Assay of ethchlorvynol                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82693  Assay of ethylene glycol                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82696  Assay of etiocholanolone                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82705  Fats/lipids feces qual                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82710  Fats/lipids feces quant                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82715  Assay of fecal fat                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82726  Long chain fatty acids                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82728  Assay of ferritin                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82731  Assay of fetal fibronectin                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82735  Assay of fluoride                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82742  Assay of flurazepam                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82746  Assay of folic acid serum                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82757  Assay of semen fructose                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82759  Assay of rbc galactokinase                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82760  Assay of galactose                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82775  Assay galactose transferase                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82776  Galactose transferase test                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82777  Galectin 3                                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82785  Assay of ige                                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82800  Blood pH                                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82803  Blood gases any combination                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82820  Hemoglobin-oxygen affinity                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82938  Gastrin test                                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82941  Assay of gastrin                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82943  Assay of glucagon                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82945  Glucose other fluid                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82946  Glucagon tolerance test                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82947  Assay glucose blood quant                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82948  Reagent strip/blood glucose                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82950  Glucose test                                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82951  Glucose tolerance test (GTT)                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82952  GTT-added samples                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82953  Glucose-tolbutamide test                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82955  Assay of g6pd enzyme                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82960  Test for G6PD enzyme                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82962  Glucose blood test                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82963  Assay of glucosidase                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82965  Assay of gdh enzyme                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82975  Assay of glutamine                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82977  Assay of GGT                                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82978  Assay of glutathione                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82979  Assay rbc glutathione                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82980  Assay of glutethimide                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
82985  Assay of glycated protein                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83001  Assay of gonadotropin (fsh)                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83002  Assay of gonadotropin (lh)                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83003  Assay growth hormone (hgh)                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83008  Assay of guanosine                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83010  Assay of haptoglobin quant                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83012  Assay of haptoglobins                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83014  H pylori drug admin                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83015  Heavy metal screen                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83018  Quantitative screen metals                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83020  Hemoglobin electrophoresis                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
8302026Hemoglobin electrophoresis                        A   0.37   0.19     0.19    0.03   0.59  0.596XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
83021  Hemoglobin chromotography                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83026  Hemoglobin copper sulfate                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83030  Fetal hemoglobin chemical                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83033  Fetal hemoglobin assay qual                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83036  Glycosylated hemoglobin test                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83037  Glycosylated hb home device                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83045  Blood methemoglobin test                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83050  Blood methemoglobin assay                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83051  Assay of plasma hemoglobin                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83055  Blood sulfhemoglobin test                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83060  Blood sulfhemoglobin assay                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83065  Assay of hemoglobin heat                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83068  Hemoglobin stability screen                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83069  Assay of urine hemoglobin                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83070  Assay of hemosiderin qual                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83071  Assay of hemosiderin quant                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83080  Assay of b hexosaminidase                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83088  Assay of histamine                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83090  Assay of homocystine                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83150  Assay of homovanillic acid                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83491  Assay of corticosteroids 17                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83497  Assay of 5-hiaa                                   X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83498  Assay of progesterone 17-d                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83499  Assay of progesterone 20-                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83500  Assay free hydroxyproline                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83505  Assay total hydroxyproline                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83516  Immunoassay nonantibody                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83518  Immunoassay dipstick                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83519  Ria nonantibody                                   X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83520  Immunoassay quant nos nonab                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83525  Assay of insulin                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83527  Assay of insulin                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83528  Assay of intrinsic factor                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83540  Assay of iron                                     X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83550  Iron binding test                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83570  Assay of idh enzyme                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83582  Assay of ketogenic steroids                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83586  Assay 17- ketosteroids                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83593  Fractionation ketosteroids                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83605  Assay of lactic acid                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83615  Lactate (LD) (LDH) enzyme                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83625  Assay of ldh enzymes                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83630  Lactoferrin fecal (qual)                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83631  Lactoferrin fecal (quant)                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83632  Placental lactogen                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83633  Test urine for lactose                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83655  Assay of lead                                     X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83662  Foam stability fetal lung                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83663  Fluoro polarize fetal lung                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83664  Lamellar bdy fetal lung                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83670  Assay of lap enzyme                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83690  Assay of lipase                                   X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83695  Assay of lipoprotein(a)                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83698  Assay lipoprotein pla2                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83700  Lipopro bld electrophoretic                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83701  Lipoprotein bld hr fraction                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83704  Lipoprotein bld by nmr                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83718  Assay of lipoprotein                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83719  Assay of blood lipoprotein                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83721  Assay of blood lipoprotein                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83727  Assay of lrh hormone                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83735  Assay of magnesium                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83775  Assay malate dehydrogenase                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83785  Assay of manganese                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83788  Mass spectrometry qual                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83789  Mass spectrometry quant                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83805  Assay of meprobamate                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83825  Assay of mercury                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83835  Assay of metanephrines                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83840  Assay of methadone                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83857  Assay of methemalbumin                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83858  Assay of methsuximide                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83861  Microfluid analy tears                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83864  Mucopolysaccharides                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83866  Mucopolysaccharides screen                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83872  Assay synovial fluid mucin                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83873  Assay of csf protein                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83874  Assay of myoglobin                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83876  Assay myeloperoxidase                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83880  Assay of natriuretic peptide                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83883  Assay nephelometry not spec                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83885  Assay of nickel                                   X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83887  Assay of nicotine                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83915  Assay of nucleotidase                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83916  Oligoclonal bands                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83918  Organic acids total quant                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83919  Organic acids qual each                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83921  Organic acid single quant                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83925  Assay of opiates                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83930  Assay of blood osmolality                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83935  Assay of urine osmolality                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83937  Assay of osteocalcin                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83945  Assay of oxalate                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83950  Oncoprotein her-2/neu                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83951  Oncoprotein dcp                                   X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83970  Assay of parathormone                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83987  Exhaled breath condensate                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83992  Assay for phencyclidine                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
83993  Assay for calprotectin fecal                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84022  Assay of phenothiazine                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84030  Assay of blood pku                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84035  Assay of phenylketones                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84060  Assay acid phosphatase                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84061  Phosphatase forensic exam                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84066  Assay prostate phosphatase                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84075  Assay alkaline phosphatase                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84078  Assay alkaline phosphatase                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84080  Assay alkaline phosphatases                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84081  Assay phosphatidylglycerol                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84087  Assay phosphohexose enzymes                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84100  Assay of phosphorus                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84105  Assay of urine phosphorus                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84106  Test for porphobilinogen                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84110  Assay of porphobilinogen                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84119  Test urine for porphyrins                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84120  Assay of urine porphyrins                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84126  Assay of feces porphyrins                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84127  Assay of feces porphyrins                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84132  Assay of serum potassium                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84133  Assay of urine potassium                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84134  Assay of prealbumin                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84135  Assay of pregnanediol                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84138  Assay of pregnanetriol                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84140  Assay of pregnenolone                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84143  Assay of 17-hydroxypregneno                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84144  Assay of progesterone                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84145  Procalcitonin (pct)                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84146  Assay of prolactin                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84150  Assay of prostaglandin                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84152  Assay of psa complexed                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84153  Assay of psa total                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84154  Assay of psa free                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84155  Assay of protein serum                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84156  Assay of protein urine                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84157  Assay of protein other                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84163  Pappa serum                                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84165  Protein e-phoresis serum                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
8416526Protein e-phoresis serum                          A   0.37   0.19     0.19    0.03   0.59  0.596XXX.00.00.0000000             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
8416626Protein e-phoresis/urine/csf                      A   0.37   0.19     0.19    0.03   0.59  0.596XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
84181  Western blot test                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
8418126Western blot test                                 A   0.37   0.19     0.19    0.03   0.59  0.596XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
84182  Protein western blot test                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
8418226Protein western blot test                         A   0.37   0.14     0.14    0.03   0.54  0.546XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
84202  Assay RBC protoporphyrin                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84203  Test RBC protoporphyrin                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84206  Assay of proinsulin                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84210  Assay of pyruvate                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84220  Assay of pyruvate kinase                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84228  Assay of quinine                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84233  Assay of estrogen                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84234  Assay of progesterone                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84235  Assay of endocrine hormone                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84238  Assay nonendocrine receptor                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84244  Assay of renin                                    X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84255  Assay of selenium                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84260  Assay of serotonin                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84275  Assay of sialic acid                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84285  Assay of silica                                   X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84295  Assay of serum sodium                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84300  Assay of urine sodium                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84302  Assay of sweat sodium                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84305  Assay of somatomedin                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84307  Assay of somatostatin                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84311  Spectrophotometry                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84315  Body fluid specific gravity                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84375  Chromatogram assay sugars                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84376  Sugars single qual                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84377  Sugars multiple qual                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84378  Sugars single quant                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84379  Sugars multiple quant                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84392  Assay of urine sulfate                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84402  Assay of free testosterone                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84403  Assay of total testosterone                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84430  Assay of thiocyanate                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84431  Thromboxane urine                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84432  Assay of thyroglobulin                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84436  Assay of total thyroxine                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84437  Assay of neonatal thyroxine                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84439  Assay of free thyroxine                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84442  Assay of thyroid activity                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84443  Assay thyroid stim hormone                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84445  Assay of tsi globulin                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84446  Assay of vitamin e                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84449  Assay of transcortin                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84450  Transferase (AST) (SGOT)                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84460  Alanine amino (ALT) (SGPT)                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84466  Assay of transferrin                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84478  Assay of triglycerides                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84480  Assay triiodothyronine (t3)                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84481  Free assay (FT-3)                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84482  T3 reverse                                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84484  Assay of troponin quant                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84485  Assay duodenal fluid trypsin                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84488  Test feces for trypsin                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84510  Assay of tyrosine                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84512  Assay of troponin qual                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84520  Assay of urea nitrogen                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84525  Urea nitrogen semi-quant                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84545  Urea-N clearance test                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84577  Assay of feces/urobilinogen                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84578  Test urine urobilinogen                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84580  Assay of urine urobilinogen                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84583  Assay of urine urobilinogen                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84585  Assay of urine vma                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84586  Assay of vip                                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84588  Assay of vasopressin                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84590  Assay of vitamin a                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84591  Assay of nos vitamin                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84597  Assay of vitamin k                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84600  Assay of volatiles                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84620  Xylose tolerance test                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84630  Assay of zinc                                     X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84681  Assay of c-peptide                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84702  Chorionic gonadotropin test                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84703  Chorionic gonadotropin assay                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84704  Hcg free betachain test                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84830  Ovulation tests                                   X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
84999  Clinical chemistry test                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85002  Bleeding time test                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85004  Automated diff wbc count                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85013  Spun microhematocrit                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85014  Hematocrit                                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85018  Hemoglobin                                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85027  Complete cbc automated                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85032  Manual cell count each                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85041  Automated rbc count                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85044  Manual reticulocyte count                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85045  Automated reticulocyte count                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85046  Reticyte/hgb concentrate                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85048  Automated leukocyte count                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85049  Automated platelet count                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85055  Reticulated platelet assay                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85060  Blood smear interpretation                        A   0.45   0.23NA   0.23    0.03   0.71  0.718XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
85097  Bone marrow interpretation                        A   0.94   1.54     0.40    0.05   2.53  1.390XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
85130  Chromogenic substrate assay                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85170  Blood clot retraction                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85175  Blood clot lysis time                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85210  Clot factor ii prothrom spec                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85220  Blooc clot factor v test                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85230  Clot factor vii proconvertin                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85240  Clot factor viii ahg 1 stage                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85244  Clot factor viii reltd antgn                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85245  Clot factor viii vw ristoctn                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85246  Clot factor viii vw antigen                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85247  Clot factor viii multimetric                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85250  Clot factor ix ptc/chrstmas                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85260  Clot factor x stuart-power                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85270  Clot factor xi pta                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85280  Clot factor xii hageman                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85290  Clot factor xiii fibrin stab                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85291  Clot factor xiii fibrin scrn                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85292  Clot factor fletcher fact                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85293  Clot factor wght kininogen                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85300  Antithrombin iii activity                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85301  Antithrombin iii antigen                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85302  Clot inhibit prot c antigen                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85303  Clot inhibit prot c activity                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85305  Clot inhibit prot s total                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85306  Clot inhibit prot s free                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85307  Assay activated protein c                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85335  Factor inhibitor test                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85337  Thrombomodulin                                    X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85345  Coagulation time lee & white                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85347  Coagulation time activated                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85348  Coagulation time otr method                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85360  Euglobulin lysis                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85362  Fibrin degradation products                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85366  Fibrinogen test                                   X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85370  Fibrinogen test                                   X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85378  Fibrin degrade semiquant                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85379  Fibrin degradation quant                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85380  Fibrin degradj d-dimer                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85384  Fibrinogen activity                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85385  Fibrinogen antigen                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85390  Fibrinolysins screen i&r                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
8539026Fibrinolysins screen i&r                          A   0.37   0.19     0.19    0.03   0.59  0.596XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
85396  Clotting assay whole blood                        A   0.37   0.19NA   0.19    0.03   0.59  0.590XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
85397  Clotting funct activity                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85400  Fibrinolytic plasmin                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85410  Fibrinolytic antiplasmin                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85415  Fibrinolytic plasminogen                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85420  Fibrinolytic plasminogen                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85421  Fibrinolytic plasminogen                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85441  Heinz bodies direct                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85445  Heinz bodies induced                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85460  Hemoglobin fetal                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85461  Hemoglobin fetal                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85475  Hemolysin acid                                    X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85520  Heparin assay                                     X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85525  Heparin neutralization                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85530  Heparin-protamine tolerance                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85536  Iron stain peripheral blood                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85540  Wbc alkaline phosphatase                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85547  RBC mechanical fragility                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85549  Muramidase                                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85555  RBC osmotic fragility                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85557  RBC osmotic fragility                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85576  Blood platelet aggregation                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
8557626Blood platelet aggregation                        A   0.37   0.19     0.19    0.03   0.59  0.596XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
85597  Phospholipid pltlt neutraliz                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85598  Hexagnal phosph pltlt neutrl                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85610  Prothrombin time                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85611  Prothrombin test                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85612  Viper venom prothrombin time                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85613  Russell viper venom diluted                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85635  Reptilase test                                    X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85651  Rbc sed rate nonautomated                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85652  Rbc sed rate automated                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85660  RBC sickle cell test                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85670  Thrombin time plasma                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85675  Thrombin time titer                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85705  Thromboplastin inhibition                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85730  Thromboplastin time partial                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85732  Thromboplastin time partial                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85810  Blood viscosity examination                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
85999  Hematology procedure                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86000  Agglutinins febrile antigen                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86001  Allergen specific igg                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86003  Allergen specific IgE                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86005  Allergen specific IgE                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86021  WBC antibody identification                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86022  Platelet antibodies                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86023  Immunoglobulin assay                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86038  Antinuclear antibodies                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86039  Antinuclear antibodies (ANA)                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86060  Antistreptolysin o titer                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86063  Antistreptolysin o screen                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86077  Phys blood bank serv xmatch                       A   0.94   0.58     0.47    0.05   1.57  1.460XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
86078  Phys blood bank serv reactj                       A   0.94   0.59     0.47    0.05   1.58  1.460XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
86079  Phys blood bank serv authrj                       A   0.94   0.58     0.46    0.05   1.57  1.450XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
86140  C-reactive protein                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86141  C-reactive protein hs                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86146  Beta-2 glycoprotein antibody                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86147  Cardiolipin antibody ea ig                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86148  Anti-phospholipid antibody                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86152  Cell enumeration & id                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
8615326Cell enumeration phys interp                      A   0.69   0.28     0.28    0.02   0.99  0.996XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
86155  Chemotaxis assay                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86156  Cold agglutinin screen                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86157  Cold agglutinin titer                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86160  Complement antigen                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86161  Complement/function activity                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86162  Complement total (ch50)                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86171  Complement fixation each                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86185  Counterimmunoelectrophoresis                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86200  Ccp antibody                                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86215  Deoxyribonuclease antibody                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86225  Dna antibody native                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86226  Dna antibody single strand                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86235  Nuclear antigen antibody                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86243  Fc receptor                                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86255  Fluorescent antibody screen                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
8625526Fluorescent antibody screen                       A   0.37   0.19     0.19    0.03   0.59  0.596XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
86256  Fluorescent antibody titer                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
8625626Fluorescent antibody titer                        A   0.37   0.18     0.18    0.01   0.56  0.566XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
86277  Growth hormone antibody                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86280  Hemagglutination inhibition                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86294  Immunoassay tumor qual                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86304  Immunoassay tumor ca 125                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86305  Human epididymis protein 4                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86308  Heterophile antibody screen                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86309  Heterophile antibody titer                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86310  Heterophile antibody absrbj                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86316  Immunoassay tumor other                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86317  Immunoassay infectious agent                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86318  Immunoassay infectious agent                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86320  Serum immunoelectrophoresis                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
