hospital_name,last_updated_on,version,hospital_location,hospital_address,license_number|OH,"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.",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
Highland District Hospital,2024-06-26,2.0.0,Highland District Hospital,"1275 N High St, Hillsboro, OH 45133",310653685,TRUE,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
SERVICE DESCRIPTION,CATEGORY,BILLING MSDRG | CPT | HCPCS,ITEM/SERVICE DESCRIPTION,BILLING REVENUE CODE,GROSS CHARGES,AETNA PLAN,AETNA REIMBURSEMENT METHOD,AETNA MEDICARE PLAN,AETNA MEDICARE REIMBURSEMENT METHOD,ANTHEM BLUE ACCESS PLAN,ANTHEM BLUE ACCESS REIMBURSEMENT METHOD,ANTHEM BLUE PREFERRED PLAN,ANTHEM BLUE PREFERRED REIMBURSEMENT METHOD,ANTHEM DUAL PLAN,ANTHEM DUAL REIMBURSEMENT METHOD,ANTHEM MEDICAID PLAN,ANTHEM MEDICAID REIMBURSEMENT METHOD,ANTHEM MEDICARE PLAN,ANTHEM MEDICARE REIMBURSEMENT METHOD,ANTHEM PATHWAY HMO PLAN,ANTHEM PATHWAY HMO REIMBURSEMENT METHOD,ANTHEM PATHWAY PPO PLAN,ANTHEM PATHWAY PPO REIMBURSEMENT METHOD,ANTHEM PATHWAY X HMO PLAN,ANTHEM PATHWAY X HMO REIMBURSEMENT METHOD,ANTHEM PATHWAY X PPO PLAN,ANTHEM PATHWAY X PPO REIMBURSEMENT METHOD,ANTHEM SMALL GROUP HMO PLAN,ANTHEM SMALL GROUP HMO REIMBURSEMENT METHOD,ANTHEM TRADITIONAL PLAN,ANTHEM TRADITIONAL REIMBURSEMENT METHOD,BUCKEYE MEDICAID PLAN,BUCKEYE MEDICAID REIMBURSEMENT METHOD,BUCKEYE MEDICARE PLAN,BUCKEYE MEDICARE REIMBURSEMENT METHOD,CARESOURCE MEDICAID PLAN,CARESOURCE MEDICAID REIMBURSEMENT METHOD,CENTRAL BENEFITS COMMERCIAL PLAN,CENTRAL BENEFITS COMMERCIAL REIMBURSEMENT METHOD,CIGNA PLAN,CIGNA REIMBURSEMENT METHOD,HIGHLAND COUNTY SHERIFF DEPT PLAN,HIGHLAND COUNTY SHERIFF DEPT REIMBURSEMENT METHOD,HUMANA PLAN,HUMANA REIMBURSEMENT METHOD,HUMANA MEDICAID PLAN,HUMANA MEDICAID REIMBURSEMENT METHOD,HUMANA MEDICARE PLAN,HUMANA MEDICARE REIMBURSEMENT METHOD,IMMERGRUN AMISH PLAN PLAN,IMMERGRUN AMISH PLAN REIMBURSEMENT METHOD,MEDBEN PLAN,MEDBEN REIMBURSEMENT METHOD,MEDICAID PLAN,MEDICAID REIMBURSEMENT METHOD,MEDICAL MUTUAL COMMERCIAL PLAN,MEDICAL MUTUAL COMMERCIAL REIMBURSEMENT METHOD,MEDICAL MUTUAL MEDICARE PLAN,MEDICAL MUTUAL MEDICARE REIMBURSEMENT METHOD,MEDICARE PLAN,MEDICARE REIMBURSEMENT METHOD,MEDIGOLD PLAN,MEDIGOLD REIMBURSEMENT METHOD,MOLINA MEDICAID PLAN,MOLINA MEDICAID REIMBURSEMENT METHOD,MOLINA MEDICARE PLAN,MOLINA MEDICARE REIMBURSEMENT METHOD,OPTUM UHC VA PLAN,OPTUM UHC VA REIMBURSEMENT METHOD,UHC  PLAN,UHC  REIMBURSEMENT METHOD,De-Identified Minimum Negotiated Rate,De-Identified Maximum Negotiated Rate,DISCOUNTED CASH PRICE
Outpatient Medical Services,Cardiopulmonary Respiratory,93225,HOLTER MONITOR RECORDING,731,492,399.5,81.2% of total billed charges,160.59,32.64% of total billed charges,364.08,74% of total billed charges,364.08,74% of total billed charges,157.44,32% of total billed charges,54.97,EAPG,157.44,32% of total billed charges,349.32,71% of total billed charges,349.32,71% of total billed charges,329.64,67% of total billed charges,329.64,67% of total billed charges,349.32,71% of total billed charges,373.92,76% of total billed charges,54.97,EAPG,162.16,32.96% of total billed charges,56.04,EAPG,442.8,90% of total billed charges,442.8,90% of total billed charges,53.37,EAPG,435.91,88.6% of total billed charges,54.97,EAPG,157.44,32% of total billed charges,393.6,80% of total billed charges,393.6,80% of total billed charges,53.37,EAPG,447.72,91% of total billed charges,160.59,32.64% of total billed charges,157.44,32% of total billed charges,165.31,33.6% of total billed charges,54.97,EAPG,157.44,32% of total billed charges,157.44,32% of total billed charges,452.64,92% of total billed charges,53.37,452.64,418.20
Outpatient Medical Services,Cardiopulmonary Respiratory,94667,CHEST PHYSIOTHERAPY INITIAL (NON PEP),410,112,90.94,81.2% of total billed charges,36.56,32.64% of total billed charges,82.88,74% of total billed charges,82.88,74% of total billed charges,35.84,32% of total billed charges,N/A,Not Separately reimbursable,35.84,32% of total billed charges,79.52,71% of total billed charges,79.52,71% of total billed charges,75.04,67% of total billed charges,75.04,67% of total billed charges,79.52,71% of total billed charges,85.12,76% of total billed charges,N/A,Not Separately reimbursable,36.92,32.96% of total billed charges,N/A,Not Separately reimbursable,100.8,90% of total billed charges,100.8,90% of total billed charges,N/A,Not Separately reimbursable,99.23,88.6% of total billed charges,N/A,Not Separately reimbursable,35.84,32% of total billed charges,89.6,80% of total billed charges,89.6,80% of total billed charges,N/A,Not Separately reimbursable,101.92,91% of total billed charges,36.56,32.64% of total billed charges,35.84,32% of total billed charges,37.63,33.6% of total billed charges,N/A,Not Separately reimbursable,35.84,32% of total billed charges,35.84,32% of total billed charges,103.04,92% of total billed charges,35.84,103.04,95.20
Outpatient Medical Services,Cardiopulmonary Respiratory,82803,ARTERIAL BLOOD GAS,300,331,268.77,81.2% of total billed charges,108.04,32.64% of total billed charges,244.94,74% of total billed charges,244.94,74% of total billed charges,105.92,32% of total billed charges,11.51,EAPG,105.92,32% of total billed charges,235.01,71% of total billed charges,235.01,71% of total billed charges,221.77,67% of total billed charges,221.77,67% of total billed charges,235.01,71% of total billed charges,251.56,76% of total billed charges,11.51,EAPG,109.1,32.96% of total billed charges,11.74,EAPG,297.9,90% of total billed charges,297.9,90% of total billed charges,11.18,EAPG,293.27,88.6% of total billed charges,11.51,EAPG,105.92,32% of total billed charges,264.8,80% of total billed charges,264.8,80% of total billed charges,11.18,EAPG,301.21,91% of total billed charges,108.04,32.64% of total billed charges,105.92,32% of total billed charges,111.22,33.6% of total billed charges,11.51,EAPG,105.92,32% of total billed charges,105.92,32% of total billed charges,304.52,92% of total billed charges,11.18,304.52,281.35
Outpatient Medical Services,Cardiopulmonary Respiratory,94060,SPIROMETRY BEFORE/AFTER,460,331,268.77,81.2% of total billed charges,108.04,32.64% of total billed charges,244.94,74% of total billed charges,244.94,74% of total billed charges,105.92,32% of total billed charges,81.19,EAPG,105.92,32% of total billed charges,235.01,71% of total billed charges,235.01,71% of total billed charges,221.77,67% of total billed charges,221.77,67% of total billed charges,235.01,71% of total billed charges,251.56,76% of total billed charges,81.19,EAPG,109.1,32.96% of total billed charges,82.77,EAPG,297.9,90% of total billed charges,297.9,90% of total billed charges,78.83,EAPG,293.27,88.6% of total billed charges,81.19,EAPG,105.92,32% of total billed charges,264.8,80% of total billed charges,264.8,80% of total billed charges,78.83,EAPG,301.21,91% of total billed charges,108.04,32.64% of total billed charges,105.92,32% of total billed charges,111.22,33.6% of total billed charges,81.19,EAPG,105.92,32% of total billed charges,105.92,32% of total billed charges,304.52,92% of total billed charges,78.83,304.52,281.35
Outpatient Medical Services,Cardiopulmonary Respiratory,94660,NONINVASIVE VENT CPAP INITIAL,410,531,431.17,81.2% of total billed charges,173.32,32.64% of total billed charges,392.94,74% of total billed charges,392.94,74% of total billed charges,169.92,32% of total billed charges,431.96,EAPG,169.92,32% of total billed charges,377.01,71% of total billed charges,377.01,71% of total billed charges,355.77,67% of total billed charges,355.77,67% of total billed charges,377.01,71% of total billed charges,403.56,76% of total billed charges,431.96,EAPG,175.02,32.96% of total billed charges,440.35,EAPG,477.9,90% of total billed charges,477.9,90% of total billed charges,419.38,EAPG,470.47,88.6% of total billed charges,431.96,EAPG,169.92,32% of total billed charges,424.8,80% of total billed charges,424.8,80% of total billed charges,419.38,EAPG,483.21,91% of total billed charges,173.32,32.64% of total billed charges,169.92,32% of total billed charges,178.42,33.6% of total billed charges,431.96,EAPG,169.92,32% of total billed charges,169.92,32% of total billed charges,488.52,92% of total billed charges,169.92,488.52,451.35
Outpatient Medical Services,Cardiopulmonary Respiratory,,,270,156,126.67,81.2% of total billed charges,50.92,32.64% of total billed charges,115.44,74% of total billed charges,115.44,74% of total billed charges,49.92,32% of total billed charges,N/A,Not Separately reimbursable,49.92,32% of total billed charges,110.76,71% of total billed charges,110.76,71% of total billed charges,104.52,67% of total billed charges,104.52,67% of total billed charges,110.76,71% of total billed charges,118.56,76% of total billed charges,N/A,Not Separately reimbursable,51.42,32.96% of total billed charges,N/A,Not Separately reimbursable,140.4,90% of total billed charges,140.4,90% of total billed charges,N/A,Not Separately reimbursable,138.22,88.6% of total billed charges,N/A,Not Separately reimbursable,49.92,32% of total billed charges,124.8,80% of total billed charges,124.8,80% of total billed charges,N/A,Not Separately reimbursable,141.96,91% of total billed charges,50.92,32.64% of total billed charges,49.92,32% of total billed charges,52.42,33.6% of total billed charges,N/A,Not Separately reimbursable,49.92,32% of total billed charges,49.92,32% of total billed charges,143.52,92% of total billed charges,49.92,143.52,132.60
