hospital_name,last_updated_on,version,hospital_location,hospital_address,license_number|MI,"To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated.",,,,,,,,,,,,,,,,,,,,,,
Schoolcraft Memorial Hospital,2/1/2025,2.0.0,Schoolcraft Memorial Hospital,"7870 W Us Highway 2, Manistique, MI 49854",742517055,TRUE,,,,,,,,,,,,,,,,,,,,,,
SERVICE DESCRIPTION,CATEGORY,BILLING MSDRG | CPT | HCPCS,ITEM/SERVICE DESCRIPTION,BILLING REVENUE CODE,GROSS CHARGES,AETNAPLAN,AETNA REIMBURSEMENT METHOD,BCBSPLAN,BCBS REIMBURSEMENT METHOD,BCNPLAN,BCN REIMBURSEMENT METHOD,CIGNAPLAN,CIGNA REIMBURSEMENT METHOD,HEALTH ALLIANCEPLAN,HEALTH ALLIANCE REIMBURSEMENT METHOD,MEDICAIDPLAN,MEDICAID REIMBURSEMENT METHOD,MEDICAREPLAN,MEDICARE REIMBURSEMENT METHOD,TRICAREPLAN,TRICARE REIMBURSEMENT METHOD,VA CCNPLAN,VA CCN REIMBURSEMENT METHOD,VA FEEPLAN,VA FEE REIMBURSEMENT METHOD,De-Identified Minimum Negotiated Rate,De-Identified Maximum Negotiated Rate,DISCOUNTED CASH PRICE
Outpatient Medical Services,AMBULATORY,90480,COVID Vaccine Admin charge,771,50,47.5,95% of total billed charges,47.36,94.72% of total billed charges,49.4,98.79% of total billed charges,49,98% of total billed charges,49,98% of total billed charges,24,48% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,24,49.4,40
Outpatient Medical Services,AMBULATORY,90471,Immunization administration: first vaccine,771,53,50.35,95% of total billed charges,50.2,94.72% of total billed charges,52.36,98.79% of total billed charges,51.94,98% of total billed charges,51.94,98% of total billed charges,25.44,48% of total billed charges,22.3,115% of CMS,18.95,97.75% of CMS,22.3,115% of CMS,22.3,115% of CMS,18.95,52.36,42.4
Outpatient Medical Services,AMBULATORY,90472,Immunization administration; each additional vaccine,771,35,33.25,95% of total billed charges,33.15,94.72% of total billed charges,34.58,98.79% of total billed charges,34.3,98% of total billed charges,34.3,98% of total billed charges,16.8,48% of total billed charges,15.95,115% of CMS,13.56,97.75% of CMS,15.95,115% of CMS,15.95,115% of CMS,13.56,34.58,28
Outpatient Medical Services,AMBULATORY,G0010,Administration of hepatitis B vaccine,771,50,47.5,95% of total billed charges,47.36,94.72% of total billed charges,49.4,98.79% of total billed charges,49,98% of total billed charges,49,98% of total billed charges,24,48% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,24,49.4,40
Outpatient Medical Services,AMBULATORY,G0008,Administration of influenza virus vaccine,771,50,47.5,95% of total billed charges,47.36,94.72% of total billed charges,49.4,98.79% of total billed charges,49,98% of total billed charges,49,98% of total billed charges,24,48% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,24,49.4,40
Outpatient Medical Services,AMBULATORY,99385,Initial new patient preventive medicine evaluation (18-39 years),521,389,369.55,95% of total billed charges,368.46,94.72% of total billed charges,384.29,98.79% of total billed charges,381.22,98% of total billed charges,381.22,98% of total billed charges,186.72,48% of total billed charges,104.68,115% of CMS,88.98,97.75% of CMS,104.68,115% of CMS,104.68,115% of CMS,88.98,384.29,311.2
Outpatient Medical Services,AMBULATORY,99386,Initial new patient preventive medicine evaluation (40-64 years),521,450,427.5,95% of total billed charges,426.24,94.72% of total billed charges,444.56,98.79% of total billed charges,441,98% of total billed charges,441,98% of total billed charges,216,48% of total billed charges,126.86,115% of CMS,107.83,97.75% of CMS,126.86,115% of CMS,126.86,115% of CMS,107.83,444.56,360
Outpatient Medical Services,AMBULATORY,99202,"New patient office or other outpatient visit, less than 30 min",521,195,185.25,95% of total billed charges,184.7,94.72% of total billed charges,192.64,98.79% of total billed charges,191.1,98% of total billed charges,191.1,98% of total billed charges,93.6,48% of total billed charges,53.14,115% of CMS,45.17,97.75% of CMS,53.14,115% of CMS,53.14,115% of CMS,45.17,192.64,156
Outpatient Medical Services,AMBULATORY,99203,"New patient office or other outpatient visit, typically 30 min",521,295,280.25,95% of total billed charges,279.42,94.72% of total billed charges,291.43,98.79% of total billed charges,289.1,98% of total billed charges,289.1,98% of total billed charges,141.6,48% of total billed charges,92.14,115% of CMS,78.32,97.75% of CMS,92.14,115% of CMS,92.14,115% of CMS,78.32,291.43,236
Outpatient Medical Services,AMBULATORY,99204,"New patient office of other outpatient visit, typically 45 min",521,471,447.45,95% of total billed charges,446.13,94.72% of total billed charges,465.3,98.79% of total billed charges,461.58,98% of total billed charges,461.58,98% of total billed charges,226.08,48% of total billed charges,149.71,115% of CMS,127.25,97.75% of CMS,149.71,115% of CMS,149.71,115% of CMS,127.25,465.3,376.8
Outpatient Medical Services,AMBULATORY,99205,"New patient office of other outpatient visit, typically 60 min",521,521,494.95,95% of total billed charges,493.49,94.72% of total billed charges,514.7,98.79% of total billed charges,510.58,98% of total billed charges,510.58,98% of total billed charges,250.08,48% of total billed charges,203.55,115% of CMS,173.02,97.75% of CMS,203.55,115% of CMS,203.55,115% of CMS,173.02,514.7,416.8
Outpatient Medical Services,AMBULATORY,99212,"Office/Outpatient - Est. Patient, Straightforward (less than 20 mins)",521,124,117.8,95% of total billed charges,117.45,94.72% of total billed charges,122.5,98.79% of total billed charges,121.52,98% of total billed charges,121.52,98% of total billed charges,59.52,48% of total billed charges,39.59,115% of CMS,33.66,97.75% of CMS,39.59,115% of CMS,39.59,115% of CMS,33.66,122.5,99.2
Outpatient Medical Services,AMBULATORY,99213,"Office/Outpatient - Est. Patient, Low (20-29 mins)",521,190,180.5,95% of total billed charges,179.97,94.72% of total billed charges,187.7,98.79% of total billed charges,186.2,98% of total billed charges,186.2,98% of total billed charges,91.2,48% of total billed charges,73.78,115% of CMS,62.72,97.75% of CMS,73.78,115% of CMS,73.78,115% of CMS,62.72,187.7,152
Outpatient Medical Services,AMBULATORY,99214,"Office/Outpatient - Est. Patient, Moderate (30-39 mins)",521,309,293.55,95% of total billed charges,292.68,94.72% of total billed charges,305.26,98.79% of total billed charges,302.82,98% of total billed charges,302.82,98% of total billed charges,148.32,48% of total billed charges,108.72,115% of CMS,92.41,97.75% of CMS,108.72,115% of CMS,108.72,115% of CMS,92.41,305.26,247.2
Outpatient Medical Services,AMBULATORY,99215,"Office/Outpatient - Est. Patient, High (40-54 mins)",521,392,372.4,95% of total billed charges,371.3,94.72% of total billed charges,387.26,98.79% of total billed charges,384.16,98% of total billed charges,384.16,98% of total billed charges,188.16,48% of total billed charges,161.35,115% of CMS,137.14,97.75% of CMS,161.35,115% of CMS,161.35,115% of CMS,137.14,387.26,313.6
Outpatient Medical Services,AMBULATORY,95117,Allergy Shot Multiple Administration Immunizations,521,47,44.65,95% of total billed charges,44.52,94.72% of total billed charges,46.43,98.79% of total billed charges,46.06,98% of total billed charges,46.06,98% of total billed charges,22.56,48% of total billed charges,13,115% of CMS,11.05,97.75% of CMS,13,115% of CMS,13,115% of CMS,11.05,46.43,37.6
Outpatient Medical Services,AMBULATORY,95115,Allergy Shot Single Administration Immunizations,521,42,39.9,95% of total billed charges,39.78,94.72% of total billed charges,41.49,98.79% of total billed charges,41.16,98% of total billed charges,41.16,98% of total billed charges,20.16,48% of total billed charges,10.9,115% of CMS,9.27,97.75% of CMS,10.9,115% of CMS,10.9,115% of CMS,9.27,41.49,33.6
Outpatient Medical Services,AMBULATORY,90677,90677 Prevnar 20 Vaccine Charge,636,896,851.2,95% of total billed charges,848.69,94.72% of total billed charges,885.16,98.79% of total billed charges,878.08,98% of total billed charges,878.08,98% of total billed charges,430.08,48% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,430.08,885.16,716.8
Outpatient Medical Services,AMBULATORY,90707,MMR,636,322,305.9,95% of total billed charges,305,94.72% of total billed charges,318.1,98.79% of total billed charges,315.56,98% of total billed charges,315.56,98% of total billed charges,154.56,48% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,154.56,318.1,257.6
Outpatient Medical Services,AMBULATORY,90710,MMRV Administration Immunizations,636,943,895.85,95% of total billed charges,893.21,94.72% of total billed charges,931.59,98.79% of total billed charges,924.14,98% of total billed charges,924.14,98% of total billed charges,452.64,48% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,452.64,931.59,754.4
Outpatient Medical Services,AMBULATORY,90696,90696 DTaP-IPV,636,255,242.25,95% of total billed charges,241.54,94.72% of total billed charges,251.91,98.79% of total billed charges,249.9,98% of total billed charges,249.9,98% of total billed charges,122.4,48% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,122.4,251.91,204
Outpatient Medical Services,AMBULATORY,90697,90697 DTaP-IPV-HibHepB (Vaxelis) Vaccine,636,501,475.95,95% of total billed charges,474.55,94.72% of total billed charges,494.94,98.79% of total billed charges,490.98,98% of total billed charges,490.98,98% of total billed charges,240.48,48% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,240.48,494.94,400.8
Outpatient Medical Services,CARDIAC,93306,US ECHO REAL/M-MODE COMP,483,2368,2249.6,95% of total billed charges,2242.97,94.72% of total billed charges,2339.35,98.79% of total billed charges,2320.64,98% of total billed charges,2320.64,98% of total billed charges,1136.64,48% of total billed charges,211.17,115% of CMS,179.5,97.75% of CMS,211.17,115% of CMS,211.17,115% of CMS,179.5,2339.35,1894.4
Outpatient Medical Services,CARDIAC,93308,US ECHO LIMITED,483,384,364.8,95% of total billed charges,363.72,94.72% of total billed charges,379.35,98.79% of total billed charges,376.32,98% of total billed charges,376.32,98% of total billed charges,184.32,48% of total billed charges,105.43,115% of CMS,89.62,97.75% of CMS,105.43,115% of CMS,105.43,115% of CMS,89.62,379.35,307.2
Outpatient Medical Services,CARDIAC,94010,PULMONARY FUNCTION,460,213,202.35,95% of total billed charges,201.75,94.72% of total billed charges,210.42,98.79% of total billed charges,208.74,98% of total billed charges,208.74,98% of total billed charges,102.24,48% of total billed charges,29.37,115% of CMS,24.97,97.75% of CMS,29.37,115% of CMS,29.37,115% of CMS,24.97,210.42,170.4
Outpatient Medical Services,CARDIAC,94070,METHACHOLINE CHALLENGE,460,362,343.9,95% of total billed charges,342.89,94.72% of total billed charges,357.62,98.79% of total billed charges,354.76,98% of total billed charges,354.76,98% of total billed charges,173.76,48% of total billed charges,68.36,115% of CMS,58.1,97.75% of CMS,68.36,115% of CMS,68.36,115% of CMS,58.1,357.62,289.6
Outpatient Medical Services,CARDIAC,94060,PULMONARY FUNCTION W/DILATION,460,325,308.75,95% of total billed charges,307.84,94.72% of total billed charges,321.07,98.79% of total billed charges,318.5,98% of total billed charges,318.5,98% of total billed charges,156,48% of total billed charges,41.75,115% of CMS,35.48,97.75% of CMS,41.75,115% of CMS,41.75,115% of CMS,35.48,321.07,260
Outpatient Medical Services,CARDIAC,93798,CARDIAC REHAB - EKG RHYTHM STRIP,943,198,188.1,95% of total billed charges,187.55,94.72% of total billed charges,195.6,98.79% of total billed charges,194.04,98% of total billed charges,194.04,98% of total billed charges,95.04,48% of total billed charges,15.1,115% of CMS,12.83,97.75% of CMS,15.1,115% of CMS,15.1,115% of CMS,12.83,195.6,158.4
Outpatient Medical Services,CHEMO INJECTION,96374,FACILITY IV INJECTION,260,201,190.95,95% of total billed charges,190.39,94.72% of total billed charges,198.57,98.79% of total billed charges,196.98,98% of total billed charges,196.98,98% of total billed charges,96.48,48% of total billed charges,39.17,115% of CMS,33.29,97.75% of CMS,39.17,115% of CMS,39.17,115% of CMS,33.29,198.57,160.8
Outpatient Medical Services,CHEMO INJECTION,96375,FACILITY IV INJECTION ADD-ON,260,118,112.1,95% of total billed charges,111.77,94.72% of total billed charges,116.57,98.79% of total billed charges,115.64,98% of total billed charges,115.64,98% of total billed charges,56.64,48% of total billed charges,16.48,115% of CMS,14.01,97.75% of CMS,16.48,115% of CMS,16.48,115% of CMS,14.01,116.57,94.4
Outpatient Medical Services,CHEMO INJECTION,96360,HYDRATION IV-1ST HOUR,260,235,223.25,95% of total billed charges,222.59,94.72% of total billed charges,232.16,98.79% of total billed charges,230.3,98% of total billed charges,230.3,98% of total billed charges,112.8,48% of total billed charges,34.5,115% of CMS,29.33,97.75% of CMS,34.5,115% of CMS,34.5,115% of CMS,29.33,232.16,188
Outpatient Medical Services,CHEMO INJECTION,96361,HYDRATION IV INFUS ADD-ON,260,74,70.3,95% of total billed charges,70.09,94.72% of total billed charges,73.1,98.79% of total billed charges,72.52,98% of total billed charges,72.52,98% of total billed charges,35.52,48% of total billed charges,13.31,115% of CMS,11.31,97.75% of CMS,13.31,115% of CMS,13.31,115% of CMS,11.31,73.1,59.2
Outpatient Medical Services,CHEMO INJECTION,96365,IV MED IST HOUR,260,294,279.3,95% of total billed charges,278.48,94.72% of total billed charges,290.44,98.79% of total billed charges,288.12,98% of total billed charges,288.12,98% of total billed charges,141.12,48% of total billed charges,66.68,115% of CMS,56.68,97.75% of CMS,66.68,115% of CMS,66.68,115% of CMS,56.68,290.44,235.2
Outpatient Medical Services,CHEMO INJECTION,96375,INJ IV PUSH EA DIFFERENT DRUG,260,140,133,95% of total billed charges,132.61,94.72% of total billed charges,138.31,98.79% of total billed charges,137.2,98% of total billed charges,137.2,98% of total billed charges,67.2,48% of total billed charges,16.48,115% of CMS,14.01,97.75% of CMS,16.48,115% of CMS,16.48,115% of CMS,14.01,138.31,112
Outpatient Medical Services,CHEMO INJECTION,96376,IV PUSH MED ADD'L>30MIN APART,260,164,155.8,95% of total billed charges,155.34,94.72% of total billed charges,162.02,98.79% of total billed charges,160.72,98% of total billed charges,160.72,98% of total billed charges,78.72,48% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,78.72,162.02,131.2
Outpatient Medical Services,CHEMO INJECTION,96366,IV INFUSION MEDICINE ADDTL HOUR,260,140,133,95% of total billed charges,132.61,94.72% of total billed charges,138.31,98.79% of total billed charges,137.2,98% of total billed charges,137.2,98% of total billed charges,67.2,48% of total billed charges,21.98,115% of CMS,18.68,97.75% of CMS,21.98,115% of CMS,21.98,115% of CMS,18.68,138.31,112