8632026Serum immunoelectrophoresis                       A   0.37   0.16     0.16    0.01   0.54  0.546XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
86325  Other immunoelectrophoresis                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
8632526Other immunoelectrophoresis                       A   0.37   0.17     0.17    0.01   0.55  0.556XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
86327  Immunoelectrophoresis assay                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
8632726Immunoelectrophoresis assay                       A   0.42   0.21     0.21    0.03   0.66  0.666XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
86329  Immunodiffusion nes                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86331  Immunodiffusion ouchterlony                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86332  Immune complex assay                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86334  Immunofix e-phoresis serum                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
8633426Immunofix e-phoresis serum                        A   0.37   0.18     0.18    0.03   0.58  0.586XXX.00.00.0000000             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
8633526Immunfix e-phorsis/urine/csf                      A   0.37   0.19     0.19    0.03   0.59  0.596XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
86336  Inhibin A                                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86337  Insulin antibodies                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86340  Intrinsic factor antibody                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86341  Islet cell antibody                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86343  Leukocyte histamine release                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86344  Leukocyte phagocytosis                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86353  Lymphocyte transformation                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86355  B cells total count                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86356  Mononuclear cell antigen                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86357  Nk cells total count                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86359  T cells total count                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86361  T cell absolute count                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86367  Stem cells total count                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86376  Microsomal antibody each                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86378  Migration inhibitory factor                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86382  Neutralization test viral                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86384  Nitroblue tetrazolium dye                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86386  Nuclear matrix protein 22                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86403  Particle agglut antbdy scrn                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86406  Particle agglut antbdy titr                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86430  Rheumatoid factor test qual                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86431  Rheumatoid factor quant                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86485  Skin test candida                                 C   0.00   0.00     0.00    0.00   0.00  0.003XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
86486  Skin test nos antigen                             A   0.00   0.16     0.16NA  0.01   0.17  0.173XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
86490  Coccidioidomycosis skin test                      A   0.00   0.14     0.14NA  0.01   0.15  0.153XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
86510  Histoplasmosis skin test                          A   0.00   0.18     0.18NA  0.01   0.19  0.193XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
86580  TB intradermal test                               A   0.00   0.23     0.23NA  0.01   0.24  0.243XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
86590  Streptokinase antibody                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86602  Antinomyces antibody                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86603  Adenovirus antibody                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86606  Aspergillus antibody                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86609  Bacterium antibody                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86611  Bartonella antibody                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86612  Blastomyces antibody                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86615  Bordetella antibody                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86617  Lyme disease antibody                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86618  Lyme disease antibody                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86619  Borrelia antibody                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86622  Brucella antibody                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86625  Campylobacter antibody                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86628  Candida antibody                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86631  Chlamydia antibody                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86632  Chlamydia igm antibody                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86635  Coccidioides antibody                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86638  Q fever antibody                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86641  Cryptococcus antibody                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86644  CMV antibody                                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86645  Cmv antibody igm                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86648  Diphtheria antibody                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86651  Encephalitis californ antbdy                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86652  Encephaltis east eqne anbdy                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86653  Encephaltis st louis antbody                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86654  Encephaltis west eqne antbdy                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86658  Enterovirus antibody                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86663  Epstein-barr antibody                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86664  Epstein-barr nuclear antigen                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86665  Epstein-barr capsid vca                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86666  Ehrlichia antibody                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86668  Francisella tularensis                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86671  Fungus nes antibody                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86674  Giardia lamblia antibody                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86677  Helicobacter pylori antibody                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86682  Helminth antibody                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86684  Hemophilus influenza antibdy                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86687  Htlv-i antibody                                   X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86688  Htlv-ii antibody                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86689  Htlv/hiv confirmj antibody                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86692  Hepatitis delta agent antbdy                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86694  Herpes simplex nes antbdy                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86695  Herpes simplex type 1 test                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86696  Herpes simplex type 2 test                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86698  Histoplasma antibody                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86701  Hiv-1antibody                                     X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86702  Hiv-2 antibody                                    X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86703  Hiv-1/hiv-2 1 result antbdy                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86706  Hep b surface antibody                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86707  Hepatitis be antibody                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86708  Hepatitis a total antibody                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86709  Hepatitis a igm antibody                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86710  Influenza virus antibody                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86711  John cunningham antibody                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86713  Legionella antibody                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86717  Leishmania antibody                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86720  Leptospira antibody                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86723  Listeria monocytogenes                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86727  Lymph choriomeningitis ab                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86729  Lympho venereum antibody                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86732  Mucormycosis antibody                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86735  Mumps antibody                                    X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86738  Mycoplasma antibody                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86741  Neisseria meningitidis                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86744  Nocardia antibody                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86747  Parvovirus antibody                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86750  Malaria antibody                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86753  Protozoa antibody nos                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86756  Respiratory virus antibody                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86757  Rickettsia antibody                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86759  Rotavirus antibody                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86762  Rubella antibody                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86765  Rubeola antibody                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86768  Salmonella antibody                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86771  Shigella antibody                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86774  Tetanus antibody                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86777  Toxoplasma antibody                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86778  Toxoplasma antibody igm                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86780  Treponema pallidum                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86784  Trichinella antibody                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86787  Varicella-zoster antibody                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86789  West nile virus antibody                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86790  Virus antibody nos                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86793  Yersinia antibody                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86800  Thyroglobulin antibody                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86803  Hepatitis c ab test                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86805  Lymphocytotoxicity assay                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86806  Lymphocytotoxicity assay                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86807  Cytotoxic antibody screening                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86808  Cytotoxic antibody screening                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86816  Hla typing dr/dq                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86817  Hla typing dr/dq                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86821  Lymphocyte culture mixed                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86822  Lymphocyte culture primed                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86828  Hla class i&ii antibody qual                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86829  Hla class i/ii antibody qual                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86830  Hla class i phenotype qual                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86831  Hla class ii phenotype qual                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86832  Hla class i high defin qual                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86833  Hla class ii high defin qual                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86834  Hla class i semiquant panel                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86835  Hla class ii semiquant panel                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86849  Immunology procedure                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86850  RBC antibody screen                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86860  RBC antibody elution                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86870  RBC antibody identification                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86880  Coombs test direct                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86885  Coombs test indirect qual                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86886  Coombs test indirect titer                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86890  Autologous blood process                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86891  Autologous blood op salvage                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86900  Blood typing abo                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86901  Blood typing rh (d)                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86904  Blood typing patient serum                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86905  Blood typing rbc antigens                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86906  Blood typing rh phenotype                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86910  Blood typing paternity test                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86911  Blood typing antigen system                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86920  Compatibility test spin                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86921  Compatibility test incubate                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86922  Compatibility test antiglob                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86923  Compatibility test electric                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86927  Plasma fresh frozen                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86930  Frozen blood prep                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86931  Frozen blood thaw                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86932  Frozen blood freeze/thaw                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86940  Hemolysins/agglutinins auto                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86941  Hemolysins/agglutinins                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86945  Blood product/irradiation                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86950  Leukacyte transfusion                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86965  Pooling blood platelets                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86970  Rbc pretx incubatj w/chemicl                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86971  Rbc pretx incubatj w/enzymes                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86972  Rbc pretx incubatj w/density                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86975  Rbc serum pretx incubj drugs                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86976  Rbc serum pretx id dilution                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86977  Rbc serum pretx incubj/inhib                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86978  Rbc pretreatment serum                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86985  Split blood or products                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
86999  Transfusion procedure                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87001  Small animal inoculation                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87003  Small animal inoculation                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87015  Specimen infect agnt concntj                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87040  Blood culture for bacteria                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87045  Feces culture aerobic bact                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87046  Stool cultr aerobic bact ea                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87070  Culture othr specimn aerobic                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87071  Culture aerobic quant other                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87073  Culture bacteria anaerobic                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87075  Cultr bacteria except blood                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87076  Culture anaerobe ident each                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87077  Culture aerobic identify                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87081  Culture screen only                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87086  Urine culture/colony count                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87088  Urine bacteria culture                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87101  Skin fungi culture                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87102  Fungus isolation culture                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87103  Blood fungus culture                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87106  Fungi identification yeast                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87107  Fungi identification mold                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87109  Mycoplasma                                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87110  Chlamydia culture                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87116  Mycobacteria culture                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87118  Mycobacteric identification                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87140  Culture type immunofluoresc                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87143  Culture typing glc/hplc                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87147  Culture type immunologic                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87149  Dna/rna direct probe                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87150  Dna/rna amplified probe                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87153  Dna/rna sequencing                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87158  Culture typing added method                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87164  Dark field examination                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
8716426Dark field examination                            A   0.37   0.16     0.16    0.03   0.56  0.566XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
87166  Dark field examination                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87168  Macroscopic exam arthropod                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87169  Macroscopic exam parasite                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87172  Pinworm exam                                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87176  Tissue homogenization cultr                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87177  Ova and parasites smears                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87181  Microbe susceptible diffuse                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87184  Microbe susceptible disk                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87185  Microbe susceptible enzyme                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87186  Microbe susceptible mic                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87187  Microbe susceptible mlc                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87188  Microbe suscept macrobroth                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87190  Microbe suscept mycobacteri                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87197  Bactericidal level serum                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87205  Smear gram stain                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87206  Smear fluorescent/acid stai                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87207  Smear special stain                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
8720726Smear special stain                               A   0.37   0.19     0.19    0.03   0.59  0.596XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
87209  Smear complex stain                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87220  Tissue exam for fungi                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87230  Assay toxin or antitoxin                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87250  Virus inoculate eggs/animal                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87252  Virus inoculation tissue                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87253  Virus inoculate tissue addl                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87254  Virus inoculation shell via                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87255  Genet virus isolate hsv                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87260  Adenovirus ag if                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87265  Pertussis ag if                                   X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87267  Enterovirus antibody dfa                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87269  Giardia ag if                                     X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87270  Chlamydia trachomatis ag if                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87271  Cytomegalovirus dfa                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87272  Cryptosporidium ag if                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87275  Influenza b ag if                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87276  Influenza a ag if                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87277  Legionella micdadei ag if                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87278  Legion pneumophilia ag if                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87279  Parainfluenza ag if                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87280  Respiratory syncytial ag if                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87281  Pneumocystis carinii ag if                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87283  Rubeola ag if                                     X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87285  Treponema pallidum ag if                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87290  Varicella zoster ag if                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87299  Antibody detection nos if                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87300  Ag detection polyval if                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87301  Adenovirus ag eia                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87305  Aspergillus ag eia                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87320  Chylmd trach ag eia                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87324  Clostridium ag eia                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87327  Cryptococcus neoform ag eia                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87328  Cryptosporidium ag eia                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87329  Giardia ag eia                                    X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87332  Cytomegalovirus ag eia                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87338  Hpylori stool eia                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87339  H pylori ag eia                                   X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87350  Hepatitis be ag eia                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87380  Hepatitis delta ag eia                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87385  Histoplasma capsul ag eia                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87389  Hiv-1 ag w/hiv-1 & hiv-2 ab                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87390  Hiv-1 ag eia                                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87391  Hiv-2 ag eia                                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87420  Resp syncytial ag eia                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87425  Rotavirus ag eia                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87430  Strep a ag eia                                    X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87470  Bartonella dna dir probe                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87471  Bartonella dna amp probe                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87472  Bartonella dna quant                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87477  Lyme dis dna quant                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87480  Candida dna dir probe                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87481  Candida dna amp probe                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87482  Candida dna quant                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87487  Chylmd pneum dna quant                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87492  Chylmd trach dna quant                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87493  C diff amplified probe                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87495  Cytomeg dna dir probe                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87496  Cytomeg dna amp probe                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87497  Cytomeg dna quant                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87498  Enterovirus probe&revrs trns                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87500  Vanomycin dna amp probe                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87502  Influenza dna amp probe                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87512  Gardner vag dna quant                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87517  Hepatitis b dna quant                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87521  Hepatitis c probe&rvrs trnsc                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87522  Hepatitis c revrs trnscrpj                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87527  Hepatitis g dna quant                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87528  Hsv dna dir probe                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87529  Hsv dna amp probe                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87530  Hsv dna quant                                     X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87533  Hhv-6 dna quant                                   X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87535  Hiv-1 probe&reverse trnscrpj                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87536  Hiv-1 quant&revrse trnscrpj                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87538  Hiv-2 probe&revrse trnscripj                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87539  Hiv-2 quant&revrse trnscripj                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87542  Legion pneumo dna quant                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87550  Mycobacteria dna dir probe                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87551  Mycobacteria dna amp probe                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87552  Mycobacteria dna quant                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87557  M.tuberculo dna quant                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87582  M.pneumon dna quant                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87592  N.gonorrhoeae dna quant                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87620  Hpv dna dir probe                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87621  Hpv dna amp probe                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87622  Hpv dna quant                                     X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87631  Resp virus 3-11 targets                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87632  Resp virus 6-11 targets                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87633  Resp virus 12-25 targets                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87652  Strep a dna quant                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87660  Trichomonas vagin dir probe                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87804  Influenza assay w/optic                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87807  Rsv assay w/optic                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87808  Trichomonas assay w/optic                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87809  Adenovirus assay w/optic                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87900  Phenotype infect agent drug                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87902  Genotype dna/rna hep c                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87905  Sialidase enzyme assay                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87906  Genotype dna/rna hiv                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87910  Genotype cytomegalovirus                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87912  Genotype dna hepatitis b                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
87999  Microbiology procedure                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88000  Autopsy (necropsy) gross                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88005  Autopsy (necropsy) gross                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88007  Autopsy (necropsy) gross                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88012  Autopsy (necropsy) gross                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88014  Autopsy (necropsy) gross                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88016  Autopsy (necropsy) gross                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88020  Autopsy (necropsy) complete                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88025  Autopsy (necropsy) complete                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88027  Autopsy (necropsy) complete                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88028  Autopsy (necropsy) complete                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88029  Autopsy (necropsy) complete                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88036  Limited autopsy                                   N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88037  Limited autopsy                                   N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88040  Forensic autopsy (necropsy)                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88045  Coroners autopsy (necropsy)                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88099  Necropsy (autopsy) procedure                      N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88104  Cytopath fl nongyn smears                         A   0.56   1.66     1.66NA  0.02   2.24  2.241XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88104TCCytopath fl nongyn smears                         A   0.00   1.39     1.39NA  0.01   1.40  1.401XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8810426Cytopath fl nongyn smears                         A   0.56   0.27     0.27    0.01   0.84  0.841XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88106  Cytopath fl nongyn filter                         A   0.37   2.12     2.12NA  0.02   2.51  2.511XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88106TCCytopath fl nongyn filter                         A   0.00   1.94     1.94NA  0.01   1.95  1.951XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8810626Cytopath fl nongyn filter                         A   0.37   0.18     0.18    0.01   0.56  0.561XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88108  Cytopath concentrate tech                         A   0.44   1.86     1.86NA  0.02   2.32  2.321XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88108TCCytopath concentrate tech                         A   0.00   1.66     1.66NA  0.01   1.67  1.671XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8810826Cytopath concentrate tech                         A   0.44   0.20     0.20    0.01   0.65  0.651XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88112  Cytopath cell enhance tech                        A   1.18   1.99     1.99NA  0.05   3.22  3.221XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88112TCCytopath cell enhance tech                        A   0.00   1.50     1.50NA  0.01   1.51  1.511XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8811226Cytopath cell enhance tech                        A   1.18   0.49     0.49    0.04   1.71  1.711XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88120  Cytp urne 3-5 probes ea spec                      A   1.20  17.01    17.01NA  0.06  18.27 18.271XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88120TCCytp urne 3-5 probes ea spec                      A   0.00  16.58    16.58NA  0.03  16.61 16.611XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8812026Cytp urne 3-5 probes ea spec                      A   1.20   0.43     0.43    0.03   1.66  1.661XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88121  Cytp urine 3-5 probes cmptr                       A   1.00  15.40    15.40NA  0.04  16.44 16.441XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88121TCCytp urine 3-5 probes cmptr                       A   0.00  14.98    14.98NA  0.01  14.99 14.991XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8812126Cytp urine 3-5 probes cmptr                       A   1.00   0.42     0.42    0.03   1.45  1.451XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88125  Forensic cytopathology                            A   0.26   0.38     0.38NA  0.02   0.66  0.661XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88125TCForensic cytopathology                            A   0.00   0.27     0.27NA  0.01   0.28  0.281XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8812526Forensic cytopathology                            A   0.26   0.11     0.11    0.01   0.38  0.381XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88130  Sex chromatin identification                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88140  Sex chromatin identification                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88141  Cytopath c/v interpret                            A   0.42   0.48     0.48    0.03   0.93  0.932XXX.00.00.0000000             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88147  Cytopath c/v automated                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88150  Cytopath c/v manual                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88153  Cytopath c/v redo                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88154  Cytopath c/v select                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88160  Cytopath smear other source                       A   0.50   1.34     1.34NA  0.02   1.86  1.861XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88160TCCytopath smear other source                       A   0.00   1.11     1.11NA  0.01   1.12  1.121XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8816026Cytopath smear other source                       A   0.50   0.23     0.23    0.01   0.74  0.741XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88161  Cytopath smear other source                       A   0.50   1.26     1.26NA  0.02   1.78  1.781XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88161TCCytopath smear other source                       A   0.00   1.05     1.05NA  0.01   1.06  1.061XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8816126Cytopath smear other source                       A   0.50   0.21     0.21    0.01   0.72  0.721XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88162  Cytopath smear other source                       A   0.76   2.03     2.03NA  0.04   2.83  2.831XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88162TCCytopath smear other source                       A   0.00   1.67     1.67NA  0.01   1.68  1.681XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8816226Cytopath smear other source                       A   0.76   0.36     0.36    0.03   1.15  1.151XXX.00.00.0000000             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88172  Cytp dx eval fna 1st ea site                      A   0.69   0.90     0.90NA  0.02   1.61  1.611XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88172TCCytp dx eval fna 1st ea site                      A   0.00   0.56     0.56NA  0.01   0.57  0.571XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8817226Cytp dx eval fna 1st ea site                      A   0.69   0.34     0.34    0.01   1.04  1.041XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88173  Cytopath eval fna report                          A   1.39   2.96     2.96NA  0.05   4.40  4.401XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88173TCCytopath eval fna report                          A   0.00   2.34     2.34NA  0.01   2.35  2.351XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8817326Cytopath eval fna report                          A   1.39   0.62     0.62    0.04   2.05  2.051XXX.00.00.0000000             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88177  Cytp fna eval ea addl                             A   0.42   0.43     0.43NA  0.02   0.87  0.871ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88177TCCytp fna eval ea addl                             A   0.00   0.22     0.22NA  0.01   0.23  0.231ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8817726Cytp fna eval ea addl                             A   0.42   0.21     0.21    0.01   0.64  0.641ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88182  Cell marker study                                 A   0.77   2.38     2.38NA  0.06   3.21  3.211XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88182TCCell marker study                                 A   0.00   2.15     2.15NA  0.03   2.18  2.181XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8818226Cell marker study                                 A   0.77   0.23     0.23    0.03   1.03  1.031XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88184  Flowcytometry/ tc 1 marker                        A   0.00   2.60     2.60NA  0.01   2.61  2.613XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88185  Flowcytometry/tc add-on                           A   0.00   1.58     1.58NA  0.01   1.59  1.593ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88187  