Outpatient Medical Services,Cardiopulmonary Respiratory,36600,ARTERIAL PUNCTURE,300,72,58.46,81.2% of total billed charges,23.5,32.64% of total billed charges,53.28,74% of total billed charges,53.28,74% of total billed charges,23.04,32% of total billed charges,22.66,EAPG,23.04,32% of total billed charges,51.12,71% of total billed charges,51.12,71% of total billed charges,48.24,67% of total billed charges,48.24,67% of total billed charges,51.12,71% of total billed charges,54.72,76% of total billed charges,22.66,EAPG,23.73,32.96% of total billed charges,23.1,EAPG,64.8,90% of total billed charges,64.8,90% of total billed charges,22,EAPG,63.79,88.6% of total billed charges,22.66,EAPG,23.04,32% of total billed charges,57.6,80% of total billed charges,57.6,80% of total billed charges,22,EAPG,65.52,91% of total billed charges,23.5,32.64% of total billed charges,23.04,32% of total billed charges,24.19,33.6% of total billed charges,22.66,EAPG,23.04,32% of total billed charges,23.04,32% of total billed charges,66.24,92% of total billed charges,22,66.24,61.20
Outpatient Medical Services,Cardiopulmonary Respiratory,94729,D L C O,460,219,177.83,81.2% of total billed charges,71.48,32.64% of total billed charges,162.06,74% of total billed charges,162.06,74% of total billed charges,70.08,32% of total billed charges,41.23,EAPG,70.08,32% of total billed charges,155.49,71% of total billed charges,155.49,71% of total billed charges,146.73,67% of total billed charges,146.73,67% of total billed charges,155.49,71% of total billed charges,166.44,76% of total billed charges,41.23,EAPG,72.18,32.96% of total billed charges,42.03,EAPG,197.1,90% of total billed charges,197.1,90% of total billed charges,40.03,EAPG,194.03,88.6% of total billed charges,41.23,EAPG,70.08,32% of total billed charges,175.2,80% of total billed charges,175.2,80% of total billed charges,40.03,EAPG,199.29,91% of total billed charges,71.48,32.64% of total billed charges,70.08,32% of total billed charges,73.58,33.6% of total billed charges,41.23,EAPG,70.08,32% of total billed charges,70.08,32% of total billed charges,201.48,92% of total billed charges,40.03,201.48,186.15
Outpatient Medical Services,Cardiopulmonary Respiratory,93017,STRESS TEST ONLY CARDIOPUL,482,1320,1071.84,81.2% of total billed charges,430.85,32.64% of total billed charges,976.8,74% of total billed charges,976.8,74% of total billed charges,422.4,32% of total billed charges,68.87,EAPG,422.4,32% of total billed charges,937.2,71% of total billed charges,937.2,71% of total billed charges,884.4,67% of total billed charges,884.4,67% of total billed charges,937.2,71% of total billed charges,1003.2,76% of total billed charges,68.87,EAPG,435.07,32.96% of total billed charges,70.21,EAPG,1188,90% of total billed charges,1188,90% of total billed charges,66.87,EAPG,1169.52,88.6% of total billed charges,68.87,EAPG,422.4,32% of total billed charges,1056,80% of total billed charges,1056,80% of total billed charges,66.87,EAPG,1201.2,91% of total billed charges,430.85,32.64% of total billed charges,422.4,32% of total billed charges,443.52,33.6% of total billed charges,68.87,EAPG,422.4,32% of total billed charges,422.4,32% of total billed charges,1214.4,92% of total billed charges,66.87,1214.4,1122.00
Outpatient Medical Services,Cardiopulmonary Respiratory,94668,CHEST PHYSIOTHERAPY SUBSEQUENT (NON PEP),410,73,59.28,81.2% of total billed charges,23.83,32.64% of total billed charges,54.02,74% of total billed charges,54.02,74% of total billed charges,23.36,32% of total billed charges,N/A,Not Separately reimbursable,23.36,32% of total billed charges,51.83,71% of total billed charges,51.83,71% of total billed charges,48.91,67% of total billed charges,48.91,67% of total billed charges,51.83,71% of total billed charges,55.48,76% of total billed charges,N/A,Not Separately reimbursable,24.06,32.96% of total billed charges,N/A,Not Separately reimbursable,65.7,90% of total billed charges,65.7,90% of total billed charges,N/A,Not Separately reimbursable,64.68,88.6% of total billed charges,N/A,Not Separately reimbursable,23.36,32% of total billed charges,58.4,80% of total billed charges,58.4,80% of total billed charges,N/A,Not Separately reimbursable,66.43,91% of total billed charges,23.83,32.64% of total billed charges,23.36,32% of total billed charges,24.53,33.6% of total billed charges,N/A,Not Separately reimbursable,23.36,32% of total billed charges,23.36,32% of total billed charges,67.16,92% of total billed charges,23.36,67.16,62.05
Outpatient Medical Services,Cardiopulmonary Respiratory,94660,NONINVASIVE VENT CPAP SUBSEQUE,410,108,87.7,81.2% of total billed charges,35.25,32.64% of total billed charges,79.92,74% of total billed charges,79.92,74% of total billed charges,34.56,32% of total billed charges,431.96,EAPG,34.56,32% of total billed charges,76.68,71% of total billed charges,76.68,71% of total billed charges,72.36,67% of total billed charges,72.36,67% of total billed charges,76.68,71% of total billed charges,82.08,76% of total billed charges,431.96,EAPG,35.6,32.96% of total billed charges,440.35,EAPG,97.2,90% of total billed charges,97.2,90% of total billed charges,419.38,EAPG,95.69,88.6% of total billed charges,431.96,EAPG,34.56,32% of total billed charges,86.4,80% of total billed charges,86.4,80% of total billed charges,419.38,EAPG,98.28,91% of total billed charges,35.25,32.64% of total billed charges,34.56,32% of total billed charges,36.29,33.6% of total billed charges,431.96,EAPG,34.56,32% of total billed charges,34.56,32% of total billed charges,99.36,92% of total billed charges,34.56,440.35,91.80
Outpatient Medical Services,Cardiopulmonary Respiratory,94761,PULSE OXIMETRY EVALUATION,460,73,59.28,81.2% of total billed charges,23.83,32.64% of total billed charges,54.02,74% of total billed charges,54.02,74% of total billed charges,23.36,32% of total billed charges,21.3,EAPG,23.36,32% of total billed charges,51.83,71% of total billed charges,51.83,71% of total billed charges,48.91,67% of total billed charges,48.91,67% of total billed charges,51.83,71% of total billed charges,55.48,76% of total billed charges,21.3,EAPG,24.06,32.96% of total billed charges,21.71,EAPG,65.7,90% of total billed charges,65.7,90% of total billed charges,20.67,EAPG,64.68,88.6% of total billed charges,21.3,EAPG,23.36,32% of total billed charges,58.4,80% of total billed charges,58.4,80% of total billed charges,20.67,EAPG,66.43,91% of total billed charges,23.83,32.64% of total billed charges,23.36,32% of total billed charges,24.53,33.6% of total billed charges,21.3,EAPG,23.36,32% of total billed charges,23.36,32% of total billed charges,67.16,92% of total billed charges,20.67,67.16,62.05
Outpatient Medical Services,Cardiopulmonary Respiratory,93005,EKG,730,250,203,81.2% of total billed charges,81.6,32.64% of total billed charges,185,74% of total billed charges,185,74% of total billed charges,80,32% of total billed charges,14.91,EAPG,80,32% of total billed charges,177.5,71% of total billed charges,177.5,71% of total billed charges,167.5,67% of total billed charges,167.5,67% of total billed charges,177.5,71% of total billed charges,190,76% of total billed charges,14.91,EAPG,82.4,32.96% of total billed charges,15.2,EAPG,225,90% of total billed charges,225,90% of total billed charges,14.48,EAPG,221.5,88.6% of total billed charges,14.91,EAPG,80,32% of total billed charges,200,80% of total billed charges,200,80% of total billed charges,14.48,EAPG,227.5,91% of total billed charges,81.6,32.64% of total billed charges,80,32% of total billed charges,84,33.6% of total billed charges,14.91,EAPG,80,32% of total billed charges,80,32% of total billed charges,230,92% of total billed charges,14.48,230,212.50
Outpatient Medical Services,Cardiopulmonary Respiratory,82800,VENOUS BLOOD GAS - pH ONLY,300,319,259.03,81.2% of total billed charges,104.12,32.64% of total billed charges,236.06,74% of total billed charges,236.06,74% of total billed charges,102.08,32% of total billed charges,11.51,EAPG,102.08,32% of total billed charges,226.49,71% of total billed charges,226.49,71% of total billed charges,213.73,67% of total billed charges,213.73,67% of total billed charges,226.49,71% of total billed charges,242.44,76% of total billed charges,11.51,EAPG,105.14,32.96% of total billed charges,11.74,EAPG,287.1,90% of total billed charges,287.1,90% of total billed charges,11.18,EAPG,282.63,88.6% of total billed charges,11.51,EAPG,102.08,32% of total billed charges,255.2,80% of total billed charges,255.2,80% of total billed charges,11.18,EAPG,290.29,91% of total billed charges,104.12,32.64% of total billed charges,102.08,32% of total billed charges,107.18,33.6% of total billed charges,11.51,EAPG,102.08,32% of total billed charges,102.08,32% of total billed charges,293.48,92% of total billed charges,11.18,293.48,271.15