Outpatient Medical Services,CHEMO INJECTION,96523,FLUSH-IMPLANTED ACCESS DEVICE,940,168,159.6,95% of total billed charges,159.13,94.72% of total billed charges,165.97,98.79% of total billed charges,164.64,98% of total billed charges,164.64,98% of total billed charges,80.64,48% of total billed charges,26.38,115% of CMS,22.42,97.75% of CMS,26.38,115% of CMS,26.38,115% of CMS,22.42,165.97,134.4
Outpatient Medical Services,CHEMO INJECTION,36591,BLOOD DRAW IMPLANTED DEVICE,761,135,128.25,95% of total billed charges,127.87,94.72% of total billed charges,133.37,98.79% of total billed charges,132.3,98% of total billed charges,132.3,98% of total billed charges,64.8,48% of total billed charges,29.04,115% of CMS,24.68,97.75% of CMS,29.04,115% of CMS,29.04,115% of CMS,24.68,133.37,108
Outpatient Medical Services,CHEMO INJECTION,96413,IV CHEMO 1ST HOUR,335,473,449.35,95% of total billed charges,448.03,94.72% of total billed charges,467.28,98.79% of total billed charges,463.54,98% of total billed charges,463.54,98% of total billed charges,227.04,48% of total billed charges,136.97,115% of CMS,116.42,97.75% of CMS,136.97,115% of CMS,136.97,115% of CMS,116.42,467.28,378.4
Outpatient Medical Services,CHEMO INJECTION,96411,IV PUSH CHEMO<15MIN ADDED DRUG,335,212,201.4,95% of total billed charges,200.81,94.72% of total billed charges,209.43,98.79% of total billed charges,207.76,98% of total billed charges,207.76,98% of total billed charges,101.76,48% of total billed charges,57.82,115% of CMS,49.15,97.75% of CMS,57.82,115% of CMS,57.82,115% of CMS,49.15,209.43,169.6
Outpatient Medical Services,CHEMO INJECTION,96416,CHEMO PROLONG INFUSE W/PUMP,335,449,426.55,95% of total billed charges,425.29,94.72% of total billed charges,443.57,98.79% of total billed charges,440.02,98% of total billed charges,440.02,98% of total billed charges,215.52,48% of total billed charges,134.63,115% of CMS,114.44,97.75% of CMS,134.63,115% of CMS,134.63,115% of CMS,114.44,443.57,359.2
Outpatient Medical Services,CHEMO INJECTION,96367,IV MED/ SEQUENTIAL 1ST HR DRUG ADDED,260,171,162.45,95% of total billed charges,161.97,94.72% of total billed charges,168.93,98.79% of total billed charges,167.58,98% of total billed charges,167.58,98% of total billed charges,82.08,48% of total billed charges,30.38,115% of CMS,25.83,97.75% of CMS,30.38,115% of CMS,30.38,115% of CMS,25.83,168.93,136.8
Outpatient Medical Services,CHEMO INJECTION,96368,IV MED/CONCURRENT IST HR,260,83,78.85,95% of total billed charges,78.62,94.72% of total billed charges,82,98.79% of total billed charges,81.34,98% of total billed charges,81.34,98% of total billed charges,39.84,48% of total billed charges,21.25,115% of CMS,18.06,97.75% of CMS,21.25,115% of CMS,21.25,115% of CMS,18.06,82,66.4
Outpatient Medical Services,CHEMO INJECTION,96417,IV CHEMO/SEQUENTIAL 1ST HR,335,243,230.85,95% of total billed charges,230.17,94.72% of total billed charges,240.06,98.79% of total billed charges,238.14,98% of total billed charges,238.14,98% of total billed charges,116.64,48% of total billed charges,67.72,115% of CMS,57.56,97.75% of CMS,67.72,115% of CMS,67.72,115% of CMS,57.56,240.06,194.4
Outpatient Medical Services,CHEMO INJECTION,96415,96415 CHEMO INFUSION EACH ADDITIONAL HOUR CHARGE,335,147,139.65,95% of total billed charges,139.24,94.72% of total billed charges,145.22,98.79% of total billed charges,144.06,98% of total billed charges,144.06,98% of total billed charges,70.56,48% of total billed charges,29.79,115% of CMS,25.32,97.75% of CMS,29.79,115% of CMS,29.79,115% of CMS,25.32,145.22,117.6
Outpatient Medical Services,CHEMO INJECTION,36000,INTRO OF NEEDLE/INTRACATHETER VEIN,510,87,82.65,95% of total billed charges,82.41,94.72% of total billed charges,85.95,98.79% of total billed charges,85.26,98% of total billed charges,85.26,98% of total billed charges,41.76,48% of total billed charges,10.22,115% of CMS,8.69,97.75% of CMS,10.22,115% of CMS,10.22,115% of CMS,8.69,85.95,69.6
Outpatient Medical Services,CHEMO INJECTION,36569,PICC PLACEMENT,361,762,723.9,95% of total billed charges,721.77,94.72% of total billed charges,752.78,98.79% of total billed charges,746.76,98% of total billed charges,746.76,98% of total billed charges,365.76,48% of total billed charges,106.67,115% of CMS,90.67,97.75% of CMS,106.67,115% of CMS,106.67,115% of CMS,90.67,752.78,609.6
Outpatient Medical Services,CHEMO INJECTION,36589,PICC REMOVAL,361,762,723.9,95% of total billed charges,721.77,94.72% of total billed charges,752.78,98.79% of total billed charges,746.76,98% of total billed charges,746.76,98% of total billed charges,365.76,48% of total billed charges,151.71,115% of CMS,128.95,97.75% of CMS,151.71,115% of CMS,151.71,115% of CMS,128.95,752.78,609.6
Outpatient Medical Services,EMERGENCY ROOM,96374,FACILITY IV INJECTION,450,201,190.95,95% of total billed charges,190.39,94.72% of total billed charges,198.57,98.79% of total billed charges,196.98,98% of total billed charges,196.98,98% of total billed charges,96.48,48% of total billed charges,39.17,115% of CMS,33.29,97.75% of CMS,39.17,115% of CMS,39.17,115% of CMS,33.29,198.57,160.8
Outpatient Medical Services,EMERGENCY ROOM,96375,FACILITY IV INJECTION ADD-ON,450,118,112.1,95% of total billed charges,111.77,94.72% of total billed charges,116.57,98.79% of total billed charges,115.64,98% of total billed charges,115.64,98% of total billed charges,56.64,48% of total billed charges,16.48,115% of CMS,14.01,97.75% of CMS,16.48,115% of CMS,16.48,115% of CMS,14.01,116.57,94.4
Outpatient Medical Services,EMERGENCY ROOM,96360,HYDRATION IV-1ST HOUR,450,235,223.25,95% of total billed charges,222.59,94.72% of total billed charges,232.16,98.79% of total billed charges,230.3,98% of total billed charges,230.3,98% of total billed charges,112.8,48% of total billed charges,34.5,115% of CMS,29.33,97.75% of CMS,34.5,115% of CMS,34.5,115% of CMS,29.33,232.16,188
Outpatient Medical Services,EMERGENCY ROOM,96361,HYDRATION IV INFUS ADD-ON,450,74,70.3,95% of total billed charges,70.09,94.72% of total billed charges,73.1,98.79% of total billed charges,72.52,98% of total billed charges,72.52,98% of total billed charges,35.52,48% of total billed charges,13.31,115% of CMS,11.31,97.75% of CMS,13.31,115% of CMS,13.31,115% of CMS,11.31,73.1,59.2
Outpatient Medical Services,EMERGENCY ROOM,96365,IV MED IST HOUR,450,294,279.3,95% of total billed charges,278.48,94.72% of total billed charges,290.44,98.79% of total billed charges,288.12,98% of total billed charges,288.12,98% of total billed charges,141.12,48% of total billed charges,66.68,115% of CMS,56.68,97.75% of CMS,66.68,115% of CMS,66.68,115% of CMS,56.68,290.44,235.2
Outpatient Medical Services,EMERGENCY ROOM,96375,INJ IV PUSH EA DIFFERENT DRUG,450,140,133,95% of total billed charges,132.61,94.72% of total billed charges,138.31,98.79% of total billed charges,137.2,98% of total billed charges,137.2,98% of total billed charges,67.2,48% of total billed charges,16.48,115% of CMS,14.01,97.75% of CMS,16.48,115% of CMS,16.48,115% of CMS,14.01,138.31,112
Outpatient Medical Services,EMERGENCY ROOM,96376,IV PUSH MED ADD'L>30MIN APART,450,164,155.8,95% of total billed charges,155.34,94.72% of total billed charges,162.02,98.79% of total billed charges,160.72,98% of total billed charges,160.72,98% of total billed charges,78.72,48% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,78.72,162.02,131.2
Outpatient Medical Services,EMERGENCY ROOM,96366,IV INFUSION MEDICINE ADDTL HOUR,450,140,133,95% of total billed charges,132.61,94.72% of total billed charges,138.31,98.79% of total billed charges,137.2,98% of total billed charges,137.2,98% of total billed charges,67.2,48% of total billed charges,21.98,115% of CMS,18.68,97.75% of CMS,21.98,115% of CMS,21.98,115% of CMS,18.68,138.31,112
Outpatient Medical Services,EMERGENCY ROOM,96367,IV MED/ SEQUENTIAL 1ST HR DRUG ADDED,450,171,162.45,95% of total billed charges,161.97,94.72% of total billed charges,168.93,98.79% of total billed charges,167.58,98% of total billed charges,167.58,98% of total billed charges,82.08,48% of total billed charges,30.38,115% of CMS,25.83,97.75% of CMS,30.38,115% of CMS,30.38,115% of CMS,25.83,168.93,136.8
Outpatient Medical Services,EMERGENCY ROOM,96368,IV MED/CONCURRENT IST HR,450,83,78.85,95% of total billed charges,78.62,94.72% of total billed charges,82,98.79% of total billed charges,81.34,98% of total billed charges,81.34,98% of total billed charges,39.84,48% of total billed charges,21.25,115% of CMS,18.06,97.75% of CMS,21.25,115% of CMS,21.25,115% of CMS,18.06,82,66.4
Outpatient Medical Services,EMERGENCY ROOM,99281,"ED VISIT E&M PATIENT, LEV 1, Fac Fee",450,217,206.15,95% of total billed charges,205.54,94.72% of total billed charges,214.37,98.79% of total billed charges,212.66,98% of total billed charges,212.66,98% of total billed charges,104.16,48% of total billed charges,13.01,115% of CMS,11.06,97.75% of CMS,13.01,115% of CMS,13.01,115% of CMS,11.06,214.37,173.6
Outpatient Medical Services,EMERGENCY ROOM,99281,"ED VISIT E&M PATIENT, LEV 1, Pro Fee",981,210,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,168
Outpatient Medical Services,EMERGENCY ROOM,99282,"ED VISIT E&M PATIENT, LEV 2, Straight forward",450,293,278.35,95% of total billed charges,277.53,94.72% of total billed charges,289.45,98.79% of total billed charges,287.14,98% of total billed charges,287.14,98% of total billed charges,140.64,48% of total billed charges,47.41,115% of CMS,40.3,97.75% of CMS,47.41,115% of CMS,47.41,115% of CMS,40.3,289.45,234.4
Outpatient Medical Services,EMERGENCY ROOM,99282,"ED VISIT E&M PATIENT, LEV 2, Straight forward",981,282,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,225.6
Outpatient Medical Services,EMERGENCY ROOM,99283,"ED VISIT E&M PATIENT, LEV 3, MED MDM Fac Fee",450,439,417.05,95% of total billed charges,415.82,94.72% of total billed charges,433.69,98.79% of total billed charges,430.22,98% of total billed charges,430.22,98% of total billed charges,210.72,48% of total billed charges,80.73,115% of CMS,68.62,97.75% of CMS,80.73,115% of CMS,80.73,115% of CMS,68.62,433.69,351.2
Outpatient Medical Services,EMERGENCY ROOM,99283,"ED VISIT E&M PATIENT, LEV 3, MED MDM Pro Fee",981,426,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,340.8
Outpatient Medical Services,EMERGENCY ROOM,99284,"ED VISIT E&M PATIENT, LEV 4,MOD MDM Fac Fee",450,651,618.45,95% of total billed charges,616.63,94.72% of total billed charges,643.12,98.79% of total billed charges,637.98,98% of total billed charges,637.98,98% of total billed charges,312.48,48% of total billed charges,137.44,115% of CMS,116.82,97.75% of CMS,137.44,115% of CMS,137.44,115% of CMS,116.82,643.12,520.8
Outpatient Medical Services,EMERGENCY ROOM,99284,"ED VISIT E&M PATIENT, LEV 4,MOD MDM  Pro Fee",981,632,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,505.6
Outpatient Medical Services,EMERGENCY ROOM,99285,"ED VISIT E&M PATIENT, LEV 5,High MDM Fac Fee",450,1531,1454.45,95% of total billed charges,1450.16,94.72% of total billed charges,1512.47,98.79% of total billed charges,1500.38,98% of total billed charges,1500.38,98% of total billed charges,734.88,48% of total billed charges,199.18,115% of CMS,169.3,97.75% of CMS,199.18,115% of CMS,199.18,115% of CMS,169.3,1512.47,1224.8
Outpatient Medical Services,EMERGENCY ROOM,99285,"ED VISIT E&M PATIENT, LEV 5,High MDM  Pro Fee",981,632,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,505.6
Outpatient Medical Services,EMERGENCY ROOM,99291,Critical Care Ill/Injured Init 30-74 Min Fac Fee,450,1758,1670.1,95% of total billed charges,1665.18,94.72% of total billed charges,1736.73,98.79% of total billed charges,1722.84,98% of total billed charges,1722.84,98% of total billed charges,843.84,48% of total billed charges,239.59,115% of CMS,203.65,97.75% of CMS,239.59,115% of CMS,239.59,115% of CMS,203.65,1736.73,1406.4
Outpatient Medical Services,EMERGENCY ROOM,99291,Critical Care Ill/Injured Init 30-74 Min Pro Fee,981,828,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,662.4
Outpatient Medical Services,EMERGENCY ROOM,99292,Critical Care Ill/Injured Patient Addl 30 Min Fac Fee,450,624,592.8,95% of total billed charges,591.05,94.72% of total billed charges,616.45,98.79% of total billed charges,611.52,98% of total billed charges,611.52,98% of total billed charges,299.52,48% of total billed charges,120.87,115% of CMS,102.74,97.75% of CMS,120.87,115% of CMS,120.87,115% of CMS,102.74,616.45,499.2
Outpatient Medical Services,EMERGENCY ROOM,99292,Critical Care Ill/Injured Patient Addl 30 Min Pro Fee,981,415,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,332
Outpatient Medical Services,EMERGENCY ROOM,94640,AEROSOL TREATMENT,412,182,172.9,95% of total billed charges,172.39,94.72% of total billed charges,179.8,98.79% of total billed charges,178.36,98% of total billed charges,178.36,98% of total billed charges,87.36,48% of total billed charges,8.46,115% of CMS,7.19,97.75% of CMS,8.46,115% of CMS,8.46,115% of CMS,7.19,179.8,145.6
Outpatient Medical Services,OUTPATIENT SURGICAL,19120,"Removal of 1 or more breast growth, open procedure",360,1679,1595.05,95% of total billed charges,1590.35,94.72% of total billed charges,1658.68,98.79% of total billed charges,1645.42,98% of total billed charges,1645.42,98% of total billed charges,805.92,48% of total billed charges,476.41,115% of CMS,404.95,97.75% of CMS,476.41,115% of CMS,476.41,115% of CMS,404.95,1658.68,1343.2
Outpatient Medical Services,OUTPATIENT SURGICAL,19120,"Removal of 1 or more breast growth, open procedure",982,1321,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,1056.8
Outpatient Medical Services,OUTPATIENT SURGICAL,29826,Shaving of shoulder bone using an endoscope,360,3325,3158.75,95% of total billed charges,3149.44,94.72% of total billed charges,3284.77,98.79% of total billed charges,3258.5,98% of total billed charges,3258.5,98% of total billed charges,1596,48% of total billed charges,193.89,115% of CMS,164.81,97.75% of CMS,193.89,115% of CMS,193.89,115% of CMS,164.81,3284.77,2660
Outpatient Medical Services,OUTPATIENT SURGICAL,29826,Shaving of shoulder bone using an endoscope,982,1463,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,1170.4
Outpatient Medical Services,OUTPATIENT SURGICAL,29881,Removal of one knee cartilage using an endoscope,360,4910,4664.5,95% of total billed charges,4650.75,94.72% of total billed charges,4850.59,98.79% of total billed charges,4811.8,98% of total billed charges,4811.8,98% of total billed charges,2356.8,48% of total billed charges,613.4,115% of CMS,521.39,97.75% of CMS,613.4,115% of CMS,613.4,115% of CMS,521.39,4850.59,3928
Outpatient Medical Services,OUTPATIENT SURGICAL,29881,Removal of one knee cartilage using an endoscope,982,2258,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,1806.4