Flowcytometry/read 2-8                            A   1.36   0.58     0.58    0.08   2.02  2.022XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88188  Flowcytometry/read 9-15                           A   1.69   0.78     0.78    0.10   2.57  2.572XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88189  Flowcytometry/read 16 & >                         A   2.23   0.78     0.78    0.12   3.13  3.132XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88199  Cytopathology procedure                           C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88199TCCytopathology procedure                           C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8819926Cytopathology procedure                           C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88230  Tissue culture lymphocyte                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88233  Tissue culture skin/biopsy                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88235  Tissue culture placenta                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88237  Tissue culture bone marrow                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88239  Tissue culture tumor                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88240  Cell cryopreserve/storage                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88241  Frozen cell preparation                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88245  Chromosome analysis 20-25                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88248  Chromosome analysis 50-100                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88249  Chromosome analysis 100                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88261  Chromosome analysis 5                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88262  Chromosome analysis 15-20                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88263  Chromosome analysis 45                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88264  Chromosome analysis 20-25                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88267  Chromosome analys placenta                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88269  Chromosome analys amniotic                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88271  Cytogenetics dna probe                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88272  Cytogenetics 3-5                                  X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88273  Cytogenetics 10-30                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88274  Cytogenetics 25-99                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88275  Cytogenetics 100-300                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88280  Chromosome karyotype study                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88283  Chromosome banding study                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88285  Chromosome count additional                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88289  Chromosome study additional                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88291  Cyto/molecular report                             A   0.52   0.35     0.35    0.03   0.90  0.902XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88299  Cytogenetic study                                 C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88300  Surgical path gross                               A   0.08   0.33     0.33NA  0.02   0.43  0.431XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88300TCSurgical path gross                               A   0.00   0.29     0.29NA  0.01   0.30  0.301XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8830026Surgical path gross                               A   0.08   0.04     0.04    0.01   0.13  0.131XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88302  Tissue exam by pathologist                        A   0.13   0.76     0.76NA  0.02   0.91  0.911XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88302TCTissue exam by pathologist                        A   0.00   0.70     0.70NA  0.01   0.71  0.711XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8830226Tissue exam by pathologist                        A   0.13   0.06     0.06    0.01   0.20  0.201XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88304  Tissue exam by pathologist                        A   0.22   1.07     1.07NA  0.02   1.31  1.311XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88304TCTissue exam by pathologist                        A   0.00   0.97     0.97NA  0.01   0.98  0.981XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8830426Tissue exam by pathologist                        A   0.22   0.10     0.10    0.01   0.33  0.331XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88305  Tissue exam by pathologist                        A   0.75   1.30     1.30NA  0.02   2.07  2.071XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88305TCTissue exam by pathologist                        A   0.00   0.98     0.98NA  0.01   0.99  0.991XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8830526Tissue exam by pathologist                        A   0.75   0.32     0.32    0.01   1.08  1.081XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88307  Tissue exam by pathologist                        A   1.59   7.10     7.10NA  0.05   8.74  8.741XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88307TCTissue exam by pathologist                        A   0.00   6.32     6.32NA  0.01   6.33  6.331XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8830726Tissue exam by pathologist                        A   1.59   0.78     0.78    0.04   2.41  2.411XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88309  Tissue exam by pathologist                        A   2.80  10.30    10.30NA  0.11  13.21 13.211XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88309TCTissue exam by pathologist                        A   0.00   8.92     8.92NA  0.03   8.95  8.951XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8830926Tissue exam by pathologist                        A   2.80   1.38     1.38    0.08   4.26  4.261XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88311  Decalcify tissue                                  A   0.24   0.34     0.34NA  0.02   0.60  0.601XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88311TCDecalcify tissue                                  A   0.00   0.23     0.23NA  0.01   0.24  0.241XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8831126Decalcify tissue                                  A   0.24   0.11     0.11    0.01   0.36  0.361XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88312  Special stains group 1                            A   0.54   2.32     2.32NA  0.02   2.88  2.881XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88312TCSpecial stains group 1                            A   0.00   2.09     2.09NA  0.01   2.10  2.101XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8831226Special stains group 1                            A   0.54   0.23     0.23    0.01   0.78  0.781XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88313  Special stains group 2                            A   0.24   1.73     1.73NA  0.02   1.99  1.991XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88313TCSpecial stains group 2                            A   0.00   1.63     1.63NA  0.01   1.64  1.641XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8831326Special stains group 2                            A   0.24   0.10     0.10    0.01   0.35  0.351XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88314  Histochemical stains add-on                       A   0.45   1.91     1.91NA  0.02   2.38  2.381XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88314TCHistochemical stains add-on                       A   0.00   1.71     1.71NA  0.01   1.72  1.721XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8831426Histochemical stains add-on                       A   0.45   0.20     0.20    0.01   0.66  0.661XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88319  Enzyme histochemistry                             A   0.53   2.00     2.00NA  0.04   2.57  2.571XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88319TCEnzyme histochemistry                             A   0.00   1.76     1.76NA  0.01   1.77  1.771XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8831926Enzyme histochemistry                             A   0.53   0.24     0.24    0.03   0.80  0.801XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88321  Microslide consultation                           A   1.63   1.01     0.72    0.10   2.74  2.450XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88323  Microslide consultation                           A   1.83   2.29     2.29NA  0.05   4.17  4.171XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88323TCMicroslide consultation                           A   0.00   1.72     1.72NA  0.01   1.73  1.731XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8832326Microslide consultation                           A   1.83   0.57     0.57    0.04   2.44  2.441XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88325  Comprehensive review of data                      A   2.50   3.56     1.16    0.12   6.18  3.780XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88329  Path consult introp                               A   0.67   0.98     0.34    0.04   1.69  1.050XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88331  Path consult intraop 1 bloc                       A   1.19   1.71     1.71NA  0.02   2.92  2.921XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88331TCPath consult intraop 1 bloc                       A   0.00   1.12     1.12NA  0.01   1.13  1.131XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8833126Path consult intraop 1 bloc                       A   1.19   0.59     0.59    0.01   1.79  1.791XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88332  Path consult intraop addl                         A   0.59   0.67     0.67NA  0.02   1.28  1.281XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88332TCPath consult intraop addl                         A   0.00   0.38     0.38NA  0.01   0.39  0.391XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8833226Path consult intraop addl                         A   0.59   0.29     0.29    0.01   0.89  0.891XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88333  Intraop cyto path consult 1                       A   1.20   1.83     1.83NA  0.05   3.08  3.081XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88333TCIntraop cyto path consult 1                       A   0.00   1.25     1.25NA  0.01   1.26  1.261XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8833326Intraop cyto path consult 1                       A   1.20   0.58     0.58    0.04   1.82  1.821XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88334  Intraop cyto path consult 2                       A   0.73   1.16     1.16NA  0.04   1.93  1.931XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88334TCIntraop cyto path consult 2                       A   0.00   0.79     0.79NA  0.01   0.80  0.801XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8833426Intraop cyto path consult 2                       A   0.73   0.37     0.37    0.03   1.13  1.131XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88342  Immunohistochemistry                              A   0.85   2.51     2.51NA  0.04   3.40  3.401XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88342TCImmunohistochemistry                              A   0.00   2.15     2.15NA  0.01   2.16  2.161XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8834226Immunohistochemistry                              A   0.85   0.36     0.36    0.03   1.24  1.241XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88346  Immunofluorescent study                           A   0.86   2.33     2.33NA  0.02   3.21  3.211XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88346TCImmunofluorescent study                           A   0.00   1.97     1.97NA  0.01   1.98  1.981XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8834626Immunofluorescent study                           A   0.86   0.36     0.36    0.01   1.23  1.231XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88347  Immunofluorescent study                           A   0.86   1.45     1.45NA  0.02   2.33  2.331XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88347TCImmunofluorescent study                           A   0.00   1.20     1.20NA  0.01   1.21  1.211XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8834726Immunofluorescent study                           A   0.86   0.25     0.25    0.01   1.12  1.121XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88348  Electron microscopy                               A   1.51  19.69    19.69NA  0.12  21.32 21.321XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88348TCElectron microscopy                               A   0.00  19.06    19.06NA  0.08  19.14 19.141XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8834826Electron microscopy                               A   1.51   0.63     0.63    0.04   2.18  2.181XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88349  Scanning electron microscopy                      A   0.76  12.03    12.03NA  0.07  12.86 12.861XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88349TCScanning electron microscopy                      A   0.00  11.64    11.64NA  0.04  11.68 11.681XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8834926Scanning electron microscopy                      A   0.76   0.39     0.39    0.03   1.18  1.181XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88355  Analysis skeletal muscle                          A   1.85   3.46     3.46NA  0.06   5.37  5.371XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88355TCAnalysis skeletal muscle                          A   0.00   2.93     2.93NA  0.01   2.94  2.941XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8835526Analysis skeletal muscle                          A   1.85   0.53     0.53    0.05   2.43  2.431XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88356  Analysis nerve                                    A   3.02   4.96     4.96NA  0.18   8.16  8.161XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88356TCAnalysis nerve                                    A   0.00   4.37     4.37NA  0.04   4.41  4.411XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8835626Analysis nerve                                    A   3.02   0.59     0.59    0.14   3.75  3.751XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88358  Analysis tumor                                    A   0.95   1.42     1.42NA  0.04   2.41  2.411XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88358TCAnalysis tumor                                    A   0.00   1.12     1.12NA  0.01   1.13  1.131XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8835826Analysis tumor                                    A   0.95   0.30     0.30    0.03   1.28  1.281XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88360  Tumor immunohistochem/manual                      A   1.10   2.60     2.60NA  0.04   3.74  3.741XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88360TCTumor immunohistochem/manual                      A   0.00   2.19     2.19NA  0.01   2.20  2.201XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8836026Tumor immunohistochem/manual                      A   1.10   0.41     0.41    0.03   1.54  1.541XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88361  Tumor immunohistochem/comput                      A   1.18   3.37     3.37NA  0.05   4.60  4.601XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88361TCTumor immunohistochem/comput                      A   0.00   2.91     2.91NA  0.01   2.92  2.921XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8836126Tumor immunohistochem/comput                      A   1.18   0.46     0.46    0.04   1.68  1.681XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88362  Nerve teasing preparations                        A   2.17   6.85     6.85NA  0.14   9.16  9.161XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88362TCNerve teasing preparations                        A   0.00   5.92     5.92NA  0.04   5.96  5.961XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8836226Nerve teasing preparations                        A   2.17   0.93     0.93    0.10   3.20  3.201XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88363  Xm archive tissue molec anal                      A   0.37   1.27     0.17    0.03   1.67  0.570XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88365  Insitu hybridization (fish)                       A   1.20   4.00     4.00NA  0.04   5.24  5.241XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88365TCInsitu hybridization (fish)                       A   0.00   3.53     3.53NA  0.01   3.54  3.541XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8836526Insitu hybridization (fish)                       A   1.20   0.47     0.47    0.03   1.70  1.701XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88367  Insitu hybridization auto                         A   1.30   6.24     6.24NA  0.06   7.60  7.601XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88367TCInsitu hybridization auto                         A   0.00   5.83     5.83NA  0.01   5.84  5.841XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8836726Insitu hybridization auto                         A   1.30   0.41     0.41    0.05   1.76  1.761XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88368  Insitu hybridization manual                       A   1.40   5.37     5.37NA  0.05   6.82  6.821XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88368TCInsitu hybridization manual                       A   0.00   5.00     5.00NA  0.01   5.01  5.011XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8836826Insitu hybridization manual                       A   1.40   0.37     0.37    0.04   1.81  1.811XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88371  Protein western blot tissue                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
8837126Protein western blot tissue                       A   0.37   0.17     0.17    0.03   0.57  0.576XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88372  Protein analysis w/probe                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
8837226Protein analysis w/probe                          A   0.37   0.07     0.07    0.03   0.47  0.476XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88375  Optical endomicroscpy interp                      C   0.00   0.00     0.00    0.00   0.00  0.000YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88380  Microdissection laser                             A   1.56   3.03     3.03NA  0.05   4.64  4.641XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88380TCMicrodissection laser                             A   0.00   2.52     2.52NA  0.01   2.53  2.531XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8838026Microdissection laser                             A   1.56   0.51     0.51    0.04   2.11  2.111XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88381  Microdissection manual                            A   1.18   3.28     3.28NA  0.04   4.50  4.501XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88381TCMicrodissection manual                            A   0.00   2.99     2.99NA  0.01   3.00  3.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8838126Microdissection manual                            A   1.18   0.29     0.29    0.03   1.50  1.501XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88387  Tiss exam molecular study                         A   0.62   0.35     0.35NA  0.02   0.99  0.991XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88387TCTiss exam molecular study                         A   0.00   0.17     0.17NA  0.01   0.18  0.181XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8838726Tiss exam molecular study                         A   0.62   0.18     0.18    0.01   0.81  0.811XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88388  Tiss ex molecul study add-on                      A   0.45   0.50     0.50NA  0.02   0.97  0.971XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88388TCTiss ex molecul study add-on                      A   0.00   0.27     0.27NA  0.01   0.28  0.281XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8838826Tiss ex molecul study add-on                      A   0.45   0.23     0.23    0.01   0.69  0.691XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88399  Surgical pathology procedure                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88399TCSurgical pathology procedure                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
8839926Surgical pathology procedure                      C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
88720  Bilirubin total transcut                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88738  Hgb quant transcutaneous                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88740  Transcutaneous carboxyhb                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88741  Transcutaneous methb                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
88749  In vivo lab service                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89049  Chct for mal hyperthermia                         A   1.40   6.55     0.41    0.10   8.05  1.910XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
89050  Body fluid cell count                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89051  Body fluid cell count                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89055  Leukocyte assessment fecal                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89060  Exam synovial fluid crystals                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
8906026Exam synovial fluid crystals                      A   0.37   0.18     0.18    0.03   0.58  0.586XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
89125  Specimen fat stain                                X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89190  Nasal smear for eosinophils                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89220  Sputum specimen collection                        A   0.00   0.51     0.51NA  0.01   0.52  0.523XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
89230  Collect sweat for test                            A   0.00   0.06     0.06NA  0.01   0.07  0.073XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
89240  Pathology lab procedure                           C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89253  Embryo hatching                                   X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89254  Oocyte identification                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89255  Prepare embryo for transfer                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89257  Sperm identification                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89258  Cryopreservation embryo(s)                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89259  Cryopreservation sperm                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89260  Sperm isolation simple                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89261  Sperm isolation complex                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89264  Identify sperm tissue                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89268  Insemination of oocytes                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89272  Extended culture of oocytes                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89280  Assist oocyte fertilization                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89281  Assist oocyte fertilization                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89290  Biopsy oocyte polar body                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89291  Biopsy oocyte polar body                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89300  Semen analysis w/huhner                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89310  Semen analysis w/count                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89321  Semen anal sperm detection                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89322  Semen anal strict criteria                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89325  Sperm antibody test                               X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89329  Sperm evaluation test                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89330  Evaluation cervical mucus                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89331  Retrograde ejaculation anal                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89335  Cryopreserve testicular tiss                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89342  Storage/year embryo(s)                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89343  Storage/year sperm/semen                          X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89344  Storage/year reprod tissue                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89346  Storage/year oocyte(s)                            X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89352  Thawing cryopresrved embryo                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89353  Thawing cryopresrved sperm                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89354  Thaw cryoprsvrd reprod tiss                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
89356  Thawing cryopresrved oocyte                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90281  Human ig im                                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90283  Human ig iv                                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90284  Human ig sc                                       X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90287  Botulinum antitoxin                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90288  Botulism ig iv                                    I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90291  Cmv ig iv                                         I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90296  Diphtheria antitoxin                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90371  Hep b ig im                                       E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90375  Rabies ig im/sc                                   E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90376  Rabies ig heat treated                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90378  Rsv mab im 50mg                                   X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90385  Rh ig minidose im                                 E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90386  Rh ig iv                                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90389  Tetanus ig im                                     I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90393  Vaccina ig im                                     E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90396  Varicella-zoster ig im                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90399  Immune globulin                                   I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90460  Im admin 1st/only component                       A   0.17   0.58     0.58NA  0.01   0.76  0.760XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90461  Im admin each addl component                      A   0.15   0.21     0.21NA  0.01   0.37  0.370ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90471  Immunization admin                                A   0.17   0.58     0.58NA  0.01   0.76  0.765XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90472  Immunization admin each add                       A   0.15   0.21     0.21NA  0.01   0.37  0.375ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90473  Immune admin oral/nasal                           R   0.17   0.58     0.58NA  0.01   0.76  0.760XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90474  Immune admin oral/nasal addl                      R   0.15   0.21     0.21NA  0.01   0.37  0.370ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90476  Adenovirus vaccine type 4                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90477  Adenovirus vaccine type 7                         E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90581  Anthrax vaccine sc or im                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90585  Bcg vaccine percut                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90586  Bcg vaccine intravesical                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90645  Hib vaccine hboc im                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90653  Flu vaccine adjuvant im                           X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90655  Flu vac no prsv 3 val 6-35 m                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90660  Flu vaccine nasal                                 X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90664  Flu vacc pandemic intranasal                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90672  Flu vaccine 4 valent nasal                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90675  Rabies vaccine im                                 E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90676  Rabies vaccine id                                 E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90685  Flu vac no prsv 4 val 6-35 m                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90686  Flu vac no prsv 4 val 3 yrs+                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90687  Flu vaccine 4 val 6-35 mo im                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90688  Flu vacc 4 val 3 yrs plus im                      X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90690  Typhoid vaccine oral                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90691  Typhoid vaccine im                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90693  Typhoid vaccine akd sc                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90702  Dt vaccine > 7 yrs im                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90703  Tetanus vaccine im                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90704  Mumps vaccine sc                                  E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90705  Measles vaccine sc                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90706  Rubella vaccine sc                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90707  Mmr vaccine sc                                    E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90708  Measles-rubella vaccine sc                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90710  Mmrv vaccine sc                                   E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90712  Oral poliovirus vaccine                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90713  Poliovirus ipv sc/im                              E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90715  Tdap vaccine 7 yrs/> im                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90716  Chicken pox vaccine sc                            E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90717  Yellow fever vaccine sc                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90719  Diphtheria vaccine im                             E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90720  Dtp/hib vaccine im                                E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90721  Dtap/hib vaccine im                               E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90725  Cholera vaccine injectable                        E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90727  Plague vaccine im                                 E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90732  Pneumococcal vaccine                              X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90733  Meningococcal vaccine sc                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90734  Meningococcal vaccine im                          E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90735  Encephalitis vaccine sc                           E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90736  Zoster vacc sc                                    E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90738  Inactivated je vacc im                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90739  Hep b vacc adult 2 dose im                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90746  Hep b vacc adult 3 dose im                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90749  Vaccine toxoid                                    E   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90785  Psytx complex interactive                         A   0.11   0.02     0.02    0.01   0.14  0.140XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90791  Psych diagnostic evaluation                       A   2.80   1.52     0.53    0.11   4.43  3.440XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90792  Psych diag eval w/med srvcs                       A   2.96   0.58     0.48    0.11   3.65  3.550XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90832  Psytx pt&/family 30 minutes                       A   1.25   0.54     0.14    0.05   1.84  1.440XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90833  Psytx pt&/fam w/e&m 30 min                        A   0.98   0.20     0.19    0.04   1.22  1.210XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90834  Psytx pt&/family 45 minutes                       A   1.89   0.41     0.20    0.07   2.37  2.160XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90836  Psytx pt&/fam w/e&m 45 min                        A   1.60   0.32     0.32    0.06   1.98  1.980XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90837  Psytx pt&/family 60 minutes                       A   2.83   0.53     0.32    0.11   3.47  3.260XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90838  Psytx pt&/fam w/e&m 60 min                        A   2.56   0.53     0.52    0.10   3.19  3.180XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90839  Psytx crisis initial 60 min                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90840  Psytx crisis ea addl 30 min                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90845  Psychoanalysis                                    A   1.79   0.34     0.33    0.07   2.20  2.190XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90846  Family psytx w/o patient                          R   1.83   0.27     0.40    0.07   2.17  2.300XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90847  Family psytx w/patient                            R   2.21   0.31     0.42    0.08   2.60  2.710XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90849  Multiple family group psytx                       R   0.59   0.38     0.22    0.03   1.00  0.840XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90853  Group psychotherapy                               A   0.59   0.10     0.10    0.03   0.72  0.720XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90863  Pharmacologic mgmt w/psytx                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90865  Narcosynthesis                                    A   2.84   1.99     0.70    0.11   4.94  3.650XXX.00.00.0000000             25.0008 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  0.000000.00.00.0000100             25.0008 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  0.000000.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
90869  Tcran magn stim redetemine                        C   0.00   0.00     0.00    0.00   0.00  0.000000.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
90870  Electroconvulsive therapy                         A   2.50   2.65     0.57    0.11   5.26  3.180000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90875  Psychophysiological therapy                       N+  1.20   0.84     0.48    0.08   2.12  1.769XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90876  Psychophysiological therapy                       N+  1.90   1.10     0.77    0.12   3.12  2.799XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90880  Hypnotherapy                                      A   2.19   0.55     0.35    0.08   2.82  2.620XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90882  Environmental manipulation                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90885  Psy evaluation of records                         B+  0.97   0.39     0.39    0.07   1.43  1.439XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90887  Consultation with family                          B+  1.48   0.98     0.60    0.10   2.56  2.189XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90889  Preparation of report                             B   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90899  Psychiatric service/therapy                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90901  Biofeedback train any meth                        A   0.41   0.74     0.17    0.01   1.16  0.590000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90911  Biofeedback peri/uro/rectal                       A   0.89   1.55     0.33    0.07   2.51  1.290000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90935  Hemodialysis one evaluation                       A   1.48   0.53NA   0.53    0.08   2.09  2.090000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90937  Hemodialysis repeated eval                        A   2.11   0.77NA   0.77    0.11   2.99  2.990000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90940  Hemodialysis access study                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90945  Dialysis one evaluation                           A   1.56   0.85NA   0.85    0.08   2.49  2.490000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90947  Dialysis repeated eval                            A   2.52   0.91NA   0.91    0.15   3.58  3.580000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90951  Esrd serv 4 visits p mo <2yr                      A  18.46   7.36     7.36    1.02  26.84 26.840XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90952  Esrd serv 2-3 vsts p mo <2yr                      C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90953  Esrd serv 1 visit p mo <2yrs                      C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90954  Esrd serv 4 vsts p mo 2-11                        A  15.98   6.47     6.47    0.90  23.35 23.350XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90955  Esrd srv 2-3 vsts p mo 2-11                       A   8.79   3.90     3.90    0.49  13.18 13.180XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90956  Esrd srv 1 visit p mo 2-11                        A   5.95   2.88     2.88    0.34   9.17  9.170XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90957  Esrd srv 4 vsts p mo 12-19                        A  12.52   5.36     5.36    0.72  18.60 18.600XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90958  Esrd srv 2-3 vsts p mo 12-19                      A   8.34   3.83     3.83    0.48  12.65 12.650XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90959  Esrd serv 1 vst p mo 12-19                        A   5.50   2.78     2.78    0.31   8.59  8.590XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90960  Esrd srv 4 visits p mo 20+                        A   5.18   2.79     2.79    0.31   8.28  8.280XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90961  Esrd srv 2-3 vsts p mo 20+                        A   4.26   2.46     2.46    0.26   6.98  6.980XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90962  Esrd serv 1 visit p mo 20+                        A   3.15   2.06     2.06    0.20   5.41  5.410XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90963  Esrd home pt serv p mo <2yrs                      A  10.56   4.62     4.62    0.60  15.78 15.780XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90964  Esrd home pt serv p mo 2-11                       A   9.14   4.10     4.10    0.52  13.76 13.760XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90965  Esrd home pt serv p mo 12-19                      A   8.69   3.90     3.90    0.49  13.08 13.080XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90966  Esrd home pt serv p mo 20+                        A   4.26   2.45     2.45    0.26   6.97  6.970XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90967  Esrd home pt serv p day <2                        A   0.35   0.15     0.15    0.01   0.51  0.510XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90968  Esrd home pt srv p day 2-11                       A   0.30   0.13     0.13    0.01   0.44  0.440XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90969  Esrd home pt srv p day 12-19                      A   0.29   0.13     0.13    0.01   0.43  0.430XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90970  Esrd home pt serv p day 20+                       A   0.14   0.08     0.08    0.01   0.23  0.230XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90989  Dialysis training complete                        X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90993  Dialysis training incompl                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
90997  Hemoperfusion                                     A   1.84   0.66NA   0.66    0.10   2.60  2.600000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