Outpatient Medical Services,Cardiopulmonary Respiratory,94726,"PLETHYSMOGRAPHY, TL BDY, TRACE",460,311,252.53,81.2% of total billed charges,101.51,32.64% of total billed charges,230.14,74% of total billed charges,230.14,74% of total billed charges,99.52,32% of total billed charges,41.23,EAPG,99.52,32% of total billed charges,220.81,71% of total billed charges,220.81,71% of total billed charges,208.37,67% of total billed charges,208.37,67% of total billed charges,220.81,71% of total billed charges,236.36,76% of total billed charges,41.23,EAPG,102.51,32.96% of total billed charges,42.03,EAPG,279.9,90% of total billed charges,279.9,90% of total billed charges,40.03,EAPG,275.55,88.6% of total billed charges,41.23,EAPG,99.52,32% of total billed charges,248.8,80% of total billed charges,248.8,80% of total billed charges,40.03,EAPG,283.01,91% of total billed charges,101.51,32.64% of total billed charges,99.52,32% of total billed charges,104.5,33.6% of total billed charges,41.23,EAPG,99.52,32% of total billed charges,99.52,32% of total billed charges,286.12,92% of total billed charges,40.03,286.12,264.35
Outpatient Medical Services,Cardiopulmonary Respiratory,93226,HOLTER MONITOR SCAN ANALYSIS W/REPORT,731,469,380.83,81.2% of total billed charges,153.08,32.64% of total billed charges,347.06,74% of total billed charges,347.06,74% of total billed charges,150.08,32% of total billed charges,54.97,EAPG,150.08,32% of total billed charges,332.99,71% of total billed charges,332.99,71% of total billed charges,314.23,67% of total billed charges,314.23,67% of total billed charges,332.99,71% of total billed charges,356.44,76% of total billed charges,54.97,EAPG,154.58,32.96% of total billed charges,56.04,EAPG,422.1,90% of total billed charges,422.1,90% of total billed charges,53.37,EAPG,415.53,88.6% of total billed charges,54.97,EAPG,150.08,32% of total billed charges,375.2,80% of total billed charges,375.2,80% of total billed charges,53.37,EAPG,426.79,91% of total billed charges,153.08,32.64% of total billed charges,150.08,32% of total billed charges,157.58,33.6% of total billed charges,54.97,EAPG,150.08,32% of total billed charges,150.08,32% of total billed charges,431.48,92% of total billed charges,53.37,431.48,398.65
Outpatient Medical Services,Cardiopulmonary Respiratory,99406,SMOKING CESSATION EDUCATION 3-10 MINS,942,62,50.34,81.2% of total billed charges,20.24,32.64% of total billed charges,45.88,74% of total billed charges,45.88,74% of total billed charges,19.84,32% of total billed charges,26.21,EAPG,19.84,32% of total billed charges,44.02,71% of total billed charges,44.02,71% of total billed charges,41.54,67% of total billed charges,41.54,67% of total billed charges,44.02,71% of total billed charges,47.12,76% of total billed charges,26.21,EAPG,20.44,32.96% of total billed charges,26.72,EAPG,55.8,90% of total billed charges,55.8,90% of total billed charges,25.45,EAPG,54.93,88.6% of total billed charges,26.21,EAPG,19.84,32% of total billed charges,49.6,80% of total billed charges,49.6,80% of total billed charges,25.45,EAPG,56.42,91% of total billed charges,20.24,32.64% of total billed charges,19.84,32% of total billed charges,20.83,33.6% of total billed charges,26.21,EAPG,19.84,32% of total billed charges,19.84,32% of total billed charges,57.04,92% of total billed charges,19.84,57.04,52.70
Outpatient Medical Services,Cardiopulmonary Respiratory,94664,SVN/MDI INITIAL,410,142,115.3,81.2% of total billed charges,46.35,32.64% of total billed charges,105.08,74% of total billed charges,105.08,74% of total billed charges,45.44,32% of total billed charges,N/A,Not Separately reimbursable,45.44,32% of total billed charges,100.82,71% of total billed charges,100.82,71% of total billed charges,95.14,67% of total billed charges,95.14,67% of total billed charges,100.82,71% of total billed charges,107.92,76% of total billed charges,N/A,Not Separately reimbursable,46.8,32.96% of total billed charges,N/A,Not Separately reimbursable,127.8,90% of total billed charges,127.8,90% of total billed charges,N/A,Not Separately reimbursable,125.81,88.6% of total billed charges,N/A,Not Separately reimbursable,45.44,32% of total billed charges,113.6,80% of total billed charges,113.6,80% of total billed charges,N/A,Not Separately reimbursable,129.22,91% of total billed charges,46.35,32.64% of total billed charges,45.44,32% of total billed charges,47.71,33.6% of total billed charges,N/A,Not Separately reimbursable,45.44,32% of total billed charges,45.44,32% of total billed charges,130.64,92% of total billed charges,45.44,130.64,120.70
Outpatient Medical Services,Cardiopulmonary Respiratory,94640,SVN/MDI SUBQS,410,100,81.2,81.2% of total billed charges,32.64,32.64% of total billed charges,74,74% of total billed charges,74,74% of total billed charges,32,32% of total billed charges,N/A,Not Separately reimbursable,32,32% of total billed charges,71,71% of total billed charges,71,71% of total billed charges,67,67% of total billed charges,67,67% of total billed charges,71,71% of total billed charges,76,76% of total billed charges,N/A,Not Separately reimbursable,32.96,32.96% of total billed charges,N/A,Not Separately reimbursable,90,90% of total billed charges,90,90% of total billed charges,N/A,Not Separately reimbursable,88.6,88.6% of total billed charges,N/A,Not Separately reimbursable,32,32% of total billed charges,80,80% of total billed charges,80,80% of total billed charges,N/A,Not Separately reimbursable,91,91% of total billed charges,32.64,32.64% of total billed charges,32,32% of total billed charges,33.6,33.6% of total billed charges,N/A,Not Separately reimbursable,32,32% of total billed charges,32,32% of total billed charges,92,92% of total billed charges,32,92,85.00
Outpatient Medical Services,Cardiopulmonary Respiratory,82805,ABG W/ DIRECT MEASURE,301,73,59.28,81.2% of total billed charges,23.83,32.64% of total billed charges,54.02,74% of total billed charges,54.02,74% of total billed charges,23.36,32% of total billed charges,13.24,EAPG,23.36,32% of total billed charges,51.83,71% of total billed charges,51.83,71% of total billed charges,48.91,67% of total billed charges,48.91,67% of total billed charges,51.83,71% of total billed charges,55.48,76% of total billed charges,13.24,EAPG,24.06,32.96% of total billed charges,13.49,EAPG,65.7,90% of total billed charges,65.7,90% of total billed charges,12.85,EAPG,64.68,88.6% of total billed charges,13.24,EAPG,23.36,32% of total billed charges,58.4,80% of total billed charges,58.4,80% of total billed charges,12.85,EAPG,66.43,91% of total billed charges,23.83,32.64% of total billed charges,23.36,32% of total billed charges,24.53,33.6% of total billed charges,13.24,EAPG,23.36,32% of total billed charges,23.36,32% of total billed charges,67.16,92% of total billed charges,12.85,67.16,62.05
Outpatient Medical Services,Emergency,99281,EMERGENCY RM LEVEL 1,450,206,167.27,81.2% of total billed charges,67.24,32.64% of total billed charges,152.44,74% of total billed charges,152.44,74% of total billed charges,65.92,32% of total billed charges,43.61,EAPG,65.92,32% of total billed charges,146.26,71% of total billed charges,146.26,71% of total billed charges,138.02,67% of total billed charges,138.02,67% of total billed charges,146.26,71% of total billed charges,156.56,76% of total billed charges,43.61,EAPG,67.9,32.96% of total billed charges,44.45,EAPG,185.4,90% of total billed charges,185.4,90% of total billed charges,42.34,EAPG,182.52,88.6% of total billed charges,43.61,EAPG,65.92,32% of total billed charges,164.8,80% of total billed charges,164.8,80% of total billed charges,42.34,EAPG,187.46,91% of total billed charges,67.24,32.64% of total billed charges,65.92,32% of total billed charges,69.22,33.6% of total billed charges,43.61,EAPG,65.92,32% of total billed charges,65.92,32% of total billed charges,189.52,92% of total billed charges,42.34,189.52,175.10
Outpatient Medical Services,Emergency,99282,EMERGENCY RM LEVEL 2,450,359,291.51,81.2% of total billed charges,117.18,32.64% of total billed charges,265.66,74% of total billed charges,265.66,74% of total billed charges,114.88,32% of total billed charges,43.61,EAPG,114.88,32% of total billed charges,254.89,71% of total billed charges,254.89,71% of total billed charges,240.53,67% of total billed charges,240.53,67% of total billed charges,254.89,71% of total billed charges,272.84,76% of total billed charges,43.61,EAPG,118.33,32.96% of total billed charges,44.45,EAPG,323.1,90% of total billed charges,323.1,90% of total billed charges,42.34,EAPG,318.07,88.6% of total billed charges,43.61,EAPG,114.88,32% of total billed charges,287.2,80% of total billed charges,287.2,80% of total billed charges,42.34,EAPG,326.69,91% of total billed charges,117.18,32.64% of total billed charges,114.88,32% of total billed charges,120.62,33.6% of total billed charges,43.61,EAPG,114.88,32% of total billed charges,114.88,32% of total billed charges,330.28,92% of total billed charges,42.34,330.28,305.15