Outpatient Medical Services,OUTPATIENT SURGICAL,42820,Removal of tonsils and adenoid glands patient younger than age 12,360,4596,4366.2,95% of total billed charges,4353.33,94.72% of total billed charges,4540.39,98.79% of total billed charges,4504.08,98% of total billed charges,4504.08,98% of total billed charges,2206.08,48% of total billed charges,329.12,115% of CMS,279.75,97.75% of CMS,329.12,115% of CMS,329.12,115% of CMS,279.75,4540.39,3676.8
Outpatient Medical Services,OUTPATIENT SURGICAL,42820,Removal of tonsils and adenoid glands patient younger than age 12,982,2385,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,1908
Outpatient Medical Services,OUTPATIENT SURGICAL,43235,"Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope",750,1326,1259.7,95% of total billed charges,1255.99,94.72% of total billed charges,1309.96,98.79% of total billed charges,1299.48,98% of total billed charges,1299.48,98% of total billed charges,636.48,48% of total billed charges,136.31,115% of CMS,115.86,97.75% of CMS,136.31,115% of CMS,136.31,115% of CMS,115.86,1309.96,1060.8
Outpatient Medical Services,OUTPATIENT SURGICAL,43235,"Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope",982,594,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,475.2
Outpatient Medical Services,OUTPATIENT SURGICAL,43239,"Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope",750,1481,1406.95,95% of total billed charges,1402.8,94.72% of total billed charges,1463.08,98.79% of total billed charges,1451.38,98% of total billed charges,1451.38,98% of total billed charges,710.88,48% of total billed charges,154.12,115% of CMS,131,97.75% of CMS,154.12,115% of CMS,154.12,115% of CMS,131,1463.08,1184.8
Outpatient Medical Services,OUTPATIENT SURGICAL,43239,"Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope",982,765,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,612
Outpatient Medical Services,OUTPATIENT SURGICAL,45378,Diagnostic examination of large bowel using an endoscope,750,1902,1806.9,95% of total billed charges,1801.57,94.72% of total billed charges,1878.99,98.79% of total billed charges,1863.96,98% of total billed charges,1863.96,98% of total billed charges,912.96,48% of total billed charges,205.38,115% of CMS,174.57,97.75% of CMS,205.38,115% of CMS,205.38,115% of CMS,174.57,1878.99,1521.6
Outpatient Medical Services,OUTPATIENT SURGICAL,45378,Diagnostic examination of large bowel using an endoscope,982,939,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,751.2
Outpatient Medical Services,OUTPATIENT SURGICAL,45380,Biopsy of large bowel using an endoscope,750,2130,2023.5,95% of total billed charges,2017.54,94.72% of total billed charges,2104.23,98.79% of total billed charges,2087.4,98% of total billed charges,2087.4,98% of total billed charges,1022.4,48% of total billed charges,222.99,115% of CMS,189.54,97.75% of CMS,222.99,115% of CMS,222.99,115% of CMS,189.54,2104.23,1704
Outpatient Medical Services,OUTPATIENT SURGICAL,45380,Biopsy of large bowel using an endoscope,982,1181,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,944.8
Outpatient Medical Services,OUTPATIENT SURGICAL,45385,Removal of polyps or growths of large bowel using an endoscope,750,1473,1399.35,95% of total billed charges,1395.23,94.72% of total billed charges,1455.18,98.79% of total billed charges,1443.54,98% of total billed charges,1443.54,98% of total billed charges,707.04,48% of total billed charges,282.38,115% of CMS,240.03,97.75% of CMS,282.38,115% of CMS,282.38,115% of CMS,240.03,1455.18,1178.4
Outpatient Medical Services,OUTPATIENT SURGICAL,45385,Removal of polyps or growths of large bowel using an endoscope,982,1150,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,920
Outpatient Medical Services,OUTPATIENT SURGICAL,47562,Removal of gallbladder using an endoscope,360,4671,4437.45,95% of total billed charges,4424.37,94.72% of total billed charges,4614.48,98.79% of total billed charges,4577.58,98% of total billed charges,4577.58,98% of total billed charges,2242.08,48% of total billed charges,756.83,115% of CMS,643.3,97.75% of CMS,756.83,115% of CMS,756.83,115% of CMS,643.3,4614.48,3736.8
Outpatient Medical Services,OUTPATIENT SURGICAL,47562,Removal of gallbladder using an endoscope,975,2183,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,1746.4
Outpatient Medical Services,OUTPATIENT SURGICAL,49505,Repair of groin hernia patient age 5 years or older,360,3185,3025.75,95% of total billed charges,3016.83,94.72% of total billed charges,3146.46,98.79% of total billed charges,3121.3,98% of total billed charges,3121.3,98% of total billed charges,1528.8,48% of total billed charges,598.98,115% of CMS,509.13,97.75% of CMS,598.98,115% of CMS,598.98,115% of CMS,509.13,3146.46,2548
Outpatient Medical Services,OUTPATIENT SURGICAL,49505,Repair of groin hernia patient age 5 years or older,975,1344,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,1075.2
Outpatient Medical Services,OUTPATIENT SURGICAL,55700,Biopsy of prostate gland,361,1830,1738.5,95% of total billed charges,1733.38,94.72% of total billed charges,1807.86,98.79% of total billed charges,1793.4,98% of total billed charges,1793.4,98% of total billed charges,878.4,48% of total billed charges,146.23,115% of CMS,124.3,97.75% of CMS,146.23,115% of CMS,146.23,115% of CMS,124.3,1807.86,1464
Outpatient Medical Services,OUTPATIENT SURGICAL,55700,Biopsy of prostate gland,982,434,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,347.2
Outpatient Medical Services,OUTPATIENT SURGICAL,62322,Injection of substance into spinal canal of lower back or sacrum using imaging guidance,761,930,883.5,95% of total billed charges,880.9,94.72% of total billed charges,918.75,98.79% of total billed charges,911.4,98% of total billed charges,911.4,98% of total billed charges,446.4,48% of total billed charges,89.29,115% of CMS,75.89,97.75% of CMS,89.29,115% of CMS,89.29,115% of CMS,75.89,918.75,744
Outpatient Medical Services,OUTPATIENT SURGICAL,62323,Injection of substance into spinal canal of lower back or sacrum using imaging guidance,761,1314,1248.3,95% of total billed charges,1244.62,94.72% of total billed charges,1298.1,98.79% of total billed charges,1287.72,98% of total billed charges,1287.72,98% of total billed charges,630.72,48% of total billed charges,111.16,115% of CMS,94.49,97.75% of CMS,111.16,115% of CMS,111.16,115% of CMS,94.49,1298.1,1051.2
Outpatient Medical Services,OUTPATIENT SURGICAL,64483,Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance,761,1443,1370.85,95% of total billed charges,1366.81,94.72% of total billed charges,1425.54,98.79% of total billed charges,1414.14,98% of total billed charges,1414.14,98% of total billed charges,692.64,48% of total billed charges,124.05,115% of CMS,105.44,97.75% of CMS,124.05,115% of CMS,124.05,115% of CMS,105.44,1425.54,1154.4
Outpatient Medical Services,OUTPATIENT SURGICAL,66984,Removal of cataract with insertion of lens,360,5235,4973.25,95% of total billed charges,4958.59,94.72% of total billed charges,5171.66,98.79% of total billed charges,5130.3,98% of total billed charges,5130.3,98% of total billed charges,2512.8,48% of total billed charges,593.41,115% of CMS,504.4,97.75% of CMS,593.41,115% of CMS,593.41,115% of CMS,504.4,5171.66,4188
Outpatient Medical Services,OUTPATIENT SURGICAL,52000,CYSTOURETHROSCOPY (CYSTOSCOPY) ProFee,982,641,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,512.8
Outpatient Medical Services,OUTPATIENT SURGICAL,52000,CYSTOURETHROSCOPY (CYSTOSCOPY) Fac Fee,360,830,788.5,95% of total billed charges,786.18,94.72% of total billed charges,819.96,98.79% of total billed charges,813.4,98% of total billed charges,813.4,98% of total billed charges,398.4,48% of total billed charges,90.11,115% of CMS,76.6,97.75% of CMS,90.11,115% of CMS,90.11,115% of CMS,76.6,819.96,664
Outpatient Medical Services,OUTPATIENT SURGICAL,20610,DRAIN/INJECT JOINT/BURSA CHARGE Unilateral Fac Fee,761,342,324.9,95% of total billed charges,323.94,94.72% of total billed charges,337.86,98.79% of total billed charges,335.16,98% of total billed charges,335.16,98% of total billed charges,164.16,48% of total billed charges,51.42,115% of CMS,43.7,97.75% of CMS,51.42,115% of CMS,51.42,115% of CMS,43.7,337.86,273.6
Outpatient Medical Services,OUTPATIENT SURGICAL,20610,DRAIN/INJECT JOINT/BURSA CHARGE Unilateral Pro Fee,982,195,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,156
Outpatient Medical Services,OUTPATIENT SURGICAL,20605,"ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, INTERMEDIATE JOINT Fac Fee",761,315,299.25,95% of total billed charges,298.37,94.72% of total billed charges,311.19,98.79% of total billed charges,308.7,98% of total billed charges,308.7,98% of total billed charges,151.2,48% of total billed charges,41.57,115% of CMS,35.34,97.75% of CMS,41.57,115% of CMS,41.57,115% of CMS,35.34,311.19,252
Outpatient Medical Services,OUTPATIENT SURGICAL,20605,"ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, INTERMEDIATE JOINT Pro Fee",982,215,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,172
Outpatient Medical Services,OUTPATIENT SURGICAL,36430,Blood Transfusion,391,885,840.75,95% of total billed charges,838.27,94.72% of total billed charges,874.29,98.79% of total billed charges,867.3,98% of total billed charges,867.3,98% of total billed charges,424.8,48% of total billed charges,44.59,115% of CMS,37.9,97.75% of CMS,44.59,115% of CMS,44.59,115% of CMS,37.9,874.29,708
Outpatient Medical Services,OUTPATIENT SURGICAL,86900,ABO/Rh,300,68,64.6,95% of total billed charges,64.41,94.72% of total billed charges,67.18,98.79% of total billed charges,66.64,98% of total billed charges,66.64,98% of total billed charges,32.64,48% of total billed charges,2.99,100% of CMS,2.54,85% of CMS,2.99,100% of CMS,2.99,100% of CMS,2.54,67.18,54.4
Outpatient Medical Services,OUTPATIENT SURGICAL,86901,RH Blood Typing SCHL,300,68,64.6,95% of total billed charges,64.41,94.72% of total billed charges,67.18,98.79% of total billed charges,66.64,98% of total billed charges,66.64,98% of total billed charges,32.64,48% of total billed charges,2.99,100% of CMS,2.54,85% of CMS,2.99,100% of CMS,2.99,100% of CMS,2.54,67.18,54.4
Outpatient Medical Services,OUTPATIENT SURGICAL,31575,PRO LARYNGOSCOPY FLEXIBLE DIAGNOSTIC,982,218,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,174.4
Outpatient Medical Services,OUTPATIENT SURGICAL,31576,PRO LARYNGOSCOPY FLEXIBLE W/BIOPSY(IES),982,360,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,288
Outpatient Medical Services,OUTPATIENT SURGICAL,31575,LARYNGOSCOPY FLEXIBLE DIAGNOSTIC Fac Fee,510,459,436.05,95% of total billed charges,434.76,94.72% of total billed charges,453.45,98.79% of total billed charges,449.82,98% of total billed charges,449.82,98% of total billed charges,220.32,48% of total billed charges,76.44,115% of CMS,64.97,97.75% of CMS,76.44,115% of CMS,76.44,115% of CMS,64.97,453.45,367.2
Outpatient Medical Services,OUTPATIENT SURGICAL,31576,LARYNGOSCOPY FLEXIBLE W/BIOPSY(IES) Fac Fee,510,977,928.15,95% of total billed charges,925.41,94.72% of total billed charges,965.18,98.79% of total billed charges,957.46,98% of total billed charges,957.46,98% of total billed charges,468.96,48% of total billed charges,133.99,115% of CMS,113.89,97.75% of CMS,133.99,115% of CMS,133.99,115% of CMS,113.89,965.18,781.6
Outpatient Medical Services,OUTPATIENT SURGICAL,38510,"Biopsy or excision of lymph node(s); open, deep cervical node(s)",510,2135,2028.25,95% of total billed charges,2022.27,94.72% of total billed charges,2109.17,98.79% of total billed charges,2092.3,98% of total billed charges,2092.3,98% of total billed charges,1024.8,48% of total billed charges,474.61,115% of CMS,403.41,97.75% of CMS,474.61,115% of CMS,474.61,115% of CMS,403.41,2109.17,1708
Outpatient Medical Services,OUTPATIENT SURGICAL,38525,"Biopsy or excision of lymph node(s); open, deep axillary node(s)",510,2046,1943.7,95% of total billed charges,1937.97,94.72% of total billed charges,2021.24,98.79% of total billed charges,2005.08,98% of total billed charges,2005.08,98% of total billed charges,982.08,48% of total billed charges,503.26,115% of CMS,427.77,97.75% of CMS,503.26,115% of CMS,503.26,115% of CMS,427.77,2021.24,1636.8
Outpatient Medical Services,OUTPATIENT SURGICAL,40490,Biopsy of lip,510,377,358.15,95% of total billed charges,357.09,94.72% of total billed charges,372.44,98.79% of total billed charges,369.46,98% of total billed charges,369.46,98% of total billed charges,180.96,48% of total billed charges,77.29,115% of CMS,65.7,97.75% of CMS,77.29,115% of CMS,77.29,115% of CMS,65.7,372.44,301.6
Outpatient Medical Services,LAB,36415,Lab Draw Fee,300,50,47.5,95% of total billed charges,47.36,94.72% of total billed charges,49.4,98.79% of total billed charges,49,98% of total billed charges,49,98% of total billed charges,24,48% of total billed charges,8.83,100% of CMS,7.51,85% of CMS,8.83,100% of CMS,8.83,100% of CMS,7.51,49.4,40
Outpatient Medical Services,LAB,88309,TISSUE SPECIMEN LEVEL 6,312,491,466.45,95% of total billed charges,465.08,94.72% of total billed charges,485.06,98.79% of total billed charges,481.18,98% of total billed charges,481.18,98% of total billed charges,235.68,48% of total billed charges,463.09,115% of CMS,393.63,97.75% of CMS,463.09,115% of CMS,463.09,115% of CMS,235.68,485.06,392.8
Outpatient Medical Services,LAB,88307,TISSUE SPECIMEN LEVEL 5,312,198,188.1,95% of total billed charges,187.55,94.72% of total billed charges,195.6,98.79% of total billed charges,194.04,98% of total billed charges,194.04,98% of total billed charges,95.04,48% of total billed charges,227.7,115% of CMS,193.55,97.75% of CMS,227.7,115% of CMS,227.7,115% of CMS,95.04,227.7,158.4
Outpatient Medical Services,LAB,88305,TISSUE SPECIMEN LEVEL 4,312,54,51.3,95% of total billed charges,51.15,94.72% of total billed charges,53.35,98.79% of total billed charges,52.92,98% of total billed charges,52.92,98% of total billed charges,25.92,48% of total billed charges,62.1,115% of CMS,52.79,97.75% of CMS,62.1,115% of CMS,62.1,115% of CMS,25.92,62.1,43.2
Outpatient Medical Services,LAB,88304,TISSUE SPECIMEN LEVEL 3,312,47,44.65,95% of total billed charges,44.52,94.72% of total billed charges,46.43,98.79% of total billed charges,46.06,98% of total billed charges,46.06,98% of total billed charges,22.56,48% of total billed charges,45.93,115% of CMS,39.04,97.75% of CMS,45.93,115% of CMS,45.93,115% of CMS,22.56,46.43,37.6
Outpatient Medical Services,LAB,88302,TISSUE SPECIMEN LEVEL 2,312,43,40.85,95% of total billed charges,40.73,94.72% of total billed charges,42.48,98.79% of total billed charges,42.14,98% of total billed charges,42.14,98% of total billed charges,20.64,48% of total billed charges,35.51,115% of CMS,30.19,97.75% of CMS,35.51,115% of CMS,35.51,115% of CMS,20.64,42.48,34.4