90999  Dialysis procedure                                C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91010  Esophagus motility study                          A   1.28   4.16     4.16NA  0.08   5.52  5.521000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91010TCEsophagus motility study                          A   0.00   3.51     3.51NA  0.01   3.52  3.521000.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9101026Esophagus motility study                          A   1.28   0.65     0.65    0.07   2.00  2.001000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91013  Esophgl motil w/stim/perfus                       A   0.18   0.54     0.54NA  0.02   0.74  0.741ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91013TCEsophgl motil w/stim/perfus                       A   0.00   0.45     0.45NA  0.01   0.46  0.461ZZZ.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9101326Esophgl motil w/stim/perfus                       A   0.18   0.09     0.09    0.01   0.28  0.281ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91020  Gastric motility studies                          A   1.44   5.91     5.91NA  0.08   7.43  7.431000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91020TCGastric motility studies                          A   0.00   5.16     5.16NA  0.01   5.17  5.171000.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9102026Gastric motility studies                          A   1.44   0.75     0.75    0.07   2.26  2.261000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91022  Duodenal motility study                           A   1.44   3.84     3.84NA  0.06   5.34  5.341000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91022TCDuodenal motility study                           A   0.00   3.08     3.08NA  0.01   3.09  3.091000.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9102226Duodenal motility study                           A   1.44   0.76     0.76    0.05   2.25  2.251000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91030  Acid perfusion of esophagus                       A   0.91   3.41     3.41NA  0.05   4.37  4.371000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91030TCAcid perfusion of esophagus                       A   0.00   2.93     2.93NA  0.01   2.94  2.941000.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9103026Acid perfusion of esophagus                       A   0.91   0.48     0.48    0.04   1.43  1.431000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91034  Gastroesophageal reflux test                      A   0.97   4.92     4.92NA  0.05   5.94  5.941000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91034TCGastroesophageal reflux test                      A   0.00   4.44     4.44NA  0.01   4.45  4.451000.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9103426Gastroesophageal reflux test                      A   0.97   0.48     0.48    0.04   1.49  1.491000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91035  G-esoph reflx tst w/electrod                      A   1.59  13.79    13.79NA  0.08  15.46 15.461000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91035TCG-esoph reflx tst w/electrod                      A   0.00  12.99    12.99NA  0.01  13.00 13.001000.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9103526G-esoph reflx tst w/electrod                      A   1.59   0.80     0.80    0.07   2.46  2.461000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91037  Esoph imped function test                         A   0.97   4.03     4.03NA  0.08   5.08  5.081000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91037TCEsoph imped function test                         A   0.00   3.54     3.54NA  0.01   3.55  3.551000.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9103726Esoph imped function test                         A   0.97   0.49     0.49    0.07   1.53  1.531000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91038  Esoph imped funct test > 1hr                      A   1.10  13.35    13.35NA  0.06  14.51 14.511000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91038TCEsoph imped funct test > 1hr                      A   0.00  12.79    12.79NA  0.01  12.80 12.801000.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9103826Esoph imped funct test > 1hr                      A   1.10   0.56     0.56    0.05   1.71  1.711000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91040  Esoph balloon distension tst                      A   0.97   8.00     8.00NA  0.04   9.01  9.011000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91040TCEsoph balloon distension tst                      A   0.00   7.65     7.65NA  0.01   7.66  7.661000.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9104026Esoph balloon distension tst                      A   0.97   0.35     0.35    0.03   1.35  1.351000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91065  Breath hydrogen test                              A   0.20   2.73     2.73NA  0.02   2.95  2.951000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91065TCBreath hydrogen test                              A   0.00   2.63     2.63NA  0.01   2.64  2.641000.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9106526Breath hydrogen test                              A   0.20   0.10     0.10    0.01   0.31  0.311000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91110  Gi tract capsule endoscopy                        A   3.64  24.73    24.73NA  0.17  28.54 28.541XXX.00.00.0000000             25.0008 090 99     31.90  31.90   0.17
91110TCGi tract capsule endoscopy                        A   0.00  22.84    22.84NA  0.01  22.85 22.851XXX.00.00.0000000             25.0008 090 99     30.01  30.01   0.01
9111026Gi tract capsule endoscopy                        A   3.64   1.89     1.89    0.16   5.69  5.691XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91111  Esophageal capsule endoscopy                      A   1.00  22.81    22.81NA  0.05  23.86 23.861XXX.00.00.0000000             25.0008 090 99     37.57  37.57   0.06
91111TCEsophageal capsule endoscopy                      A   0.00  22.29    22.29NA  0.01  22.30 22.301XXX.00.00.0000000             25.0008 090 99     37.05  37.05   0.02
9111126Esophageal capsule endoscopy                      A   1.00   0.52     0.52    0.04   1.56  1.561XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91112  Gi wireless capsule measure                       A   2.10  32.73    32.73NA  0.10  34.93 34.931XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91112TCGi wireless capsule measure                       A   0.00  31.63    31.63NA  0.01  31.64 31.641XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
9111226Gi wireless capsule measure                       A   2.10   1.10     1.10    0.09   3.29  3.291XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91117  Colon motility 6 hr study                         A   2.45   1.89NA   1.89    0.38   4.72  4.720000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91120  Rectal sensation test                             A   0.97  11.52    11.52NA  0.09  12.58 12.581XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91120TCRectal sensation test                             A   0.00  11.09    11.09NA  0.01  11.10 11.101XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9112026Rectal sensation test                             A   0.97   0.43     0.43    0.08   1.48  1.481XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91122  Anal pressure record                              A   1.77   4.86     4.86NA  0.11   6.74  6.741000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91122TCAnal pressure record                              A   0.00   4.13     4.13NA  0.01   4.14  4.141000.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9112226Anal pressure record                              A   1.77   0.73     0.73    0.10   2.60  2.601000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91132  Electrogastrography                               A   0.52   4.42     4.42NA  0.04   4.98  4.981XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91132TCElectrogastrography                               A   0.00   4.15     4.15NA  0.01   4.16  4.161XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9113226Electrogastrography                               A   0.52   0.27     0.27    0.03   0.82  0.821XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91133  Electrogastrography w/test                        A   0.66   5.03     5.03NA  0.05   5.74  5.741XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91133TCElectrogastrography w/test                        A   0.00   4.68     4.68NA  0.01   4.69  4.691XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9113326Electrogastrography w/test                        A   0.66   0.35     0.35    0.04   1.05  1.051XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91299  Gastroenterology procedure                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
91299TCGastroenterology procedure                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
9129926Gastroenterology procedure                        C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92002  Eye exam new patient                              A   0.88   1.49     0.47    0.07   2.44  1.420XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
92004  Eye exam new patient                              A   1.82   2.51     1.00    0.12   4.45  2.940XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
92012  Eye exam establish patient                        A   0.92   1.58     0.57    0.07   2.57  1.560XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
92014  Eye exam&tx estab pt 1/>vst                       A   1.42   2.19     0.84    0.10   3.71  2.360XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
92015  Determine refractive state                        N+  0.38   0.17     0.15    0.03   0.58  0.569XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92018  New eye exam & treatment                          A   2.50   1.56NA   1.56    0.16   4.22  4.220XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92019  Eye exam & treatment                              A   1.31   0.66NA   0.66    0.07   2.04  2.040XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92020  Special eye evaluation                            A   0.37   0.41     0.23    0.03   0.81  0.630XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
92025  Corneal topography                                A   0.35   0.76     0.76NA  0.02   1.13  1.131XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92025TCCorneal topography                                A   0.00   0.54     0.54NA  0.01   0.55  0.551XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
9202526Corneal topography                                A   0.35   0.22     0.22    0.01   0.58  0.581XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92060  Special eye evaluation                            A   0.69   1.23     1.23NA  0.04   1.96  1.961XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92060TCSpecial eye evaluation                            A   0.00   0.82     0.82NA  0.01   0.83  0.831XXX.00.00.0072000             25.0008 010 99      0.00   0.00   0.00
9206026Special eye evaluation                            A   0.69   0.41     0.41    0.03   1.13  1.131XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92065  Orthoptic/pleoptic training                       A   0.37   1.24     1.24NA  0.02   1.63  1.631XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
92065TCOrthoptic/pleoptic training                       A   0.00   1.10     1.10NA  0.01   1.11  1.111XXX.00.00.0002000             25.0008 010 99      0.00   0.00   0.00
9206526Orthoptic/pleoptic training                       A   0.37   0.14     0.14    0.01   0.52  0.521XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
92071  Contact lens fitting for tx                       A   0.61   0.35     0.25    0.03   0.99  0.890XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
92072  Fit contac lens for managmnt                      A   1.97   1.67     0.79    0.11   3.75  2.870XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
92081  Visual field examination(s)                       A   0.30   0.88     0.88NA  0.04   1.22  1.221XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92081TCVisual field examination(s)                       A   0.00   0.72     0.72NA  0.01   0.73  0.731XXX.00.00.0072000             25.0008 010 99      0.00   0.00   0.00
9208126Visual field examination(s)                       A   0.30   0.16     0.16    0.03   0.49  0.491XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92082  Visual field examination(s)                       A   0.40   1.47     1.47NA  0.05   1.92  1.921XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92082TCVisual field examination(s)                       A   0.00   1.25     1.25NA  0.01   1.26  1.261XXX.00.00.0072000             25.0008 010 99      0.00   0.00   0.00
9208226Visual field examination(s)                       A   0.40   0.22     0.22    0.04   0.66  0.661XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92083  Visual field examination(s)                       A   0.50   1.34     1.34NA  0.04   1.88  1.881XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92083TCVisual field examination(s)                       A   0.00   1.04     1.04NA  0.01   1.05  1.051XXX.00.00.0072000             25.0008 010 99      0.00   0.00   0.00
9208326Visual field examination(s)                       A   0.50   0.30     0.30    0.03   0.83  0.831XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92100  Serial tonometry exam(s)                          A   0.61   1.77     0.35    0.03   2.41  0.990XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
92132  Cmptr ophth dx img ant segmt                      A   0.35   0.68     0.68NA  0.04   1.07  1.071XXX.00.00.0072000             25.0008 090 99      2.10   2.10   0.07
92132TCCmptr ophth dx img ant segmt                      A   0.00   0.48     0.48NA  0.01   0.49  0.491XXX.00.00.0072000             25.0008 010 99      1.90   1.90   0.04
9213226Cmptr ophth dx img ant segmt                      A   0.35   0.20     0.20    0.03   0.58  0.581XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92133  Cmptr ophth img optic nerve                       A   0.50   0.79     0.79NA  0.04   1.33  1.331XXX.00.00.0072000             25.0008 090 99      2.20   2.20   0.07
92133TCCmptr ophth img optic nerve                       A   0.00   0.49     0.49NA  0.01   0.50  0.501XXX.00.00.0072000             25.0008 010 99      1.90   1.90   0.04
9213326Cmptr ophth img optic nerve                       A   0.50   0.30     0.30    0.03   0.83  0.831XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92134  Cptr ophth dx img post segmt                      A   0.50   0.82     0.82NA  0.04   1.36  1.361XXX.00.00.0072000             25.0008 090 99      2.22   2.22   0.07
92134TCCptr ophth dx img post segmt                      A   0.00   0.50     0.50NA  0.01   0.51  0.511XXX.00.00.0072000             25.0008 010 99      1.90   1.90   0.04
9213426Cptr ophth dx img post segmt                      A   0.50   0.32     0.32    0.03   0.85  0.851XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92136  Ophthalmic biometry                               A   0.54   2.18     2.18NA  0.02   2.74  2.741XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92136TCOphthalmic biometry                               A   0.00   1.82     1.82NA  0.01   1.83  1.831XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
9213626Ophthalmic biometry                               A   0.54   0.36     0.36    0.01   0.91  0.911XXX.00.00.0073000             25.0008 090 99      0.00   0.00   0.00
92140  Glaucoma provocative tests                        A   0.50   1.38     0.25    0.03   1.91  0.780XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
92225  Special eye exam initial                          A   0.38   0.40     0.23    0.03   0.81  0.640XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
92226  Special eye exam subsequent                       A   0.33   0.39     0.21    0.01   0.73  0.550XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
92227  Remote dx retinal imaging                         A   0.00   0.40     0.40NA  0.01   0.41  0.413XXX.00.00.0002000             25.0008 090 99      0.91   0.91   0.02
92228  Remote retinal imaging mgmt                       A   0.37   0.67     0.67NA  0.02   1.06  1.061XXX.00.00.0072000             25.0008 090 99      1.17   1.17   0.03
92228TCRemote retinal imaging mgmt                       A   0.00   0.42     0.42NA  0.01   0.43  0.431XXX.00.00.0072000             25.0008 010 99      0.92   0.92   0.02
9222826Remote retinal imaging mgmt                       A   0.37   0.25     0.25    0.01   0.63  0.631XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92230  Eye exam with photos                              A   0.60   1.12     0.36    0.04   1.76  1.000XXX.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
92235  Eye exam with photos                              A   0.81   2.92     2.92NA  0.04   3.77  3.771XXX.00.00.0073000             25.0008 090 99      6.31   6.31   0.05
92235TCEye exam with photos                              A   0.00   2.38     2.38NA  0.01   2.39  2.391XXX.00.00.0073000             25.0008 020 99      5.77   5.77   0.02
9223526Eye exam with photos                              A   0.81   0.54     0.54    0.03   1.38  1.381XXX.00.00.0073000             25.0008 090 99      0.00   0.00   0.00
92240  Icg angiography                                   A   1.10   6.67     6.67NA  0.04   7.81  7.811XXX.00.00.0073000             25.0008 090 99      6.53   6.53   0.04
92240TCIcg angiography                                   A   0.00   5.93     5.93NA  0.01   5.94  5.941XXX.00.00.0073000             25.0008 020 99      5.79   5.79   0.01
9224026Icg angiography                                   A   1.10   0.74     0.74    0.03   1.87  1.871XXX.00.00.0073000             25.0008 090 99      0.00   0.00   0.00
92250  Eye exam with photos                              A   0.44   1.93     1.93NA  0.02   2.39  2.391XXX.00.00.0072000             25.0008 090 99      2.17   2.17   0.02
92250TCEye exam with photos                              A   0.00   1.69     1.69NA  0.01   1.70  1.701XXX.00.00.0072000             25.0008 010 99      1.93   1.93   0.01
9225026Eye exam with photos                              A   0.44   0.24     0.24    0.01   0.69  0.691XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92260  Ophthalmoscopy/dynamometry                        A   0.20   0.36     0.12    0.01   0.57  0.330XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
92265  Eye muscle evaluation                             A   0.81   1.56     1.56NA  0.02   2.39  2.391XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92265TCEye muscle evaluation                             A   0.00   1.13     1.13NA  0.01   1.14  1.141XXX.00.00.0072000             25.0008 030 99      0.00   0.00   0.00
9226526Eye muscle evaluation                             A   0.81   0.43     0.43    0.01   1.25  1.251XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92270  Electro-oculography                               A   0.81   1.90     1.90NA  0.04   2.75  2.751XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92270TCElectro-oculography                               A   0.00   1.55     1.55NA  0.01   1.56  1.561XXX.00.00.0072000             25.0008 010 99      0.00   0.00   0.00
9227026Electro-oculography                               A   0.81   0.35     0.35    0.03   1.19  1.191XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92275  Electroretinography                               A   1.01   3.79     3.79NA  0.05   4.85  4.851XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92275TCElectroretinography                               A   0.00   3.13     3.13NA  0.01   3.14  3.141XXX.00.00.0072000             25.0008 010 99      0.00   0.00   0.00
9227526Electroretinography                               A   1.01   0.66     0.66    0.04   1.71  1.711XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92283  Color vision examination                          A   0.17   1.50     1.50NA  0.02   1.69  1.691XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92283TCColor vision examination                          A   0.00   1.41     1.41NA  0.01   1.42  1.421XXX.00.00.0072000             25.0008 010 99      0.00   0.00   0.00
9228326Color vision examination                          A   0.17   0.09     0.09    0.01   0.27  0.271XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92284  Dark adaptation eye exam                          A   0.24   1.62     1.62NA  0.02   1.88  1.881XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92284TCDark adaptation eye exam                          A   0.00   1.51     1.51NA  0.01   1.52  1.521XXX.00.00.0072000             25.0008 010 99      0.00   0.00   0.00
9228426Dark adaptation eye exam                          A   0.24   0.11     0.11    0.01   0.36  0.361XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92285  Eye photography                                   A   0.05   0.56     0.56NA  0.02   0.63  0.631XXX.00.00.0072000             25.0008 090 99      1.93   1.93   0.05
92285TCEye photography                                   A   0.00   0.53     0.53NA  0.01   0.54  0.541XXX.00.00.0072000             25.0008 010 99      1.90   1.90   0.04
9228526Eye photography                                   A   0.05   0.03     0.03    0.01   0.09  0.091XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92286  Internal eye photography                          A   0.40   0.65     0.65NA  0.02   1.07  1.071XXX.00.00.0072000             25.0008 090 99      3.12   3.12   0.08
92286TCInternal eye photography                          A   0.00   0.42     0.42NA  0.01   0.43  0.431XXX.00.00.0072000             25.0008 010 99      2.89   2.89   0.07
9228626Internal eye photography                          A   0.40   0.23     0.23    0.01   0.64  0.641XXX.00.00.0072000             25.0008 090 99      0.00   0.00   0.00
92287  Internal eye photography                          A   0.81   2.97     0.54    0.04   3.82  1.390XXX.00.00.0002000             25.0008 090 99      2.92   2.92   0.04
92310  Contact lens fitting                              N+  1.17   1.58     0.47    0.08   2.83  1.729XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92311  Contact lens fitting                              A   1.08   1.94     0.51    0.08   3.10  1.670XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92312  Contact lens fitting                              A   1.26   2.17     0.54    0.05   3.48  1.850XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
92313  Contact lens fitting                              A   0.92   2.09     0.49    0.05   3.06  1.460XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92314  Prescription of contact lens                      N+  0.69   1.64     0.28    0.04   2.37  1.019XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92315  Rx cntact lens aphakia 1 eye                      A   0.45   2.00     0.24    0.04   2.49  0.730XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92316  Rx cntact lens aphakia 2 eye                      A   0.68   2.57     0.45    0.04   3.29  1.170XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
92317  Rx corneoscleral cntact lens                      A   0.45   1.85     0.17    0.01   2.31  0.630XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92325  Modification of contact lens                      A   0.00   1.26     1.26NA  0.01   1.27  1.275XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92326  Replacement of contact lens                       A   0.00   1.07     1.07NA  0.01   1.08  1.085XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92340  Fit spectacles monofocal                          N+  0.37   0.66     0.15    0.03   1.06  0.559XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92341  Fit spectacles bifocal                            N+  0.47   0.70     0.19    0.03   1.20  0.699XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92342  Fit spectacles multifocal                         N+  0.53   0.72     0.21    0.04   1.29  0.789XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92352  Fit aphakia spectcl monofocl                      B+  0.37   0.81     0.15    0.03   1.21  0.559XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92353  Fit aphakia spectcl multifoc                      B+  0.50   0.87     0.20    0.03   1.40  0.739XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92354  Fit spectacles single system                      B+  0.00   0.41     0.41NA  0.01   0.42  0.429XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92355  Fit spectacles compound lens                      B+  0.00   0.64     0.64NA  0.01   0.65  0.659XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92358  Aphakia prosth service temp                       B+  0.00   0.34     0.34NA  0.01   0.35  0.359XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92370  Repair & adjust spectacles                        N+  0.32   0.57     0.13    0.03   0.92  0.489XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92371  Repair & adjust spectacles                        B+  0.00   0.35     0.35NA  0.01   0.36  0.369XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92499  Eye service or procedure                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92499TCEye service or procedure                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
9249926Eye service or procedure                          C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92502  Ear and throat examination                        A   1.51   1.27NA   1.27    0.07   2.85  2.850000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92504  Ear microscopy examination                        A   0.18   0.74     0.09    0.01   0.93  0.280XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92506  Speech/hearing evaluation                         A   0.86   5.47     5.47NA  0.05   6.38  6.387XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
92507  Speech/hearing therapy                            A   1.30   0.72     0.72NA  0.07   2.09  2.097XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
92508  Speech/hearing therapy                            A   0.33   0.27     0.27NA  0.01   0.61  0.617XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
92511  Nasopharyngoscopy                                 A   0.61   3.58     0.81    0.03   4.22  1.450000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
92512  Nasal function studies                            A   0.55   1.27     0.25    0.03   1.85  0.830XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92516  Facial nerve function test                        A   0.43   1.66     0.21    0.03   2.12  0.670XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92520  Laryngeal function studies                        A   0.75   1.41     0.39    0.04   2.20  1.180XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92526  Oral function therapy                             A   1.34   0.86     0.86NA  0.07   2.27  2.277XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
92531  Spontaneous nystagmus study                       B   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92532  Positional nystagmus test                         B   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92533  Caloric vestibular test                           B   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92534  Optokinetic nystagmus test                        B   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92540  Basic vestibular evaluation                       A   1.50   1.41     1.41NA  0.05   2.96  2.961XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92540TCBasic vestibular evaluation                       A   0.00   0.66     0.66NA  0.01   0.67  0.671XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9254026Basic vestibular evaluation                       A   1.50   0.75     0.75    0.04   2.29  2.291XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92541  Spontaneous nystagmus test                        A   0.40   0.47     0.47NA  0.02   0.89  0.891XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92541TCSpontaneous nystagmus test                        A   0.00   0.28     0.28NA  0.01   0.29  0.291XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9254126Spontaneous nystagmus test                        A   0.40   0.19     0.19    0.01   0.60  0.601XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92542  Positional nystagmus test                         A   0.33   0.44     0.44NA  0.02   0.79  0.791XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92542TCPositional nystagmus test                         A   0.00   0.28     0.28NA  0.01   0.29  0.291XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9254226Positional nystagmus test                         A   0.33   0.16     0.16    0.01   0.50  0.501XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92543  Caloric vestibular test                           A   0.10   0.36     0.36NA  0.02   0.48  0.481XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92543TCCaloric vestibular test                           A   0.00   0.31     0.31NA  0.01   0.32  0.321XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9254326Caloric vestibular test                           A   0.10   0.05     0.05    0.01   0.16  0.161XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92544  Optokinetic nystagmus test                        A   0.26   0.41     0.41NA  0.02   0.69  0.691XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92544TCOptokinetic nystagmus test                        A   0.00   0.28     0.28NA  0.01   0.29  0.291XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9254426Optokinetic nystagmus test                        A   0.26   0.13     0.13    0.01   0.40  0.401XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92545  Oscillating tracking test                         A   0.23   0.36     0.36NA  0.02   0.61  0.611XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92545TCOscillating tracking test                         A   0.00   0.26     0.26NA  0.01   0.27  0.271XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9254526Oscillating tracking test                         A   0.23   0.10     0.10    0.01   0.34  0.341XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92546  Sinusoidal rotational test                        A   0.29   2.83     2.83NA  0.02   3.14  3.141XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92546TCSinusoidal rotational test                        A   0.00   2.70     2.70NA  0.01   2.71  2.711XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9254626Sinusoidal rotational test                        A   0.29   0.13     0.13    0.01   0.43  0.431XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92547  Supplemental electrical test                      A   0.00   0.18     0.18NA  0.01   0.19  0.193ZZZ.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
92548  Posturography                                     A   0.50   2.62     2.62NA  0.02   3.14  3.141XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92548TCPosturography                                     A   0.00   2.39     2.39NA  0.01   2.40  2.401XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9254826Posturography                                     A   0.50   0.23     0.23    0.01   0.74  0.741XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92550  Tympanometry & reflex thresh                      A   0.35   0.25     0.25NA  0.01   0.61  0.617XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92551  Pure tone hearing test air                        N+  0.00   0.36     0.36NA  0.01   0.37  0.379XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92552  Pure tone audiometry air                          A   0.00   0.94     0.94NA  0.01   0.95  0.953XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92553  Audiometry air & bone                             A   0.00   1.14     1.14NA  0.01   1.15  1.153XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92555  Speech threshold audiometry                       A   0.00   0.71     0.71NA  0.01   0.72  0.723XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92556  Speech audiometry complete                        A   0.00   1.12     1.12NA  0.01   1.13  1.133XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92557  Comprehensive hearing test                        A   0.60   0.47     0.31    0.03   1.10  0.947XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92558  Evoked auditory test qual                         X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92559  Group audiometric testing                         N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92560  Bekesy audiometry screen                          N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92561  Bekesy audiometry diagnosis                       A   0.00   1.15     1.15NA  0.01   1.16  1.163XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92562  Loudness balance test                             A   0.00   1.43     1.43NA  0.01   1.44  1.443XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92563  Tone decay hearing test                           A   0.00   0.96     0.96NA  0.01   0.97  0.973XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92564  Sisi hearing test                                 A   0.00   0.87     0.87NA  0.01   0.88  0.883XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92565  Stenger test pure tone                            A   0.00   0.51     0.51NA  0.01   0.52  0.523XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92567  Tympanometry                                      A   0.20   0.21     0.10    0.01   0.42  0.317XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92568  Acoustic refl threshold tst                       A   0.29   0.15     0.15    0.01   0.45  0.457XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92570  Acoustic immitance testing                        A   0.55   0.36     0.29    0.03   0.94  0.877XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92571  Filtered speech hearing test                      A   0.00   0.83     0.83NA  0.01   0.84  0.843XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92572  Staggered spondaic word test                      A   0.00   1.61     1.61NA  0.01   1.62  1.623XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92575  Sensorineural acuity test                         A   0.00   2.32     2.32NA  0.01   2.33  2.333XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92576  Synthetic sentence test                           A   0.00   1.03     1.03NA  0.01   1.04  1.043XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92577  Stenger test speech                               A   0.00   0.56     0.56NA  0.01   0.57  0.573XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92579  Visual audiometry (vra)                           A   0.70   0.49     0.35    0.03   1.22  1.087XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92582  Conditioning play audiometry                      A   0.00   2.20     2.20NA  0.01   2.21  2.213XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92583  Select picture audiometry                         A   0.00   1.58     1.58NA  0.01   1.59  1.593XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92584  Electrocochleography                              A   0.00   2.14     2.14NA  0.01   2.15  2.153XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92585  Auditor evoke potent compre                       A   0.50   3.33     3.33NA  0.02   3.85  3.851XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
92585TCAuditor evoke potent compre                       A   0.00   3.08     3.08NA  0.01   3.09  3.091XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
9258526Auditor evoke potent compre                       A   0.50   0.25     0.25    0.01   0.76  0.761XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
92586  Auditor evoke potent limit                        A   0.00   2.62     2.62NA  0.01   2.63  2.633XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92587  Evoked auditory test limited                      A   0.35   0.25     0.25NA  0.04   0.64  0.641XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
92587TCEvoked auditory test limited                      A   0.00   0.08     0.08NA  0.01   0.09  0.091XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
9258726Evoked auditory test limited                      A   0.35   0.17     0.17    0.03   0.55  0.551XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
92588  Evoked auditory tst complete                      A   0.55   0.39     0.39NA  0.03   0.97  0.971XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
92588TCEvoked auditory tst complete                      A   0.00   0.11     0.11NA  0.01   0.12  0.121XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
9258826Evoked auditory tst complete                      A   0.55   0.28     0.28    0.02   0.85  0.851XXX.00.00.0002000             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92596  Ear protector evaluation                          A   0.00   1.32     1.32NA  0.01   1.33  1.333XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
92597  Oral speech device eval                           A   1.26   0.70     0.70NA  0.07   2.03  2.037XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
92601  Cochlear implt f/up exam <7                       A   2.30   1.49     0.93    0.11   3.90  3.347XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
92602  Reprogram cochlear implt 7/>                      A   1.30   1.27     0.61    0.07   2.64  1.987XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
92603  Cochlear implt f/up exam 7/>                      A   2.25   1.95     1.18    0.11   4.31  3.547XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
92604  Reprogram cochlear implt 7/>                      A   1.25   1.30     0.66    0.05   2.60  1.967XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
92605  Ex for nonspeech device rx                        B+  1.75   0.83     0.71    0.09   2.67  2.559XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92606  Non-speech device service                         B+  1.40   0.92     0.56    0.07   2.39  2.039XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92607  Ex for speech device rx 1hr                       A   1.85   1.55     1.55NA  0.10   3.50  3.507XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
92608  Ex for speech device rx addl                      A   0.70   0.66     0.66NA  0.04   1.40  1.407ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92609  Use of speech device service                      A   1.50   1.32     1.32NA  0.07   2.89  2.897XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
92610  Evaluate swallowing function                      A   1.30   0.92     0.60    0.07   2.29  1.977XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92611  Motion fluoroscopy/swallow                        A   1.34   1.15     1.15NA  0.08   2.57  2.577XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92612  Endoscopy swallow tst (fees)                      A   1.27   3.94     0.61    0.07   5.28  1.950XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92613  Endoscopy swallow tst (fees)                      A   0.71   0.37     0.36    0.04   1.12  1.110XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92614  Laryngoscopic sensory test                        A   1.27   3.20     0.63    0.07   4.54  1.970XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92615  Eval laryngoscopy sense tst                       A   0.63   0.31     0.31    0.03   0.97  0.970XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92616  Fees w/laryngeal sense test                       A   1.88   4.25     0.92    0.10   6.23  2.900XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92617  Interprt fees/laryngeal test                      A   0.79   0.38     0.38    0.04   1.21  1.210XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92618  Ex for nonspeech dev rx add                       B+  0.65   0.28     0.26    0.03   0.96  0.949ZZZ.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92620  Auditory function 60 min                          A   1.50   1.15     0.84    0.07   2.72  2.419XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92621  Auditory function + 15 min                        A   0.35   0.29     0.19    0.01   0.65  0.559ZZZ.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
92625  Tinnitus assessment                               A   1.15   0.82     0.60    0.05   2.02  1.809XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92626  Eval aud rehab status                             A   1.40   1.16     0.75    0.07   2.63  2.229XXX.00.00.0002000             25.0008 020 99      0.00   0.00   0.00
92627  Eval aud status rehab add-on                      A   0.33   0.29     0.17    0.01   0.63  0.519ZZZ.00.00.0000000             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92640  Aud brainstem implt programg                      A   1.76   1.49     0.94    0.37   3.62  3.079XXX.00.00.0002000             25.0008 050 99      0.00   0.00   0.00
92700  Ent procedure/service                             C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92920  Prq cardiac angioplast 1 art                      A  10.10   3.69NA   3.69    2.19  15.98 15.980000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
92921  Prq cardiac angio addl art                        B   0.00   0.00     0.00    0.00   0.00  0.009ZZZ.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92924  Prq card angio/athrect 1 art                      A  11.99   4.39NA   4.39    2.61  18.99 18.990000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
92925  Prq card angio/athrect addl                       B   0.00   0.00     0.00    0.00   0.00  0.009ZZZ.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92928  Prq card stent w/angio 1 vsl                      A  11.21   4.08NA   4.08    2.45  17.74 17.740000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
92929  Prq card stent w/angio addl                       B   0.00   0.00     0.00    0.00   0.00  0.009ZZZ.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92933  Prq card stent/ath/angio                          A  12.54   4.57NA   4.57    2.74  19.85 19.850000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
92934  Prq card stent/ath/angio                          B   0.00   0.00     0.00    0.00   0.00  0.009ZZZ.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92937  Prq revasc byp graft 1 vsl                        A  11.20   4.08NA   4.08    2.45  17.73 17.730000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