Outpatient Medical Services,Emergency,99283,EMERGENCY RM LEVEL 3,450,565,458.78,81.2% of total billed charges,184.42,32.64% of total billed charges,418.1,74% of total billed charges,418.1,74% of total billed charges,180.8,32% of total billed charges,43.61,EAPG,180.8,32% of total billed charges,401.15,71% of total billed charges,401.15,71% of total billed charges,378.55,67% of total billed charges,378.55,67% of total billed charges,401.15,71% of total billed charges,429.4,76% of total billed charges,43.61,EAPG,186.22,32.96% of total billed charges,44.45,EAPG,508.5,90% of total billed charges,508.5,90% of total billed charges,42.34,EAPG,500.59,88.6% of total billed charges,43.61,EAPG,180.8,32% of total billed charges,452,80% of total billed charges,452,80% of total billed charges,42.34,EAPG,514.15,91% of total billed charges,184.42,32.64% of total billed charges,180.8,32% of total billed charges,189.84,33.6% of total billed charges,43.61,EAPG,180.8,32% of total billed charges,180.8,32% of total billed charges,519.8,92% of total billed charges,42.34,519.8,480.25
Outpatient Medical Services,Emergency,99284,EMERGENCY RM LEVEL 4,450,865,702.38,81.2% of total billed charges,282.34,32.64% of total billed charges,640.1,74% of total billed charges,640.1,74% of total billed charges,276.8,32% of total billed charges,43.61,EAPG,276.8,32% of total billed charges,614.15,71% of total billed charges,614.15,71% of total billed charges,579.55,67% of total billed charges,579.55,67% of total billed charges,614.15,71% of total billed charges,657.4,76% of total billed charges,43.61,EAPG,285.1,32.96% of total billed charges,44.45,EAPG,778.5,90% of total billed charges,778.5,90% of total billed charges,42.34,EAPG,766.39,88.6% of total billed charges,43.61,EAPG,276.8,32% of total billed charges,692,80% of total billed charges,692,80% of total billed charges,42.34,EAPG,787.15,91% of total billed charges,282.34,32.64% of total billed charges,276.8,32% of total billed charges,290.64,33.6% of total billed charges,43.61,EAPG,276.8,32% of total billed charges,276.8,32% of total billed charges,795.8,92% of total billed charges,42.34,795.8,735.25
Outpatient Medical Services,Emergency,99285,EMERGENCY RM LEVEL 5,450,1318,1070.22,81.2% of total billed charges,430.2,32.64% of total billed charges,975.32,74% of total billed charges,975.32,74% of total billed charges,421.76,32% of total billed charges,43.61,EAPG,421.76,32% of total billed charges,935.78,71% of total billed charges,935.78,71% of total billed charges,883.06,67% of total billed charges,883.06,67% of total billed charges,935.78,71% of total billed charges,1001.68,76% of total billed charges,43.61,EAPG,434.41,32.96% of total billed charges,44.45,EAPG,1186.2,90% of total billed charges,1186.2,90% of total billed charges,42.34,EAPG,1167.75,88.6% of total billed charges,43.61,EAPG,421.76,32% of total billed charges,1054.4,80% of total billed charges,1054.4,80% of total billed charges,42.34,EAPG,1199.38,91% of total billed charges,430.2,32.64% of total billed charges,421.76,32% of total billed charges,442.85,33.6% of total billed charges,43.61,EAPG,421.76,32% of total billed charges,421.76,32% of total billed charges,1212.56,92% of total billed charges,42.34,1212.56,1120.30
Outpatient Medical Services,Emergency,99291,ER LEVEL 6 CRIT CARE 30 74 MIN,450,2779,2256.55,81.2% of total billed charges,907.07,32.64% of total billed charges,2056.46,74% of total billed charges,2056.46,74% of total billed charges,889.28,32% of total billed charges,43.61,EAPG,889.28,32% of total billed charges,1973.09,71% of total billed charges,1973.09,71% of total billed charges,1861.93,67% of total billed charges,1861.93,67% of total billed charges,1973.09,71% of total billed charges,2112.04,76% of total billed charges,43.61,EAPG,915.96,32.96% of total billed charges,44.45,EAPG,2501.1,90% of total billed charges,2501.1,90% of total billed charges,42.34,EAPG,2462.19,88.6% of total billed charges,43.61,EAPG,889.28,32% of total billed charges,2223.2,80% of total billed charges,2223.2,80% of total billed charges,42.34,EAPG,2528.89,91% of total billed charges,907.07,32.64% of total billed charges,889.28,32% of total billed charges,933.74,33.6% of total billed charges,43.61,EAPG,889.28,32% of total billed charges,889.28,32% of total billed charges,2556.68,92% of total billed charges,42.34,2556.68,2362.15
Outpatient Medical Services,Emergency,96374,THER PROPH DX INJ IV PUSH 1,260,109,88.51,81.2% of total billed charges,35.58,32.64% of total billed charges,80.66,74% of total billed charges,80.66,74% of total billed charges,34.88,32% of total billed charges,28.89,EAPG,34.88,32% of total billed charges,77.39,71% of total billed charges,77.39,71% of total billed charges,73.03,67% of total billed charges,73.03,67% of total billed charges,77.39,71% of total billed charges,82.84,76% of total billed charges,28.89,EAPG,35.93,32.96% of total billed charges,29.46,EAPG,98.1,90% of total billed charges,98.1,90% of total billed charges,28.05,EAPG,96.57,88.6% of total billed charges,28.89,EAPG,34.88,32% of total billed charges,87.2,80% of total billed charges,87.2,80% of total billed charges,28.05,EAPG,99.19,91% of total billed charges,35.58,32.64% of total billed charges,34.88,32% of total billed charges,36.62,33.6% of total billed charges,28.89,EAPG,34.88,32% of total billed charges,34.88,32% of total billed charges,100.28,92% of total billed charges,28.05,100.28,92.65
Outpatient Medical Services,Emergency,96372,INJECTION IM/SUBQ,260,109,88.51,81.2% of total billed charges,35.58,32.64% of total billed charges,80.66,74% of total billed charges,80.66,74% of total billed charges,34.88,32% of total billed charges,28.89,EAPG,34.88,32% of total billed charges,77.39,71% of total billed charges,77.39,71% of total billed charges,73.03,67% of total billed charges,73.03,67% of total billed charges,77.39,71% of total billed charges,82.84,76% of total billed charges,28.89,EAPG,35.93,32.96% of total billed charges,29.46,EAPG,98.1,90% of total billed charges,98.1,90% of total billed charges,28.05,EAPG,96.57,88.6% of total billed charges,28.89,EAPG,34.88,32% of total billed charges,87.2,80% of total billed charges,87.2,80% of total billed charges,28.05,EAPG,99.19,91% of total billed charges,35.58,32.64% of total billed charges,34.88,32% of total billed charges,36.62,33.6% of total billed charges,28.89,EAPG,34.88,32% of total billed charges,34.88,32% of total billed charges,100.28,92% of total billed charges,28.05,100.28,92.65
Outpatient Medical Services,Emergency,90471,IMMUN/VACCINE ADMIN ONE,771,44,35.73,81.2% of total billed charges,14.36,32.64% of total billed charges,32.56,74% of total billed charges,32.56,74% of total billed charges,14.08,32% of total billed charges,10.84,EAPG,14.08,32% of total billed charges,31.24,71% of total billed charges,31.24,71% of total billed charges,29.48,67% of total billed charges,29.48,67% of total billed charges,31.24,71% of total billed charges,33.44,76% of total billed charges,10.84,EAPG,14.5,32.96% of total billed charges,11.05,EAPG,39.6,90% of total billed charges,39.6,90% of total billed charges,10.52,EAPG,38.98,88.6% of total billed charges,10.84,EAPG,14.08,32% of total billed charges,35.2,80% of total billed charges,35.2,80% of total billed charges,10.52,EAPG,40.04,91% of total billed charges,14.36,32.64% of total billed charges,14.08,32% of total billed charges,14.78,33.6% of total billed charges,10.84,EAPG,14.08,32% of total billed charges,14.08,32% of total billed charges,40.48,92% of total billed charges,10.52,40.48,37.40
Outpatient Medical Services,Emergency,36430,BLOOD ADMIN 1 UNIT,391,146,118.55,81.2% of total billed charges,47.65,32.64% of total billed charges,108.04,74% of total billed charges,108.04,74% of total billed charges,46.72,32% of total billed charges,288.04,EAPG,46.72,32% of total billed charges,103.66,71% of total billed charges,103.66,71% of total billed charges,97.82,67% of total billed charges,97.82,67% of total billed charges,103.66,71% of total billed charges,110.96,76% of total billed charges,288.04,EAPG,48.12,32.96% of total billed charges,293.63,EAPG,131.4,90% of total billed charges,131.4,90% of total billed charges,279.65,EAPG,129.36,88.6% of total billed charges,288.04,EAPG,46.72,32% of total billed charges,116.8,80% of total billed charges,116.8,80% of total billed charges,279.65,EAPG,132.86,91% of total billed charges,47.65,32.64% of total billed charges,46.72,32% of total billed charges,49.06,33.6% of total billed charges,288.04,EAPG,46.72,32% of total billed charges,46.72,32% of total billed charges,134.32,92% of total billed charges,46.72,293.63,124.10
Outpatient Medical Services,Emergency,96365,IV THERAPY 1ST HOUR,260,263,213.56,81.2% of total billed charges,85.84,32.64% of total billed charges,194.62,74% of total billed charges,194.62,74% of total billed charges,84.16,32% of total billed charges,176.12,EAPG,84.16,32% of total billed charges,186.73,71% of total billed charges,186.73,71% of total billed charges,176.21,67% of total billed charges,176.21,67% of total billed charges,186.73,71% of total billed charges,199.88,76% of total billed charges,176.12,EAPG,86.68,32.96% of total billed charges,179.54,EAPG,236.7,90% of total billed charges,236.7,90% of total billed charges,170.99,EAPG,233.02,88.6% of total billed charges,176.12,EAPG,84.16,32% of total billed charges,210.4,80% of total billed charges,210.4,80% of total billed charges,170.99,EAPG,239.33,91% of total billed charges,85.84,32.64% of total billed charges,84.16,32% of total billed charges,88.37,33.6% of total billed charges,176.12,EAPG,84.16,32% of total billed charges,84.16,32% of total billed charges,241.96,92% of total billed charges,84.16,241.96,223.55