Outpatient Medical Services,LAB,88300,TISSUE SPECIMEN LEVEL 1 GROSS ONLY,312,70,66.5,95% of total billed charges,66.3,94.72% of total billed charges,69.15,98.79% of total billed charges,68.6,98% of total billed charges,68.6,98% of total billed charges,33.6,48% of total billed charges,17.56,115% of CMS,14.93,97.75% of CMS,17.56,115% of CMS,17.56,115% of CMS,14.93,69.15,56
Outpatient Medical Services,LAB,87086,Culture Urine,300,108,102.6,95% of total billed charges,102.3,94.72% of total billed charges,106.69,98.79% of total billed charges,105.84,98% of total billed charges,105.84,98% of total billed charges,51.84,48% of total billed charges,8.07,100% of CMS,6.86,85% of CMS,8.07,100% of CMS,8.07,100% of CMS,6.86,106.69,86.4
Outpatient Medical Services,LAB,87070,Culture Wound / body fluid / Throat / Eye / Ear,300,116,110.2,95% of total billed charges,109.88,94.72% of total billed charges,114.6,98.79% of total billed charges,113.68,98% of total billed charges,113.68,98% of total billed charges,55.68,48% of total billed charges,8.62,100% of CMS,7.33,85% of CMS,8.62,100% of CMS,8.62,100% of CMS,7.33,114.6,92.8
Outpatient Medical Services,LAB,87040,"Culture, bacterial; blood",300,120,114,95% of total billed charges,113.66,94.72% of total billed charges,118.55,98.79% of total billed charges,117.6,98% of total billed charges,117.6,98% of total billed charges,57.6,48% of total billed charges,10.32,100% of CMS,8.77,85% of CMS,10.32,100% of CMS,10.32,100% of CMS,8.77,118.55,96
Outpatient Medical Services,LAB,86140,C-REACTIVE PROTEIN,300,86,81.7,95% of total billed charges,81.46,94.72% of total billed charges,84.96,98.79% of total billed charges,84.28,98% of total billed charges,84.28,98% of total billed charges,41.28,48% of total billed charges,5.18,100% of CMS,4.4,85% of CMS,5.18,100% of CMS,5.18,100% of CMS,4.4,84.96,68.8
Outpatient Medical Services,LAB,85730,Coagulation assessment blood test,300,80,76,95% of total billed charges,75.78,94.72% of total billed charges,79.03,98.79% of total billed charges,78.4,98% of total billed charges,78.4,98% of total billed charges,38.4,48% of total billed charges,6.01,100% of CMS,5.11,85% of CMS,6.01,100% of CMS,6.01,100% of CMS,5.11,79.03,64
Outpatient Medical Services,LAB,85610,"Blood test, clotting time",300,50,47.5,95% of total billed charges,47.36,94.72% of total billed charges,49.4,98.79% of total billed charges,49,98% of total billed charges,49,98% of total billed charges,24,48% of total billed charges,4.29,100% of CMS,3.65,85% of CMS,4.29,100% of CMS,4.29,100% of CMS,3.65,49.4,40
Outpatient Medical Services,LAB,85610,PROTIME/INR,300,50,47.5,95% of total billed charges,47.36,94.72% of total billed charges,49.4,98.79% of total billed charges,49,98% of total billed charges,49,98% of total billed charges,24,48% of total billed charges,4.29,100% of CMS,3.65,85% of CMS,4.29,100% of CMS,4.29,100% of CMS,3.65,49.4,40
Outpatient Medical Services,LAB,85379,D-DIMER,300,164,155.8,95% of total billed charges,155.34,94.72% of total billed charges,162.02,98.79% of total billed charges,160.72,98% of total billed charges,160.72,98% of total billed charges,78.72,48% of total billed charges,10.18,100% of CMS,8.65,85% of CMS,10.18,100% of CMS,10.18,100% of CMS,8.65,162.02,131.2
Outpatient Medical Services,LAB,85027,"Complete blood count, automated",300,90,85.5,95% of total billed charges,85.25,94.72% of total billed charges,88.91,98.79% of total billed charges,88.2,98% of total billed charges,88.2,98% of total billed charges,43.2,48% of total billed charges,6.47,100% of CMS,5.5,85% of CMS,6.47,100% of CMS,6.47,100% of CMS,5.5,88.91,72
Outpatient Medical Services,LAB,85025,"Complete blood cell count, with diff white blood cells, automated",300,97,92.15,95% of total billed charges,91.88,94.72% of total billed charges,95.83,98.79% of total billed charges,95.06,98% of total billed charges,95.06,98% of total billed charges,46.56,48% of total billed charges,7.77,100% of CMS,6.6,85% of CMS,7.77,100% of CMS,7.77,100% of CMS,6.6,95.83,77.6
Outpatient Medical Services,LAB,84484,TROPONIN,300,114,108.3,95% of total billed charges,107.98,94.72% of total billed charges,112.62,98.79% of total billed charges,111.72,98% of total billed charges,111.72,98% of total billed charges,54.72,48% of total billed charges,12.47,100% of CMS,10.6,85% of CMS,12.47,100% of CMS,12.47,100% of CMS,10.6,112.62,91.2
Outpatient Medical Services,LAB,84443,"Blood test, thyroid stimulating hormone (TSH)",300,182,172.9,95% of total billed charges,172.39,94.72% of total billed charges,179.8,98.79% of total billed charges,178.36,98% of total billed charges,178.36,98% of total billed charges,87.36,48% of total billed charges,16.8,100% of CMS,14.28,85% of CMS,16.8,100% of CMS,16.8,100% of CMS,14.28,179.8,145.6
Outpatient Medical Services,LAB,84154,PSA FREE  TOTAL,300,17,16.15,95% of total billed charges,16.1,94.72% of total billed charges,16.79,98.79% of total billed charges,16.66,98% of total billed charges,16.66,98% of total billed charges,8.16,48% of total billed charges,18.39,100% of CMS,15.63,85% of CMS,18.39,100% of CMS,18.39,100% of CMS,8.16,18.39,13.6
Outpatient Medical Services,LAB,84153,PSA DIAGNOSTIC,300,169,160.55,95% of total billed charges,160.08,94.72% of total billed charges,166.96,98.79% of total billed charges,165.62,98% of total billed charges,165.62,98% of total billed charges,81.12,48% of total billed charges,18.39,100% of CMS,15.63,85% of CMS,18.39,100% of CMS,18.39,100% of CMS,15.63,166.96,135.2
Outpatient Medical Services,LAB,84145,PROCALCITONIN,300,309,293.55,95% of total billed charges,292.68,94.72% of total billed charges,305.26,98.79% of total billed charges,302.82,98% of total billed charges,302.82,98% of total billed charges,148.32,48% of total billed charges,27.22,100% of CMS,23.14,85% of CMS,27.22,100% of CMS,27.22,100% of CMS,23.14,305.26,247.2
Outpatient Medical Services,LAB,83735,MAGNESIUM,300,79,75.05,95% of total billed charges,74.83,94.72% of total billed charges,78.04,98.79% of total billed charges,77.42,98% of total billed charges,77.42,98% of total billed charges,37.92,48% of total billed charges,6.7,100% of CMS,5.7,85% of CMS,6.7,100% of CMS,6.7,100% of CMS,5.7,78.04,63.2
Outpatient Medical Services,LAB,83690,Lipase,300,132,125.4,95% of total billed charges,125.03,94.72% of total billed charges,130.4,98.79% of total billed charges,129.36,98% of total billed charges,129.36,98% of total billed charges,63.36,48% of total billed charges,6.89,100% of CMS,5.86,85% of CMS,6.89,100% of CMS,6.89,100% of CMS,5.86,130.4,105.6
Outpatient Medical Services,LAB,83605,LACTIC ACID,300,188,178.6,95% of total billed charges,178.07,94.72% of total billed charges,185.73,98.79% of total billed charges,184.24,98% of total billed charges,184.24,98% of total billed charges,90.24,48% of total billed charges,11.57,100% of CMS,9.83,85% of CMS,11.57,100% of CMS,11.57,100% of CMS,9.83,185.73,150.4
Outpatient Medical Services,LAB,83036,HEMOGLOBIN GLYCOSYLATED (A1C),300,110,104.5,95% of total billed charges,104.19,94.72% of total billed charges,108.67,98.79% of total billed charges,107.8,98% of total billed charges,107.8,98% of total billed charges,52.8,48% of total billed charges,9.71,100% of CMS,8.25,85% of CMS,9.71,100% of CMS,9.71,100% of CMS,8.25,108.67,88
Outpatient Medical Services,LAB,82607,VITAMIN B12,300,180,171,95% of total billed charges,170.5,94.72% of total billed charges,177.82,98.79% of total billed charges,176.4,98% of total billed charges,176.4,98% of total billed charges,86.4,48% of total billed charges,15.08,100% of CMS,12.82,85% of CMS,15.08,100% of CMS,15.08,100% of CMS,12.82,177.82,144
Outpatient Medical Services,LAB,82306,VITAMIN D 25 HYDROXY,300,269,255.55,95% of total billed charges,254.8,94.72% of total billed charges,265.75,98.79% of total billed charges,263.62,98% of total billed charges,263.62,98% of total billed charges,129.12,48% of total billed charges,29.6,100% of CMS,25.16,85% of CMS,29.6,100% of CMS,29.6,100% of CMS,25.16,265.75,215.2
Outpatient Medical Services,LAB,81003,Automated urinalysis test,307,27,25.65,95% of total billed charges,25.57,94.72% of total billed charges,26.67,98.79% of total billed charges,26.46,98% of total billed charges,26.46,98% of total billed charges,12.96,48% of total billed charges,2.25,100% of CMS,1.91,85% of CMS,2.25,100% of CMS,2.25,100% of CMS,1.91,26.67,21.6
Outpatient Medical Services,LAB,81001,Manual urinalysis test with examination using microscope,307,57,54.15,95% of total billed charges,53.99,94.72% of total billed charges,56.31,98.79% of total billed charges,55.86,98% of total billed charges,55.86,98% of total billed charges,27.36,48% of total billed charges,3.17,100% of CMS,2.69,85% of CMS,3.17,100% of CMS,3.17,100% of CMS,2.69,56.31,45.6
Outpatient Medical Services,LAB,80076,Liver function blood test panel,300,145,137.75,95% of total billed charges,137.34,94.72% of total billed charges,143.25,98.79% of total billed charges,142.1,98% of total billed charges,142.1,98% of total billed charges,69.6,48% of total billed charges,8.17,100% of CMS,6.94,85% of CMS,8.17,100% of CMS,8.17,100% of CMS,6.94,143.25,116
Outpatient Medical Services,LAB,80069,Kidney function panel test,300,124,117.8,95% of total billed charges,117.45,94.72% of total billed charges,122.5,98.79% of total billed charges,121.52,98% of total billed charges,121.52,98% of total billed charges,59.52,48% of total billed charges,8.68,100% of CMS,7.38,85% of CMS,8.68,100% of CMS,8.68,100% of CMS,7.38,122.5,99.2
Outpatient Medical Services,LAB,80061,"Blood test, lipids (cholesterol and triglycerides)",300,171,162.45,95% of total billed charges,161.97,94.72% of total billed charges,168.93,98.79% of total billed charges,167.58,98% of total billed charges,167.58,98% of total billed charges,82.08,48% of total billed charges,13.39,100% of CMS,11.38,85% of CMS,13.39,100% of CMS,13.39,100% of CMS,11.38,168.93,136.8
Outpatient Medical Services,LAB,80053,"Blood test, comprehensive group of blood chemicals",300,161,152.95,95% of total billed charges,152.5,94.72% of total billed charges,159.05,98.79% of total billed charges,157.78,98% of total billed charges,157.78,98% of total billed charges,77.28,48% of total billed charges,10.56,100% of CMS,8.98,85% of CMS,10.56,100% of CMS,10.56,100% of CMS,8.98,159.05,128.8
Outpatient Medical Services,LAB,80048,Basic metabolic panel (BMP),300,140,133,95% of total billed charges,132.61,94.72% of total billed charges,138.31,98.79% of total billed charges,137.2,98% of total billed charges,137.2,98% of total billed charges,67.2,48% of total billed charges,8.46,100% of CMS,7.19,85% of CMS,8.46,100% of CMS,8.46,100% of CMS,7.19,138.31,112
Outpatient Medical Services,LAB,87651,STREP GROUP A PCR,300,261,247.95,95% of total billed charges,247.22,94.72% of total billed charges,257.84,98.79% of total billed charges,255.78,98% of total billed charges,255.78,98% of total billed charges,125.28,48% of total billed charges,35.09,100% of CMS,29.83,85% of CMS,35.09,100% of CMS,35.09,100% of CMS,29.83,257.84,208.8
Outpatient Medical Services,LAB,87502,INFLUENZA A PCR,300,124,117.8,95% of total billed charges,117.45,94.72% of total billed charges,122.5,98.79% of total billed charges,121.52,98% of total billed charges,121.52,98% of total billed charges,59.52,48% of total billed charges,95.8,100% of CMS,81.43,85% of CMS,95.8,100% of CMS,95.8,100% of CMS,59.52,122.5,99.2
Outpatient Medical Services,LAB,87502,INFLUENZA B PCR,300,124,117.8,95% of total billed charges,117.45,94.72% of total billed charges,122.5,98.79% of total billed charges,121.52,98% of total billed charges,121.52,98% of total billed charges,59.52,48% of total billed charges,95.8,100% of CMS,81.43,85% of CMS,95.8,100% of CMS,95.8,100% of CMS,59.52,122.5,99.2
Outpatient Medical Services,LAB,87077,CULTURE ID,300,129,122.55,95% of total billed charges,122.19,94.72% of total billed charges,127.44,98.79% of total billed charges,126.42,98% of total billed charges,126.42,98% of total billed charges,61.92,48% of total billed charges,8.08,100% of CMS,6.87,85% of CMS,8.08,100% of CMS,8.08,100% of CMS,6.87,127.44,103.2
Outpatient Medical Services,LAB,82728,FERRITIN,300,164,155.8,95% of total billed charges,155.34,94.72% of total billed charges,162.02,98.79% of total billed charges,160.72,98% of total billed charges,160.72,98% of total billed charges,78.72,48% of total billed charges,13.63,100% of CMS,11.59,85% of CMS,13.63,100% of CMS,13.63,100% of CMS,11.59,162.02,131.2
Outpatient Medical Services,LAB,82746,FOLATE-FOLIC ACID,300,183,173.85,95% of total billed charges,173.34,94.72% of total billed charges,180.79,98.79% of total billed charges,179.34,98% of total billed charges,179.34,98% of total billed charges,87.84,48% of total billed charges,14.7,100% of CMS,12.5,85% of CMS,14.7,100% of CMS,14.7,100% of CMS,12.5,180.79,146.4
Outpatient Medical Services,LAB,84550,URIC ACID,300,44,41.8,95% of total billed charges,41.68,94.72% of total billed charges,43.47,98.79% of total billed charges,43.12,98% of total billed charges,43.12,98% of total billed charges,21.12,48% of total billed charges,4.52,100% of CMS,3.84,85% of CMS,4.52,100% of CMS,4.52,100% of CMS,3.84,43.47,35.2
Outpatient Medical Services,LAB,83615,Lactate dehydrogenase (LD) (LDH),300,50,47.5,95% of total billed charges,47.36,94.72% of total billed charges,49.4,98.79% of total billed charges,49,98% of total billed charges,49,98% of total billed charges,24,48% of total billed charges,6.04,100% of CMS,5.13,85% of CMS,6.04,100% of CMS,6.04,100% of CMS,5.13,49.4,40
Outpatient Medical Services,LAB,82565,CREATININE SERUM,300,45,42.75,95% of total billed charges,42.62,94.72% of total billed charges,44.46,98.79% of total billed charges,44.1,98% of total billed charges,44.1,98% of total billed charges,21.6,48% of total billed charges,5.12,100% of CMS,4.35,85% of CMS,5.12,100% of CMS,5.12,100% of CMS,4.35,44.46,36
Outpatient Medical Services,LAB,81025,PREGNANCY URINE,307,85,80.75,95% of total billed charges,80.51,94.72% of total billed charges,83.97,98.79% of total billed charges,83.3,98% of total billed charges,83.3,98% of total billed charges,40.8,48% of total billed charges,8.61,100% of CMS,7.32,85% of CMS,8.61,100% of CMS,8.61,100% of CMS,7.32,83.97,68
Outpatient Medical Services,LAB,88185,FLOW CYTOMETRY-ADDITIONAL MARKER,310,61,57.95,95% of total billed charges,57.78,94.72% of total billed charges,60.26,98.79% of total billed charges,59.78,98% of total billed charges,59.78,98% of total billed charges,29.28,48% of total billed charges,24.76,115% of CMS,21.05,97.75% of CMS,24.76,115% of CMS,24.76,115% of CMS,21.05,60.26,48.8