92938  Prq revasc byp graft addl                         B   0.00   0.00     0.00    0.00   0.00  0.009ZZZ.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92941  Prq card revasc mi 1 vsl                          A  12.56   4.58NA   4.58    2.75  19.89 19.890000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
92943  Prq card revasc chronic 1vsl                      A  12.56   4.58NA   4.58    2.75  19.89 19.890000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
92944  Prq card revasc chronic addl                      B   0.00   0.00     0.00    0.00   0.00  0.009ZZZ.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92950  Heart/lung resuscitation cpr                      A   4.00   4.72     1.06    0.32   9.04  5.380000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92953  Temporary external pacing                         A   0.23   0.07NA   0.07    0.01   0.31  0.310000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92960  Cardioversion electric ext                        A   2.25   3.65     1.13    0.14   6.04  3.520000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92961  Cardioversion electric int                        A   4.59   1.99NA   1.99    0.44   7.02  7.020000.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
92970  Cardioassist internal                             A   3.51   1.39NA   1.39    0.24   5.14  5.140000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92971  Cardioassist external                             A   1.77   0.80NA   0.80    0.11   2.68  2.680000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92973  Prq coronary mech thrombect                       A   3.28   1.20NA   1.20    0.71   5.19  5.190ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92974  Cath place cardio brachytx                        A   3.00   1.09NA   1.09    0.65   4.74  4.740ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92975  Dissolve clot heart vessel                        A   7.24   2.64NA   2.64    1.58  11.46 11.460000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
92977  Dissolve clot heart vessel                        A   0.00   1.64     1.64NA  0.03   1.67  1.675XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92978  Intravasc us heart add-on                         C   0.00   0.00     0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92978TCIntravasc us heart add-on                         C   0.00   0.00     0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9297826Intravasc us heart add-on                         A   1.80   0.66     0.66    0.12   2.58  2.581ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92979  Intravasc us heart add-on                         C   0.00   0.00     0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92979TCIntravasc us heart add-on                         C   0.00   0.00     0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9297926Intravasc us heart add-on                         A   1.44   0.53     0.53    0.10   2.07  2.071ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
92986  Revision of aortic valve                          A  22.85  11.48NA  11.48    4.98  39.31 39.310090.09.84.0720000             25.0008 090 99      0.00   0.00   0.00
92987  Revision of mitral valve                          A  23.63  11.90NA  11.90    5.14  40.67 40.670090.09.84.0720000             25.0008 090 99      0.00   0.00   0.00
92990  Revision of pulmonary valve                       A  18.27   9.64NA   9.64    3.99  31.90 31.900090.09.84.0720000             25.0008 090 99      0.00   0.00   0.00
92992  Revision of heart chamber                         C   0.00   0.00     0.00    0.00   0.00  0.000090.09.84.0720200             25.0008 090 99      0.00   0.00   0.00
92993  Revision of heart chamber                         C   0.00   0.00     0.00    0.00   0.00  0.000090.09.84.0720200             25.0008 090 99      0.00   0.00   0.00
92997  Pul art balloon repr percut                       A  11.98   4.54NA   4.54    2.61  19.13 19.130000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
92998  Pul art balloon repr percut                       A   5.99   2.17NA   2.17    1.31   9.47  9.470ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93000  Electrocardiogram complete                        A   0.17   0.35     0.35NA  0.02   0.54  0.544XXX.00.00.0060000             25.0008 010 99      0.00   0.00   0.00
93005  Electrocardiogram tracing                         A   0.00   0.29     0.29NA  0.01   0.30  0.303XXX.00.00.0060000             25.0008 010 99      0.00   0.00   0.00
93010  Electrocardiogram report                          A   0.17   0.06     0.06    0.01   0.24  0.242XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93015  Cardiovascular stress test                        A   0.75   1.56     1.56NA  0.03   2.34  2.344XXX.00.00.0060000             25.0008 020 99      0.00   0.00   0.00
93016  Cardiovascular stress test                        A   0.45   0.17     0.17    0.01   0.63  0.632XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
93017  Cardiovascular stress test                        A   0.00   1.28     1.28NA  0.01   1.29  1.293XXX.00.00.0060000             25.0008 020 99      0.00   0.00   0.00
93018  Cardiovascular stress test                        A   0.30   0.11     0.11    0.01   0.42  0.422XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93024  Cardiac drug stress test                          A   1.17   2.09     2.09NA  0.05   3.31  3.311XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93024TCCardiac drug stress test                          A   0.00   1.66     1.66NA  0.01   1.67  1.671XXX.00.00.0060000             25.0008 030 99      0.00   0.00   0.00
9302426Cardiac drug stress test                          A   1.17   0.43     0.43    0.04   1.64  1.641XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93025  Microvolt t-wave assess                           A   0.75   4.24     4.24NA  0.04   5.03  5.031XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93025TCMicrovolt t-wave assess                           A   0.00   3.95     3.95NA  0.01   3.96  3.961XXX.00.00.0060000             25.0008 010 99      0.00   0.00   0.00
9302526Microvolt t-wave assess                           A   0.75   0.29     0.29    0.03   1.07  1.071XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93040  Rhythm ECG with report                            A   0.15   0.22     0.22NA  0.02   0.39  0.394XXX.00.00.0060000             25.0008 010 99      0.00   0.00   0.00
93041  Rhythm ecg tracing                                A   0.00   0.17     0.17NA  0.01   0.18  0.183XXX.00.00.0060000             25.0008 010 99      0.00   0.00   0.00
93042  Rhythm ecg report                                 A   0.15   0.05     0.05    0.01   0.21  0.212XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93224  Ecg monit/reprt up to 48 hrs                      A   0.52   2.21     2.21NA  0.03   2.76  2.764XXX.00.00.0060000             25.0008 010 99      0.00   0.00   0.00
93225  Ecg monit/reprt up to 48 hrs                      A   0.00   0.82     0.82NA  0.01   0.83  0.833XXX.00.00.0060000             25.0008 010 99      0.00   0.00   0.00
93226  Ecg monit/reprt up to 48 hrs                      A   0.00   1.16     1.16NA  0.01   1.17  1.173XXX.00.00.0060000             25.0008 010 99      0.00   0.00   0.00
93227  Ecg monit/reprt up to 48 hrs                      A   0.52   0.23     0.23    0.01   0.76  0.762XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93228  Remote 30 day ecg rev/report                      A   0.52   0.19     0.19    0.03   0.74  0.742XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93229  Remote 30 day ecg tech supp                       A   0.00  21.65    21.65NA  0.01  21.66 21.663XXX.00.00.0060000             25.0008 010 99      0.00   0.00   0.00
93268  ECG record/review                                 A   0.52   5.95     5.95NA  0.03   6.50  6.504XXX.00.00.0060000             25.0008 010 99      0.00   0.00   0.00
93270  Remote 30 day ecg rev/report                      A   0.00   0.27     0.27NA  0.01   0.28  0.283XXX.00.00.0060000             25.0008 010 99      0.00   0.00   0.00
93271  Ecg/monitoring and analysis                       A   0.00   5.50     5.50NA  0.01   5.51  5.513XXX.00.00.0060000             25.0008 010 99      0.00   0.00   0.00
93272  Ecg/review interpret only                         A   0.52   0.18     0.18    0.01   0.71  0.712XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93278  ECG/signal-averaged                               A   0.25   0.64     0.64NA  0.02   0.91  0.911XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93278TCECG/signal-averaged                               A   0.00   0.54     0.54NA  0.01   0.55  0.551XXX.00.00.0060000             25.0008 010 99      0.00   0.00   0.00
9327826ECG/signal-averaged                               A   0.25   0.10     0.10    0.01   0.36  0.361XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93279  Pm device progr eval sngl                         A   0.65   0.77     0.77NA  0.04   1.46  1.461XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93279TCPm device progr eval sngl                         A   0.00   0.52     0.52NA  0.01   0.53  0.531XXX.00.00.0060000             25.0008 020 99      0.00   0.00   0.00
9327926Pm device progr eval sngl                         A   0.65   0.25     0.25    0.03   0.93  0.931XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93280  Pm device progr eval dual                         A   0.77   0.87     0.87NA  0.04   1.68  1.681XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93280TCPm device progr eval dual                         A   0.00   0.58     0.58NA  0.01   0.59  0.591XXX.00.00.0060000             25.0008 020 99      0.00   0.00   0.00
9328026Pm device progr eval dual                         A   0.77   0.29     0.29    0.03   1.09  1.091XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93281  Pm device progr eval multi                        A   0.90   1.02     1.02NA  0.04   1.96  1.961XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93281TCPm device progr eval multi                        A   0.00   0.68     0.68NA  0.01   0.69  0.691XXX.00.00.0060000             25.0008 020 99      0.00   0.00   0.00
9328126Pm device progr eval multi                        A   0.90   0.34     0.34    0.03   1.27  1.271XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93282  Icd device progr eval 1 sngl                      A   0.85   0.92     0.92NA  0.04   1.81  1.811XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93282TCIcd device progr eval 1 sngl                      A   0.00   0.60     0.60NA  0.01   0.61  0.611XXX.00.00.0060000             25.0008 020 99      0.00   0.00   0.00
9328226Icd device progr eval 1 sngl                      A   0.85   0.32     0.32    0.03   1.20  1.201XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93283  Icd device progr eval dual                        A   1.15   1.14     1.14NA  0.05   2.34  2.341XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93283TCIcd device progr eval dual                        A   0.00   0.70     0.70NA  0.01   0.71  0.711XXX.00.00.0060000             25.0008 020 99      0.00   0.00   0.00
9328326Icd device progr eval dual                        A   1.15   0.44     0.44    0.04   1.63  1.631XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93284  Icd device progr eval mult                        A   1.25   1.28     1.28NA  0.05   2.58  2.581XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93284TCIcd device progr eval mult                        A   0.00   0.80     0.80NA  0.01   0.81  0.811XXX.00.00.0060000             25.0008 020 99      0.00   0.00   0.00
9328426Icd device progr eval mult                        A   1.25   0.48     0.48    0.04   1.77  1.771XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93285  Ilr device eval progr                             A   0.52   0.66     0.66NA  0.02   1.20  1.201XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93285TCIlr device eval progr                             A   0.00   0.46     0.46NA  0.01   0.47  0.471XXX.00.00.0060000             25.0008 020 99      0.00   0.00   0.00
9328526Ilr device eval progr                             A   0.52   0.20     0.20    0.01   0.73  0.731XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93286  Peri-px pacemaker device evl                      A   0.30   0.46     0.46NA  0.02   0.78  0.781XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93286TCPeri-px pacemaker device evl                      A   0.00   0.34     0.34NA  0.01   0.35  0.351XXX.00.00.0060000             25.0008 020 99      0.00   0.00   0.00
9328626Peri-px pacemaker device evl                      A   0.30   0.12     0.12    0.01   0.43  0.431XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93287  Peri-px icd device eval&prgr                      A   0.45   0.55     0.55NA  0.02   1.02  1.021XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93287TCPeri-px icd device eval&prgr                      A   0.00   0.38     0.38NA  0.01   0.39  0.391XXX.00.00.0060000             25.0008 020 99      0.00   0.00   0.00
9328726Peri-px icd device eval&prgr                      A   0.45   0.17     0.17    0.01   0.63  0.631XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93288  Pm device eval in person                          A   0.43   0.63     0.63NA  0.02   1.08  1.081XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93288TCPm device eval in person                          A   0.00   0.47     0.47NA  0.01   0.48  0.481XXX.00.00.0060000             25.0008 020 99      0.00   0.00   0.00
9328826Pm device eval in person                          A   0.43   0.16     0.16    0.01   0.60  0.601XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93289  Icd device interrogate                            A   0.92   0.92     0.92NA  0.04   1.88  1.881XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93289TCIcd device interrogate                            A   0.00   0.58     0.58NA  0.01   0.59  0.591XXX.00.00.0060000             25.0008 020 99      0.00   0.00   0.00
9328926Icd device interrogate                            A   0.92   0.34     0.34    0.03   1.29  1.291XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93290  Icm device eval                                   A   0.43   0.44     0.44NA  0.02   0.89  0.891XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93290TCIcm device eval                                   A   0.00   0.28     0.28NA  0.01   0.29  0.291XXX.00.00.0060000             25.0008 020 99      0.00   0.00   0.00
9329026Icm device eval                                   A   0.43   0.16     0.16    0.01   0.60  0.601XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93291  Ilr device interrogate                            A   0.43   0.59     0.59NA  0.02   1.04  1.041XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93291TCIlr device interrogate                            A   0.00   0.43     0.43NA  0.01   0.44  0.441XXX.00.00.0060000             25.0008 020 99      0.00   0.00   0.00
9329126Ilr device interrogate                            A   0.43   0.16     0.16    0.01   0.60  0.601XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93292  Wcd device interrogate                            A   0.43   0.49     0.49NA  0.02   0.94  0.941XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93292TCWcd device interrogate                            A   0.00   0.33     0.33NA  0.01   0.34  0.341XXX.00.00.0060000             25.0008 020 99      0.00   0.00   0.00
9329226Wcd device interrogate                            A   0.43   0.16     0.16    0.01   0.60  0.601XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93293  Pm phone r-strip device eval                      A   0.32   1.22     1.22NA  0.02   1.56  1.561XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93293TCPm phone r-strip device eval                      A   0.00   1.11     1.11NA  0.01   1.12  1.121XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9329326Pm phone r-strip device eval                      A   0.32   0.11     0.11    0.01   0.44  0.441XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93294  Pm device interrogate remote                      A   0.65   0.27     0.27    0.04   0.96  0.962XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93295  Icd device interrogat remote                      A   1.29   0.52     0.52    0.08   1.89  1.892XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93296  Pm/icd remote tech serv                           A   0.00   0.76     0.76NA  0.01   0.77  0.773XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
93297  Icm device interrogat remote                      A   0.52   0.20     0.20    0.03   0.75  0.752XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93298  Ilr device interrogat remote                      A   0.52   0.20     0.20    0.03   0.75  0.752XXX.00.00.0000000             25.0008 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  0.003XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
93303  Echo transthoracic                                A   1.30   4.46     4.46NA  0.05   5.81  5.811XXX.00.00.0060000             25.0008 090 99     22.78  22.78   0.10
93303TCEcho transthoracic                                A   0.00   3.97     3.97NA  0.01   3.98  3.981XXX.00.00.0060000             25.0008 010 99     22.29  22.29   0.06
9330326Echo transthoracic                                A   1.30   0.49     0.49    0.04   1.83  1.831XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93304  Echo transthoracic                                A   0.75   3.06     3.06NA  0.04   3.85  3.851XXX.00.00.0060000             25.0008 090 99     15.83  15.83   0.09
93304TCEcho transthoracic                                A   0.00   2.79     2.79NA  0.01   2.80  2.801XXX.00.00.0060000             25.0008 010 99     15.56  15.56   0.06
9330426Echo transthoracic                                A   0.75   0.27     0.27    0.03   1.05  1.051XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93306  Tte w/doppler complete                            A   1.30   4.22     4.22NA  0.05   5.57  5.571XXX.00.00.0060000             25.0008 090 99     16.06  16.06   0.08
93306TCTte w/doppler complete                            A   0.00   3.74     3.74NA  0.01   3.75  3.751XXX.00.00.0060000             25.0008 010 99     15.58  15.58   0.04
9330626Tte w/doppler complete                            A   1.30   0.48     0.48    0.04   1.82  1.821XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93307  Tte w/o doppler complete                          A   0.92   2.40     2.40NA  0.04   3.36  3.361XXX.00.00.0060000             25.0008 090 99     15.89  15.89   0.11
93307TCTte w/o doppler complete                          A   0.00   2.05     2.05NA  0.01   2.06  2.061XXX.00.00.0060000             25.0008 010 99     15.54  15.54   0.08
9330726Tte w/o doppler complete                          A   0.92   0.35     0.35    0.03   1.30  1.301XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93308  Tte f-up or lmtd                                  A   0.53   2.40     2.40NA  0.02   2.95  2.951XXX.00.00.0060000             25.0008 090 99      8.66   8.66   0.05
93308TCTte f-up or lmtd                                  A   0.00   2.21     2.21NA  0.01   2.22  2.221XXX.00.00.0060000             25.0008 010 99      8.47   8.47   0.04
9330826Tte f-up or lmtd                                  A   0.53   0.19     0.19    0.01   0.73  0.731XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93312  Echo transesophageal                              A   2.20   6.66     6.66NA  0.10   8.96  8.961XXX.00.00.0060000             25.0008 090 99     22.95  22.95   0.18
93312TCEcho transesophageal                              A   0.00   5.94     5.94NA  0.03   5.97  5.971XXX.00.00.0060000             25.0008 030 99     22.23  22.23   0.11
9331226Echo transesophageal                              A   2.20   0.72     0.72    0.07   2.99  2.991XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93313  Echo transesophageal                              A   0.95   0.17NA   0.17    0.07   1.19  1.190XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
93314  Echo transesophageal                              A   1.25   7.05     7.05NA  0.07   8.37  8.371XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93314TCEcho transesophageal                              A   0.00   6.62     6.62NA  0.03   6.65  6.651XXX.00.00.0060000             25.0008 030 99      0.00   0.00   0.00
9331426Echo transesophageal                              A   1.25   0.43     0.43    0.04   1.72  1.721XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93315  Echo transesophageal                              C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99     16.58  16.58   0.24
93315TCEcho transesophageal                              C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99     15.61  15.61   0.01
9331526Echo transesophageal                              A   2.78   0.97     0.97    0.23   3.98  3.981XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93316  Echo transesophageal                              A   0.95   0.20NA   0.20    0.07   1.22  1.220XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
93317  Echo transesophageal                              C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93317TCEcho transesophageal                              C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9331726Echo transesophageal                              A   1.83   0.62     0.62    0.23   2.68  2.681XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93318  Echo transesophageal intraop                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0060000             25.0008 090 99     23.04  23.04   0.32
93318TCEcho transesophageal intraop                      C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0060000             25.0008 090 99     22.34  22.34   0.01
9331826Echo transesophageal intraop                      A   2.20   0.70     0.70    0.31   3.21  3.211XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93320  Doppler echo exam heart                           A   0.38   0.91     0.91NA  0.02   1.31  1.311ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93320TCDoppler echo exam heart                           A   0.00   0.78     0.78NA  0.01   0.79  0.791ZZZ.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9332026Doppler echo exam heart                           A   0.38   0.13     0.13    0.01   0.52  0.521ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93321  Doppler echo exam heart                           A   0.15   0.53     0.53NA  0.02   0.70  0.701ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93321TCDoppler echo exam heart                           A   0.00   0.48     0.48NA  0.01   0.49  0.491ZZZ.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9332126Doppler echo exam heart                           A   0.15   0.05     0.05    0.01   0.21  0.211ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93325  Doppler color flow add-on                         A   0.07   0.49     0.49NA  0.02   0.58  0.581ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93325TCDoppler color flow add-on                         A   0.00   0.47     0.47NA  0.01   0.48  0.481ZZZ.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9332526Doppler color flow add-on                         A   0.07   0.02     0.02    0.01   0.10  0.101ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93350  Stress tte only                                   A   1.46   4.37     4.37NA  0.06   5.89  5.891XXX.00.00.0060000             25.0008 090 99     16.12  16.12   0.09
93350TCStress tte only                                   A   0.00   3.83     3.83NA  0.01   3.84  3.841XXX.00.00.0060000             25.0008 020 99     15.58  15.58   0.04
9335026Stress tte only                                   A   1.46   0.54     0.54    0.05   2.05  2.051XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93351  Stress tte complete                               A   1.75   5.06     5.06NA  0.08   6.89  6.891XXX.00.00.0060999             25.0008 090 99     22.84  22.84   0.20
93351TCStress tte complete                               A   0.00   4.42     4.42NA  0.03   4.45  4.451XXX.00.00.0060999             25.0008 020 99     22.20  22.20   0.15
9335126Stress tte complete                               A   1.75   0.64     0.64    0.05   2.44  2.441XXX.00.00.0060999             25.0008 090 99      0.00   0.00   0.00
93352  Admin ecg contrast agent                          A   0.19   0.82     0.82NA  0.01   1.02  1.020ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93451  Right heart cath                                  A   2.72  20.72    20.72NA  0.62  24.06 24.061000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93451TCRight heart cath                                  A   0.00  19.73    19.73NA  0.03  19.76 19.761000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9345126Right heart cath                                  A   2.72   0.99     0.99    0.59   4.30  4.301000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93452  Left hrt cath w/ventrclgrphy                      A   4.75  20.80    20.80NA  1.09  26.64 26.641000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93452TCLeft hrt cath w/ventrclgrphy                      A   0.00  19.07    19.07NA  0.03  19.10 19.101000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9345226Left hrt cath w/ventrclgrphy                      A   4.75   1.73     1.73    1.06   7.54  7.541000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93453  R&l hrt cath w/ventriclgrphy                      A   6.24  27.09    27.09NA  1.41  34.74 34.741000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93453TCR&l hrt cath w/ventriclgrphy                      A   0.00  24.80    24.80NA  0.04  24.84 24.841000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9345326R&l hrt cath w/ventriclgrphy                      A   6.24   2.29     2.29    1.37   9.90  9.901000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93454  Coronary artery angio s&i                         A   4.79  21.41    21.41NA  1.09  27.29 27.291000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93454TCCoronary artery angio s&i                         A   0.00  19.66    19.66NA  0.03  19.69 19.691000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9345426Coronary artery angio s&i                         A   4.79   1.75     1.75    1.06   7.60  7.601000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93455  Coronary art/grft angio s&i                       A   5.54  24.92    24.92NA  1.25  31.71 31.711000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93455TCCoronary art/grft angio s&i                       A   0.00  22.90    22.90NA  0.04  22.94 22.941000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9345526Coronary art/grft angio s&i                       A   5.54   2.02     2.02    1.21   8.77  8.771000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93456  R hrt coronary artery angio                       A   6.15  26.67    26.67NA  1.37  34.19 34.191000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93456TCR hrt coronary artery angio                       A   0.00  24.43    24.43NA  0.04  24.47 24.471000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9345626R hrt coronary artery angio                       A   6.15   2.24     2.24    1.33   9.72  9.721000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93457  R hrt art/grft angio                              A   6.89  30.17    30.17NA  1.54  38.60 38.601000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93457TCR hrt art/grft angio                              A   0.00  27.65    27.65NA  0.04  27.69 27.691000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9345726R hrt art/grft angio                              A   6.89   2.52     2.52    1.50  10.91 10.911000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93458  L hrt artery/ventricle angio                      A   5.85  25.49    25.49NA  1.33  32.67 32.671000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93458TCL hrt artery/ventricle angio                      A   0.00  23.36    23.36NA  0.04  23.40 23.401000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9345826L hrt artery/ventricle angio                      A   5.85   2.13     2.13    1.29   9.27  9.271000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93459  L hrt art/grft angio                              A   6.60  28.01    28.01NA  1.47  36.08 36.081000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93459TCL hrt art/grft angio                              A   0.00  25.60    25.60NA  0.04  25.64 25.641000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9345926L hrt art/grft angio                              A   6.60   2.41     2.41    1.43  10.44 10.441000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93460  R&l hrt art/ventricle angio                       A   7.35  29.67    29.67NA  1.63  38.65 38.651000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93460TCR&l hrt art/ventricle angio                       A   0.00  26.99    26.99NA  0.04  27.03 27.031000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9346026R&l hrt art/ventricle angio                       A   7.35   2.68     2.68    1.59  11.62 11.621000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93461  R&l hrt art/ventricle angio                       A   8.10  34.36    34.36NA  1.82  44.28 44.281000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93461TCR&l hrt art/ventricle angio                       A   0.00  31.40    31.40NA  0.05  31.45 31.451000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9346126R&l hrt art/ventricle angio                       A   8.10   2.96     2.96    1.77  12.83 12.831000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93462  L hrt cath trnsptl puncture                       A   3.73   1.47     1.47    0.80   6.00  6.000ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93463  Drug admin & hemodynmic meas                      A   2.00   0.72     0.72    0.39   3.11  3.110ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93464  Exercise w/hemodynamic meas                       A   1.80   6.40     6.40NA  0.36   8.56  8.561ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93464TCExercise w/hemodynamic meas                       A   0.00   5.74     5.74NA  0.01   5.75  5.751ZZZ.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9346426Exercise w/hemodynamic meas                       A   1.80   0.66     0.66    0.35   2.81  2.811ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93503  Insert/place heart catheter                       A   2.91   0.56NA   0.56    0.27   3.74  3.740000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93505  Biopsy of heart lining                            A   4.37  17.80    17.80NA  0.86  23.03 23.031000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93505TCBiopsy of heart lining                            A   0.00  16.21    16.21NA  0.03  16.24 16.241000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9350526Biopsy of heart lining                            A   4.37   1.59     1.59    0.83   6.79  6.791000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93530  Rt heart cath congenital                          C   0.00   0.00NA   0.00NA  0.00   0.00  0.001000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93530TCRt heart cath congenital                          C   0.00   0.00NA   0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9353026Rt heart cath congenital                          A   4.22   1.53     1.53    0.91   6.66  6.661000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93531  R & l heart cath congenital                       C   0.00   0.00NA   0.00NA  0.00   0.00  0.001000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93531TCR & l heart cath congenital                       C   0.00   0.00NA   0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9353126R & l heart cath congenital                       A   8.34   3.03     3.03    1.82  13.19 13.191000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93532  R & l heart cath congenital                       C   0.00   0.00NA   0.00NA  0.00   0.00  0.001000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93532TCR & l heart cath congenital                       C   0.00   0.00NA   0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9353226R & l heart cath congenital                       A   9.99   3.62     3.62    2.18  15.79 15.791000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93533  R & l heart cath congenital                       C   0.00   0.00NA   0.00NA  0.00   0.00  0.001000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93533TCR & l heart cath congenital                       C   0.00   0.00NA   0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9353326R & l heart cath congenital                       A   6.69   2.42     2.42    1.47  10.58 10.581000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93561  Cardiac output measurement                        C   0.00   0.00NA   0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93561TCCardiac output measurement                        C   0.00   0.00NA   0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9356126Cardiac output measurement                        A   0.50   0.16     0.16    0.04   0.70  0.701000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93562  Card output measure subsq                         C   0.00   0.00NA   0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93562TCCard output measure subsq                         C   0.00   0.00NA   0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9356226Card output measure subsq                         A   0.16   0.05     0.05    0.01   0.22  0.221000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93563  Inject congenital card cath                       A   1.11   0.40     0.40    0.10   1.61  1.610ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93564  Inject hrt congntl art/grft                       A   1.13   0.41     0.41    0.11   1.65  1.650ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93565  Inject l ventr/atrial angio                       A   0.86   0.31     0.31    0.08   1.25  1.250ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93566  Inject r ventr/atrial angio                       A   0.86   4.26     0.31    0.08   5.20  1.250ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93567  Inject suprvlv aortography                        A   0.97   3.21     0.35    0.08   4.26  1.400ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93568  Inject pulm art hrt cath                          A   0.88   3.69     0.32    0.08   4.65  1.280ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93571  Heart flow reserve measure                        C   0.00   0.00NA   0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93571TCHeart flow reserve measure                        C   0.00   0.00NA   0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9357126Heart flow reserve measure                        A   1.80   0.66     0.66    0.11   2.57  2.571ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93572  Heart flow reserve measure                        C   0.00   0.00NA   0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93572TCHeart flow reserve measure                        C   0.00   0.00NA   0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9357226Heart flow reserve measure                        A   1.44   0.53     0.53    0.11   2.08  2.081ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93580  Transcath closure of asd                          A  17.97   6.99NA   6.99    3.92  28.88 28.880000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93581  Transcath closure of vsd                          A  24.39   9.24NA   9.24    5.32  38.95 38.950000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93600  Bundle of His recording                           C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93600TCBundle of His recording                           C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9360026Bundle of His recording                           A   2.12   0.84     0.84    0.45   3.41  3.411000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93602  Intra-atrial recording                            C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93602TCIntra-atrial recording                            C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9360226Intra-atrial recording                            A   2.12   0.82     0.82    0.45   3.39  3.391000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93603  Right ventricular recording                       C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93603TCRight ventricular recording                       C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9360326Right ventricular recording                       A   2.12   0.81     0.81    0.45   3.38  3.381000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93609  Map tachycardia add-on                            C   0.00   0.00     0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93609TCMap tachycardia add-on                            C   0.00   0.00     0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9360926Map tachycardia add-on                            A   4.99   1.95     1.95    1.09   8.03  8.031ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93610  Intra-atrial pacing                               C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93610TCIntra-atrial pacing                               C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9361026Intra-atrial pacing                               A   3.02   1.16     1.16    0.65   4.83  4.831000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93612  Intraventricular pacing                           C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93612TCIntraventricular pacing                           C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9361226Intraventricular pacing                           A   3.02   1.12     1.12    0.65   4.79  4.791000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93613  Electrophys map 3d add-on                         A   6.99   2.76NA   2.76    1.52  11.27 11.270ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93615  Esophageal recording                              C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93615TCEsophageal recording                              C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9361526Esophageal recording                              A   0.99   0.36     0.36    0.05   1.40  1.401000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93616  Esophageal recording                              C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93616TCEsophageal recording                              C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9361626Esophageal recording                              A   1.49   0.27     0.27    0.11   1.87  1.871000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93618  Heart rhythm pacing                               C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93618TCHeart rhythm pacing                               C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9361826Heart rhythm pacing                               A   4.25   1.67     1.67    0.91   6.83  6.831000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93619  Electrophysiology evaluation                      C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93619TCElectrophysiology evaluation                      C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9361926Electrophysiology evaluation                      A   7.31   2.84     2.84    1.59  11.74 11.741000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93620  Electrophysiology evaluation                      C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93620TCElectrophysiology evaluation                      C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9362026Electrophysiology evaluation                      A  11.57   4.53     4.53    2.52  18.62 18.621000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93621  Electrophysiology evaluation                      C   0.00   0.00     0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93621TCElectrophysiology evaluation                      C   0.00   0.00     0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9362126Electrophysiology evaluation                      A   2.10   0.82     0.82    0.45   3.37  3.371ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93622  Electrophysiology evaluation                      C   0.00   0.00     0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93622TCElectrophysiology evaluation                      C   0.00   0.00     0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9362226Electrophysiology evaluation                      A   3.10   1.21     1.21    0.67   4.98  4.981ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93623  Stimulation pacing heart                          C   0.00   0.00     0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93623TCStimulation pacing heart                          C   0.00   0.00     0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9362326Stimulation pacing heart                          A   2.85   1.12     1.12    0.63   4.60  4.601ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93624  Electrophysiologic study                          C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93624TCElectrophysiologic study                          C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9362426Electrophysiologic study                          A   4.80   1.81     1.81NA  1.05   7.66  7.661000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93631  Heart pacing mapping                              C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93631TCHeart pacing mapping                              C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9363126Heart pacing mapping                              A   7.59   2.48     2.48    1.81  11.88 11.881000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93640  Evaluation heart device                           C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93640TCEvaluation heart device                           C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9364026Evaluation heart device                           A   3.51   1.32     1.32    0.76   5.59  5.591000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93641  Electrophysiology evaluation                      C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93641TCElectrophysiology evaluation                      C   0.00   0.00     0.00NA  0.00   0.00  0.001000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9364126Electrophysiology evaluation                      A   5.92   2.29     2.29    1.29   9.50  9.501000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93642  Electrophysiology evaluation                      A   4.88   6.39     6.39NA  0.21  11.48 11.481000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93642TCElectrophysiology evaluation                      A   0.00   4.49     4.49NA  0.03   4.52  4.521000.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9364226Electrophysiology evaluation                      A   4.88   1.90     1.90    0.18   6.96  6.961000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93650  Ablate heart dysrhythm focus                      A  10.49   4.44NA   4.44    2.27  17.20 17.200000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93653  Ep & ablate supravent arrhyt                      A  15.00   5.89NA   5.89    3.27  24.16 24.160000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93654  Ep & ablate ventric tachy                         A  20.00   7.88NA   7.88    4.36  32.24 32.240000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93655  Ablate arrhythmia add on                          A   7.50   2.95NA   2.95    1.63  12.08 12.080ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93656  Tx atrial fib pulm vein isol                      A  20.02   7.87NA   7.87    4.36  32.25 32.250000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93657  Tx l/r atrial fib addl                            A   7.50   2.95NA   2.95NA  1.64  12.09 12.091ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93660  Tilt table evaluation                             A   1.89   2.61     2.61NA  0.08   4.58  4.581000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93660TCTilt table evaluation                             A   0.00   1.89     1.89NA  0.01   1.90  1.901000.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9366026Tilt table evaluation                             A   1.89   0.72     0.72    0.07   2.68  2.681000.00.00.0020000             25.0008 090 99      0.00   0.00   0.00