Outpatient Medical Services,Emergency,96366,IV THERAPY EA ADD HR UP TO 8,260,146,118.55,81.2% of total billed charges,47.65,32.64% of total billed charges,108.04,74% of total billed charges,108.04,74% of total billed charges,46.72,32% of total billed charges,248.1,EAPG,46.72,32% of total billed charges,103.66,71% of total billed charges,103.66,71% of total billed charges,97.82,67% of total billed charges,97.82,67% of total billed charges,103.66,71% of total billed charges,110.96,76% of total billed charges,248.1,EAPG,48.12,32.96% of total billed charges,252.92,EAPG,131.4,90% of total billed charges,131.4,90% of total billed charges,240.87,EAPG,129.36,88.6% of total billed charges,248.1,EAPG,46.72,32% of total billed charges,116.8,80% of total billed charges,116.8,80% of total billed charges,240.87,EAPG,132.86,91% of total billed charges,47.65,32.64% of total billed charges,46.72,32% of total billed charges,49.06,33.6% of total billed charges,248.1,EAPG,46.72,32% of total billed charges,46.72,32% of total billed charges,134.32,92% of total billed charges,46.72,252.92,124.10
Outpatient Medical Services,Emergency,96375,EA ADDIT SEQUENTIAL IV PUSH,260,117,95,81.2% of total billed charges,38.19,32.64% of total billed charges,86.58,74% of total billed charges,86.58,74% of total billed charges,37.44,32% of total billed charges,28.89,EAPG,37.44,32% of total billed charges,83.07,71% of total billed charges,83.07,71% of total billed charges,78.39,67% of total billed charges,78.39,67% of total billed charges,83.07,71% of total billed charges,88.92,76% of total billed charges,28.89,EAPG,38.56,32.96% of total billed charges,29.46,EAPG,105.3,90% of total billed charges,105.3,90% of total billed charges,28.05,EAPG,103.66,88.6% of total billed charges,28.89,EAPG,37.44,32% of total billed charges,93.6,80% of total billed charges,93.6,80% of total billed charges,28.05,EAPG,106.47,91% of total billed charges,38.19,32.64% of total billed charges,37.44,32% of total billed charges,39.31,33.6% of total billed charges,28.89,EAPG,37.44,32% of total billed charges,37.44,32% of total billed charges,107.64,92% of total billed charges,28.05,107.64,99.45
Outpatient Medical Services,Emergency,96360,HYDRATION THERAPY UP TO 1 HR,260,154,125.05,81.2% of total billed charges,50.27,32.64% of total billed charges,113.96,74% of total billed charges,113.96,74% of total billed charges,49.28,32% of total billed charges,176.12,EAPG,49.28,32% of total billed charges,109.34,71% of total billed charges,109.34,71% of total billed charges,103.18,67% of total billed charges,103.18,67% of total billed charges,109.34,71% of total billed charges,117.04,76% of total billed charges,176.12,EAPG,50.76,32.96% of total billed charges,179.54,EAPG,138.6,90% of total billed charges,138.6,90% of total billed charges,170.99,EAPG,136.44,88.6% of total billed charges,176.12,EAPG,49.28,32% of total billed charges,123.2,80% of total billed charges,123.2,80% of total billed charges,170.99,EAPG,140.14,91% of total billed charges,50.27,32.64% of total billed charges,49.28,32% of total billed charges,51.74,33.6% of total billed charges,176.12,EAPG,49.28,32% of total billed charges,49.28,32% of total billed charges,141.68,92% of total billed charges,49.28,179.54,130.90
Outpatient Medical Services,Emergency,96361,HYDRATION THERAPY EACH ADD HR,260,146,118.55,81.2% of total billed charges,47.65,32.64% of total billed charges,108.04,74% of total billed charges,108.04,74% of total billed charges,46.72,32% of total billed charges,248.1,EAPG,46.72,32% of total billed charges,103.66,71% of total billed charges,103.66,71% of total billed charges,97.82,67% of total billed charges,97.82,67% of total billed charges,103.66,71% of total billed charges,110.96,76% of total billed charges,248.1,EAPG,48.12,32.96% of total billed charges,252.92,EAPG,131.4,90% of total billed charges,131.4,90% of total billed charges,240.87,EAPG,129.36,88.6% of total billed charges,248.1,EAPG,46.72,32% of total billed charges,116.8,80% of total billed charges,116.8,80% of total billed charges,240.87,EAPG,132.86,91% of total billed charges,47.65,32.64% of total billed charges,46.72,32% of total billed charges,49.06,33.6% of total billed charges,248.1,EAPG,46.72,32% of total billed charges,46.72,32% of total billed charges,134.32,92% of total billed charges,46.72,252.92,124.10
Outpatient Medical Services,Emergency,96376,EA ADDIT SEQUENTIAL IV PUSH SAME DRUG,260,110,89.32,81.2% of total billed charges,35.9,32.64% of total billed charges,81.4,74% of total billed charges,81.4,74% of total billed charges,35.2,32% of total billed charges,28.89,EAPG,35.2,32% of total billed charges,78.1,71% of total billed charges,78.1,71% of total billed charges,73.7,67% of total billed charges,73.7,67% of total billed charges,78.1,71% of total billed charges,83.6,76% of total billed charges,28.89,EAPG,36.26,32.96% of total billed charges,29.46,EAPG,99,90% of total billed charges,99,90% of total billed charges,28.05,EAPG,97.46,88.6% of total billed charges,28.89,EAPG,35.2,32% of total billed charges,88,80% of total billed charges,88,80% of total billed charges,28.05,EAPG,100.1,91% of total billed charges,35.9,32.64% of total billed charges,35.2,32% of total billed charges,36.96,33.6% of total billed charges,28.89,EAPG,35.2,32% of total billed charges,35.2,32% of total billed charges,101.2,92% of total billed charges,28.05,101.2,93.50
Outpatient Medical Services,Emergency,96367,IV INFU ADD SEQ UP TO 1 HOUR,260,252,204.62,81.2% of total billed charges,82.25,32.64% of total billed charges,186.48,74% of total billed charges,186.48,74% of total billed charges,80.64,32% of total billed charges,176.12,EAPG,80.64,32% of total billed charges,178.92,71% of total billed charges,178.92,71% of total billed charges,168.84,67% of total billed charges,168.84,67% of total billed charges,178.92,71% of total billed charges,191.52,76% of total billed charges,176.12,EAPG,83.06,32.96% of total billed charges,179.54,EAPG,226.8,90% of total billed charges,226.8,90% of total billed charges,170.99,EAPG,223.27,88.6% of total billed charges,176.12,EAPG,80.64,32% of total billed charges,201.6,80% of total billed charges,201.6,80% of total billed charges,170.99,EAPG,229.32,91% of total billed charges,82.25,32.64% of total billed charges,80.64,32% of total billed charges,84.67,33.6% of total billed charges,176.12,EAPG,80.64,32% of total billed charges,80.64,32% of total billed charges,231.84,92% of total billed charges,80.64,231.84,214.20
Outpatient Medical Services,Emergency,96368,IV INFUSION CONCURRENT,260,256,207.87,81.2% of total billed charges,83.56,32.64% of total billed charges,189.44,74% of total billed charges,189.44,74% of total billed charges,81.92,32% of total billed charges,176.12,EAPG,81.92,32% of total billed charges,181.76,71% of total billed charges,181.76,71% of total billed charges,171.52,67% of total billed charges,171.52,67% of total billed charges,181.76,71% of total billed charges,194.56,76% of total billed charges,176.12,EAPG,84.38,32.96% of total billed charges,179.54,EAPG,230.4,90% of total billed charges,230.4,90% of total billed charges,170.99,EAPG,226.82,88.6% of total billed charges,176.12,EAPG,81.92,32% of total billed charges,204.8,80% of total billed charges,204.8,80% of total billed charges,170.99,EAPG,232.96,91% of total billed charges,83.56,32.64% of total billed charges,81.92,32% of total billed charges,86.02,33.6% of total billed charges,176.12,EAPG,81.92,32% of total billed charges,81.92,32% of total billed charges,235.52,92% of total billed charges,81.92,235.52,217.60
Outpatient Medical Services,Emergency,12001,SIMPLE REPAIR SUPER WOUND/SNGTHF<2.5CM,450,290,235.48,81.2% of total billed charges,94.66,32.64% of total billed charges,214.6,74% of total billed charges,214.6,74% of total billed charges,92.8,32% of total billed charges,118.17,EAPG,92.8,32% of total billed charges,205.9,71% of total billed charges,205.9,71% of total billed charges,194.3,67% of total billed charges,194.3,67% of total billed charges,205.9,71% of total billed charges,220.4,76% of total billed charges,118.17,EAPG,95.58,32.96% of total billed charges,120.47,EAPG,261,90% of total billed charges,261,90% of total billed charges,114.73,EAPG,256.94,88.6% of total billed charges,118.17,EAPG,92.8,32% of total billed charges,232,80% of total billed charges,232,80% of total billed charges,114.73,EAPG,263.9,91% of total billed charges,94.66,32.64% of total billed charges,92.8,32% of total billed charges,97.44,33.6% of total billed charges,118.17,EAPG,92.8,32% of total billed charges,92.8,32% of total billed charges,266.8,92% of total billed charges,92.8,266.8,246.50