Outpatient Medical Services,LAB,82274,OCCULT BLD DIAGNOSTIC (LAB),300,212,201.4,95% of total billed charges,200.81,94.72% of total billed charges,209.43,98.79% of total billed charges,207.76,98% of total billed charges,207.76,98% of total billed charges,101.76,48% of total billed charges,15.92,100% of CMS,13.53,85% of CMS,15.92,100% of CMS,15.92,100% of CMS,13.53,209.43,169.6
Outpatient Medical Services,RADIOLOGY,70200,ORBITS MIN 4 VIEW,320,228,216.6,95% of total billed charges,215.96,94.72% of total billed charges,225.24,98.79% of total billed charges,223.44,98% of total billed charges,223.44,98% of total billed charges,109.44,48% of total billed charges,51.37,115% of CMS,43.66,97.75% of CMS,51.37,115% of CMS,51.37,115% of CMS,43.66,225.24,182.4
Outpatient Medical Services,RADIOLOGY,70450,"CT scan, head or brain, without contrast",351,1147,1089.65,95% of total billed charges,1086.44,94.72% of total billed charges,1133.12,98.79% of total billed charges,1124.06,98% of total billed charges,1124.06,98% of total billed charges,550.56,48% of total billed charges,117.08,115% of CMS,99.52,97.75% of CMS,117.08,115% of CMS,117.08,115% of CMS,99.52,1133.12,917.6
Outpatient Medical Services,RADIOLOGY,70486,CT SINUSES without contrast,351,1143,1085.85,95% of total billed charges,1082.65,94.72% of total billed charges,1129.17,98.79% of total billed charges,1120.14,98% of total billed charges,1120.14,98% of total billed charges,548.64,48% of total billed charges,140.79,115% of CMS,119.68,97.75% of CMS,140.79,115% of CMS,140.79,115% of CMS,119.68,1129.17,914.4
Outpatient Medical Services,RADIOLOGY,70553,MRI scan of brain before and after contrast,610,3974,3775.3,95% of total billed charges,3764.17,94.72% of total billed charges,3925.91,98.79% of total billed charges,3894.52,98% of total billed charges,3894.52,98% of total billed charges,1907.52,48% of total billed charges,351.76,115% of CMS,299,97.75% of CMS,351.76,115% of CMS,351.76,115% of CMS,299,3925.91,3179.2
Outpatient Medical Services,RADIOLOGY,71045,CHEST SINGLE VIEW,320,211,200.45,95% of total billed charges,199.86,94.72% of total billed charges,208.45,98.79% of total billed charges,206.78,98% of total billed charges,206.78,98% of total billed charges,101.28,48% of total billed charges,27.66,115% of CMS,23.51,97.75% of CMS,27.66,115% of CMS,27.66,115% of CMS,23.51,208.45,168.8
Outpatient Medical Services,RADIOLOGY,71046,CHEST 2 VIEWS,320,272,258.4,95% of total billed charges,257.64,94.72% of total billed charges,268.71,98.79% of total billed charges,266.56,98% of total billed charges,266.56,98% of total billed charges,130.56,48% of total billed charges,36.17,115% of CMS,30.74,97.75% of CMS,36.17,115% of CMS,36.17,115% of CMS,30.74,268.71,217.6
Outpatient Medical Services,RADIOLOGY,72074,X-RAY THORACIC SPINE MIN 4 VIEWS,320,245,232.75,95% of total billed charges,232.06,94.72% of total billed charges,242.04,98.79% of total billed charges,240.1,98% of total billed charges,240.1,98% of total billed charges,117.6,48% of total billed charges,47.78,115% of CMS,40.62,97.75% of CMS,47.78,115% of CMS,47.78,115% of CMS,40.62,242.04,196
Outpatient Medical Services,RADIOLOGY,72110,"X-Ray, lower back, minimum four views",320,301,285.95,95% of total billed charges,285.11,94.72% of total billed charges,297.36,98.79% of total billed charges,294.98,98% of total billed charges,294.98,98% of total billed charges,144.48,48% of total billed charges,55.49,115% of CMS,47.16,97.75% of CMS,55.49,115% of CMS,55.49,115% of CMS,47.16,297.36,240.8
Outpatient Medical Services,RADIOLOGY,72148,MRI scan of lower spinal canal W/o contrast,610,3357,3189.15,95% of total billed charges,3179.75,94.72% of total billed charges,3316.38,98.79% of total billed charges,3289.86,98% of total billed charges,3289.86,98% of total billed charges,1611.36,48% of total billed charges,211.8,115% of CMS,180.03,97.75% of CMS,211.8,115% of CMS,211.8,115% of CMS,180.03,3316.38,2685.6
Outpatient Medical Services,RADIOLOGY,72193,"CT scan, pelvis, with contrast",352,1345,1277.75,95% of total billed charges,1273.98,94.72% of total billed charges,1328.73,98.79% of total billed charges,1318.1,98% of total billed charges,1318.1,98% of total billed charges,645.6,48% of total billed charges,211.33,115% of CMS,211.33,97.75% of CMS,211.33,115% of CMS,211.33,115% of CMS,211.33,1328.73,1076
Outpatient Medical Services,RADIOLOGY,73080,X-RAY ELBOW 3 VIEW,320,154,146.3,95% of total billed charges,145.87,94.72% of total billed charges,152.14,98.79% of total billed charges,150.92,98% of total billed charges,150.92,98% of total billed charges,73.92,48% of total billed charges,35.29,115% of CMS,30,97.75% of CMS,35.29,115% of CMS,35.29,115% of CMS,30,152.14,123.2
Outpatient Medical Services,RADIOLOGY,73130,X-RAY HAND 3 VIEW MIN,320,190,180.5,95% of total billed charges,179.97,94.72% of total billed charges,187.7,98.79% of total billed charges,186.2,98% of total billed charges,186.2,98% of total billed charges,91.2,48% of total billed charges,39.84,115% of CMS,33.86,97.75% of CMS,39.84,115% of CMS,39.84,115% of CMS,33.86,187.7,152
Outpatient Medical Services,RADIOLOGY,73140,X-RAY FINGERS HAND 2ND DIGIT,320,143,135.85,95% of total billed charges,135.45,94.72% of total billed charges,141.27,98.79% of total billed charges,140.14,98% of total billed charges,140.14,98% of total billed charges,68.64,48% of total billed charges,40.74,115% of CMS,34.63,97.75% of CMS,40.74,115% of CMS,40.74,115% of CMS,34.63,141.27,114.4
Outpatient Medical Services,RADIOLOGY,73502,X-RAY HIP 2 VIEW,320,196,186.2,95% of total billed charges,185.65,94.72% of total billed charges,193.63,98.79% of total billed charges,192.08,98% of total billed charges,192.08,98% of total billed charges,94.08,48% of total billed charges,50.82,115% of CMS,43.2,97.75% of CMS,50.82,115% of CMS,50.82,115% of CMS,43.2,193.63,156.8
Outpatient Medical Services,RADIOLOGY,73560,X-RAY KNEE 2 VIEW,320,161,152.95,95% of total billed charges,152.5,94.72% of total billed charges,159.05,98.79% of total billed charges,157.78,98% of total billed charges,157.78,98% of total billed charges,77.28,48% of total billed charges,36.66,115% of CMS,31.16,97.75% of CMS,36.66,115% of CMS,36.66,115% of CMS,31.16,159.05,128.8
Outpatient Medical Services,RADIOLOGY,73564,X-RAY KNEE 4 VIEWS RT,320,229,217.55,95% of total billed charges,216.91,94.72% of total billed charges,226.23,98.79% of total billed charges,224.42,98% of total billed charges,224.42,98% of total billed charges,109.92,48% of total billed charges,50.46,115% of CMS,42.89,97.75% of CMS,50.46,115% of CMS,50.46,115% of CMS,42.89,226.23,183.2
Outpatient Medical Services,RADIOLOGY,73620,X-RAY FOOT 2 VIEW,320,154,146.3,95% of total billed charges,145.87,94.72% of total billed charges,152.14,98.79% of total billed charges,150.92,98% of total billed charges,150.92,98% of total billed charges,73.92,48% of total billed charges,30.73,115% of CMS,26.12,97.75% of CMS,30.73,115% of CMS,30.73,115% of CMS,26.12,152.14,123.2
Outpatient Medical Services,RADIOLOGY,73718,MRI LEG without contrast,610,2547,2419.65,95% of total billed charges,2412.52,94.72% of total billed charges,2516.18,98.79% of total billed charges,2496.06,98% of total billed charges,2496.06,98% of total billed charges,1222.56,48% of total billed charges,245.78,115% of CMS,208.91,97.75% of CMS,245.78,115% of CMS,245.78,115% of CMS,208.91,2516.18,2037.6
Outpatient Medical Services,RADIOLOGY,73721,MRI scan of leg joint Without contrast,610,2674,2540.3,95% of total billed charges,2532.81,94.72% of total billed charges,2641.64,98.79% of total billed charges,2620.52,98% of total billed charges,2620.52,98% of total billed charges,1283.52,48% of total billed charges,223.46,115% of CMS,189.94,97.75% of CMS,223.46,115% of CMS,223.46,115% of CMS,189.94,2641.64,2139.2
Outpatient Medical Services,RADIOLOGY,74177,CT scan of abdomen and pelvis with contrast,350,2128,2021.6,95% of total billed charges,2015.64,94.72% of total billed charges,2102.25,98.79% of total billed charges,2085.44,98% of total billed charges,2085.44,98% of total billed charges,1021.44,48% of total billed charges,333.02,115% of CMS,283.06,97.75% of CMS,333.02,115% of CMS,333.02,115% of CMS,283.06,2102.25,1702.4
Outpatient Medical Services,RADIOLOGY,76700,Ultrasound of abdomen,402,922,875.9,95% of total billed charges,873.32,94.72% of total billed charges,910.84,98.79% of total billed charges,903.56,98% of total billed charges,903.56,98% of total billed charges,442.56,48% of total billed charges,125.06,115% of CMS,106.3,97.75% of CMS,125.06,115% of CMS,125.06,115% of CMS,106.3,910.84,737.6
Outpatient Medical Services,RADIOLOGY,76706,US ABD AORTA SCREENING,402,537,510.15,95% of total billed charges,508.65,94.72% of total billed charges,530.5,98.79% of total billed charges,526.26,98% of total billed charges,526.26,98% of total billed charges,257.76,48% of total billed charges,113.86,115% of CMS,96.78,97.75% of CMS,113.86,115% of CMS,113.86,115% of CMS,96.78,530.5,429.6
Outpatient Medical Services,RADIOLOGY,76805,Abdominal ultrasound of pregnant uterus (greater or equal to 14 weeks 0 days) single or first fetus,402,810,769.5,95% of total billed charges,767.23,94.72% of total billed charges,800.2,98.79% of total billed charges,793.8,98% of total billed charges,793.8,98% of total billed charges,388.8,48% of total billed charges,145.9,115% of CMS,124.02,97.75% of CMS,145.9,115% of CMS,145.9,115% of CMS,124.02,800.2,648
Outpatient Medical Services,RADIOLOGY,76830,Ultrasound pelvis through vagina,402,657,624.15,95% of total billed charges,622.31,94.72% of total billed charges,649.05,98.79% of total billed charges,643.86,98% of total billed charges,643.86,98% of total billed charges,315.36,48% of total billed charges,127.7,115% of CMS,108.54,97.75% of CMS,127.7,115% of CMS,127.7,115% of CMS,108.54,649.05,525.6
Outpatient Medical Services,RADIOLOGY,77065,Mammography of one breast,401,1151,1093.45,95% of total billed charges,1090.23,94.72% of total billed charges,1137.07,98.79% of total billed charges,1127.98,98% of total billed charges,1127.98,98% of total billed charges,552.48,48% of total billed charges,134.38,115% of CMS,114.22,97.75% of CMS,134.38,115% of CMS,134.38,115% of CMS,114.22,1137.07,920.8
Outpatient Medical Services,RADIOLOGY,77066,Mammography of both breasts,401,1418,1347.1,95% of total billed charges,1343.13,94.72% of total billed charges,1400.84,98.79% of total billed charges,1389.64,98% of total billed charges,1389.64,98% of total billed charges,680.64,48% of total billed charges,170.1,115% of CMS,144.58,97.75% of CMS,170.1,115% of CMS,170.1,115% of CMS,144.58,1400.84,1134.4
Outpatient Medical Services,RADIOLOGY,77067,"Mammography, screening, bilateral",403,657,624.15,95% of total billed charges,622.31,94.72% of total billed charges,649.05,98.79% of total billed charges,643.86,98% of total billed charges,643.86,98% of total billed charges,315.36,48% of total billed charges,137,115% of CMS,116.45,97.75% of CMS,137,115% of CMS,137,115% of CMS,116.45,649.05,525.6
Outpatient Medical Services,RADIOLOGY,93005,X-RAY EKG EO,730,160,152,95% of total billed charges,151.55,94.72% of total billed charges,158.06,98.79% of total billed charges,156.8,98% of total billed charges,156.8,98% of total billed charges,76.8,48% of total billed charges,6.72,115% of CMS,5.71,97.75% of CMS,6.72,115% of CMS,6.72,115% of CMS,5.71,158.06,128
Outpatient Medical Services,RADIOLOGY,97112,PT NEUROMUSCULAR RE-ED EA 15 MIN,320,86,81.7,95% of total billed charges,81.46,94.72% of total billed charges,84.96,98.79% of total billed charges,84.28,98% of total billed charges,84.28,98% of total billed charges,41.28,48% of total billed charges,37.02,115% of CMS,31.47,97.75% of CMS,37.02,115% of CMS,37.02,115% of CMS,31.47,84.96,68.8
Outpatient Medical Services,RADIOLOGY,70470,"CT scan, head or brain, with & without contrast",351,1798,1708.1,95% of total billed charges,1703.07,94.72% of total billed charges,1776.24,98.79% of total billed charges,1762.04,98% of total billed charges,1762.04,98% of total billed charges,863.04,48% of total billed charges,191.45,115% of CMS,162.73,97.75% of CMS,191.45,115% of CMS,191.45,115% of CMS,162.73,1776.24,1438.4
Outpatient Medical Services,RADIOLOGY,70460,"CT scan, head or brain, with contrast",351,1427,1355.65,95% of total billed charges,1351.65,94.72% of total billed charges,1409.73,98.79% of total billed charges,1398.46,98% of total billed charges,1398.46,98% of total billed charges,684.96,48% of total billed charges,163.56,115% of CMS,139.03,97.75% of CMS,163.56,115% of CMS,163.56,115% of CMS,139.03,1409.73,1141.6
Outpatient Medical Services,RADIOLOGY,74176,CT ABD/PELVIS W/O,350,1932,1835.4,95% of total billed charges,1829.99,94.72% of total billed charges,1908.62,98.79% of total billed charges,1893.36,98% of total billed charges,1893.36,98% of total billed charges,927.36,48% of total billed charges,203.37,115% of CMS,172.86,97.75% of CMS,203.37,115% of CMS,203.37,115% of CMS,172.86,1908.62,1545.6
Outpatient Medical Services,RADIOLOGY,74177,CT ABD/PELVIS W,350,2128,2021.6,95% of total billed charges,2015.64,94.72% of total billed charges,2102.25,98.79% of total billed charges,2085.44,98% of total billed charges,2085.44,98% of total billed charges,1021.44,48% of total billed charges,333.02,115% of CMS,283.06,97.75% of CMS,333.02,115% of CMS,333.02,115% of CMS,283.06,2102.25,1702.4
Outpatient Medical Services,RADIOLOGY,77080,BD Bone Density DEXA,320,611,580.45,95% of total billed charges,578.74,94.72% of total billed charges,603.61,98.79% of total billed charges,598.78,98% of total billed charges,598.78,98% of total billed charges,293.28,48% of total billed charges,41.68,115% of CMS,35.42,97.75% of CMS,41.68,115% of CMS,41.68,115% of CMS,35.42,603.61,488.8
Outpatient Medical Services,RADIOLOGY,71271,CT LUNG LDCT SCREENING,320,405,384.75,95% of total billed charges,383.62,94.72% of total billed charges,400.1,98.79% of total billed charges,396.9,98% of total billed charges,396.9,98% of total billed charges,194.4,48% of total billed charges,152,115% of CMS,129.2,97.75% of CMS,152,115% of CMS,152,115% of CMS,129.2,400.1,324
Outpatient Medical Services,RADIOLOGY,73630,X-RAY FOOT 3 VIEW,320,212,201.4,95% of total billed charges,200.81,94.72% of total billed charges,209.43,98.79% of total billed charges,207.76,98% of total billed charges,207.76,98% of total billed charges,101.76,48% of total billed charges,36.7,115% of CMS,31.19,97.75% of CMS,36.7,115% of CMS,36.7,115% of CMS,31.19,209.43,169.6
Outpatient Medical Services,RADIOLOGY,72170,PELVIS 1 TO 2 VIEWS,320,183,173.85,95% of total billed charges,173.34,94.72% of total billed charges,180.79,98.79% of total billed charges,179.34,98% of total billed charges,179.34,98% of total billed charges,87.84,48% of total billed charges,30.07,115% of CMS,25.56,97.75% of CMS,30.07,115% of CMS,30.07,115% of CMS,25.56,180.79,146.4