93662  Intracardiac ecg (ice)                            C   0.00   0.00     0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93662TCIntracardiac ecg (ice)                            C   0.00   0.00     0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9366226Intracardiac ecg (ice)                            A   2.80   1.10     1.10    0.20   4.10  4.101ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93668  Peripheral vascular rehab                         N+  0.00   0.58     0.58NA  0.01   0.59  0.599XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
93701  Bioimpedance cv analysis                          A   0.00   0.73     0.73NA  0.01   0.74  0.743XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93724  Analyze pacemaker system                          A   4.88   2.69     2.69NA  0.19   7.76  7.761000.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93724TCAnalyze pacemaker system                          A   0.00   0.84     0.84NA  0.01   0.85  0.851000.00.00.0060000             25.0008 030 99      0.00   0.00   0.00
9372426Analyze pacemaker system                          A   4.88   1.85     1.85    0.18   6.91  6.911000.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93740  Temperature gradient studies                      B+  0.16   0.06     0.06    0.03   0.25  0.259XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
93745  Set-up cardiovert-defibrill                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93745TCSet-up cardiovert-defibrill                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9374526Set-up cardiovert-defibrill                       C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93750  Interrogation vad in person                       A   0.92   0.61     0.32    0.05   1.58  1.290XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93770  Measure venous pressure                           B+  0.16   0.06     0.06    0.03   0.25  0.259XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
93784  Ambulatory BP monitoring                          A   0.38   1.23     1.23NA  0.03   1.64  1.644XXX.00.00.0060000             25.0008 010 99      0.00   0.00   0.00
93786  Ambulatory BP recording                           A   0.00   0.92     0.92NA  0.01   0.93  0.933XXX.00.00.0060000             25.0008 010 99      0.00   0.00   0.00
93788  Ambulatory BP analysis                            A   0.00   0.16     0.16NA  0.01   0.17  0.173XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93790  Review/report BP recording                        A   0.38   0.15     0.15    0.01   0.54  0.542XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93797  Cardiac rehab                                     A   0.18   0.30     0.07    0.01   0.49  0.260000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93798  Cardiac rehab/monitor                             A   0.28   0.44     0.11    0.01   0.73  0.400000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93799  Cardiovascular procedure                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93799TCCardiovascular procedure                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
9379926Cardiovascular procedure                          C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93880  Extracranial bilat study                          A   0.60   6.56     6.56NA  0.05   7.21  7.211XXX.00.00.0062000             25.0008 090 99      6.40   6.40   0.05
93880TCExtracranial bilat study                          A   0.00   6.34     6.34NA  0.01   6.35  6.351XXX.00.00.0062000             25.0008 010 99      6.18   6.18   0.01
9388026Extracranial bilat study                          A   0.60   0.22     0.22    0.04   0.86  0.861XXX.00.00.0062000             25.0008 090 99      0.00   0.00   0.00
93882  Extracranial uni/ltd study                        A   0.40   4.72     4.72NA  0.06   5.18  5.181XXX.00.00.0060000             25.0008 090 99      6.31   6.31   0.06
93882TCExtracranial uni/ltd study                        A   0.00   4.59     4.59NA  0.01   4.60  4.601XXX.00.00.0060000             25.0008 010 99      6.18   6.18   0.01
9388226Extracranial uni/ltd study                        A   0.40   0.13     0.13    0.05   0.58  0.581XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93886  Intracranial complete study                       A   0.94  10.21    10.21NA  0.05  11.20 11.201XXX.00.00.0060000             25.0008 090 99      6.59   6.59   0.05
93886TCIntracranial complete study                       A   0.00   9.80     9.80NA  0.01   9.81  9.811XXX.00.00.0060000             25.0008 010 99      6.18   6.18   0.01
9388626Intracranial complete study                       A   0.94   0.41     0.41    0.04   1.39  1.391XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93888  Intracranial limited study                        A   0.62   5.84     5.84NA  0.05   6.51  6.511XXX.00.00.0060000             25.0008 090 99      2.83   2.83   0.04
93888TCIntracranial limited study                        A   0.00   5.59     5.59NA  0.01   5.60  5.601XXX.00.00.0060000             25.0008 010 99      2.58   2.58   0.00
9388826Intracranial limited study                        A   0.62   0.25     0.25    0.04   0.91  0.911XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93890  Tcd vasoreactivity study                          A   1.00   7.77     7.77NA  0.05   8.82  8.821XXX.00.00.0060000             25.0008 090 99      4.38   4.38   0.05
93890TCTcd vasoreactivity study                          A   0.00   7.36     7.36NA  0.01   7.37  7.371XXX.00.00.0060000             25.0008 010 99      3.97   3.97   0.01
9389026Tcd vasoreactivity study                          A   1.00   0.41     0.41    0.04   1.45  1.451XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93892  Tcd emboli detect w/o inj                         A   1.15   8.75     8.75NA  0.06   9.96  9.961XXX.00.00.0060000             25.0008 090 99      4.45   4.45   0.05
93892TCTcd emboli detect w/o inj                         A   0.00   8.27     8.27NA  0.01   8.28  8.281XXX.00.00.0060000             25.0008 010 99      3.97   3.97   0.00
9389226Tcd emboli detect w/o inj                         A   1.15   0.48     0.48    0.05   1.68  1.681XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93893  Tcd emboli detect w/inj                           A   1.15   9.40     9.40NA  0.06  10.61 10.611XXX.00.00.0060000             25.0008 090 99      4.47   4.47   0.05
93893TCTcd emboli detect w/inj                           A   0.00   8.90     8.90NA  0.01   8.91  8.911XXX.00.00.0060000             25.0008 010 99      3.97   3.97   0.00
9389326Tcd emboli detect w/inj                           A   1.15   0.50     0.50    0.05   1.70  1.701XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93922  Upr/l xtremity art 2 levels                       A   0.25   2.50     2.50NA  0.02   2.77  2.771XXX.00.00.0062000             25.0008 090 99      0.00   0.00   0.00
93922TCUpr/l xtremity art 2 levels                       A   0.00   2.41     2.41NA  0.01   2.42  2.421XXX.00.00.0062000             25.0008 010 99      0.00   0.00   0.00
9392226Upr/l xtremity art 2 levels                       A   0.25   0.09     0.09    0.01   0.35  0.351XXX.00.00.0062000             25.0008 090 99      0.00   0.00   0.00
93923  Upr/lxtr art stdy 3+ lvls                         A   0.45   3.81     3.81NA  0.05   4.31  4.311XXX.00.00.0062000             25.0008 090 99      0.00   0.00   0.00
93923TCUpr/lxtr art stdy 3+ lvls                         A   0.00   3.66     3.66NA  0.01   3.67  3.671XXX.00.00.0062000             25.0008 010 99      0.00   0.00   0.00
9392326Upr/lxtr art stdy 3+ lvls                         A   0.45   0.15     0.15    0.04   0.64  0.641XXX.00.00.0062000             25.0008 090 99      0.00   0.00   0.00
93924  Lwr xtr vasc stdy bilat                           A   0.50   4.85     4.85NA  0.05   5.40  5.401XXX.00.00.0062000             25.0008 090 99      0.00   0.00   0.00
93924TCLwr xtr vasc stdy bilat                           A   0.00   4.68     4.68NA  0.01   4.69  4.691XXX.00.00.0062000             25.0008 010 99      0.00   0.00   0.00
9392426Lwr xtr vasc stdy bilat                           A   0.50   0.17     0.17    0.04   0.71  0.711XXX.00.00.0062000             25.0008 090 99      0.00   0.00   0.00
93925  Lower extremity study                             A   0.80   6.62     6.62NA  0.09   7.51  7.511XXX.00.00.0062000             25.0008 090 99      6.44   6.44   0.09
93925TCLower extremity study                             A   0.00   6.34     6.34NA  0.03   6.37  6.371XXX.00.00.0062000             25.0008 010 99      6.16   6.16   0.03
9392526Lower extremity study                             A   0.80   0.28     0.28    0.06   1.14  1.141XXX.00.00.0062000             25.0008 090 99      0.00   0.00   0.00
93926  Lower extremity study                             A   0.50   3.78     3.78NA  0.07   4.35  4.351XXX.00.00.0060000             25.0008 090 99      4.12   4.12   0.07
93926TCLower extremity study                             A   0.00   3.62     3.62NA  0.01   3.63  3.631XXX.00.00.0060000             25.0008 010 99      3.96   3.96   0.01
9392626Lower extremity study                             A   0.50   0.16     0.16    0.06   0.72  0.721XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93930  Upper extremity study                             A   0.46   6.71     6.71NA  0.05   7.22  7.221XXX.00.00.0062000             25.0008 090 99      6.34   6.34   0.05
93930TCUpper extremity study                             A   0.00   6.55     6.55NA  0.01   6.56  6.561XXX.00.00.0062000             25.0008 010 99      6.18   6.18   0.01
9393026Upper extremity study                             A   0.46   0.16     0.16    0.04   0.66  0.661XXX.00.00.0062000             25.0008 090 99      0.00   0.00   0.00
93931  Upper extremity study                             A   0.31   4.49     4.49NA  0.04   4.84  4.841XXX.00.00.0060000             25.0008 090 99      4.06   4.06   0.04
93931TCUpper extremity study                             A   0.00   4.39     4.39NA  0.01   4.40  4.401XXX.00.00.0060000             25.0008 010 99      3.96   3.96   0.01
9393126Upper extremity study                             A   0.31   0.10     0.10    0.03   0.44  0.441XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93965  Extremity study                                   A   0.35   3.31     3.31NA  0.04   3.70  3.701XXX.00.00.0062000             25.0008 090 99      0.00   0.00   0.00
93965TCExtremity study                                   A   0.00   3.19     3.19NA  0.01   3.20  3.201XXX.00.00.0062000             25.0008 010 99      0.00   0.00   0.00
9396526Extremity study                                   A   0.35   0.12     0.12    0.03   0.50  0.501XXX.00.00.0062000             25.0008 090 99      0.00   0.00   0.00
93970  Extremity study                                   A   0.70   4.87     4.87NA  0.08   5.65  5.651XXX.00.00.0062000             25.0008 090 99      6.42   6.42   0.08
93970TCExtremity study                                   A   0.00   4.63     4.63NA  0.01   4.64  4.641XXX.00.00.0062000             25.0008 010 99      6.18   6.18   0.01
9397026Extremity study                                   A   0.70   0.24     0.24    0.07   1.01  1.011XXX.00.00.0062000             25.0008 090 99      0.00   0.00   0.00
93971  Extremity study                                   A   0.45   2.96     2.96NA  0.05   3.46  3.461XXX.00.00.0060000             25.0008 090 99      4.12   4.12   0.05
93971TCExtremity study                                   A   0.00   2.80     2.80NA  0.01   2.81  2.811XXX.00.00.0060000             25.0008 010 99      3.96   3.96   0.01
9397126Extremity study                                   A   0.45   0.16     0.16    0.04   0.65  0.651XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93975  Vascular study                                    A   1.80   8.93     8.93NA  0.17  10.90 10.901XXX.00.00.0060000             25.0008 090 99      6.80   6.80   0.16
93975TCVascular study                                    A   0.00   8.30     8.30NA  0.03   8.33  8.331XXX.00.00.0060000             25.0008 010 99      6.17   6.17   0.02
9397526Vascular study                                    A   1.80   0.63     0.63    0.14   2.57  2.571XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93976  Vascular study                                    A   1.21   5.04     5.04NA  0.09   6.34  6.341XXX.00.00.0060000             25.0008 090 99      6.62   6.62   0.09
93976TCVascular study                                    A   0.00   4.60     4.60NA  0.01   4.61  4.611XXX.00.00.0060000             25.0008 010 99      6.18   6.18   0.01
9397626Vascular study                                    A   1.21   0.44     0.44    0.08   1.73  1.731XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93978  Vascular study                                    A   0.65   6.24     6.24NA  0.08   6.97  6.971XXX.00.00.0060000             25.0008 090 99      6.40   6.40   0.08
93978TCVascular study                                    A   0.00   6.02     6.02NA  0.01   6.03  6.031XXX.00.00.0060000             25.0008 010 99      6.18   6.18   0.01
9397826Vascular study                                    A   0.65   0.22     0.22    0.07   0.94  0.941XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93979  Vascular study                                    A   0.44   4.34     4.34NA  0.05   4.83  4.831XXX.00.00.0060000             25.0008 090 99      4.10   4.10   0.05
93979TCVascular study                                    A   0.00   4.20     4.20NA  0.01   4.21  4.211XXX.00.00.0060000             25.0008 010 99      3.96   3.96   0.01
9397926Vascular study                                    A   0.44   0.14     0.14    0.04   0.62  0.621XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93980  Penile vascular study                             A   1.25   3.54     3.54NA  0.08   4.87  4.871XXX.00.00.0060000             25.0008 090 99      6.63   6.63   0.09
93980TCPenile vascular study                             A   0.00   3.08     3.08NA  0.01   3.09  3.091XXX.00.00.0060000             25.0008 010 99      6.17   6.17   0.02
9398026Penile vascular study                             A   1.25   0.46     0.46    0.07   1.78  1.781XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93981  Penile vascular study                             A   0.44   2.87     2.87NA  0.04   3.35  3.351XXX.00.00.0060000             25.0008 090 99      6.33   6.33   0.05
93981TCPenile vascular study                             A   0.00   2.71     2.71NA  0.01   2.72  2.721XXX.00.00.0060000             25.0008 010 99      6.17   6.17   0.02
9398126Penile vascular study                             A   0.44   0.16     0.16    0.03   0.63  0.631XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93982  Aneurysm pressure sens study                      R   0.30   0.96     0.96NA  0.05   1.31  1.310XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
93990  Doppler flow testing                              A   0.25   5.88     5.88NA  0.05   6.18  6.181XXX.00.00.0060000             25.0008 090 99      4.04   4.04   0.05
93990TCDoppler flow testing                              A   0.00   5.81     5.81NA  0.01   5.82  5.821XXX.00.00.0060000             25.0008 010 99      3.97   3.97   0.01
9399026Doppler flow testing                              A   0.25   0.07     0.07    0.04   0.36  0.361XXX.00.00.0060000             25.0008 090 99      0.00   0.00   0.00
93998  Noninvas vasc dx study proc                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000011             25.0008 090 99      0.00   0.00   0.00
94002  Vent mgmt inpat init day                          A   1.99   0.53NA   0.53    0.16   2.68  2.680XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94003  Vent mgmt inpat subq day                          A   1.37   0.48NA   0.48    0.10   1.95  1.950XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94004  Vent mgmt nf per day                              A   1.00   0.36NA   0.36    0.07   1.43  1.430XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94005  Home vent mgmt supervision                        B+  1.50   1.11     1.11NA  0.10   2.71  2.719XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
94010  Breathing capacity test                           A   0.17   0.91     0.91NA  0.02   1.10  1.101XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94010TCBreathing capacity test                           A   0.00   0.85     0.85NA  0.01   0.86  0.861XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9401026Breathing capacity test                           A   0.17   0.06     0.06    0.01   0.24  0.241XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94011  Spirometry up to 2 yrs old                        A   2.00   0.76NA   0.76    0.14   2.90  2.900XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94012  Spirmtry w/brnchdil inf-2 yr                      A   3.10   1.25NA   1.25    0.23   4.58  4.580XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94013  Meas lung vol thru 2 yrs                          A   0.66   0.33NA   0.33    0.04   1.03  1.030XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94014  Patient recorded spirometry                       A   0.52   0.92     0.92NA  0.02   1.46  1.464XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
94015  Patient recorded spirometry                       A   0.00   0.74     0.74NA  0.01   0.75  0.753XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
94016  Review patient spirometry                         A   0.52   0.18     0.18    0.01   0.71  0.712XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94060  Evaluation of wheezing                            A   0.27   1.60     1.60NA  0.02   1.89  1.891XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94060TCEvaluation of wheezing                            A   0.00   1.50     1.50NA  0.01   1.51  1.511XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9406026Evaluation of wheezing                            A   0.27   0.10     0.10    0.01   0.38  0.381XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94070  Evaluation of wheezing                            A   0.60   1.16     1.16NA  0.04   1.80  1.801XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94070TCEvaluation of wheezing                            A   0.00   0.95     0.95NA  0.01   0.96  0.961XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9407026Evaluation of wheezing                            A   0.60   0.21     0.21    0.03   0.84  0.841XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94150  Vital capacity test                               B+  0.07   0.68     0.68NA  0.02   0.77  0.771XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
94150TCVital capacity test                               B+  0.00   0.65     0.65NA  0.01   0.66  0.661XXX.00.00.0099999             25.0008 010 99      0.00   0.00   0.00
9415026Vital capacity test                               B+  0.07   0.03     0.03    0.01   0.11  0.111XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
94200  Lung function test (MBC/MVV)                      A   0.11   0.64     0.64NA  0.02   0.77  0.771XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94200TCLung function test (MBC/MVV)                      A   0.00   0.60     0.60NA  0.01   0.61  0.611XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9420026Lung function test (MBC/MVV)                      A   0.11   0.04     0.04    0.01   0.16  0.161XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94250  Expired gas collection                            A   0.11   0.65     0.65NA  0.02   0.78  0.781XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94250TCExpired gas collection                            A   0.00   0.61     0.61NA  0.01   0.62  0.621XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9425026Expired gas collection                            A   0.11   0.04     0.04    0.01   0.16  0.161XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94375  Respiratory flow volume loop                      A   0.31   0.86     0.86NA  0.02   1.19  1.191XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94375TCRespiratory flow volume loop                      A   0.00   0.75     0.75NA  0.01   0.76  0.761XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9437526Respiratory flow volume loop                      A   0.31   0.11     0.11    0.01   0.43  0.431XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94400  CO2 breathing response curve                      A   0.40   1.34     1.34NA  0.02   1.76  1.761XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94400TCCO2 breathing response curve                      A   0.00   1.20     1.20NA  0.01   1.21  1.211XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9440026CO2 breathing response curve                      A   0.40   0.14     0.14    0.01   0.55  0.551XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94450  Hypoxia response curve                            A   0.40   1.65     1.65NA  0.02   2.07  2.071XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94450TCHypoxia response curve                            A   0.00   1.49     1.49NA  0.01   1.50  1.501XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9445026Hypoxia response curve                            A   0.40   0.16     0.16    0.01   0.57  0.571XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94452  Hast w/report                                     A   0.31   1.48     1.48NA  0.02   1.81  1.811XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94452TCHast w/report                                     A   0.00   1.37     1.37NA  0.01   1.38  1.381XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9445226Hast w/report                                     A   0.31   0.11     0.11    0.01   0.43  0.431XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94453  Hast w/oxygen titrate                             A   0.40   2.12     2.12NA  0.02   2.54  2.541XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94453TCHast w/oxygen titrate                             A   0.00   1.98     1.98NA  0.01   1.99  1.991XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9445326Hast w/oxygen titrate                             A   0.40   0.14     0.14    0.01   0.55  0.551XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94610  Surfactant admin thru tube                        A   1.16   0.53NA   0.53    0.07   1.76  1.760XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94620  Pulmonary stress test/simple                      A   0.64   1.00     1.00NA  0.04   1.68  1.681XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94620TCPulmonary stress test/simple                      A   0.00   0.78     0.78NA  0.01   0.79  0.791XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9462026Pulmonary stress test/simple                      A   0.64   0.22     0.22    0.03   0.89  0.891XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94621  Pulm stress test/complex                          A   1.42   3.44     3.44NA  0.06   4.92  4.921XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94621TCPulm stress test/complex                          A   0.00   2.92     2.92NA  0.01   2.93  2.931XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9462126Pulm stress test/complex                          A   1.42   0.52     0.52    0.05   1.99  1.991XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94640  Airway inhalation treatment                       A   0.00   0.56     0.56NA  0.01   0.57  0.575XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94642  Aerosol inhalation treatment                      C   0.00   0.00     0.00    0.00   0.00  0.005XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94644  Cbt 1st hour                                      A   0.00   1.37     1.37NA  0.01   1.38  1.385XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94645  Cbt each addl hour                                A   0.00   0.43     0.43NA  0.01   0.44  0.445XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94660  Pos airway pressure cpap                          A   0.76   1.07     0.29    0.05   1.88  1.100XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94662  Neg press ventilation cnp                         A   0.76   0.24NA   0.24    0.05   1.05  1.050XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94664  Evaluate pt use of inhaler                        A   0.00   0.54     0.54NA  0.01   0.55  0.555XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
94667  Chest wall manipulation                           A   0.00   0.76     0.76NA  0.01   0.77  0.775XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94668  Chest wall manipulation                           A   0.00   0.79     0.79NA  0.01   0.80  0.805XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94680  Exhaled air analysis o2                           A   0.26   1.52     1.52NA  0.02   1.80  1.801XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94680TCExhaled air analysis o2                           A   0.00   1.42     1.42NA  0.01   1.43  1.431XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9468026Exhaled air analysis o2                           A   0.26   0.10     0.10    0.01   0.37  0.371XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94681  Exhaled air analysis o2/co2                       A   0.20   1.40     1.40NA  0.02   1.62  1.621XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94681TCExhaled air analysis o2/co2                       A   0.00   1.32     1.32NA  0.01   1.33  1.331XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9468126Exhaled air analysis o2/co2                       A   0.20   0.08     0.08    0.01   0.29  0.291XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94690  Exhaled air analysis                              A   0.07   1.43     1.43NA  0.02   1.52  1.521XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94690TCExhaled air analysis                              A   0.00   1.40     1.40NA  0.01   1.41  1.411XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9469026Exhaled air analysis                              A   0.07   0.03     0.03    0.01   0.11  0.111XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94726  Pulm funct tst plethysmograp                      A   0.26   1.49     1.49NA  0.03   1.78  1.781XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94726TCPulm funct tst plethysmograp                      A   0.00   1.39     1.39NA  0.02   1.41  1.411XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9472626Pulm funct tst plethysmograp                      A   0.26   0.10     0.10    0.01   0.37  0.371XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94727  Pulm function test by gas                         A   0.26   1.11     1.11NA  0.02   1.39  1.391XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94727TCPulm function test by gas                         A   0.00   1.01     1.01NA  0.01   1.02  1.021XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9472726Pulm function test by gas                         A   0.26   0.10     0.10    0.01   0.37  0.371XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94728  Pulm funct test oscillometry                      A   0.26   1.06     1.06NA  0.02   1.34  1.341XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94728TCPulm funct test oscillometry                      A   0.00   0.96     0.96NA  0.01   0.97  0.971XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9472826Pulm funct test oscillometry                      A   0.26   0.10     0.10    0.01   0.37  0.371XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94729  Co/membane diffuse capacity                       A   0.19   1.63     1.63NA  0.02   1.84  1.841ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94729TCCo/membane diffuse capacity                       A   0.00   1.55     1.55NA  0.01   1.56  1.561ZZZ.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9472926Co/membane diffuse capacity                       A   0.19   0.08     0.08    0.01   0.28  0.281ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94750  Pulmonary compliance study                        A   0.23   2.32     2.32NA  0.02   2.57  2.571XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94750TCPulmonary compliance study                        A   0.00   2.24     2.24NA  0.01   2.25  2.251XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9475026Pulmonary compliance study                        A   0.23   0.08     0.08    0.01   0.32  0.321XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94760  Measure blood oxygen level                        T   0.00   0.09     0.09NA  0.01   0.10  0.103XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
94761  Measure blood oxygen level                        T   0.00   0.14     0.14NA  0.01   0.15  0.153XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
94762  Measure blood oxygen level                        A   0.00   0.73     0.73NA  0.01   0.74  0.743XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
94770  Exhaled carbon dioxide test                       A   0.15   0.06NA   0.06    0.03   0.24  0.240XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94772  Breath recording infant                           C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94772TCBreath recording infant                           C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9477226Breath recording infant                           C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 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  0.004YYY.00.00.0000000             25.0008 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  0.003YYY.00.00.0000000             25.0008 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  0.003YYY.00.00.0000000             25.0008 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  0.002YYY.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94780  Car seat/bed test 60 min                          A   0.48   1.03     0.17    0.03   1.54  0.680XXX.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
94781  Car seat/bed test + 30 min                        A   0.17   0.43     0.06    0.01   0.61  0.240ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
94799  Pulmonary service/procedure                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
94799TCPulmonary service/procedure                       C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
9479926Pulmonary service/procedure                       C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95004  Percut allergy skin tests                         A   0.01   0.18     0.18NA  0.01   0.20  0.200XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
95012  Exhaled nitric oxide meas                         A   0.00   0.60     0.60NA  0.01   0.61  0.615XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95017  Perq & icut allg test venoms                      A   0.07   2.44     0.03    0.01   2.52  0.110XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95018  Perq&ic allg test drugs/biol                      A   0.14   0.71     0.06    0.01   0.86  0.210XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95024  Icut allergy test drug/bug                        A   0.01   0.22     0.01    0.01   0.24  0.030XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
95027  Icut allergy titrate-airborn                      A   0.01   0.13     0.13NA  0.01   0.15  0.150XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
95028  Icut allergy test-delayed                         A   0.00   0.42     0.42NA  0.01   0.43  0.433XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
95044  Allergy patch tests                               A   0.00   0.16     0.16NA  0.01   0.17  0.175XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
95052  Photo patch test                                  A   0.00   0.20     0.20NA  0.01   0.21  0.215XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
95056  Photosensitivity tests                            A   0.00   1.38     1.38NA  0.01   1.39  1.395XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
95060  Eye allergy tests                                 A   0.00   1.03     1.03NA  0.01   1.04  1.043XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
95065  Nose allergy test                                 A   0.00   0.80     0.80NA  0.01   0.81  0.813XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
95070  Bronchial allergy tests                           A   0.00   0.92     0.92NA  0.01   0.93  0.933XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
95071  Bronchial allergy tests                           A   0.00   1.05     1.05NA  0.01   1.06  1.063XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
95076  Ingest challenge ini 120 min                      A   1.50   1.87     0.55    0.05   3.42  2.100XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95079  Ingest challenge addl 60 min                      A   1.38   0.98     0.51    0.05   2.41  1.940ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95115  Immunotherapy one injection                       A   0.00   0.27     0.27NA  0.01   0.28  0.285XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95117  Immunotherapy injections                          A   0.00   0.31     0.31NA  0.01   0.32  0.325XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95120  Immunotherapy one injection                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
95125  Immunotherapy 2/> injections                      I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
95130  Immntx 1 sting insect                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
95131  Immntx 2 sting insects                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
95132  Immntx 3 sting insects                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
95133  Immntx 4 sting insects                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
95134  Immntx 5 sting insects                            I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
95144  Antigen therapy services                          A   0.06   0.31     0.02    0.01   0.38  0.090XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95145  Antigen therapy services                          A   0.06   0.59     0.02    0.01   0.66  0.090XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95146  Antigen therapy services                          A   0.06   1.12     0.02    0.01   1.19  0.090XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95147  Antigen therapy services                          A   0.06   1.00     0.02    0.01   1.07  0.090XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95148  Antigen therapy services                          A   0.06   1.54     0.02    0.01   1.61  0.090XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95149  Antigen therapy services                          A   0.06   2.09     0.02    0.01   2.16  0.090XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95165  Antigen therapy services                          A   0.06   0.32     0.02    0.01   0.39  0.090XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95170  Antigen therapy services                          A   0.06   0.22     0.02    0.01   0.29  0.090XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95180  Rapid desensitization                             A   2.01   1.81     0.83    0.07   3.89  2.910XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95199  Allergy immunology services                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95250  Glucose monitoring cont                           A   0.00   4.88     4.88NA  0.01   4.89  4.893XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95251  Gluc monitor cont phys i&r                        A   0.85   0.36     0.36    0.04   1.25  1.252XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95782  Polysom <6 yrs 4/> paramtrs                       A   2.60  28.46    28.46NA  0.29  31.35 31.351XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95782TCPolysom <6 yrs 4/> paramtrs                       A   0.00  27.41    27.41NA  0.19  27.60 27.601XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
9578226Polysom <6 yrs 4/> paramtrs                       A   2.60   1.05     1.05    0.10   3.75  3.751XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95783  Polysom <6 yrs cpap/bilvl                         A   2.83  29.67    29.67NA  0.33  32.83 32.831XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95783TCPolysom <6 yrs cpap/bilvl                         A   0.00  28.53    28.53NA  0.21  28.74 28.741XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