Outpatient Medical Services,Emergency,12002,SIMPLE REPAIR SUPER WOUNDS SNGTE 2.6-7.5,450,318,258.22,81.2% of total billed charges,103.8,32.64% of total billed charges,235.32,74% of total billed charges,235.32,74% of total billed charges,101.76,32% of total billed charges,118.17,EAPG,101.76,32% of total billed charges,225.78,71% of total billed charges,225.78,71% of total billed charges,213.06,67% of total billed charges,213.06,67% of total billed charges,225.78,71% of total billed charges,241.68,76% of total billed charges,118.17,EAPG,104.81,32.96% of total billed charges,120.47,EAPG,286.2,90% of total billed charges,286.2,90% of total billed charges,114.73,EAPG,281.75,88.6% of total billed charges,118.17,EAPG,101.76,32% of total billed charges,254.4,80% of total billed charges,254.4,80% of total billed charges,114.73,EAPG,289.38,91% of total billed charges,103.8,32.64% of total billed charges,101.76,32% of total billed charges,106.85,33.6% of total billed charges,118.17,EAPG,101.76,32% of total billed charges,101.76,32% of total billed charges,292.56,92% of total billed charges,101.76,292.56,270.30
Outpatient Medical Services,Emergency,51702,CATH INSERT TEMP INDWELL (FOLEY),450,83,67.4,81.2% of total billed charges,27.09,32.64% of total billed charges,61.42,74% of total billed charges,61.42,74% of total billed charges,26.56,32% of total billed charges,31.52,EAPG,26.56,32% of total billed charges,58.93,71% of total billed charges,58.93,71% of total billed charges,55.61,67% of total billed charges,55.61,67% of total billed charges,58.93,71% of total billed charges,63.08,76% of total billed charges,31.52,EAPG,27.36,32.96% of total billed charges,32.13,EAPG,74.7,90% of total billed charges,74.7,90% of total billed charges,30.6,EAPG,73.54,88.6% of total billed charges,31.52,EAPG,26.56,32% of total billed charges,66.4,80% of total billed charges,66.4,80% of total billed charges,30.6,EAPG,75.53,91% of total billed charges,27.09,32.64% of total billed charges,26.56,32% of total billed charges,27.89,33.6% of total billed charges,31.52,EAPG,26.56,32% of total billed charges,26.56,32% of total billed charges,76.36,92% of total billed charges,26.56,76.36,70.55
Outpatient Medical Services,Endoscopy,45378,COLONOSCOPY,750,2305,1871.66,81.2% of total billed charges,752.35,32.64% of total billed charges,4917,74% of total billed charges,4917,74% of total billed charges,737.6,32% of total billed charges,N/A,Not Separately reimbursable,737.6,32% of total billed charges,4671,71% of total billed charges,4671,71% of total billed charges,4425,67% of total billed charges,4425,67% of total billed charges,4671,71% of total billed charges,1751.8,76% of total billed charges,N/A,Not Separately reimbursable,759.73,32.96% of total billed charges,N/A,Not Separately reimbursable,2074.5,90% of total billed charges,2074.5,90% of total billed charges,N/A,Not Separately reimbursable,2042.23,88.6% of total billed charges,N/A,Not Separately reimbursable,737.6,32% of total billed charges,1844,80% of total billed charges,1844,80% of total billed charges,N/A,Not Separately reimbursable,2097.55,91% of total billed charges,752.35,32.64% of total billed charges,737.6,32% of total billed charges,774.48,33.6% of total billed charges,N/A,Not Separately reimbursable,737.6,32% of total billed charges,737.6,32% of total billed charges,2120.6,92% of total billed charges,737.6,4917,1959.25
Outpatient Medical Services,Endoscopy,45380,COLONOSCOPY W/ BX/POLY (COLD FORCEP),750,3262,2648.74,81.2% of total billed charges,1064.72,32.64% of total billed charges,4917,74% of total billed charges,4917,74% of total billed charges,1043.84,32% of total billed charges,N/A,Not Separately reimbursable,1043.84,32% of total billed charges,4671,71% of total billed charges,4671,71% of total billed charges,4425,67% of total billed charges,4425,67% of total billed charges,4671,71% of total billed charges,2479.12,76% of total billed charges,N/A,Not Separately reimbursable,1075.16,32.96% of total billed charges,N/A,Not Separately reimbursable,2935.8,90% of total billed charges,2935.8,90% of total billed charges,N/A,Not Separately reimbursable,2890.13,88.6% of total billed charges,N/A,Not Separately reimbursable,1043.84,32% of total billed charges,2609.6,80% of total billed charges,2609.6,80% of total billed charges,N/A,Not Separately reimbursable,2968.42,91% of total billed charges,1064.72,32.64% of total billed charges,1043.84,32% of total billed charges,1096.03,33.6% of total billed charges,N/A,Not Separately reimbursable,1043.84,32% of total billed charges,1043.84,32% of total billed charges,3001.04,92% of total billed charges,1043.84,4917,2772.70
Outpatient Medical Services,Endoscopy,43239,EGD WITH BIOPSY,750,3262,2648.74,81.2% of total billed charges,1064.72,32.64% of total billed charges,4917,74% of total billed charges,4917,74% of total billed charges,1043.84,32% of total billed charges,495.1,EAPG,1043.84,32% of total billed charges,4671,71% of total billed charges,4671,71% of total billed charges,4425,67% of total billed charges,4425,67% of total billed charges,4671,71% of total billed charges,2479.12,76% of total billed charges,495.1,EAPG,1075.16,32.96% of total billed charges,504.71,EAPG,2935.8,90% of total billed charges,2935.8,90% of total billed charges,480.68,EAPG,2890.13,88.6% of total billed charges,495.1,EAPG,1043.84,32% of total billed charges,2609.6,80% of total billed charges,2609.6,80% of total billed charges,480.68,EAPG,2968.42,91% of total billed charges,1064.72,32.64% of total billed charges,1043.84,32% of total billed charges,1096.03,33.6% of total billed charges,495.1,EAPG,1043.84,32% of total billed charges,1043.84,32% of total billed charges,3001.04,92% of total billed charges,480.68,4917,2772.70
Outpatient Medical Services,Endoscopy,45385,COLONOSCOPY W/ POLYPECTOMY (SNARE),750,3488,2832.26,81.2% of total billed charges,1138.48,32.64% of total billed charges,4917,74% of total billed charges,4917,74% of total billed charges,1116.16,32% of total billed charges,564.86,EAPG,1116.16,32% of total billed charges,4671,71% of total billed charges,4671,71% of total billed charges,4425,67% of total billed charges,4425,67% of total billed charges,4671,71% of total billed charges,2650.88,76% of total billed charges,564.86,EAPG,1149.64,32.96% of total billed charges,575.82,EAPG,3139.2,90% of total billed charges,3139.2,90% of total billed charges,548.4,EAPG,3090.37,88.6% of total billed charges,564.86,EAPG,1116.16,32% of total billed charges,2790.4,80% of total billed charges,2790.4,80% of total billed charges,548.4,EAPG,3174.08,91% of total billed charges,1138.48,32.64% of total billed charges,1116.16,32% of total billed charges,1171.97,33.6% of total billed charges,564.86,EAPG,1116.16,32% of total billed charges,1116.16,32% of total billed charges,3208.96,92% of total billed charges,548.4,4917,2964.80
Outpatient Medical Services,Laboratory,80329,ACETAMINOPHEN,301,105,85.26,81.2% of total billed charges,34.27,32.64% of total billed charges,77.7,74% of total billed charges,77.7,74% of total billed charges,33.6,32% of total billed charges,11.51,EAPG,33.6,32% of total billed charges,74.55,71% of total billed charges,74.55,71% of total billed charges,70.35,67% of total billed charges,70.35,67% of total billed charges,74.55,71% of total billed charges,79.8,76% of total billed charges,11.51,EAPG,34.61,32.96% of total billed charges,11.74,EAPG,94.5,90% of total billed charges,94.5,90% of total billed charges,11.18,EAPG,93.03,88.6% of total billed charges,11.51,EAPG,33.6,32% of total billed charges,84,80% of total billed charges,84,80% of total billed charges,11.18,EAPG,95.55,91% of total billed charges,34.27,32.64% of total billed charges,33.6,32% of total billed charges,35.28,33.6% of total billed charges,11.51,EAPG,33.6,32% of total billed charges,33.6,32% of total billed charges,96.6,92% of total billed charges,11.18,96.6,89.25
Outpatient Medical Services,Laboratory,85730,ACTIVATED PTT,305,63,51.16,81.2% of total billed charges,20.56,32.64% of total billed charges,46.62,74% of total billed charges,46.62,74% of total billed charges,20.16,32% of total billed charges,6.16,EAPG,20.16,32% of total billed charges,44.73,71% of total billed charges,44.73,71% of total billed charges,42.21,67% of total billed charges,42.21,67% of total billed charges,44.73,71% of total billed charges,47.88,76% of total billed charges,6.16,EAPG,20.76,32.96% of total billed charges,6.28,EAPG,56.7,90% of total billed charges,56.7,90% of total billed charges,5.98,EAPG,55.82,88.6% of total billed charges,6.16,EAPG,20.16,32% of total billed charges,50.4,80% of total billed charges,50.4,80% of total billed charges,5.98,EAPG,57.33,91% of total billed charges,20.56,32.64% of total billed charges,20.16,32% of total billed charges,21.17,33.6% of total billed charges,6.16,EAPG,20.16,32% of total billed charges,20.16,32% of total billed charges,57.96,92% of total billed charges,5.98,57.96,53.55
Outpatient Medical Services,Laboratory,80320,ALCOHOL ETHANOL SERUM,301,48,38.98,81.2% of total billed charges,15.67,32.64% of total billed charges,35.52,74% of total billed charges,35.52,74% of total billed charges,15.36,32% of total billed charges,11.51,EAPG,15.36,32% of total billed charges,34.08,71% of total billed charges,34.08,71% of total billed charges,32.16,67% of total billed charges,32.16,67% of total billed charges,34.08,71% of total billed charges,36.48,76% of total billed charges,11.51,EAPG,15.82,32.96% of total billed charges,11.74,EAPG,43.2,90% of total billed charges,43.2,90% of total billed charges,11.18,EAPG,42.53,88.6% of total billed charges,11.51,EAPG,15.36,32% of total billed charges,38.4,80% of total billed charges,38.4,80% of total billed charges,11.18,EAPG,43.68,91% of total billed charges,15.67,32.64% of total billed charges,15.36,32% of total billed charges,16.13,33.6% of total billed charges,11.51,EAPG,15.36,32% of total billed charges,15.36,32% of total billed charges,44.16,92% of total billed charges,11.18,44.16,40.80