Outpatient Medical Services,RADIOLOGY,72190,PELVIS MIN 3 VIEWS,320,183,173.85,95% of total billed charges,173.34,94.72% of total billed charges,180.79,98.79% of total billed charges,179.34,98% of total billed charges,179.34,98% of total billed charges,87.84,48% of total billed charges,45.33,115% of CMS,38.53,97.75% of CMS,45.33,115% of CMS,45.33,115% of CMS,38.53,180.79,146.4
Outpatient Medical Services,RADIOLOGY,73020,SHOULDER ONE VIEW,320,140,133,95% of total billed charges,132.61,94.72% of total billed charges,138.31,98.79% of total billed charges,137.2,98% of total billed charges,137.2,98% of total billed charges,67.2,48% of total billed charges,23.38,115% of CMS,19.87,97.75% of CMS,23.38,115% of CMS,23.38,115% of CMS,19.87,138.31,112
Outpatient Medical Services,RADIOLOGY,73030,SHOULDER MIN 2 VIEWS,320,175,166.25,95% of total billed charges,165.76,94.72% of total billed charges,172.88,98.79% of total billed charges,171.5,98% of total billed charges,171.5,98% of total billed charges,84,48% of total billed charges,37.42,115% of CMS,31.81,97.75% of CMS,37.42,115% of CMS,37.42,115% of CMS,31.81,172.88,140
Outpatient Medical Services,RADIOLOGY,72125,CT C SPINE W/O CONTRAST,350,1691,1606.45,95% of total billed charges,1601.72,94.72% of total billed charges,1670.54,98.79% of total billed charges,1657.18,98% of total billed charges,1657.18,98% of total billed charges,811.68,48% of total billed charges,143.5,115% of CMS,121.97,97.75% of CMS,143.5,115% of CMS,143.5,115% of CMS,121.97,1670.54,1352.8
Outpatient Medical Services,RADIOLOGY,72126,CT C SPINE WITH CONTRAST,352,1705,1619.75,95% of total billed charges,1614.98,94.72% of total billed charges,1684.37,98.79% of total billed charges,1670.9,98% of total billed charges,1670.9,98% of total billed charges,818.4,48% of total billed charges,185.94,115% of CMS,158.05,97.75% of CMS,185.94,115% of CMS,185.94,115% of CMS,158.05,1684.37,1364
Outpatient Medical Services,RADIOLOGY,74240,X-RAY UPPER GI,320,416,395.2,95% of total billed charges,394.04,94.72% of total billed charges,410.97,98.79% of total billed charges,407.68,98% of total billed charges,407.68,98% of total billed charges,199.68,48% of total billed charges,131.56,115% of CMS,111.83,97.75% of CMS,131.56,115% of CMS,131.56,115% of CMS,111.83,410.97,332.8
Outpatient Medical Services,RADIOLOGY,77012,CT BIO THYROID,350,1608,1527.6,95% of total billed charges,1523.1,94.72% of total billed charges,1588.54,98.79% of total billed charges,1575.84,98% of total billed charges,1575.84,98% of total billed charges,771.84,48% of total billed charges,151.54,115% of CMS,128.81,97.75% of CMS,151.54,115% of CMS,151.54,115% of CMS,128.81,1588.54,1286.4
Outpatient Medical Services,RADIOLOGY,74150,CT ABD W/O,352,1416,1345.2,95% of total billed charges,1341.24,94.72% of total billed charges,1398.87,98.79% of total billed charges,1387.68,98% of total billed charges,1387.68,98% of total billed charges,679.68,48% of total billed charges,151.23,115% of CMS,128.54,97.75% of CMS,151.23,115% of CMS,151.23,115% of CMS,128.54,1398.87,1132.8
Outpatient Medical Services,RADIOLOGY,74160,CT ABD WITH Contrast,352,1416,1345.2,95% of total billed charges,1341.24,94.72% of total billed charges,1398.87,98.79% of total billed charges,1387.68,98% of total billed charges,1387.68,98% of total billed charges,679.68,48% of total billed charges,216.42,115% of CMS,216.42,97.75% of CMS,216.42,115% of CMS,216.42,115% of CMS,216.42,1398.87,1132.8
Outpatient Medical Services,RADIOLOGY,74170,CT ABD With & WITHOUT CONTRAST,352,2148,2040.6,95% of total billed charges,2034.59,94.72% of total billed charges,2122.01,98.79% of total billed charges,2105.04,98% of total billed charges,2105.04,98% of total billed charges,1031.04,48% of total billed charges,221.76,115% of CMS,221.76,97.75% of CMS,221.76,115% of CMS,221.76,115% of CMS,221.76,2122.01,1718.4
Outpatient Medical Services,RADIOLOGY,73070,X-RAY ELBOW 2 VIEW,320,154,146.3,95% of total billed charges,145.87,94.72% of total billed charges,152.14,98.79% of total billed charges,150.92,98% of total billed charges,150.92,98% of total billed charges,73.92,48% of total billed charges,31.43,115% of CMS,26.72,97.75% of CMS,31.43,115% of CMS,31.43,115% of CMS,26.72,152.14,123.2
Outpatient Medical Services,RADIOLOGY,74220,X-RAY ESOPHAGUS,320,314,298.3,95% of total billed charges,297.42,94.72% of total billed charges,310.2,98.79% of total billed charges,307.72,98% of total billed charges,307.72,98% of total billed charges,150.72,48% of total billed charges,104.27,115% of CMS,88.63,97.75% of CMS,104.27,115% of CMS,104.27,115% of CMS,88.63,310.2,251.2
Outpatient Medical Services,RADIOLOGY,74230,X-RAY MODIFIED BA SWALLOW-STUDY,320,398,378.1,95% of total billed charges,376.99,94.72% of total billed charges,393.18,98.79% of total billed charges,390.04,98% of total billed charges,390.04,98% of total billed charges,191.04,48% of total billed charges,132.63,115% of CMS,112.74,97.75% of CMS,132.63,115% of CMS,132.63,115% of CMS,112.74,393.18,318.4
Outpatient Medical Services,SLEEP,95810,POLYSOMNOGRAPHY > 4 PARAMETERS OBSERVATI CHARGE,740,3157,2999.15,95% of total billed charges,2990.31,94.72% of total billed charges,3118.8,98.79% of total billed charges,3093.86,98% of total billed charges,3093.86,98% of total billed charges,1515.36,48% of total billed charges,663.76,115% of CMS,564.19,97.75% of CMS,663.76,115% of CMS,663.76,115% of CMS,564.19,3118.8,2525.6
Outpatient Medical Services,SLEEP,95811,POLYSOMNOGRAPHY W/CPAP > 4 PARAMETERS CHARGE,740,3528,3351.6,95% of total billed charges,3341.72,94.72% of total billed charges,3485.31,98.79% of total billed charges,3457.44,98% of total billed charges,3457.44,98% of total billed charges,1693.44,48% of total billed charges,693.93,115% of CMS,589.84,97.75% of CMS,693.93,115% of CMS,693.93,115% of CMS,589.84,3485.31,2822.4
Outpatient Medical Services,SLEEP,95812,EEG 41-60 MINS CHARGE,740,946,898.7,95% of total billed charges,896.05,94.72% of total billed charges,934.55,98.79% of total billed charges,927.08,98% of total billed charges,927.08,98% of total billed charges,454.08,48% of total billed charges,371.45,115% of CMS,315.73,97.75% of CMS,371.45,115% of CMS,371.45,115% of CMS,315.73,934.55,756.8
Outpatient Medical Services,SLEEP,95813,EEG >1HOUR CHARGE,740,1146,1088.7,95% of total billed charges,1085.49,94.72% of total billed charges,1132.13,98.79% of total billed charges,1123.08,98% of total billed charges,1123.08,98% of total billed charges,550.08,48% of total billed charges,470.57,115% of CMS,399.98,97.75% of CMS,470.57,115% of CMS,470.57,115% of CMS,399.98,1132.13,916.8
Outpatient Medical Services,SLEEP,95816,EEG AWAKE AND DROWSY CHARGE CHARGE,740,739,702.05,95% of total billed charges,699.98,94.72% of total billed charges,730.06,98.79% of total billed charges,724.22,98% of total billed charges,724.22,98% of total billed charges,354.72,48% of total billed charges,417.93,115% of CMS,355.24,97.75% of CMS,417.93,115% of CMS,417.93,115% of CMS,354.72,730.06,591.2
Outpatient Medical Services,SLEEP,95819,EEG AWAKE AND ASLEEP CHARGE,740,836,794.2,95% of total billed charges,791.86,94.72% of total billed charges,825.88,98.79% of total billed charges,819.28,98% of total billed charges,819.28,98% of total billed charges,401.28,48% of total billed charges,480.8,115% of CMS,408.68,97.75% of CMS,480.8,115% of CMS,480.8,115% of CMS,401.28,825.88,668.8
Outpatient Medical Services,THERAPY,97112,PT NEUROMUSCULAR RE-ED EA 15 MIN,421,86,81.7,95% of total billed charges,81.46,94.72% of total billed charges,84.96,98.79% of total billed charges,84.28,98% of total billed charges,84.28,98% of total billed charges,41.28,48% of total billed charges,37.02,115% of CMS,31.47,97.75% of CMS,37.02,115% of CMS,37.02,115% of CMS,31.47,84.96,68.8
Outpatient Medical Services,THERAPY,97140,PT MANUAL TRACTION THERAPY,421,86,81.7,95% of total billed charges,81.46,94.72% of total billed charges,84.96,98.79% of total billed charges,84.28,98% of total billed charges,84.28,98% of total billed charges,41.28,48% of total billed charges,29.81,115% of CMS,25.34,97.75% of CMS,29.81,115% of CMS,29.81,115% of CMS,25.34,84.96,68.8
Outpatient Medical Services,THERAPY,97110,"Physical therapy, therapeutic exercise Each 15 Minutes",421,90,85.5,95% of total billed charges,85.25,94.72% of total billed charges,88.91,98.79% of total billed charges,88.2,98% of total billed charges,88.2,98% of total billed charges,43.2,48% of total billed charges,32.32,115% of CMS,27.47,97.75% of CMS,32.32,115% of CMS,32.32,115% of CMS,27.47,88.91,72
Outpatient Medical Services,THERAPY,97012,PT Mechanical Traction Assistant Units,421,29,27.55,95% of total billed charges,27.47,94.72% of total billed charges,28.65,98.79% of total billed charges,28.42,98% of total billed charges,28.42,98% of total billed charges,13.92,48% of total billed charges,15.59,115% of CMS,13.25,97.75% of CMS,15.59,115% of CMS,15.59,115% of CMS,13.25,28.65,23.2
Outpatient Medical Services,THERAPY,97014,PT Unattended E-Stim Assistant Units,421,58,55.1,95% of total billed charges,54.94,94.72% of total billed charges,57.3,98.79% of total billed charges,56.84,98% of total billed charges,56.84,98% of total billed charges,27.84,48% of total billed charges,13.62,115% of CMS,11.57,97.75% of CMS,13.62,115% of CMS,13.62,115% of CMS,11.57,57.3,46.4
Outpatient Medical Services,THERAPY,97032,Attended E-Stim Charges,421,68,64.6,95% of total billed charges,64.41,94.72% of total billed charges,67.18,98.79% of total billed charges,66.64,98% of total billed charges,66.64,98% of total billed charges,32.64,48% of total billed charges,15.94,115% of CMS,13.55,97.75% of CMS,15.94,115% of CMS,15.94,115% of CMS,13.55,67.18,54.4
Outpatient Medical Services,THERAPY,97033,Iontophoresis Charges,421,68,64.6,95% of total billed charges,64.41,94.72% of total billed charges,67.18,98.79% of total billed charges,66.64,98% of total billed charges,66.64,98% of total billed charges,32.64,48% of total billed charges,21.21,115% of CMS,18.03,97.75% of CMS,21.21,115% of CMS,21.21,115% of CMS,18.03,67.18,54.4
Outpatient Medical Services,THERAPY,97035,PT Phonophoresis Assitant Units,421,74,70.3,95% of total billed charges,70.09,94.72% of total billed charges,73.1,98.79% of total billed charges,72.52,98% of total billed charges,72.52,98% of total billed charges,35.52,48% of total billed charges,15.46,115% of CMS,13.14,97.75% of CMS,15.46,115% of CMS,15.46,115% of CMS,13.14,73.1,59.2
Outpatient Medical Services,THERAPY,97110,PT Therapeutic Exercise Assit Units,421,90,85.5,95% of total billed charges,85.25,94.72% of total billed charges,88.91,98.79% of total billed charges,88.2,98% of total billed charges,88.2,98% of total billed charges,43.2,48% of total billed charges,32.32,115% of CMS,27.47,97.75% of CMS,32.32,115% of CMS,32.32,115% of CMS,27.47,88.91,72
Outpatient Medical Services,THERAPY,97112,Neuromuscular Reeducation Charges,421,86,81.7,95% of total billed charges,81.46,94.72% of total billed charges,84.96,98.79% of total billed charges,84.28,98% of total billed charges,84.28,98% of total billed charges,41.28,48% of total billed charges,37.02,115% of CMS,31.47,97.75% of CMS,37.02,115% of CMS,37.02,115% of CMS,31.47,84.96,68.8
Outpatient Medical Services,THERAPY,97116,Gait Training Charges,421,81,76.95,95% of total billed charges,76.72,94.72% of total billed charges,80.02,98.79% of total billed charges,79.38,98% of total billed charges,79.38,98% of total billed charges,38.88,48% of total billed charges,32.32,115% of CMS,27.47,97.75% of CMS,32.32,115% of CMS,32.32,115% of CMS,27.47,80.02,64.8
Outpatient Medical Services,THERAPY,97140,Manual Therapy Charge Units,421,86,81.7,95% of total billed charges,81.46,94.72% of total billed charges,84.96,98.79% of total billed charges,84.28,98% of total billed charges,84.28,98% of total billed charges,41.28,48% of total billed charges,29.81,115% of CMS,25.34,97.75% of CMS,29.81,115% of CMS,29.81,115% of CMS,25.34,84.96,68.8
Outpatient Medical Services,THERAPY,97124,PT Massage Assistant Units,421,68,64.6,95% of total billed charges,64.41,94.72% of total billed charges,67.18,98.79% of total billed charges,66.64,98% of total billed charges,66.64,98% of total billed charges,32.64,48% of total billed charges,33.02,115% of CMS,28.06,97.75% of CMS,33.02,115% of CMS,33.02,115% of CMS,28.06,67.18,54.4
Outpatient Medical Services,THERAPY,97530,PT Therapeutic Activities Assistant Units,421,84,79.8,95% of total billed charges,79.56,94.72% of total billed charges,82.98,98.79% of total billed charges,82.32,98% of total billed charges,82.32,98% of total billed charges,40.32,48% of total billed charges,39.95,115% of CMS,33.96,97.75% of CMS,39.95,115% of CMS,39.95,115% of CMS,33.96,82.98,67.2
Outpatient Medical Services,THERAPY,97760,"PT Orthotic Mgmt, Train Assistant Units",421,163,154.85,95% of total billed charges,154.39,94.72% of total billed charges,161.03,98.79% of total billed charges,159.74,98% of total billed charges,159.74,98% of total billed charges,78.24,48% of total billed charges,51.67,115% of CMS,43.92,97.75% of CMS,51.67,115% of CMS,51.67,115% of CMS,43.92,161.03,130.4
Outpatient Medical Services,THERAPY,97161,PT Eval Low Complex Units,424,187,177.65,95% of total billed charges,177.13,94.72% of total billed charges,184.74,98.79% of total billed charges,183.26,98% of total billed charges,183.26,98% of total billed charges,89.76,48% of total billed charges,110.61,115% of CMS,94.02,97.75% of CMS,110.61,115% of CMS,110.61,115% of CMS,89.76,184.74,149.6
Outpatient Medical Services,THERAPY,97162,PT Eval Moderate Complex Units,424,198,188.1,95% of total billed charges,187.55,94.72% of total billed charges,195.6,98.79% of total billed charges,194.04,98% of total billed charges,194.04,98% of total billed charges,95.04,48% of total billed charges,110.61,115% of CMS,94.02,97.75% of CMS,110.61,115% of CMS,110.61,115% of CMS,94.02,195.6,158.4
Outpatient Medical Services,THERAPY,97163,PT Eval High Complex Units,424,208,197.6,95% of total billed charges,197.02,94.72% of total billed charges,205.48,98.79% of total billed charges,203.84,98% of total billed charges,203.84,98% of total billed charges,99.84,48% of total billed charges,110.61,115% of CMS,94.02,97.75% of CMS,110.61,115% of CMS,110.61,115% of CMS,94.02,205.48,166.4
Outpatient Medical Services,THERAPY,97113,THER PX 1/> AREAS EACH 15 MIN AQUA THERAPY,430,84,79.8,95% of total billed charges,79.56,94.72% of total billed charges,82.98,98.79% of total billed charges,82.32,98% of total billed charges,82.32,98% of total billed charges,40.32,48% of total billed charges,40.09,115% of CMS,34.08,97.75% of CMS,40.09,115% of CMS,40.09,115% of CMS,34.08,82.98,67.2