9578326Polysom <6 yrs cpap/bilvl                         A   2.83   1.14     1.14    0.12   4.09  4.091XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95800  Slp stdy unattended                               A   1.05   4.27     4.27NA  0.05   5.37  5.371XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95800TCSlp stdy unattended                               A   0.00   3.86     3.86NA  0.01   3.87  3.871XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9580026Slp stdy unattended                               A   1.05   0.41     0.41    0.04   1.50  1.501XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95801  Slp stdy unatnd w/anal                            A   1.00   1.75     1.75NA  0.05   2.80  2.801XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95801TCSlp stdy unatnd w/anal                            A   0.00   1.39     1.39NA  0.01   1.40  1.401XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9580126Slp stdy unatnd w/anal                            A   1.00   0.36     0.36    0.04   1.40  1.401XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95803  Actigraphy testing                                A   0.90   3.53     3.53NA  0.05   4.48  4.481XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95803TCActigraphy testing                                A   0.00   3.18     3.18NA  0.01   3.19  3.191XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9580326Actigraphy testing                                A   0.90   0.35     0.35    0.04   1.29  1.291XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95805  Multiple sleep latency test                       A   1.20  11.34    11.34NA  0.08  12.62 12.621XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95805TCMultiple sleep latency test                       A   0.00  10.89    10.89NA  0.04  10.93 10.931XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9580526Multiple sleep latency test                       A   1.20   0.45     0.45    0.04   1.69  1.691XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95806  Sleep study unatt&resp efft                       A   1.25   4.06     4.06NA  0.08   5.39  5.391XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95806TCSleep study unatt&resp efft                       A   0.00   3.57     3.57NA  0.03   3.60  3.601XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9580626Sleep study unatt&resp efft                       A   1.25   0.49     0.49    0.05   1.79  1.791XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95807  Sleep study attended                              A   1.28  13.26    13.26NA  0.15  14.69 14.691XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95807TCSleep study attended                              A   0.00  12.80    12.80NA  0.10  12.90 12.901XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9580726Sleep study attended                              A   1.28   0.46     0.46    0.05   1.79  1.791XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95808  Polysom any age 1-3> param                        A   1.74  17.32    17.32NA  0.17  19.23 19.231XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95808TCPolysom any age 1-3> param                        A   0.00  16.64    16.64NA  0.10  16.74 16.741XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9580826Polysom any age 1-3> param                        A   1.74   0.68     0.68    0.07   2.49  2.491XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95810  Polysom 6/> yrs 4/> param                         A   2.50  16.28    16.28NA  0.21  18.99 18.991XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95810TCPolysom 6/> yrs 4/> param                         A   0.00  15.36    15.36NA  0.11  15.47 15.471XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9581026Polysom 6/> yrs 4/> param                         A   2.50   0.92     0.92    0.10   3.52  3.521XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95811  Polysom 6/>yrs cpap 4/> parm                      A   2.60  17.09    17.09NA  0.23  19.92 19.921XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95811TCPolysom 6/>yrs cpap 4/> parm                      A   0.00  16.14    16.14NA  0.12  16.26 16.261XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9581126Polysom 6/>yrs cpap 4/> parm                      A   2.60   0.95     0.95    0.11   3.66  3.661XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95812  Eeg 41-60 minutes                                 A   1.08  12.17    12.17NA  0.07  13.32 13.321XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95812TCEeg 41-60 minutes                                 A   0.00  11.65    11.65NA  0.03  11.68 11.681XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9581226Eeg 41-60 minutes                                 A   1.08   0.52     0.52    0.04   1.64  1.641XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95813  Eeg over 1 hour                                   A   1.73  13.47    13.47NA  0.11  15.31 15.311XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95813TCEeg over 1 hour                                   A   0.00  12.64    12.64NA  0.04  12.68 12.681XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9581326Eeg over 1 hour                                   A   1.73   0.83     0.83    0.07   2.63  2.631XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95816  Eeg awake and drowsy                              A   1.08  11.06    11.06NA  0.08  12.22 12.221XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95816TCEeg awake and drowsy                              A   0.00  10.53    10.53NA  0.03  10.56 10.561XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9581626Eeg awake and drowsy                              A   1.08   0.53     0.53    0.05   1.66  1.661XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95819  Eeg awake and asleep                              A   1.08  12.89    12.89NA  0.07  14.04 14.041XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95819TCEeg awake and asleep                              A   0.00  12.36    12.36NA  0.03  12.39 12.391XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9581926Eeg awake and asleep                              A   1.08   0.53     0.53    0.04   1.65  1.651XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95822  Eeg coma or sleep only                            A   1.08  11.40    11.40NA  0.07  12.55 12.551XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95822TCEeg coma or sleep only                            A   0.00  10.87    10.87NA  0.03  10.90 10.901XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9582226Eeg coma or sleep only                            A   1.08   0.53     0.53    0.04   1.65  1.651XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95824  Eeg cerebral death only                           C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95824TCEeg cerebral death only                           C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9582426Eeg cerebral death only                           A   0.74   0.36     0.36    0.05   1.15  1.151XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95827  Eeg all night recording                           A   1.08  22.67    22.67NA  0.13  23.88 23.881XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95827TCEeg all night recording                           A   0.00  22.15    22.15NA  0.08  22.23 22.231XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9582726Eeg all night recording                           A   1.08   0.52     0.52    0.05   1.65  1.651XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95829  Surgery electrocorticogram                        A   6.20  51.55    51.55NA  0.21  57.96 57.961XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95829TCSurgery electrocorticogram                        A   0.00  48.55    48.55NA  0.05  48.60 48.601XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9582926Surgery electrocorticogram                        A   6.20   3.00     3.00    0.16   9.36  9.361XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95830  Insert electrodes for EEG                         A   1.70   6.06     0.83    0.14   7.90  2.670XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95831  Limb muscle testing manual                        A   0.28   0.54     0.11    0.03   0.85  0.420XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95832  Hand muscle testing manual                        A   0.29   0.49     0.12    0.03   0.81  0.440XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95833  Body muscle testing manual                        A   0.47   0.62     0.13    0.01   1.10  0.610XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95834  Body muscle testing manual                        A   0.60   0.90     0.26    0.03   1.53  0.890XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95851  Range of motion measurements                      A   0.16   0.37     0.05    0.01   0.54  0.220XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95852  Range of motion measurements                      A   0.11   0.38     0.05    0.01   0.50  0.170XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95857  Cholinesterase challenge                          A   0.53   1.01     0.29    0.04   1.58  0.860XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95860  Muscle test one limb                              A   0.96   2.74     2.74NA  0.04   3.74  3.741XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95860TCMuscle test one limb                              A   0.00   2.24     2.24NA  0.01   2.25  2.251XXX.00.00.0000000             25.0008 6A0 99      0.00   0.00   0.00
9586026Muscle test one limb                              A   0.96   0.50     0.50    0.03   1.49  1.491XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95861  Muscle test 2 limbs                               A   1.54   3.53     3.53NA  0.06   5.13  5.131XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95861TCMuscle test 2 limbs                               A   0.00   2.74     2.74NA  0.01   2.75  2.751XXX.00.00.0000000             25.0008 6A0 99      0.00   0.00   0.00
9586126Muscle test 2 limbs                               A   1.54   0.79     0.79    0.05   2.38  2.381XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95863  Muscle test 3 limbs                               A   1.87   4.32     4.32NA  0.08   6.27  6.271XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95863TCMuscle test 3 limbs                               A   0.00   3.39     3.39NA  0.01   3.40  3.401XXX.00.00.0000000             25.0008 6A0 99      0.00   0.00   0.00
9586326Muscle test 3 limbs                               A   1.87   0.93     0.93    0.07   2.87  2.871XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95864  Muscle test 4 limbs                               A   1.99   5.11     5.11NA  0.08   7.18  7.181XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95864TCMuscle test 4 limbs                               A   0.00   4.12     4.12NA  0.01   4.13  4.131XXX.00.00.0000000             25.0008 6A0 99      0.00   0.00   0.00
9586426Muscle test 4 limbs                               A   1.99   0.99     0.99    0.07   3.05  3.051XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95865  Muscle test larynx                                A   1.57   2.38     2.38NA  0.05   4.00  4.001XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
95865TCMuscle test larynx                                A   0.00   1.63     1.63NA  0.01   1.64  1.641XXX.00.00.0002000             25.0008 6A0 99      0.00   0.00   0.00
9586526Muscle test larynx                                A   1.57   0.75     0.75    0.04   2.36  2.361XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
95866  Muscle test hemidiaphragm                         A   1.25   2.78     2.78NA  0.06   4.09  4.091XXX.00.00.0001000             25.0008 090 99      0.00   0.00   0.00
95866TCMuscle test hemidiaphragm                         A   0.00   2.15     2.15NA  0.01   2.16  2.161XXX.00.00.0001000             25.0008 6A0 99      0.00   0.00   0.00
9586626Muscle test hemidiaphragm                         A   1.25   0.63     0.63    0.05   1.93  1.931XXX.00.00.0001000             25.0008 090 99      0.00   0.00   0.00
95867  Muscle test cran nerv unilat                      A   0.79   2.56     2.56NA  0.04   3.39  3.391XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95867TCMuscle test cran nerv unilat                      A   0.00   2.17     2.17NA  0.01   2.18  2.181XXX.00.00.0000000             25.0008 6A0 99      0.00   0.00   0.00
9586726Muscle test cran nerv unilat                      A   0.79   0.39     0.39    0.03   1.21  1.211XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95868  Muscle test cran nerve bilat                      A   1.18   3.02     3.02NA  0.05   4.25  4.251XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
95868TCMuscle test cran nerve bilat                      A   0.00   2.44     2.44NA  0.01   2.45  2.451XXX.00.00.0002000             25.0008 6A0 99      0.00   0.00   0.00
9586826Muscle test cran nerve bilat                      A   1.18   0.58     0.58    0.04   1.80  1.801XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
95869  Muscle test thor paraspinal                       A   0.37   2.17     2.17NA  0.02   2.56  2.561XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95869TCMuscle test thor paraspinal                       A   0.00   1.99     1.99NA  0.01   2.00  2.001XXX.00.00.0000000             25.0008 6A0 99      0.00   0.00   0.00
9586926Muscle test thor paraspinal                       A   0.37   0.18     0.18    0.01   0.56  0.561XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95870  Muscle test nonparaspinal                         A   0.37   2.30     2.30NA  0.02   2.69  2.691XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95870TCMuscle test nonparaspinal                         A   0.00   2.11     2.11NA  0.01   2.12  2.121XXX.00.00.0000000             25.0008 6A0 99      0.00   0.00   0.00
9587026Muscle test nonparaspinal                         A   0.37   0.19     0.19    0.01   0.57  0.571XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95872  Muscle test one fiber                             A   2.88   2.96     2.96NA  0.12   5.96  5.961XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95872TCMuscle test one fiber                             A   0.00   1.54     1.54NA  0.01   1.55  1.551XXX.00.00.0000000             25.0008 660 99      0.00   0.00   0.00
9587226Muscle test one fiber                             A   2.88   1.42     1.42    0.11   4.41  4.411XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95873  Guide nerv destr elec stim                        A   0.37   1.91     1.91NA  0.02   2.30  2.301ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95873TCGuide nerv destr elec stim                        A   0.00   1.70     1.70NA  0.01   1.71  1.711ZZZ.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9587326Guide nerv destr elec stim                        A   0.37   0.21     0.21    0.01   0.59  0.591ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95874  Guide nerv destr needle emg                       A   0.37   1.81     1.81NA  0.02   2.20  2.201ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95874TCGuide nerv destr needle emg                       A   0.00   1.62     1.62NA  0.01   1.63  1.631ZZZ.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9587426Guide nerv destr needle emg                       A   0.37   0.19     0.19    0.01   0.57  0.571ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95875  Limb exercise test                                A   1.10   2.61     2.61NA  0.06   3.77  3.771XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95875TCLimb exercise test                                A   0.00   2.07     2.07NA  0.01   2.08  2.081XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9587526Limb exercise test                                A   1.10   0.54     0.54    0.05   1.69  1.691XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95885  Musc tst done w/nerv tst lim                      A   0.35   1.43     1.43NA  0.02   1.80  1.801ZZZ.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
95885TCMusc tst done w/nerv tst lim                      A   0.00   1.25     1.25NA  0.01   1.26  1.261ZZZ.00.00.0003000             25.0008 6A0 99      0.00   0.00   0.00
9588526Musc tst done w/nerv tst lim                      A   0.35   0.18     0.18    0.01   0.54  0.541ZZZ.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
95886  Musc test done w/n test comp                      A   0.70   1.76     1.76NA  0.03   2.49  2.491ZZZ.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
95886TCMusc test done w/n test comp                      A   0.00   1.40     1.40NA  0.01   1.41  1.411ZZZ.00.00.0003000             25.0008 6A0 99      0.00   0.00   0.00
9588626Musc test done w/n test comp                      A   0.70   0.36     0.36    0.02   1.08  1.081ZZZ.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
95887  Musc tst done w/n tst nonext                      A   0.47   1.60     1.60NA  0.02   2.09  2.091ZZZ.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
95887TCMusc tst done w/n tst nonext                      A   0.00   1.37     1.37NA  0.01   1.38  1.381ZZZ.00.00.0003000             25.0008 6A0 99      0.00   0.00   0.00
9588726Musc tst done w/n tst nonext                      A   0.47   0.23     0.23    0.01   0.71  0.711ZZZ.00.00.0003000             25.0008 090 99      0.00   0.00   0.00
95905  Motor &/ sens nrve cndj test                      A   0.05   2.02     2.02NA  0.02   2.09  2.091XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95905TCMotor &/ sens nrve cndj test                      A   0.00   2.00     2.00NA  0.01   2.01  2.011XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9590526Motor &/ sens nrve cndj test                      A   0.05   0.02     0.02    0.01   0.08  0.081XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95907  Motor&/sens 1-2 nrv cndj tst                      A   1.00   1.72     1.72NA  0.06   2.78  2.781XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95907TCMotor&/sens 1-2 nrv cndj tst                      A   0.00   1.23     1.23NA  0.03   1.26  1.261XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
9590726Motor&/sens 1-2 nrv cndj tst                      A   1.00   0.49     0.49    0.03   1.52  1.521XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95908  Motor&/sens 3-4 nrv cndj tst                      A   1.25   2.11     2.11NA  0.07   3.43  3.431XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95908TCMotor&/sens 3-4 nrv cndj tst                      A   0.00   1.49     1.49NA  0.03   1.52  1.521XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
9590826Motor&/sens 3-4 nrv cndj tst                      A   1.25   0.62     0.62    0.04   1.91  1.911XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95909  Motor&/sens 5-6 nrv cndj tst                      A   1.50   2.52     2.52NA  0.09   4.11  4.111XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95909TCMotor&/sens 5-6 nrv cndj tst                      A   0.00   1.78     1.78NA  0.05   1.83  1.831XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
9590926Motor&/sens 5-6 nrv cndj tst                      A   1.50   0.74     0.74    0.04   2.28  2.281XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95910  Motor&sens 7-8 nrv cndj test                      A   2.00   3.29     3.29NA  0.12   5.41  5.411XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95910TCMotor&sens 7-8 nrv cndj test                      A   0.00   2.30     2.30NA  0.06   2.36  2.361XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
9591026Motor&sens 7-8 nrv cndj test                      A   2.00   0.99     0.99    0.06   3.05  3.051XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95911  Motor&sen 9-10 nrv cndj test                      A   2.50   3.89     3.89NA  0.15   6.54  6.541XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95911TCMotor&sen 9-10 nrv cndj test                      A   0.00   2.66     2.66NA  0.08   2.74  2.741XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
9591126Motor&sen 9-10 nrv cndj test                      A   2.50   1.23     1.23    0.07   3.80  3.801XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95912  Motor&sen 11-12 nrv cnd test                      A   3.00   4.49     4.49NA  0.18   7.67  7.671XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95912TCMotor&sen 11-12 nrv cnd test                      A   0.00   3.01     3.01NA  0.09   3.10  3.101XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
9591226Motor&sen 11-12 nrv cnd test                      A   3.00   1.48     1.48    0.09   4.57  4.571XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95913  Motor&sens 13/> nrv cnd test                      A   3.56   5.11     5.11NA  0.21   8.88  8.881XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95913TCMotor&sens 13/> nrv cnd test                      A   0.00   3.36     3.36NA  0.11   3.47  3.471XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
9591326Motor&sens 13/> nrv cnd test                      A   3.56   1.75     1.75    0.10   5.41  5.411XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95921  Autonomic nrv parasym inervj                      A   0.90   1.71     1.71NA  0.05   2.66  2.661XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95921TCAutonomic nrv parasym inervj                      A   0.00   1.33     1.33NA  0.01   1.34  1.341XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9592126Autonomic nrv parasym inervj                      A   0.90   0.38     0.38    0.04   1.32  1.321XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95922  Autonomic nrv adrenrg inervj                      A   0.96   2.19     2.19NA  0.05   3.20  3.201XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95922TCAutonomic nrv adrenrg inervj                      A   0.00   1.77     1.77NA  0.01   1.78  1.781XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9592226Autonomic nrv adrenrg inervj                      A   0.96   0.42     0.42    0.04   1.42  1.421XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95923  Autonomic nrv syst funj test                      A   0.90   6.78     6.78NA  0.05   7.73  7.731XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95923TCAutonomic nrv syst funj test                      A   0.00   6.35     6.35NA  0.01   6.36  6.361XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9592326Autonomic nrv syst funj test                      A   0.90   0.43     0.43    0.04   1.37  1.371XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95924  Ans parasymp & symp w/tilt                        A   1.73   2.51     2.51NA  0.09   4.33  4.331XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95924TCAns parasymp & symp w/tilt                        A   0.00   1.78     1.78NA  0.01   1.79  1.791XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
9592426Ans parasymp & symp w/tilt                        A   1.73   0.73     0.73    0.08   2.54  2.541XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95925  Somatosensory testing                             A   0.54   5.23     5.23NA  0.02   5.79  5.791XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
95925TCSomatosensory testing                             A   0.00   4.97     4.97NA  0.01   4.98  4.981XXX.00.00.0002000             25.0008 210 99      0.00   0.00   0.00
9592526Somatosensory testing                             A   0.54   0.26     0.26    0.01   0.81  0.811XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
95926  Somatosensory testing                             A   0.54   5.02     5.02NA  0.04   5.60  5.601XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
95926TCSomatosensory testing                             A   0.00   4.76     4.76NA  0.01   4.77  4.771XXX.00.00.0002000             25.0008 210 99      0.00   0.00   0.00
9592626Somatosensory testing                             A   0.54   0.26     0.26    0.03   0.83  0.831XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
95927  Somatosensory testing                             A   0.54   4.51     4.51NA  0.02   5.07  5.071XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95927TCSomatosensory testing                             A   0.00   4.27     4.27NA  0.01   4.28  4.281XXX.00.00.0000000             25.0008 210 99      0.00   0.00   0.00
9592726Somatosensory testing                             A   0.54   0.24     0.24    0.01   0.79  0.791XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95928  C motor evoked uppr limbs                         A   1.50   7.11     7.11NA  0.10   8.71  8.711XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
95928TCC motor evoked uppr limbs                         A   0.00   6.38     6.38NA  0.03   6.41  6.411XXX.00.00.0002000             25.0008 210 99      0.00   0.00   0.00
9592826C motor evoked uppr limbs                         A   1.50   0.73     0.73    0.07   2.30  2.301XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
95929  C motor evoked lwr limbs                          A   1.50   7.16     7.16NA  0.10   8.76  8.761XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
95929TCC motor evoked lwr limbs                          A   0.00   6.43     6.43NA  0.03   6.46  6.461XXX.00.00.0002000             25.0008 210 99      0.00   0.00   0.00
9592926C motor evoked lwr limbs                          A   1.50   0.73     0.73    0.07   2.30  2.301XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
95930  Visual evoked potential test                      A   0.35   4.46     4.46NA  0.02   4.83  4.831XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
95930TCVisual evoked potential test                      A   0.00   4.29     4.29NA  0.01   4.30  4.301XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
9593026Visual evoked potential test                      A   0.35   0.17     0.17    0.01   0.53  0.531XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
95933  Blink reflex test                                 A   0.59   2.08     2.08NA  0.04   2.71  2.711XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95933TCBlink reflex test                                 A   0.00   1.79     1.79NA  0.01   1.80  1.801XXX.00.00.0000000             25.0008 7A0 99      0.00   0.00   0.00
9593326Blink reflex test                                 A   0.59   0.29     0.29    0.03   0.91  0.911XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95937  Neuromuscular junction test                       A   0.65   1.63     1.63NA  0.05   2.33  2.331XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95937TCNeuromuscular junction test                       A   0.00   1.33     1.33NA  0.01   1.34  1.341XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
9593726Neuromuscular junction test                       A   0.65   0.30     0.30    0.04   0.99  0.991XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95938  Somatosensory testing                             A   0.86   8.88     8.88NA  0.07   9.81  9.811XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
95938TCSomatosensory testing                             A   0.00   8.46     8.46NA  0.03   8.49  8.491XXX.00.00.0002000             25.0008 210 99      0.00   0.00   0.00
9593826Somatosensory testing                             A   0.86   0.42     0.42    0.04   1.32  1.321XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
95939  C motor evoked upr&lwr limbs                      A   2.25  12.57    12.57NA  0.15  14.97 14.971XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
95939TCC motor evoked upr&lwr limbs                      A   0.00  11.48    11.48NA  0.04  11.52 11.521XXX.00.00.0002000             25.0008 210 99      0.00   0.00   0.00
9593926C motor evoked upr&lwr limbs                      A   2.25   1.09     1.09    0.11   3.45  3.451XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
95940  Ionm in operatng room 15 min                      A   0.60   0.30NA   0.30    0.03   0.93  0.930XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
95941  Ionm remote/>1 pt or per hr                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
95943  Parasymp&symp hrt rate test                       C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95943TCParasymp&symp hrt rate test                       C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
9594326Parasymp&symp hrt rate test                       C   0.00   0.00     0.00    0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95950  Ambulatory eeg monitoring                         A   1.51   8.67     8.67NA  0.10  10.28 10.281XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95950TCAmbulatory eeg monitoring                         A   0.00   7.94     7.94NA  0.03   7.97  7.971XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9595026Ambulatory eeg monitoring                         A   1.51   0.73     0.73    0.07   2.31  2.311XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95951  EEG monitoring/videorecord                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95951TCEEG monitoring/videorecord                        C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9595126EEG monitoring/videorecord                        A   5.99   2.93     2.93    0.48   9.40  9.401XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95953  EEG monitoring/computer                           A   3.08   9.77     9.77NA  0.18  13.03 13.031XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95953TCEEG monitoring/computer                           A   0.00   8.29     8.29NA  0.03   8.32  8.321XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9595326EEG monitoring/computer                           A   3.08   1.48     1.48    0.15   4.71  4.711XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95954  EEG monitoring/giving drugs                       A   2.45  11.43    11.43NA  0.15  14.03 14.031XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95954TCEEG monitoring/giving drugs                       A   0.00  10.43    10.43NA  0.04  10.47 10.471XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9595426EEG monitoring/giving drugs                       A   2.45   1.00     1.00    0.11   3.56  3.561XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95955  EEG during surgery                                A   1.01   5.96     5.96NA  0.05   7.02  7.021XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95955TCEEG during surgery                                A   0.00   5.46     5.46NA  0.01   5.47  5.471XXX.00.00.0000000             25.0008 020 99      0.00   0.00   0.00
9595526EEG during surgery                                A   1.01   0.50     0.50    0.04   1.55  1.551XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95956  Eeg monitor technol attended                      A   3.61  47.24    47.24NA  0.32  51.17 51.171XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95956TCEeg monitor technol attended                      A   0.00  45.51    45.51NA  0.16  45.67 45.671XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9595626Eeg monitor technol attended                      A   3.61   1.73     1.73    0.16   5.50  5.501XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95957  EEG digital analysis                              A   1.98  11.60    11.60NA  0.11  13.69 13.691XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95957TCEEG digital analysis                              A   0.00  10.65    10.65NA  0.01  10.66 10.661XXX.00.00.0000000             25.0008 010 99      0.00   0.00   0.00
9595726EEG digital analysis                              A   1.98   0.95     0.95    0.10   3.03  3.031XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95958  EEG monitoring/function test                      A   4.24  12.74    12.74NA  0.26  17.24 17.241XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95958TCEEG monitoring/function test                      A   0.00  10.78    10.78NA  0.04  10.82 10.821XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9595826EEG monitoring/function test                      A   4.24   1.96     1.96    0.22   6.42  6.421XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95961  Electrode stimulation brain                       A   2.97   5.32     5.32NA  0.15   8.44  8.441XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95961TCElectrode stimulation brain                       A   0.00   3.90     3.90NA  0.01   3.91  3.911XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9596126Electrode stimulation brain                       A   2.97   1.42     1.42    0.14   4.53  4.531XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95962  Electrode stim brain add-on                       A   3.21   3.95     3.95NA  0.15   7.31  7.311ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95962TCElectrode stim brain add-on                       A   0.00   2.42     2.42NA  0.01   2.43  2.431ZZZ.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9596226Electrode stim brain add-on                       A   3.21   1.53     1.53    0.14   4.88  4.881ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95965  Meg spontaneous                                   C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95965TCMeg spontaneous                                   C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
9596526Meg spontaneous                                   A   7.99   3.92     3.92    0.64  12.55 12.551XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95966  Meg evoked single                                 C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95966TCMeg evoked single                                 C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
9596626Meg evoked single                                 A   3.99   1.47     1.47    0.31   5.77  5.771XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95967  Meg evoked each addl                              C   0.00   0.00     0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95967TCMeg evoked each addl                              C   0.00   0.00     0.00NA  0.00   0.00  0.001ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
9596726Meg evoked each addl                              A   3.49   1.29     1.29    0.29   5.07  5.071ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95970  Analyze neurostim no prog                         A   0.45   1.62     0.21    0.04   2.11  0.700XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95971  Analyze neurostim simple                          A   0.78   0.92     0.33    0.07   1.77  1.180XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95972  Analyze neurostim complex                         A   1.50   1.59     0.64    0.14   3.23  2.280XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95973  Analyze neurostim complex                         A   0.92   0.85     0.41    0.08   1.85  1.410ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95974  Cranial neurostim complex                         A   3.00   2.78     1.43    0.26   6.04  4.690XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95975  Cranial neurostim complex                         A   1.70   1.41     0.83    0.12   3.23  2.650ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95978  Analyze neurostim brain/1h                        A   3.50   3.47     1.71    0.38   7.35  5.590XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95979  Analyz neurostim brain addon                      A   1.64   1.37     0.80    0.14   3.15  2.580ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95980  Io anal gast n-stim init                          A   0.80   0.40NA   0.40    0.16   1.36  1.360XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95981  Io anal gast n-stim subsq                         A   0.30   0.66     0.19    0.03   0.99  0.520XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95982  Io ga n-stim subsq w/reprog                       A   0.65   0.86     0.35    0.05   1.56  1.050XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95990  Spin/brain pump refil & main                      A   0.00   2.80     2.80NA  0.03   2.83  2.835XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95991  Spin/brain pump refil & main                      A   0.77   2.93     0.34    0.05   3.75  1.160XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95992  Canalith repositioning proc                       A   0.75   0.46     0.29    0.05   1.26  1.090XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
95999  Neurological procedure                            C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96000  Motion analysis video/3d                          A   1.80   0.96NA   0.96    0.11   2.87  2.877XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
96001  Motion test w/ft press meas                       A   2.15   0.56NA   0.56    0.12   2.83  2.837XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
96002  Dynamic surface emg                               A   0.41   0.19NA   0.19    0.03   0.63  0.630XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
96003  Dynamic fine wire emg                             A   0.37   0.09NA   0.09    0.03   0.49  0.490XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
96004  Phys review of motion tests                       A   2.14   1.01     1.01    0.14   3.29  3.292XXX.00.00.0002000             25.0008 090 99      0.00   0.00   0.00
96020  Functional brain mapping                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96020TCFunctional brain mapping                          C   0.00   0.00     0.00NA  0.00   0.00  0.001XXX.00.00.0000000             25.0008 030 99      0.00   0.00   0.00
9602026Functional brain mapping                          A   3.43   1.10     1.10    0.31   4.84  4.841XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96040  Genetic counseling 30 min                         B+  0.00   1.42     1.42NA  0.03   1.45  1.459XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
96101  Psycho testing by psych/phys                      A   1.86   0.50     0.26    0.07   2.43  2.190XXX.00.00.0000000             25.0008 040 99      0.00   0.00   0.00
96102  Psycho testing by technician                      A   0.50   2.00     0.13    0.03   2.53  0.660XXX.00.00.0000000             25.0008 040 99      0.00   0.00   0.00
96103  Psycho testing admin by comp                      A   0.51   1.52     0.21    0.03   2.06  0.750XXX.00.00.0000000             25.0008 040 99      0.00   0.00   0.00
96105  Assessment of aphasia                             A   1.75   0.97     0.97NA  0.04   2.76  2.760XXX.00.00.0000000             25.0008 040 99      0.00   0.00   0.00
96110  Developmental screen                              N+  0.00   0.26     0.26NA  0.01   0.27  0.279XXX.00.00.0099999             25.0008 040 99      0.00   0.00   0.00
96111  Developmental test extend                         A   2.60   0.97     0.76    0.16   3.73  3.520XXX.00.00.0000000             25.0008 040 99      0.00   0.00   0.00
96116  Neurobehavioral status exam                       A   1.86   0.66     0.48    0.10   2.62  2.440XXX.00.00.0000000             25.0008 040 99      0.00   0.00   0.00
96118  Neuropsych tst by psych/phys                      A   1.86   0.76     0.25    0.07   2.69  2.180XXX.00.00.0000000             25.0008 040 99      0.00   0.00   0.00
96119  Neuropsych testing by tec                         A   0.55   1.62     0.09    0.01   2.18  0.650XXX.00.00.0000000             25.0008 040 99      0.00   0.00   0.00
96120  Neuropsych tst admin w/comp                       A   0.51   2.48     0.19    0.03   3.02  0.730XXX.00.00.0000000             25.0008 040 99      0.00   0.00   0.00
96125  Cognitive test by hc pro                          A   1.70   1.40     1.40NA  0.07   3.17  3.177XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
96150  Assess hlth/behave init                           A   0.50   0.08     0.07    0.01   0.59  0.580XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96151  Assess hlth/behave subseq                         A   0.48   0.08     0.07    0.01   0.57  0.560XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96152  Intervene hlth/behave indiv                       A   0.46   0.07     0.06    0.01   0.54  0.530XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96153  Intervene hlth/behave group                       A   0.10   0.02     0.01    0.01   0.13  0.120XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96154  Interv hlth/behav fam w/pt                        A   0.45   0.07     0.06    0.01   0.53  0.520XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96155  Interv hlth/behav fam no pt                       N+  0.44   0.18     0.18    0.03   0.65  0.659XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
96360  Hydration iv infusion init                        A   0.17   1.52     1.52NA  0.03   1.72  1.725XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96361  Hydrate iv infusion add-on                        A   0.09   0.35     0.35NA  0.01   0.45  0.455ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96365  Ther/proph/diag iv inf init                       A   0.21   1.98     1.98NA  0.03   2.22  2.225XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96366  Ther/proph/diag iv inf addon                      A   0.18   0.45     0.45NA  0.01   0.64  0.645ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96367  Tx/proph/dg addl seq iv inf                       A   0.19   0.74     0.74NA  0.01   0.94  0.945ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96368  Ther/diag concurrent inf                          A   0.17   0.37     0.37NA  0.01   0.55  0.555ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96369  Sc ther infusion up to 1 hr                       A   0.21   6.00     6.00NA  0.03   6.24  6.245XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96370  Sc ther infusion addl hr                          A   0.18   0.32     0.32NA  0.01   0.51  0.515ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96371  Sc ther infusion reset pump                       A   0.00   2.97     2.97NA  0.01   2.98  2.985ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96372  Ther/proph/diag inj sc/im                         A   0.17   0.58     0.58NA  0.01   0.76  0.765XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96373  Ther/proph/diag inj ia                            A   0.17   0.41     0.41NA  0.01   0.59  0.595XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96374  Ther/proph/diag inj iv push                       A   0.18   1.48     1.48NA  0.03   1.69  1.695XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96375  Tx/pro/dx inj new drug addon                      A   0.10   0.55     0.55NA  0.01   0.66  0.665ZZZ.00.00.0000000             25.0008 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  0.009ZZZ.00.00.0099999             25.0008 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  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96401  Chemo anti-neopl sq/im                            A   0.21   1.98     1.98NA  0.04   2.23  2.235XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96402  Chemo hormon antineopl sq/im                      A   0.19   0.76     0.76NA  0.01   0.96  0.965XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96405  Chemo intralesional up to 7                       A   0.52   1.92     0.33    0.03   2.47  0.880000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
96406  Chemo intralesional over 7                        A   0.80   2.63     0.49    0.04   3.47  1.330000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
96409  Chemo iv push sngl drug                           A   0.24   3.00     3.00NA  0.05   3.29  3.295XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96411  Chemo iv push addl drug                           A   0.20   1.61     1.61NA  0.03   1.84  1.845ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96413  Chemo iv infusion 1 hr                            A   0.28   3.88     3.88NA  0.05   4.21  4.215XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96415  Chemo iv infusion addl hr                         A   0.19   0.70     0.70NA  0.01   0.90  0.905ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96416  Chemo prolong infuse w/pump                       A   0.21   3.91     3.91NA  0.07   4.19  4.195XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96417  Chemo iv infus each addl seq                      A   0.21   1.85     1.85NA  0.03   2.09  2.095ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96420  Chemo ia push tecnique                            A   0.17   2.92     2.92NA  0.08   3.17  3.175XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96422  Chemo ia infusion up to 1 hr                      A   0.17   4.82     4.82NA  0.08   5.07  5.075XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96423  Chemo ia infuse each addl hr                      A   0.17   2.13     2.13NA  0.04   2.34  2.345ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96425  Chemotherapy infusion method                      A   0.17   5.18     5.18NA  0.10   5.45  5.455XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96440  Chemotherapy intracavitary                        A   2.37  23.70     1.18    0.54  26.61  4.090000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96446  Chemotx admn prtl cavity                          A   0.37   5.44     0.18    0.07   5.88  0.625XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96450  Chemotherapy into cns                             A   1.53   3.69     0.67    0.11   5.33  2.310000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96521  Refill/maint portable pump                        A   0.21   3.88     3.88NA  0.05   4.14  4.145XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96522  Refill/maint pump/resvr syst                      A   0.21   3.10     3.10NA  0.05   3.36  3.365XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96523  Irrig drug delivery device                        T   0.04   0.69     0.69NA  0.01   0.74  0.745XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96542  Chemotherapy injection                            A   0.75   2.79     0.40    0.04   3.58  1.190XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96549  Chemotherapy unspecified                          C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96567  Photodynamic tx skin                              A   0.00   4.22     4.22NA  0.01   4.23  4.235XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96570  Photodynmc tx 30 min add-on                       A   1.10   0.39     0.39    0.18   1.67  1.670ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