Outpatient Medical Services,Laboratory,82140,AMMONIA,301,81,65.77,81.2% of total billed charges,26.44,32.64% of total billed charges,59.94,74% of total billed charges,59.94,74% of total billed charges,25.92,32% of total billed charges,11.51,EAPG,25.92,32% of total billed charges,57.51,71% of total billed charges,57.51,71% of total billed charges,54.27,67% of total billed charges,54.27,67% of total billed charges,57.51,71% of total billed charges,61.56,76% of total billed charges,11.51,EAPG,26.7,32.96% of total billed charges,11.74,EAPG,72.9,90% of total billed charges,72.9,90% of total billed charges,11.18,EAPG,71.77,88.6% of total billed charges,11.51,EAPG,25.92,32% of total billed charges,64.8,80% of total billed charges,64.8,80% of total billed charges,11.18,EAPG,73.71,91% of total billed charges,26.44,32.64% of total billed charges,25.92,32% of total billed charges,27.22,33.6% of total billed charges,11.51,EAPG,25.92,32% of total billed charges,25.92,32% of total billed charges,74.52,92% of total billed charges,11.18,74.52,68.85
Outpatient Medical Services,Laboratory,82150,AMYLASE,301,61,49.53,81.2% of total billed charges,19.91,32.64% of total billed charges,45.14,74% of total billed charges,45.14,74% of total billed charges,19.52,32% of total billed charges,7.45,EAPG,19.52,32% of total billed charges,43.31,71% of total billed charges,43.31,71% of total billed charges,40.87,67% of total billed charges,40.87,67% of total billed charges,43.31,71% of total billed charges,46.36,76% of total billed charges,7.45,EAPG,20.11,32.96% of total billed charges,7.6,EAPG,54.9,90% of total billed charges,54.9,90% of total billed charges,7.24,EAPG,54.05,88.6% of total billed charges,7.45,EAPG,19.52,32% of total billed charges,48.8,80% of total billed charges,48.8,80% of total billed charges,7.24,EAPG,55.51,91% of total billed charges,19.91,32.64% of total billed charges,19.52,32% of total billed charges,20.5,33.6% of total billed charges,7.45,EAPG,19.52,32% of total billed charges,19.52,32% of total billed charges,56.12,92% of total billed charges,7.24,56.12,51.85
Outpatient Medical Services,Laboratory,86038,ANA,302,99,80.39,81.2% of total billed charges,32.31,32.64% of total billed charges,73.26,74% of total billed charges,73.26,74% of total billed charges,31.68,32% of total billed charges,14.64,EAPG,31.68,32% of total billed charges,70.29,71% of total billed charges,70.29,71% of total billed charges,66.33,67% of total billed charges,66.33,67% of total billed charges,70.29,71% of total billed charges,75.24,76% of total billed charges,14.64,EAPG,32.63,32.96% of total billed charges,14.93,EAPG,89.1,90% of total billed charges,89.1,90% of total billed charges,14.22,EAPG,87.71,88.6% of total billed charges,14.64,EAPG,31.68,32% of total billed charges,79.2,80% of total billed charges,79.2,80% of total billed charges,14.22,EAPG,90.09,91% of total billed charges,32.31,32.64% of total billed charges,31.68,32% of total billed charges,33.26,33.6% of total billed charges,14.64,EAPG,31.68,32% of total billed charges,31.68,32% of total billed charges,91.08,92% of total billed charges,14.22,91.08,84.15
Outpatient Medical Services,Laboratory,87075,ANAEROBE CULTURE,306,147,119.36,81.2% of total billed charges,47.98,32.64% of total billed charges,108.78,74% of total billed charges,108.78,74% of total billed charges,47.04,32% of total billed charges,10.56,EAPG,47.04,32% of total billed charges,104.37,71% of total billed charges,104.37,71% of total billed charges,98.49,67% of total billed charges,98.49,67% of total billed charges,104.37,71% of total billed charges,111.72,76% of total billed charges,10.56,EAPG,48.45,32.96% of total billed charges,10.76,EAPG,132.3,90% of total billed charges,132.3,90% of total billed charges,10.25,EAPG,130.24,88.6% of total billed charges,10.56,EAPG,47.04,32% of total billed charges,117.6,80% of total billed charges,117.6,80% of total billed charges,10.25,EAPG,133.77,91% of total billed charges,47.98,32.64% of total billed charges,47.04,32% of total billed charges,49.39,33.6% of total billed charges,10.56,EAPG,47.04,32% of total billed charges,47.04,32% of total billed charges,135.24,92% of total billed charges,10.25,135.24,124.95
Outpatient Medical Services,Laboratory,84702,BETA HCG QUANT,301,130,105.56,81.2% of total billed charges,42.43,32.64% of total billed charges,96.2,74% of total billed charges,96.2,74% of total billed charges,41.6,32% of total billed charges,13.96,EAPG,41.6,32% of total billed charges,92.3,71% of total billed charges,92.3,71% of total billed charges,87.1,67% of total billed charges,87.1,67% of total billed charges,92.3,71% of total billed charges,98.8,76% of total billed charges,13.96,EAPG,42.85,32.96% of total billed charges,14.23,EAPG,117,90% of total billed charges,117,90% of total billed charges,13.55,EAPG,115.18,88.6% of total billed charges,13.96,EAPG,41.6,32% of total billed charges,104,80% of total billed charges,104,80% of total billed charges,13.55,EAPG,118.3,91% of total billed charges,42.43,32.64% of total billed charges,41.6,32% of total billed charges,43.68,33.6% of total billed charges,13.96,EAPG,41.6,32% of total billed charges,41.6,32% of total billed charges,119.6,92% of total billed charges,13.55,119.6,110.50
Outpatient Medical Services,Laboratory,84520,BUN,301,75,60.9,81.2% of total billed charges,24.48,32.64% of total billed charges,55.5,74% of total billed charges,55.5,74% of total billed charges,24,32% of total billed charges,7.45,EAPG,24,32% of total billed charges,53.25,71% of total billed charges,53.25,71% of total billed charges,50.25,67% of total billed charges,50.25,67% of total billed charges,53.25,71% of total billed charges,57,76% of total billed charges,7.45,EAPG,24.72,32.96% of total billed charges,7.6,EAPG,67.5,90% of total billed charges,67.5,90% of total billed charges,7.24,EAPG,66.45,88.6% of total billed charges,7.45,EAPG,24,32% of total billed charges,60,80% of total billed charges,60,80% of total billed charges,7.24,EAPG,68.25,91% of total billed charges,24.48,32.64% of total billed charges,24,32% of total billed charges,25.2,33.6% of total billed charges,7.45,EAPG,24,32% of total billed charges,24,32% of total billed charges,69,92% of total billed charges,7.24,69,63.75
Outpatient Medical Services,Laboratory,82378,CARCINEOMBRYO ANTIGEN CEA,301,143,116.12,81.2% of total billed charges,46.68,32.64% of total billed charges,105.82,74% of total billed charges,105.82,74% of total billed charges,45.76,32% of total billed charges,11.51,EAPG,45.76,32% of total billed charges,101.53,71% of total billed charges,101.53,71% of total billed charges,95.81,67% of total billed charges,95.81,67% of total billed charges,101.53,71% of total billed charges,108.68,76% of total billed charges,11.51,EAPG,47.13,32.96% of total billed charges,11.74,EAPG,128.7,90% of total billed charges,128.7,90% of total billed charges,11.18,EAPG,126.7,88.6% of total billed charges,11.51,EAPG,45.76,32% of total billed charges,114.4,80% of total billed charges,114.4,80% of total billed charges,11.18,EAPG,130.13,91% of total billed charges,46.68,32.64% of total billed charges,45.76,32% of total billed charges,48.05,33.6% of total billed charges,11.51,EAPG,45.76,32% of total billed charges,45.76,32% of total billed charges,131.56,92% of total billed charges,11.18,131.56,121.55
Outpatient Medical Services,Laboratory,86850,BB ANTIBODY SCREEN,300,103,83.64,81.2% of total billed charges,33.62,32.64% of total billed charges,76.22,74% of total billed charges,76.22,74% of total billed charges,32.96,32% of total billed charges,42.87,EAPG,32.96,32% of total billed charges,73.13,71% of total billed charges,73.13,71% of total billed charges,69.01,67% of total billed charges,69.01,67% of total billed charges,73.13,71% of total billed charges,78.28,76% of total billed charges,42.87,EAPG,33.95,32.96% of total billed charges,43.7,EAPG,92.7,90% of total billed charges,92.7,90% of total billed charges,41.62,EAPG,91.26,88.6% of total billed charges,42.87,EAPG,32.96,32% of total billed charges,82.4,80% of total billed charges,82.4,80% of total billed charges,41.62,EAPG,93.73,91% of total billed charges,33.62,32.64% of total billed charges,32.96,32% of total billed charges,34.61,33.6% of total billed charges,42.87,EAPG,32.96,32% of total billed charges,32.96,32% of total billed charges,94.76,92% of total billed charges,32.96,94.76,87.55