Outpatient Medical Services,THERAPY,97530,Therapeutic Activity Assistant Units,430,84,79.8,95% of total billed charges,79.56,94.72% of total billed charges,82.98,98.79% of total billed charges,82.32,98% of total billed charges,82.32,98% of total billed charges,40.32,48% of total billed charges,39.95,115% of CMS,33.96,97.75% of CMS,39.95,115% of CMS,39.95,115% of CMS,33.96,82.98,67.2
Outpatient Medical Services,THERAPY,97026,OT INFRARED THERAPY,430,40,38,95% of total billed charges,37.89,94.72% of total billed charges,39.52,98.79% of total billed charges,39.2,98% of total billed charges,39.2,98% of total billed charges,19.2,48% of total billed charges,7.27,115% of CMS,6.18,97.75% of CMS,7.27,115% of CMS,7.27,115% of CMS,6.18,39.52,32
Outpatient Medical Services,THERAPY,97014,OT Unattended E-stim Assistant Units,431,58,55.1,95% of total billed charges,54.94,94.72% of total billed charges,57.3,98.79% of total billed charges,56.84,98% of total billed charges,56.84,98% of total billed charges,27.84,48% of total billed charges,13.62,115% of CMS,11.57,97.75% of CMS,13.62,115% of CMS,13.62,115% of CMS,11.57,57.3,46.4
Outpatient Medical Services,THERAPY,97018,OT Paraffin Bath Assistant Units,431,63,59.85,95% of total billed charges,59.67,94.72% of total billed charges,62.24,98.79% of total billed charges,61.74,98% of total billed charges,61.74,98% of total billed charges,30.24,48% of total billed charges,6.23,115% of CMS,5.3,97.75% of CMS,6.23,115% of CMS,6.23,115% of CMS,5.3,62.24,50.4
Outpatient Medical Services,THERAPY,97022,OT Whirlpool Therapy Assistant Units,431,100,95,95% of total billed charges,94.72,94.72% of total billed charges,98.79,98.79% of total billed charges,98,98% of total billed charges,98,98% of total billed charges,48,48% of total billed charges,18.46,115% of CMS,15.69,97.75% of CMS,18.46,115% of CMS,18.46,115% of CMS,15.69,98.79,80
Outpatient Medical Services,THERAPY,97024,OT Diathermy Assistant Charge,431,54,51.3,95% of total billed charges,51.15,94.72% of total billed charges,53.35,98.79% of total billed charges,52.92,98% of total billed charges,52.92,98% of total billed charges,25.92,48% of total billed charges,7.97,115% of CMS,6.77,97.75% of CMS,7.97,115% of CMS,7.97,115% of CMS,6.77,53.35,43.2
Outpatient Medical Services,THERAPY,97033,Iontophoresis Charges,431,68,64.6,95% of total billed charges,64.41,94.72% of total billed charges,67.18,98.79% of total billed charges,66.64,98% of total billed charges,66.64,98% of total billed charges,32.64,48% of total billed charges,21.21,115% of CMS,18.03,97.75% of CMS,21.21,115% of CMS,21.21,115% of CMS,18.03,67.18,54.4
Outpatient Medical Services,THERAPY,97035,Ultrasound Charges,431,75,71.25,95% of total billed charges,71.04,94.72% of total billed charges,74.09,98.79% of total billed charges,73.5,98% of total billed charges,73.5,98% of total billed charges,36,48% of total billed charges,15.46,115% of CMS,13.14,97.75% of CMS,15.46,115% of CMS,15.46,115% of CMS,13.14,74.09,60
Outpatient Medical Services,THERAPY,97110,OT Therapeutic Exercise Assistant units,431,90,85.5,95% of total billed charges,85.25,94.72% of total billed charges,88.91,98.79% of total billed charges,88.2,98% of total billed charges,88.2,98% of total billed charges,43.2,48% of total billed charges,32.32,115% of CMS,27.47,97.75% of CMS,32.32,115% of CMS,32.32,115% of CMS,27.47,88.91,72
Outpatient Medical Services,THERAPY,97112,OT Neuromuscular Reeducation Charges,431,86,81.7,95% of total billed charges,81.46,94.72% of total billed charges,84.96,98.79% of total billed charges,84.28,98% of total billed charges,84.28,98% of total billed charges,41.28,48% of total billed charges,37.02,115% of CMS,31.47,97.75% of CMS,37.02,115% of CMS,37.02,115% of CMS,31.47,84.96,68.8
Outpatient Medical Services,THERAPY,97124,OT Massage Charge Units,431,68,64.6,95% of total billed charges,64.41,94.72% of total billed charges,67.18,98.79% of total billed charges,66.64,98% of total billed charges,66.64,98% of total billed charges,32.64,48% of total billed charges,33.02,115% of CMS,28.06,97.75% of CMS,33.02,115% of CMS,33.02,115% of CMS,28.06,67.18,54.4
Outpatient Medical Services,THERAPY,97140,OT Manual Therapy Assistant Units,431,86,81.7,95% of total billed charges,81.46,94.72% of total billed charges,84.96,98.79% of total billed charges,84.28,98% of total billed charges,84.28,98% of total billed charges,41.28,48% of total billed charges,29.81,115% of CMS,25.34,97.75% of CMS,29.81,115% of CMS,29.81,115% of CMS,25.34,84.96,68.8
Outpatient Medical Services,THERAPY,97530,OT Therapeutic Activities Assistant Units,431,84,79.8,95% of total billed charges,79.56,94.72% of total billed charges,82.98,98.79% of total billed charges,82.32,98% of total billed charges,82.32,98% of total billed charges,40.32,48% of total billed charges,39.95,115% of CMS,33.96,97.75% of CMS,39.95,115% of CMS,39.95,115% of CMS,33.96,82.98,67.2
Outpatient Medical Services,THERAPY,97535,ADL Training Charges,431,75,71.25,95% of total billed charges,71.04,94.72% of total billed charges,74.09,98.79% of total billed charges,73.5,98% of total billed charges,73.5,98% of total billed charges,36,48% of total billed charges,35.8,115% of CMS,30.43,97.75% of CMS,35.8,115% of CMS,35.8,115% of CMS,30.43,74.09,60
Outpatient Medical Services,THERAPY,97760,"OT Orthotic Mgmt, Train Assistant Units",431,163,154.85,95% of total billed charges,154.39,94.72% of total billed charges,161.03,98.79% of total billed charges,159.74,98% of total billed charges,159.74,98% of total billed charges,78.24,48% of total billed charges,51.67,115% of CMS,43.92,97.75% of CMS,51.67,115% of CMS,51.67,115% of CMS,43.92,161.03,130.4
Outpatient Medical Services,THERAPY,97763,OT Orthotic Mgmt/Train Establish Charge,431,187,177.65,95% of total billed charges,177.13,94.72% of total billed charges,184.74,98.79% of total billed charges,183.26,98% of total billed charges,183.26,98% of total billed charges,89.76,48% of total billed charges,56.48,115% of CMS,48.01,97.75% of CMS,56.48,115% of CMS,56.48,115% of CMS,48.01,184.74,149.6
Outpatient Medical Services,THERAPY,97166,OT EVAL Moderate Complex Units,434,200,190,95% of total billed charges,189.44,94.72% of total billed charges,197.58,98.79% of total billed charges,196,98% of total billed charges,196,98% of total billed charges,96,48% of total billed charges,111.65,115% of CMS,94.91,97.75% of CMS,111.65,115% of CMS,111.65,115% of CMS,94.91,197.58,160
Outpatient Medical Services,THERAPY,97168,OT ReEval Units,434,158,150.1,95% of total billed charges,149.66,94.72% of total billed charges,156.09,98.79% of total billed charges,154.84,98% of total billed charges,154.84,98% of total billed charges,75.84,48% of total billed charges,76.8,115% of CMS,65.28,97.75% of CMS,76.8,115% of CMS,76.8,115% of CMS,65.28,156.09,126.4
Outpatient Medical Services,THERAPY,97677,OT EVAL High Complex Units,434,227,215.65,95% of total billed charges,215.01,94.72% of total billed charges,224.25,98.79% of total billed charges,222.46,98% of total billed charges,222.46,98% of total billed charges,108.96,48% of total billed charges,102.15,45% of total billed charges,86.83,38.25% of total billed charges,102.15,45% of total billed charges,102.15,45% of total billed charges,86.83,224.25,181.6
Outpatient Medical Services,THERAPY,92507,INDIVIDUAL SPEECH THERAPY,440,144,136.8,95% of total billed charges,136.4,94.72% of total billed charges,142.26,98.79% of total billed charges,141.12,98% of total billed charges,141.12,98% of total billed charges,69.12,48% of total billed charges,84.58,115% of CMS,71.9,97.75% of CMS,84.58,115% of CMS,84.58,115% of CMS,69.12,142.26,115.2
Outpatient Medical Services,THERAPY,92521,ST EVALUATION OF SPEECH FLUENCY,444,385,365.75,95% of total billed charges,364.67,94.72% of total billed charges,380.34,98.79% of total billed charges,377.3,98% of total billed charges,377.3,98% of total billed charges,184.8,48% of total billed charges,147.37,115% of CMS,125.27,97.75% of CMS,147.37,115% of CMS,147.37,115% of CMS,125.27,380.34,308
Outpatient Medical Services,THERAPY,92522,ST EVAL OF SPEECH SOUND PRODUCT,444,385,365.75,95% of total billed charges,364.67,94.72% of total billed charges,380.34,98.79% of total billed charges,377.3,98% of total billed charges,377.3,98% of total billed charges,184.8,48% of total billed charges,123.72,115% of CMS,105.16,97.75% of CMS,123.72,115% of CMS,123.72,115% of CMS,105.16,380.34,308
Outpatient Medical Services,THERAPY,92523,ST EVAL OF SPEECH SOUND  LANGUAGE,444,385,365.75,95% of total billed charges,364.67,94.72% of total billed charges,380.34,98.79% of total billed charges,377.3,98% of total billed charges,377.3,98% of total billed charges,184.8,48% of total billed charges,252.62,115% of CMS,214.73,97.75% of CMS,252.62,115% of CMS,252.62,115% of CMS,184.8,380.34,308
Outpatient Medical Services,THERAPY,92526,ST SWALLOWING/ORAL MOTOR -TREATMENT,441,247,234.65,95% of total billed charges,233.96,94.72% of total billed charges,244.01,98.79% of total billed charges,242.06,98% of total billed charges,242.06,98% of total billed charges,118.56,48% of total billed charges,93.44,115% of CMS,79.42,97.75% of CMS,93.44,115% of CMS,93.44,115% of CMS,79.42,244.01,197.6
Outpatient Medical Services,THERAPY,92610,ST SWALLOW EVAL CHARGE,444,247,234.65,95% of total billed charges,233.96,94.72% of total billed charges,244.01,98.79% of total billed charges,242.06,98% of total billed charges,242.06,98% of total billed charges,118.56,48% of total billed charges,78.06,115% of CMS,66.35,97.75% of CMS,78.06,115% of CMS,78.06,115% of CMS,66.35,244.01,197.6
Outpatient Medical Services,VISIT,90832,"Psychotherapy, 30 min",900,107,101.65,95% of total billed charges,101.35,94.72% of total billed charges,105.71,98.79% of total billed charges,104.86,98% of total billed charges,104.86,98% of total billed charges,51.36,48% of total billed charges,78.05,115% of CMS,66.34,97.75% of CMS,78.05,115% of CMS,78.05,115% of CMS,51.36,105.71,85.6
Outpatient Medical Services,VISIT,90834,"Psychotherapy, 45 min",900,191,181.45,95% of total billed charges,180.92,94.72% of total billed charges,188.69,98.79% of total billed charges,187.18,98% of total billed charges,187.18,98% of total billed charges,91.68,48% of total billed charges,103.11,115% of CMS,87.64,97.75% of CMS,103.11,115% of CMS,103.11,115% of CMS,87.64,188.69,152.8
Outpatient Medical Services,VISIT,90837,"Psychotherapy, 60 min",900,197,187.15,95% of total billed charges,186.6,94.72% of total billed charges,194.62,98.79% of total billed charges,193.06,98% of total billed charges,193.06,98% of total billed charges,94.56,48% of total billed charges,152.21,115% of CMS,129.38,97.75% of CMS,152.21,115% of CMS,152.21,115% of CMS,94.56,194.62,157.6
Outpatient Medical Services,VISIT,90853,Group psychotherapy,915,125,118.75,95% of total billed charges,118.4,94.72% of total billed charges,123.49,98.79% of total billed charges,122.5,98% of total billed charges,122.5,98% of total billed charges,60,48% of total billed charges,27.42,115% of CMS,23.3,97.75% of CMS,27.42,115% of CMS,27.42,115% of CMS,23.3,123.49,100
Outpatient Medical Services,VISIT,99202,"New patient office or other outpatient visit, less than 30 min",510,195,185.25,95% of total billed charges,184.7,94.72% of total billed charges,192.64,98.79% of total billed charges,191.1,98% of total billed charges,191.1,98% of total billed charges,93.6,48% of total billed charges,53.14,115% of CMS,45.17,97.75% of CMS,53.14,115% of CMS,53.14,115% of CMS,45.17,192.64,156
Outpatient Medical Services,VISIT,99203,"New patient office or other outpatient visit, typically 30 min",510,295,280.25,95% of total billed charges,279.42,94.72% of total billed charges,291.43,98.79% of total billed charges,289.1,98% of total billed charges,289.1,98% of total billed charges,141.6,48% of total billed charges,92.14,115% of CMS,78.32,97.75% of CMS,92.14,115% of CMS,92.14,115% of CMS,78.32,291.43,236
Outpatient Medical Services,VISIT,99204,"New patient office of other outpatient visit, typically 45 min",510,471,447.45,95% of total billed charges,446.13,94.72% of total billed charges,465.3,98.79% of total billed charges,461.58,98% of total billed charges,461.58,98% of total billed charges,226.08,48% of total billed charges,149.71,115% of CMS,127.25,97.75% of CMS,149.71,115% of CMS,149.71,115% of CMS,127.25,465.3,376.8
Outpatient Medical Services,VISIT,99205,"New patient office of other outpatient visit, typically 60 min",510,521,494.95,95% of total billed charges,493.49,94.72% of total billed charges,514.7,98.79% of total billed charges,510.58,98% of total billed charges,510.58,98% of total billed charges,250.08,48% of total billed charges,203.55,115% of CMS,173.02,97.75% of CMS,203.55,115% of CMS,203.55,115% of CMS,173.02,514.7,416.8
Outpatient Medical Services,VISIT,99242,"Patient office consultation, Min of 20 Minutes",510,410,389.5,95% of total billed charges,388.35,94.72% of total billed charges,405.04,98.79% of total billed charges,401.8,98% of total billed charges,401.8,98% of total billed charges,196.8,48% of total billed charges,62.26,115% of CMS,52.92,97.75% of CMS,62.26,115% of CMS,62.26,115% of CMS,52.92,405.04,328
Outpatient Medical Services,VISIT,99243,"Patient office consultation, Min of 30 Minutes",510,464,440.8,95% of total billed charges,439.5,94.72% of total billed charges,458.39,98.79% of total billed charges,454.72,98% of total billed charges,454.72,98% of total billed charges,222.72,48% of total billed charges,98.6,115% of CMS,83.81,97.75% of CMS,98.6,115% of CMS,98.6,115% of CMS,83.81,458.39,371.2
Outpatient Medical Services,VISIT,99244,"Patient office consultation, Min of 40 Minutes",510,580,551,95% of total billed charges,549.38,94.72% of total billed charges,572.98,98.79% of total billed charges,568.4,98% of total billed charges,568.4,98% of total billed charges,278.4,48% of total billed charges,149.91,115% of CMS,127.43,97.75% of CMS,149.91,115% of CMS,149.91,115% of CMS,127.43,572.98,464
Outpatient Medical Services,VISIT,99245,"Patient office consultation, Min of 55 Minutes",510,692,657.4,95% of total billed charges,655.46,94.72% of total billed charges,683.63,98.79% of total billed charges,678.16,98% of total billed charges,678.16,98% of total billed charges,332.16,48% of total billed charges,202,115% of CMS,171.7,97.75% of CMS,202,115% of CMS,202,115% of CMS,171.7,683.63,553.6
Outpatient Medical Services,VISIT,99385,Initial new patient preventive medicine evaluation (18-39 years),510,389,369.55,95% of total billed charges,368.46,94.72% of total billed charges,384.29,98.79% of total billed charges,381.22,98% of total billed charges,381.22,98% of total billed charges,186.72,48% of total billed charges,104.68,115% of CMS,88.98,97.75% of CMS,104.68,115% of CMS,104.68,115% of CMS,88.98,384.29,311.2