96571  Photodynamic tx addl 15 min                       A   0.55   0.18     0.18    0.04   0.77  0.770ZZZ.00.00.0000100             25.0008 090 99      0.00   0.00   0.00
96900  Ultraviolet light therapy                         A   0.00   0.64     0.64NA  0.01   0.65  0.655XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96902  Trichogram                                        B+  0.41   0.19     0.17    0.03   0.63  0.619XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
96904  Whole body photography                            R   0.00   2.13     2.13NA  0.01   2.14  2.145XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96910  Photochemotherapy with UV-B                       A   0.00   2.23     2.23NA  0.01   2.24  2.245XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96912  Photochemotherapy with UV-A                       A   0.00   2.86     2.86NA  0.01   2.87  2.875XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96913  Photochemotherapy uv-a or b                       A   0.00   4.03     4.03NA  0.01   4.04  4.045XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
96920  Laser tx skin < 250 sq cm                         A   1.15   3.47     0.75    0.04   4.66  1.940000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
96921  Laser tx skin 250-500 sq cm                       A   1.30   3.78     0.85    0.04   5.12  2.190000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
96922  Laser tx skin >500 sq cm                          A   2.10   4.92     1.38    0.08   7.10  3.560000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
96999  Dermatological procedure                          C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
97001  Pt evaluation                                     A   1.20   0.94     0.94NA  0.05   2.19  2.197XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97002  Pt re-evaluation                                  A   0.60   0.61     0.61NA  0.03   1.24  1.247XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97003  Ot evaluation                                     A   1.20   1.24     1.24NA  0.05   2.49  2.497XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97004  Ot re-evaluation                                  A   0.60   0.94     0.94NA  0.03   1.57  1.577XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97005  Athletic train eval                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
97006  Athletic train reeval                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
97010  Hot or cold packs therapy                         B+  0.06   0.11     0.11NA  0.01   0.18  0.189XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
97012  Mechanical traction therapy                       A   0.25   0.21     0.21NA  0.01   0.47  0.477XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97014  Electric stimulation therapy                      I+  0.18   0.28     0.28NA  0.01   0.47  0.479XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
97016  Vasopneumatic device therapy                      A   0.18   0.38     0.38NA  0.01   0.57  0.577XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97018  Paraffin bath therapy                             A   0.06   0.26     0.26NA  0.01   0.33  0.337XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97022  Whirlpool therapy                                 A   0.17   0.52     0.52NA  0.01   0.70  0.707XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97024  Diathermy eg microwave                            A   0.06   0.12     0.12NA  0.01   0.19  0.197XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97026  Infrared therapy                                  R   0.06   0.11     0.11NA  0.01   0.18  0.187XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97028  Ultraviolet therapy                               A   0.08   0.13     0.13NA  0.01   0.22  0.227XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97032  Electrical stimulation                            A   0.25   0.30     0.30NA  0.01   0.56  0.567XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97033  Electric current therapy                          A   0.26   0.70     0.70NA  0.01   0.97  0.977XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97034  Contrast bath therapy                             A   0.21   0.31     0.31NA  0.01   0.53  0.537XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97035  Ultrasound therapy                                A   0.21   0.15     0.15NA  0.01   0.37  0.377XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97036  Hydrotherapy                                      A   0.28   0.69     0.69NA  0.01   0.98  0.987XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97039  Physical therapy treatment                        C   0.00   0.00     0.00    0.00   0.00  0.007XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
97110  Therapeutic exercises                             A   0.45   0.48     0.48NA  0.01   0.94  0.947XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97112  Neuromuscular reeducation                         A   0.45   0.52     0.52NA  0.01   0.98  0.987XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97113  Aquatic therapy/exercises                         A   0.44   0.83     0.83NA  0.01   1.28  1.287XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97116  Gait training therapy                             A   0.40   0.42     0.42NA  0.01   0.83  0.837XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97124  Massage therapy                                   A   0.35   0.41     0.41NA  0.01   0.77  0.777XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97139  Physical medicine procedure                       C   0.00   0.00     0.00    0.00   0.00  0.007XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
97140  Manual therapy 1/> regions                        A   0.43   0.44     0.44NA  0.01   0.88  0.887XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97150  Group therapeutic procedures                      A   0.29   0.17     0.17NA  0.01   0.47  0.477XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97530  Therapeutic activities                            A   0.44   0.58     0.58NA  0.01   1.03  1.037XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97532  Cognitive skills development                      A   0.44   0.32     0.32NA  0.01   0.77  0.777XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
97533  Sensory integration                               A   0.44   0.40     0.40NA  0.01   0.85  0.857XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97535  Self care mngment training                        A   0.45   0.56     0.56NA  0.01   1.02  1.027XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97537  Community/work reintegration                      A   0.45   0.42     0.42NA  0.01   0.88  0.887XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97542  Wheelchair mngment training                       A   0.45   0.43     0.43NA  0.01   0.89  0.897XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97545  Work hardening                                    R   0.00   0.00     0.00    0.00   0.00  0.007XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
97546  Work hardening add-on                             R   0.00   0.00     0.00    0.00   0.00  0.007ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
97597  Rmvl devital tis 20 cm/<                          A   0.51   1.74     0.13    0.05   2.30  0.690000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
97598  Rmvl devital tis addl 20cm/<                      A   0.24   0.48     0.06    0.03   0.75  0.330ZZZ.00.00.0000000             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
97605  Neg press wound tx </=50 cm                       A   0.55   0.62     0.14    0.08   1.25  0.770XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
97606  Neg press wound tx >50 cm                         A   0.60   0.63     0.16    0.10   1.33  0.860XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
97750  Physical performance test                         A   0.45   0.50     0.50NA  0.03   0.98  0.987XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97755  Assistive technology assess                       A   0.62   0.40     0.40NA  0.03   1.05  1.057XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97760  Orthotic mgmt and training                        A   0.45   0.65     0.65NA  0.03   1.13  1.137XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97761  Prosthetic training                               A   0.45   0.50     0.50NA  0.03   0.98  0.987XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97762  C/o for orthotic/prosth use                       A   0.25   1.18     1.18NA  0.01   1.44  1.447XXX.00.00.0050000             25.0008 090 99      0.00   0.00   0.00
97799  Physical medicine procedure                       C   0.00   0.00     0.00    0.00   0.00  0.007XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
97802  Medical nutrition indiv in                        A   0.53   0.48     0.40    0.03   1.04  0.960XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
97803  Med nutrition indiv subseq                        A   0.45   0.42     0.34    0.03   0.90  0.820XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
97804  Medical nutrition group                           A   0.25   0.20     0.19    0.01   0.46  0.450XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
97810  Acupunct w/o stimul 15 min                        N+  0.60   0.41     0.24    0.04   1.05  0.889XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
97811  Acupunct w/o stimul addl 15m                      N+  0.50   0.26     0.20    0.03   0.79  0.739ZZZ.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
97813  Acupunct w/stimul 15 min                          N+  0.65   0.43     0.26    0.04   1.12  0.959XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
97814  Acupunct w/stimul addl 15m                        N+  0.55   0.31     0.22    0.04   0.90  0.819ZZZ.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
98925  Osteopath manj 1-2 regions                        A   0.46   0.42     0.19    0.03   0.91  0.680000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
98926  Osteopath manj 3-4 regions                        A   0.71   0.57     0.28    0.03   1.31  1.020000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
98927  Osteopath manj 5-6 regions                        A   0.96   0.72     0.35    0.04   1.72  1.350000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
98928  Osteopath manj 7-8 regions                        A   1.21   0.85     0.45    0.06   2.12  1.720000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
98929  Osteopath manj 9-10 regions                       A   1.46   0.98     0.52    0.09   2.53  2.070000.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
98940  Chiropract manj 1-2 regions                       A   0.45   0.31     0.15    0.01   0.77  0.610000.00.00.0000000             25.0008 093 99      0.00   0.00   0.00
98941  Chiropract manj 3-4 regions                       A   0.65   0.39     0.21    0.03   1.07  0.890000.00.00.0000000             25.0008 093 99      0.00   0.00   0.00
98942  Chiropractic manj 5 regions                       A   0.87   0.47     0.29    0.03   1.37  1.190000.00.00.0000000             25.0008 093 99      0.00   0.00   0.00
98943  Chiropract manj xtrspinl 1/>                      N+  0.40   0.28     0.16    0.03   0.71  0.599XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
98960  Self-mgmt educ & train 1 pt                       B+  0.00   0.84     0.84NA  0.01   0.85  0.859XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
98961  Self-mgmt educ/train 2-4 pt                       B+  0.00   0.40     0.40NA  0.01   0.41  0.419XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
98962  Self-mgmt educ/train 5-8 pt                       B+  0.00   0.29     0.29NA  0.01   0.30  0.309XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
98966  Hc pro phone call 5-10 min                        N+  0.25   0.14     0.10    0.01   0.40  0.369XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
98967  Hc pro phone call 11-20 min                       N+  0.50   0.24     0.20    0.03   0.77  0.739XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
98968  Hc pro phone call 21-30 min                       N+  0.75   0.34     0.30    0.05   1.14  1.109XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99000  Specimen handling office-lab                      B   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99001  Specimen handling pt-lab                          B   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99002  Device handling phys/qhp                          B   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99024  Postop follow-up visit                            B   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99050  Medical services after hrs                        B   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99058  Office emergency care                             B   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99070  Special supplies phys/qhp                         B   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99071  Patient education materials                       B   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99075  Medical testimony                                 N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99078  Group health education                            B   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99080  Special reports or forms                          B   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99082  Unusual physician travel                          C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99090  Computer data analysis                            B   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99091  Collect/review data from pt                       B+  1.10   0.44     0.44NA  0.07   1.61  1.619XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99100  Special anesthesia service                        B   0.00   0.00     0.00    0.00   0.00  0.009ZZZ.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99116  Anesthesia with hypothermia                       B   0.00   0.00     0.00    0.00   0.00  0.009ZZZ.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99135  Special anesthesia procedure                      B   0.00   0.00     0.00    0.00   0.00  0.009ZZZ.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99140  Emergency anesthesia                              B   0.00   0.00     0.00    0.00   0.00  0.009ZZZ.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99143  Mod sedat phys/qhp <5 yrs                         C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99144  Mod sedat phys/qhp 5yrs/>                         C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99145  Mod sedat phys/qhp ea 15 min                      C   0.00   0.00     0.00    0.00   0.00  0.000ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99148  Mod sed diff phys/qhp<5 yrs                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99149  Mod sed diff phys/qhp 5/>yrs                      C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99150  Mod sed diff phys/qhp add on                      C   0.00   0.00     0.00    0.00   0.00  0.000ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99170  Anogenital exam child                             A   1.75   1.83     0.69    0.12   3.70  2.560000.00.00.0020100             25.0008 090 99      0.00   0.00   0.00
99172  Ocular function screen                            N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99173  Visual acuity screen                              N+  0.00   0.08     0.08NA  0.01   0.09  0.099XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99174  Ocular instrumnt screen bil                       N+  0.00   0.89     0.89NA  0.01   0.90  0.909XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99175  Induction of vomiting                             A   0.00   0.49     0.49NA  0.01   0.50  0.505XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99183  Hyperbaric oxygen therapy                         A   2.34   3.80     0.92    0.26   6.40  3.520XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99190  Special pump services                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99191  Special pump services                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99192  Special pump services                             X   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99195  Phlebotomy                                        A   0.00   2.97     2.97NA  0.05   3.02  3.025XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99199  Special service/proc/report                       C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99201  Office/outpatient visit new                       A   0.48   0.77     0.24    0.04   1.29  0.760XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99202  Office/outpatient visit new                       A   0.93   1.19     0.44    0.07   2.19  1.440XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99203  Office/outpatient visit new                       A   1.42   1.61     0.64    0.14   3.17  2.200XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99204  Office/outpatient visit new                       A   2.43   2.18     1.10    0.23   4.84  3.760XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99205  Office/outpatient visit new                       A   3.17   2.55     1.39    0.27   5.99  4.830XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99211  Office/outpatient visit est                       A   0.18   0.41     0.07    0.01   0.60  0.260XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99212  Office/outpatient visit est                       A   0.48   0.77     0.20    0.04   1.29  0.720XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99213  Office/outpatient visit est                       A   0.97   1.09     0.42    0.07   2.13  1.460XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99214  Office/outpatient visit est                       A   1.50   1.53     0.65    0.10   3.13  2.250XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99215  Office/outpatient visit est                       A   2.11   1.95     0.92    0.14   4.20  3.170XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99217  Observation care discharge                        A   1.28   0.72NA   0.72    0.08   2.08  2.080XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99218  Initial observation care                          A   1.92   0.80NA   0.80    0.12   2.84  2.840XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99219  Initial observation care                          A   2.60   1.10NA   1.10    0.17   3.87  3.870XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99220  Initial observation care                          A   3.56   1.50NA   1.50    0.24   5.30  5.300XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99221  Initial hospital care                             A   1.92   0.81NA   0.81    0.18   2.91  2.910XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99222  Initial hospital care                             A   2.61   1.12NA   1.12    0.22   3.95  3.950XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99223  Initial hospital care                             A   3.86   1.66NA   1.66    0.29   5.81  5.810XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99224  Subsequent observation care                       A   0.76   0.32NA   0.32    0.06   1.14  1.140XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99225  Subsequent observation care                       A   1.39   0.60NA   0.60    0.07   2.06  2.060XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99226  Subsequent observation care                       A   2.00   0.86NA   0.86    0.11   2.97  2.970XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99231  Subsequent hospital care                          A   0.76   0.31NA   0.31    0.05   1.12  1.120XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99232  Subsequent hospital care                          A   1.39   0.59NA   0.59    0.08   2.06  2.060XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99233  Subsequent hospital care                          A   2.00   0.85NA   0.85    0.12   2.97  2.970XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99234  Observ/hosp same date                             A   2.56   1.08NA   1.08    0.22   3.86  3.860XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99235  Observ/hosp same date                             A   3.24   1.37NA   1.37    0.22   4.83  4.830XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99236  Observ/hosp same date                             A   4.20   1.75NA   1.75    0.29   6.24  6.240XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99238  Hospital discharge day                            A   1.28   0.73NA   0.73    0.07   2.08  2.080XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99239  Hospital discharge day                            A   1.90   1.06NA   1.06    0.11   3.07  3.070XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99241  Office consultation                               I+  0.64   0.66     0.24    0.07   1.37  0.959XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99242  Office consultation                               I+  1.34   1.10     0.51    0.14   2.58  1.999XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99243  Office consultation                               I+  1.88   1.46     0.71    0.18   3.52  2.779XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99244  Office consultation                               I+  3.02   1.96     1.14    0.22   5.20  4.389XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99245  Office consultation                               I+  3.77   2.30     1.38    0.29   6.36  5.449XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99251  Inpatient consultation                            I+  1.00   0.32NA   0.32    0.07   1.39  1.399XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99252  Inpatient consultation                            I+  1.50   0.52NA   0.52    0.12   2.14  2.149XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99253  Inpatient consultation                            I+  2.27   0.84NA   0.84    0.15   3.26  3.269XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99254  Inpatient consultation                            I+  3.29   1.23NA   1.23    0.18   4.70  4.709XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99255  Inpatient consultation                            I+  4.00   1.61NA   1.61    0.24   5.85  5.859XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99281  Emergency dept visit                              A   0.45   0.12NA   0.12    0.03   0.60  0.600XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99282  Emergency dept visit                              A   0.88   0.23NA   0.23    0.07   1.18  1.180XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99283  Emergency dept visit                              A   1.34   0.32NA   0.32    0.10   1.76  1.760XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99284  Emergency dept visit                              A   2.56   0.58NA   0.58    0.22   3.36  3.360XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99285  Emergency dept visit                              A   3.80   0.83NA   0.83    0.30   4.93  4.930XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99288  Direct advanced life support                      B   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99291  Critical care first hour                          A   4.50   3.15     1.56    0.34   7.99  6.400XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99292  Critical care addl 30 min                         A   2.25   1.12     0.79    0.18   3.55  3.220ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99304  Nursing facility care init                        A   1.64   0.91     0.91    0.14   2.69  2.690XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99305  Nursing facility care init                        A   2.35   1.27     1.27    0.20   3.82  3.820XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99306  Nursing facility care init                        A   3.06   1.53     1.53    0.23   4.82  4.820XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99307  Nursing fac care subseq                           A   0.76   0.48     0.48    0.04   1.28  1.280XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99308  Nursing fac care subseq                           A   1.16   0.76     0.76    0.07   1.99  1.990XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99309  Nursing fac care subseq                           A   1.55   0.98     0.98    0.08   2.61  2.610XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99310  Nursing fac care subseq                           A   2.35   1.39     1.39    0.14   3.88  3.880XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99315  Nursing fac discharge day                         A   1.28   0.74     0.74    0.08   2.10  2.100XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99316  Nursing fac discharge day                         A   1.90   1.01     1.01    0.10   3.01  3.010XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99318  Annual nursing fac assessmnt                      A   1.71   0.94     0.94    0.10   2.75  2.750XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99324  Domicil/r-home visit new pat                      A   1.01   0.52     0.52NA  0.07   1.60  1.600XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99325  Domicil/r-home visit new pat                      A   1.52   0.68     0.68NA  0.10   2.30  2.300XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99326  Domicil/r-home visit new pat                      A   2.63   1.20     1.20NA  0.16   3.99  3.990XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99327  Domicil/r-home visit new pat                      A   3.46   1.66     1.66NA  0.22   5.34  5.340XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99328  Domicil/r-home visit new pat                      A   4.09   1.86     1.86NA  0.24   6.19  6.190XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99334  Domicil/r-home visit est pat                      A   1.07   0.60     0.60NA  0.07   1.74  1.740XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99335  Domicil/r-home visit est pat                      A   1.72   0.90     0.90NA  0.10   2.72  2.720XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99336  Domicil/r-home visit est pat                      A   2.46   1.25     1.25NA  0.14   3.85  3.850XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99337  Domicil/r-home visit est pat                      A   3.58   1.72     1.72NA  0.23   5.53  5.530XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99339  Domicil/r-home care supervis                      B+  1.25   0.92     0.92NA  0.08   2.25  2.259XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99340  Domicil/r-home care supervis                      B+  1.80   1.23     1.23NA  0.12   3.15  3.159XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99341  Home visit new patient                            A   1.01   0.51     0.51NA  0.07   1.59  1.590XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99342  Home visit new patient                            A   1.52   0.65     0.65NA  0.11   2.28  2.280XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99343  Home visit new patient                            A   2.53   1.05     1.05NA  0.18   3.76  3.760XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99344  Home visit new patient                            A   3.38   1.63     1.63NA  0.22   5.23  5.230XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99345  Home visit new patient                            A   4.09   1.94     1.94NA  0.26   6.29  6.290XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99347  Home visit est patient                            A   1.00   0.53     0.53NA  0.07   1.60  1.600XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99348  Home visit est patient                            A   1.56   0.76     0.76NA  0.10   2.42  2.420XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99349  Home visit est patient                            A   2.33   1.20     1.20NA  0.14   3.67  3.670XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99350  Home visit est patient                            A   3.28   1.60     1.60NA  0.22   5.10  5.100XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99354  Prolonged service office                          A   1.77   0.98     0.76    0.11   2.86  2.640ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99355  Prolonged service office                          A   1.77   0.91     0.69    0.11   2.79  2.570ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99356  Prolonged service inpatient                       A   1.71   0.81NA   0.81    0.11   2.63  2.630ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99357  Prolonged service inpatient                       A   1.71   0.79NA   0.79    0.11   2.61  2.610ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99358  Prolong service w/o contact                       B+  2.10   0.89     0.89    0.14   3.13  3.139XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99359  Prolong serv w/o contact add                      B+  1.00   0.45     0.45    0.07   1.52  1.529ZZZ.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99360  Physician standby services                        X+  1.20   0.48NA   0.48    0.08   1.76  1.769XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99363  Anticoagulant mgmt initial                        B+  1.65   1.98     0.67    0.11   3.74  2.439XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99364  Anticoagulant mgmt subseq                         B+  0.63   0.59     0.25    0.04   1.26  0.929XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99366  Team conf w/pat by hc prof                        B+  0.82   0.35     0.33    0.05   1.22  1.209XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99367  Team conf w/o pat by phys                         B+  1.10   0.44NA   0.44    0.07   1.61  1.619XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99368  Team conf w/o pat by hc pro                       B+  0.72   0.29NA   0.29    0.04   1.05  1.059XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99374  Home health care supervision                      B+  1.10   0.86     0.44    0.07   2.03  1.619XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99375  Home health care supervision                      I+  1.73   1.20     0.70    0.11   3.04  2.549XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99377  Hospice care supervision                          B+  1.10   0.86     0.44    0.07   2.03  1.619XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99378  Hospice care supervision                          I+  1.73   1.20     0.70    0.11   3.04  2.549XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99379  Nursing fac care supervision                      B+  1.10   0.86     0.44    0.07   2.03  1.619XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99380  Nursing fac care supervision                      B+  1.73   1.20     0.70    0.11   3.04  2.549XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99381  Init pm e/m new pat infant                        N+  1.50   1.63     0.60    0.10   3.23  2.209XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99382  Init pm e/m new pat 1-4 yrs                       N+  1.60   1.67     0.65    0.09   3.36  2.349XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99383  Prev visit new age 5-11                           N+  1.70   1.70     0.69    0.10   3.50  2.499XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99384  Prev visit new age 12-17                          N+  2.00   1.82     0.81    0.13   3.95  2.949XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99385  Prev visit new age 18-39                          N+  1.92   1.79     0.77    0.13   3.84  2.829XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99386  Prev visit new age 40-64                          N+  2.33   1.95     0.94    0.15   4.43  3.429XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99387  Init pm e/m new pat 65+ yrs                       N+  2.50   2.15     1.01    0.17   4.82  3.689XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99391  Per pm reeval est pat infant                      N+  1.37   1.44     0.55    0.09   2.90  2.019XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99392  Prev visit est age 1-4                            N+  1.50   1.49     0.60    0.10   3.09  2.209XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99393  Prev visit est age 5-11                           N+  1.50   1.48     0.60    0.10   3.08  2.209XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99394  Prev visit est age 12-17                          N+  1.70   1.57     0.69    0.10   3.37  2.499XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99395  Prev visit est age 18-39                          N+  1.75   1.59     0.71    0.10   3.44  2.569XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99396  Prev visit est age 40-64                          N+  1.90   1.65     0.77    0.12   3.67  2.799XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99397  Per pm reeval est pat 65+ yr                      N+  2.00   1.83     0.81    0.13   3.96  2.949XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99401  Preventive counseling indiv                       N+  0.48   0.55     0.19    0.03   1.06  0.709XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99402  Preventive counseling indiv                       N+  0.98   0.75     0.40    0.07   1.80  1.459XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99403  Preventive counseling indiv                       N+  1.46   0.94     0.59    0.10   2.50  2.159XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99404  Preventive counseling indiv                       N+  1.95   1.14     0.79    0.12   3.21  2.869XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99406  Behav chng smoking 3-10 min                       A   0.24   0.15     0.10    0.01   0.40  0.350XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99407  Behav chng smoking > 10 min                       A   0.50   0.26     0.20    0.03   0.79  0.730XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99408  Audit/dast 15-30 min                              N+  0.65   0.32     0.26    0.04   1.01  0.959XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99409  Audit/dast over 30 min                            N+  1.30   0.58     0.52    0.08   1.96  1.909XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99411  Preventive counseling group                       N+  0.15   0.32     0.06    0.01   0.48  0.229XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99412  Preventive counseling group                       N+  0.25   0.37     0.10    0.01   0.63  0.369XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99420  Health risk assessment test                       N+  0.00   0.32     0.32NA  0.01   0.33  0.339XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99429  Unlisted preventive service                       N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99441  Phone e/m phys/qhp 5-10 min                       N+  0.25   0.14     0.10    0.01   0.40  0.369XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99442  Phone e/m phys/qhp 11-20 min                      N+  0.50   0.24     0.20    0.03   0.77  0.739XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99443  Phone e/m phys/qhp 21-30 min                      N+  0.75   0.34     0.30    0.05   1.14  1.109XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99444  Online e/m by phys/qhp                            N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99450  Basic life disability exam                        N   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99455  Work related disability exam                      R   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99456  Disability examination                            R   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99460  Init nb em per day hosp                           A   1.92   0.60NA   0.60    0.08   2.60  2.600XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99461  Init nb em per day non-fac                        A   1.26   1.59     0.52    0.08   2.93  1.860XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99462  Sbsq nb em per day hosp                           A   0.84   0.30NA   0.30    0.05   1.19  1.190XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99463  Same day nb discharge                             A   2.13   1.07NA   1.07    0.11   3.31  3.310XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99464  Attendance at delivery                            A   1.50   0.62NA   0.62    0.07   2.19  2.190XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99465  Nb resuscitation                                  A   2.93   1.06NA   1.06    0.22   4.21  4.210XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99466  Ped crit care transport                           A   4.79   1.93NA   1.93    1.02   7.74  7.740XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99467  Ped crit care transport addl                      A   2.40   0.97NA   0.97    0.14   3.51  3.510ZZZ.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99468  Neonate crit care initial                         A  18.46   7.45NA   7.45    1.52  27.43 27.430XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99469  Neonate crit care subsq                           A   7.99   2.88NA   2.88    0.42  11.29 11.290XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99471  Ped critical care initial                         A  15.98   7.65NA   7.65    0.87  24.50 24.500XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99472  Ped critical care subsq                           A   7.99   3.18NA   3.18    0.48  11.65 11.650XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99475  Ped crit care age 2-5 init                        A  11.25   4.06NA   4.06    0.86  16.17 16.170XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99476  Ped crit care age 2-5 subsq                       A   6.75   2.75NA   2.75    0.52  10.02 10.020XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99477  Init day hosp neonate care                        A   7.00   2.67NA   2.67    0.38  10.05 10.050XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99478  Ic lbw inf < 1500 gm subsq                        A   2.75   1.11NA   1.11    0.18   4.04  4.040XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99479  Ic lbw inf 1500-2500 g subsq                      A   2.50   1.01NA   1.01    0.16   3.67  3.670XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99480  Ic inf pbw 2501-5000 g subsq                      A   2.40   0.87NA   0.87    0.16   3.43  3.430XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99485  Suprv interfacilty transport                      B+  1.50   0.60NA   0.60    0.08   2.18  2.189XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99486  Suprv interfac trnsport addl                      B+  1.30   0.52NA   0.52    0.08   1.90  1.909XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99487  Cmplx chron care w/o pt vsit                      B+  1.00   1.35     1.35NA  0.06   2.41  2.419XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99488  Cmplx chron care w/ pt vsit                       B+  2.50   2.73     2.73NA  0.17   5.40  5.409XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99489  Complx chron care addl30 min                      B+  0.50   0.68     0.68NA  0.03   1.21  1.219ZZZ.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99495  Trans care mgmt 14 day disch                      A   2.11   2.57     1.71    0.14   4.82  3.960XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99496  Trans care mgmt 7 day disch                       A   3.05   3.54     2.56    0.20   6.79  5.810XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99499  Unlisted e&m service                              C   0.00   0.00     0.00    0.00   0.00  0.000XXX.00.00.0000000             25.0008 090 99      0.00   0.00   0.00
99500  Home visit prenatal                               I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99501  Home visit postnatal                              I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99502  Home visit nb care                                I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99503  Home visit resp therapy                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99504  Home visit mech ventilator                        I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99505  Home visit stoma care                             I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99506  Home visit im injection                           I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99507  Home visit cath maintain                          I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99512  Home visit for hemodialysis                       I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
99600  Home visit nos                                    I   0.00   0.00     0.00    0.00   0.00  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 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  0.009XXX.00.00.0099999             25.0008 090 99      0.00   0.00   0.00
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