Outpatient Medical Services,VISIT,99386,Initial new patient preventive medicine evaluation (40-64 years),510,450,427.5,95% of total billed charges,426.24,94.72% of total billed charges,444.56,98.79% of total billed charges,441,98% of total billed charges,441,98% of total billed charges,216,48% of total billed charges,126.86,115% of CMS,107.83,97.75% of CMS,126.86,115% of CMS,126.86,115% of CMS,107.83,444.56,360
Outpatient Medical Services,VISIT,99202,"New patient office or other outpatient visit, less than 30 min",982,189,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,151.2
Outpatient Medical Services,VISIT,99203,"New patient office or other outpatient visit, typically 30 min",982,277,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,221.6
Outpatient Medical Services,VISIT,99204,"New patient office of other outpatient visit, typically 45 min",982,457,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,365.6
Outpatient Medical Services,VISIT,99205,"New patient office of other outpatient visit, typically 60 min",982,506,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,404.8
Outpatient Medical Services,VISIT,99212,"Office/Outpatient - Est. Patient, Straightforward (less than 20 mins)",982,120,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,96
Outpatient Medical Services,VISIT,99213,"Office/Outpatient - Est. Patient, Low (20-29 mins)",982,185,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,148
Outpatient Medical Services,VISIT,99214,"Office/Outpatient - Est. Patient, Moderate (30-39 mins)",982,298,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,238.4
Outpatient Medical Services,VISIT,99215,"Office/Outpatient - Est. Patient, High (40-54 mins)",982,379,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,303.2
Outpatient Medical Services,VISIT,99212,"Office/Outpatient - Est. Patient, Straightforward (less than 20 mins)",510,124,117.8,95% of total billed charges,117.45,94.72% of total billed charges,122.5,98.79% of total billed charges,121.52,98% of total billed charges,121.52,98% of total billed charges,59.52,48% of total billed charges,39.59,115% of CMS,33.66,97.75% of CMS,39.59,115% of CMS,39.59,115% of CMS,33.66,122.5,99.2
Outpatient Medical Services,VISIT,99213,"Office/Outpatient - Est. Patient, Low (20-29 mins)",510,190,180.5,95% of total billed charges,179.97,94.72% of total billed charges,187.7,98.79% of total billed charges,186.2,98% of total billed charges,186.2,98% of total billed charges,91.2,48% of total billed charges,73.78,115% of CMS,62.72,97.75% of CMS,73.78,115% of CMS,73.78,115% of CMS,62.72,187.7,152
Outpatient Medical Services,VISIT,99214,"Office/Outpatient - Est. Patient, Moderate (30-39 mins)",510,309,293.55,95% of total billed charges,292.68,94.72% of total billed charges,305.26,98.79% of total billed charges,302.82,98% of total billed charges,302.82,98% of total billed charges,148.32,48% of total billed charges,108.72,115% of CMS,92.41,97.75% of CMS,108.72,115% of CMS,108.72,115% of CMS,92.41,305.26,247.2
Outpatient Medical Services,VISIT,99215,"Office/Outpatient - Est. Patient, High (40-54 mins)",510,392,372.4,95% of total billed charges,371.3,94.72% of total billed charges,387.26,98.79% of total billed charges,384.16,98% of total billed charges,384.16,98% of total billed charges,188.16,48% of total billed charges,161.35,115% of CMS,137.14,97.75% of CMS,161.35,115% of CMS,161.35,115% of CMS,137.14,387.26,313.6
Outpatient Medical Services,VISIT,99242,"Patient office consultation, typically 30 min",988,397,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,317.6
Outpatient Medical Services,VISIT,99243,"Patient office consultation, typically 40 min",988,449,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,359.2
Outpatient Medical Services,VISIT,99244,"Patient office consultation, typically 60 min",988,580,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,464
Outpatient Medical Services,VISIT,99245,"Patient office consultation, Min of 55 Minutes",988,671,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,Not Applicable,N/A,N/A,536.8
Outpatient Medical Services,VISIT,95117,Allergy Shot Multiple Administration Immunizations,940,47,44.65,95% of total billed charges,44.52,94.72% of total billed charges,46.43,98.79% of total billed charges,46.06,98% of total billed charges,46.06,98% of total billed charges,22.56,48% of total billed charges,13,115% of CMS,11.05,97.75% of CMS,13,115% of CMS,13,115% of CMS,11.05,46.43,37.6
Outpatient Medical Services,VISIT,95115,Allergy Shot Single Administration Immunizations,940,42,39.9,95% of total billed charges,39.78,94.72% of total billed charges,41.49,98.79% of total billed charges,41.16,98% of total billed charges,41.16,98% of total billed charges,20.16,48% of total billed charges,10.9,115% of CMS,9.27,97.75% of CMS,10.9,115% of CMS,10.9,115% of CMS,9.27,41.49,33.6
Outpatient Medical Services,VISIT,69210,REMOVAL OF CERUMEN,761,173,164.35,95% of total billed charges,163.87,94.72% of total billed charges,170.91,98.79% of total billed charges,169.54,98% of total billed charges,169.54,98% of total billed charges,83.04,48% of total billed charges,36.71,115% of CMS,31.2,97.75% of CMS,36.71,115% of CMS,36.71,115% of CMS,31.2,170.91,138.4
Outpatient Medical Services,VISIT,97802,MNT INITIAL VISIT PER 15 MIN EA,942,43,40.85,95% of total billed charges,40.73,94.72% of total billed charges,42.48,98.79% of total billed charges,42.14,98% of total billed charges,42.14,98% of total billed charges,20.64,48% of total billed charges,35.03,115% of CMS,29.77,97.75% of CMS,35.03,115% of CMS,35.03,115% of CMS,20.64,42.48,34.4
Outpatient Medical Services,VISIT,97803,MNT VISIT PER 15 MIN EA,942,43,40.85,95% of total billed charges,40.73,94.72% of total billed charges,42.48,98.79% of total billed charges,42.14,98% of total billed charges,42.14,98% of total billed charges,20.64,48% of total billed charges,29.88,115% of CMS,25.4,97.75% of CMS,29.88,115% of CMS,29.88,115% of CMS,20.64,42.48,34.4
Outpatient Medical Services,VISIT,95860,95860 Needle electromyography; 1 extremity with or without r,922,231,219.45,95% of total billed charges,218.8,94.72% of total billed charges,228.2,98.79% of total billed charges,226.38,98% of total billed charges,226.38,98% of total billed charges,110.88,48% of total billed charges,121.29,115% of CMS,103.1,97.75% of CMS,121.29,115% of CMS,121.29,115% of CMS,103.1,228.2,184.8
Outpatient Medical Services,VISIT,95861,95861 Needle electromyography; 2 extremities with or without,922,338,321.1,95% of total billed charges,320.15,94.72% of total billed charges,333.91,98.79% of total billed charges,331.24,98% of total billed charges,331.24,98% of total billed charges,162.24,48% of total billed charges,172.74,115% of CMS,146.83,97.75% of CMS,172.74,115% of CMS,172.74,115% of CMS,146.83,333.91,270.4
Outpatient Medical Services,VISIT,95863,95863 Needle electromyography; 3 extremities with or without,922,372,353.4,95% of total billed charges,352.36,94.72% of total billed charges,367.5,98.79% of total billed charges,364.56,98% of total billed charges,364.56,98% of total billed charges,178.56,48% of total billed charges,223.84,115% of CMS,190.26,97.75% of CMS,223.84,115% of CMS,223.84,115% of CMS,178.56,367.5,297.6
Outpatient Medical Services,VISIT,95864,95864 Needle electromyography; 4 extremities with or without,922,580,551,95% of total billed charges,549.38,94.72% of total billed charges,572.98,98.79% of total billed charges,568.4,98% of total billed charges,568.4,98% of total billed charges,278.4,48% of total billed charges,249.9,115% of CMS,212.41,97.75% of CMS,249.9,115% of CMS,249.9,115% of CMS,212.41,572.98,464
Outpatient Medical Services,VISIT,95874,95874 Needle electromyography for guidance in conjunction wi,922,127,120.65,95% of total billed charges,120.29,94.72% of total billed charges,125.46,98.79% of total billed charges,124.46,98% of total billed charges,124.46,98% of total billed charges,60.96,48% of total billed charges,80.87,115% of CMS,68.74,97.75% of CMS,80.87,115% of CMS,80.87,115% of CMS,60.96,125.46,101.6
Outpatient Medical Services,VISIT,95885,"95885 Needle electromyography, each extremity; limited",922,140,133,95% of total billed charges,132.61,94.72% of total billed charges,138.31,98.79% of total billed charges,137.2,98% of total billed charges,137.2,98% of total billed charges,67.2,48% of total billed charges,65.8,115% of CMS,55.93,97.75% of CMS,65.8,115% of CMS,65.8,115% of CMS,55.93,138.31,112
Outpatient Medical Services,VISIT,95886,"95886 Needle electromyography, each extremity, ; complete, 5",922,170,161.5,95% of total billed charges,161.02,94.72% of total billed charges,167.94,98.79% of total billed charges,166.6,98% of total billed charges,166.6,98% of total billed charges,81.6,48% of total billed charges,103.66,115% of CMS,88.11,97.75% of CMS,103.66,115% of CMS,103.66,115% of CMS,81.6,167.94,136
Outpatient Medical Services,VISIT,95907,95907 Nerve conduction studies; 1-2 studies,922,125,118.75,95% of total billed charges,118.4,94.72% of total billed charges,123.49,98.79% of total billed charges,122.5,98% of total billed charges,122.5,98% of total billed charges,60,48% of total billed charges,98.06,115% of CMS,83.35,97.75% of CMS,98.06,115% of CMS,98.06,115% of CMS,60,123.49,100
Outpatient Medical Services,VISIT,95908,95908 Nerve conduction studies; 3-4 studies,922,152,144.4,95% of total billed charges,143.97,94.72% of total billed charges,150.16,98.79% of total billed charges,148.96,98% of total billed charges,148.96,98% of total billed charges,72.96,48% of total billed charges,121.68,115% of CMS,103.43,97.75% of CMS,121.68,115% of CMS,121.68,115% of CMS,72.96,150.16,121.6
Outpatient Medical Services,VISIT,95909,95909 Nerve conduction studies; 5-6 studies,922,247,234.65,95% of total billed charges,233.96,94.72% of total billed charges,244.01,98.79% of total billed charges,242.06,98% of total billed charges,242.06,98% of total billed charges,118.56,48% of total billed charges,146,115% of CMS,124.1,97.75% of CMS,146,115% of CMS,146,115% of CMS,118.56,244.01,197.6
Outpatient Medical Services,VISIT,95910,95910 Nerve conduction studies; 7-8 studies,922,554,526.3,95% of total billed charges,524.75,94.72% of total billed charges,547.3,98.79% of total billed charges,542.92,98% of total billed charges,542.92,98% of total billed charges,265.92,48% of total billed charges,190.8,115% of CMS,162.18,97.75% of CMS,190.8,115% of CMS,190.8,115% of CMS,162.18,547.3,443.2
Outpatient Medical Services,VISIT,95911,95911 Nerve conduction studies; 9-10 studies,922,337,320.15,95% of total billed charges,319.21,94.72% of total billed charges,332.92,98.79% of total billed charges,330.26,98% of total billed charges,330.26,98% of total billed charges,161.76,48% of total billed charges,230.37,115% of CMS,195.81,97.75% of CMS,230.37,115% of CMS,230.37,115% of CMS,161.76,332.92,269.6
Outpatient Medical Services,VISIT,95912,95912 Nerve conduction studies; 11-12 studies,922,692,657.4,95% of total billed charges,655.46,94.72% of total billed charges,683.63,98.79% of total billed charges,678.16,98% of total billed charges,678.16,98% of total billed charges,332.16,48% of total billed charges,269.69,115% of CMS,229.23,97.75% of CMS,269.69,115% of CMS,269.69,115% of CMS,229.23,683.63,553.6
Outpatient Medical Services,BEHAVIORAL,90846,"Family psychotherapy, not including patient, 50 minutes",900,SERVICE NOT OFFERED,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,N/A,N/A
Outpatient Medical Services,BEHAVIORAL,90847,"Family psychotherapy, including patient, 50 min",900,SERVICE NOT OFFERED,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,N/A,N/A
Outpatient Medical Services,LAB,80055,Obstetric blood test panel,300,SERVICE NOT OFFERED,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,N/A,N/A
Outpatient Medical Services,LAB,81000,Manual urinalysis test with examination using microscope,300,SERVICE NOT OFFERED,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,N/A,N/A
Outpatient Medical Services,LAB,81002,Automated urinalysis test,300,SERVICE NOT OFFERED,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,45391,Ultrasound examination of lower large bowel using an endoscope,360,SERVICE NOT OFFERED,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,55866,Surgical removal of prostate and surrounding lymph nodes using an endoscope,360,SERVICE NOT OFFERED,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,59400,"Routine obstetric care for vaginal delivery, including pre-and post-delivery care",720,SERVICE NOT OFFERED,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,59510,"Routine obstetric care for cesarean delivery, including pre-and post-delivery care",720,SERVICE NOT OFFERED,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,59610,Routine obstetric care for vaginal delivery after prior cesarean delivery including pre-and post-delivery care,720,SERVICE NOT OFFERED,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,66821,Removal of recurring cataract in lens capsule using laser,360,SERVICE NOT OFFERED,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,N/A,N/A
Outpatient Medical Services,ECCG,93000,"Electrocardiogram, routine, with interpretation and report",730,SERVICE NOT OFFERED,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,N/A,N/A
Outpatient Medical Services,CARDIOLOGY,93452,Insertion of catheter into left heart for diagnosis,480,SERVICE NOT OFFERED,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,N/A,N/A
Inpatient Medical Services,INPATIENT PROCEDURES,216,Cardiac valve and other major cardiothoracic procedures with cardiac catheterization with major complications or comorbidities,100,SERVICE NOT OFFERED,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,N/A,N/A
Inpatient Medical Services,INPATIENT PROCEDURES,460,Spinal fusion except cervical without major comorbid conditions or complications,100,SERVICE NOT OFFERED,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,N/A,N/A
Inpatient Medical Services,INPATIENT PROCEDURES,470,Major joint replacement or reattachment of lower extremity without major comorbid conditions or complications,100,SERVICE NOT OFFERED,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,N/A,N/A
Inpatient Medical Services,INPATIENT PROCEDURES,473,Cervical spinal fusion without comorbid conditions or major comorbid conditions or complications,100,SERVICE NOT OFFERED,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,N/A,N/A
Inpatient Medical Services,INPATIENT PROCEDURES,743,Uterine and adnexa procedures for non-malignancy without comorbid conditions or major comorbid conditions or complications,100,SERVICE NOT OFFERED,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,Not applicable service not offered,N/A,N/A,N/A