Outpatient Medical Services,Laboratory,82550,CPK/CKI TOTAL,301,50,40.6,81.2% of total billed charges,16.32,32.64% of total billed charges,37,74% of total billed charges,37,74% of total billed charges,16,32% of total billed charges,7.45,EAPG,16,32% of total billed charges,35.5,71% of total billed charges,35.5,71% of total billed charges,33.5,67% of total billed charges,33.5,67% of total billed charges,35.5,71% of total billed charges,38,76% of total billed charges,7.45,EAPG,16.48,32.96% of total billed charges,7.6,EAPG,45,90% of total billed charges,45,90% of total billed charges,7.24,EAPG,44.3,88.6% of total billed charges,7.45,EAPG,16,32% of total billed charges,40,80% of total billed charges,40,80% of total billed charges,7.24,EAPG,45.5,91% of total billed charges,16.32,32.64% of total billed charges,16,32% of total billed charges,16.8,33.6% of total billed charges,7.45,EAPG,16,32% of total billed charges,16,32% of total billed charges,46,92% of total billed charges,7.24,46,42.50
Outpatient Medical Services,Laboratory,82565,CREATININE,301,77,62.52,81.2% of total billed charges,25.13,32.64% of total billed charges,56.98,74% of total billed charges,56.98,74% of total billed charges,24.64,32% of total billed charges,7.45,EAPG,24.64,32% of total billed charges,54.67,71% of total billed charges,54.67,71% of total billed charges,51.59,67% of total billed charges,51.59,67% of total billed charges,54.67,71% of total billed charges,58.52,76% of total billed charges,7.45,EAPG,25.38,32.96% of total billed charges,7.6,EAPG,69.3,90% of total billed charges,69.3,90% of total billed charges,7.24,EAPG,68.22,88.6% of total billed charges,7.45,EAPG,24.64,32% of total billed charges,61.6,80% of total billed charges,61.6,80% of total billed charges,7.24,EAPG,70.07,91% of total billed charges,25.13,32.64% of total billed charges,24.64,32% of total billed charges,25.87,33.6% of total billed charges,7.45,EAPG,24.64,32% of total billed charges,24.64,32% of total billed charges,70.84,92% of total billed charges,7.24,70.84,65.45
Outpatient Medical Services,Laboratory,86922,BB CROSSMATCH,309,103,83.64,81.2% of total billed charges,33.62,32.64% of total billed charges,76.22,74% of total billed charges,76.22,74% of total billed charges,32.96,32% of total billed charges,42.87,EAPG,32.96,32% of total billed charges,73.13,71% of total billed charges,73.13,71% of total billed charges,69.01,67% of total billed charges,69.01,67% of total billed charges,73.13,71% of total billed charges,78.28,76% of total billed charges,42.87,EAPG,33.95,32.96% of total billed charges,43.7,EAPG,92.7,90% of total billed charges,92.7,90% of total billed charges,41.62,EAPG,91.26,88.6% of total billed charges,42.87,EAPG,32.96,32% of total billed charges,82.4,80% of total billed charges,82.4,80% of total billed charges,41.62,EAPG,93.73,91% of total billed charges,33.62,32.64% of total billed charges,32.96,32% of total billed charges,34.61,33.6% of total billed charges,42.87,EAPG,32.96,32% of total billed charges,32.96,32% of total billed charges,94.76,92% of total billed charges,32.96,94.76,87.55
Outpatient Medical Services,Laboratory,86140,CRP,302,86,69.83,81.2% of total billed charges,28.07,32.64% of total billed charges,63.64,74% of total billed charges,63.64,74% of total billed charges,27.52,32% of total billed charges,14.64,EAPG,27.52,32% of total billed charges,61.06,71% of total billed charges,61.06,71% of total billed charges,57.62,67% of total billed charges,57.62,67% of total billed charges,61.06,71% of total billed charges,65.36,76% of total billed charges,14.64,EAPG,28.35,32.96% of total billed charges,14.93,EAPG,77.4,90% of total billed charges,77.4,90% of total billed charges,14.22,EAPG,76.2,88.6% of total billed charges,14.64,EAPG,27.52,32% of total billed charges,68.8,80% of total billed charges,68.8,80% of total billed charges,14.22,EAPG,78.26,91% of total billed charges,28.07,32.64% of total billed charges,27.52,32% of total billed charges,28.9,33.6% of total billed charges,14.64,EAPG,27.52,32% of total billed charges,27.52,32% of total billed charges,79.12,92% of total billed charges,14.22,79.12,73.10
Outpatient Medical Services,Laboratory,80164,DEPAKENE,301,99,80.39,81.2% of total billed charges,32.31,32.64% of total billed charges,73.26,74% of total billed charges,73.26,74% of total billed charges,31.68,32% of total billed charges,11.61,EAPG,31.68,32% of total billed charges,70.29,71% of total billed charges,70.29,71% of total billed charges,66.33,67% of total billed charges,66.33,67% of total billed charges,70.29,71% of total billed charges,75.24,76% of total billed charges,11.61,EAPG,32.63,32.96% of total billed charges,11.84,EAPG,89.1,90% of total billed charges,89.1,90% of total billed charges,11.28,EAPG,87.71,88.6% of total billed charges,11.61,EAPG,31.68,32% of total billed charges,79.2,80% of total billed charges,79.2,80% of total billed charges,11.28,EAPG,90.09,91% of total billed charges,32.31,32.64% of total billed charges,31.68,32% of total billed charges,33.26,33.6% of total billed charges,11.61,EAPG,31.68,32% of total billed charges,31.68,32% of total billed charges,91.08,92% of total billed charges,11.28,91.08,84.15
Outpatient Medical Services,Laboratory,80162,DIGOXIN,301,122,99.06,81.2% of total billed charges,39.82,32.64% of total billed charges,90.28,74% of total billed charges,90.28,74% of total billed charges,39.04,32% of total billed charges,11.61,EAPG,39.04,32% of total billed charges,86.62,71% of total billed charges,86.62,71% of total billed charges,81.74,67% of total billed charges,81.74,67% of total billed charges,86.62,71% of total billed charges,92.72,76% of total billed charges,11.61,EAPG,40.21,32.96% of total billed charges,11.84,EAPG,109.8,90% of total billed charges,109.8,90% of total billed charges,11.28,EAPG,108.09,88.6% of total billed charges,11.61,EAPG,39.04,32% of total billed charges,97.6,80% of total billed charges,97.6,80% of total billed charges,11.28,EAPG,111.02,91% of total billed charges,39.82,32.64% of total billed charges,39.04,32% of total billed charges,40.99,33.6% of total billed charges,11.61,EAPG,39.04,32% of total billed charges,39.04,32% of total billed charges,112.24,92% of total billed charges,11.28,112.24,103.70
Outpatient Medical Services,Laboratory,84165,ELECTROPHORESIS PROTEIN SERUM,301,48,38.98,81.2% of total billed charges,15.67,32.64% of total billed charges,35.52,74% of total billed charges,35.52,74% of total billed charges,15.36,32% of total billed charges,11.51,EAPG,15.36,32% of total billed charges,34.08,71% of total billed charges,34.08,71% of total billed charges,32.16,67% of total billed charges,32.16,67% of total billed charges,34.08,71% of total billed charges,36.48,76% of total billed charges,11.51,EAPG,15.82,32.96% of total billed charges,11.74,EAPG,43.2,90% of total billed charges,43.2,90% of total billed charges,11.18,EAPG,42.53,88.6% of total billed charges,11.51,EAPG,15.36,32% of total billed charges,38.4,80% of total billed charges,38.4,80% of total billed charges,11.18,EAPG,43.68,91% of total billed charges,15.67,32.64% of total billed charges,15.36,32% of total billed charges,16.13,33.6% of total billed charges,11.51,EAPG,15.36,32% of total billed charges,15.36,32% of total billed charges,44.16,92% of total billed charges,11.18,44.16,40.80
Outpatient Medical Services,Laboratory,84166,"ELECTROPHORESIS PROTEIN URINE,RANDOM",301,75,60.9,81.2% of total billed charges,24.48,32.64% of total billed charges,55.5,74% of total billed charges,55.5,74% of total billed charges,24,32% of total billed charges,11.51,EAPG,24,32% of total billed charges,53.25,71% of total billed charges,53.25,71% of total billed charges,50.25,67% of total billed charges,50.25,67% of total billed charges,53.25,71% of total billed charges,57,76% of total billed charges,11.51,EAPG,24.72,32.96% of total billed charges,11.74,EAPG,67.5,90% of total billed charges,67.5,90% of total billed charges,11.18,EAPG,66.45,88.6% of total billed charges,11.51,EAPG,24,32% of total billed charges,60,80% of total billed charges,60,80% of total billed charges,11.18,EAPG,68.25,91% of total billed charges,24.48,32.64% of total billed charges,24,32% of total billed charges,25.2,33.6% of total billed charges,11.51,EAPG,24,32% of total billed charges,24,32% of total billed charges,69,92% of total billed charges,11.18,69,63.75
Outpatient Medical Services,Laboratory,85652,ESR SED RATE AUTOMATED,305,49,39.79,81.2% of total billed charges,15.99,32.64% of total billed charges,36.26,74% of total billed charges,36.26,74% of total billed charges,15.68,32% of total billed charges,5.38,EAPG,15.68,32% of total billed charges,34.79,71% of total billed charges,34.79,71% of total billed charges,32.83,67% of total billed charges,32.83,67% of total billed charges,34.79,71% of total billed charges,37.24,76% of total billed charges,5.38,EAPG,16.15,32.96% of total billed charges,5.49,EAPG,44.1,90% of total billed charges,44.1,90% of total billed charges,5.23,EAPG,43.41,88.6% of total billed charges,5.38,EAPG,15.68,32% of total billed charges,39.2,80% of total billed charges,39.2,80% of total billed charges,5.23,EAPG,44.59,91% of total billed charges,15.99,32.64% of total billed charges,15.68,32% of total billed charges,16.46,33.6% of total billed charges,5.38,EAPG,15.68,32% of total billed charges,15.68,32% of total billed charges,45.08,92% of total billed charges,5.23,45.08,41.65
Outpatient Medical Services,Laboratory,82728,FERRITIN,301,93,75.52,81.2% of total billed charges,30.36,32.64% of total billed charges,68.82,74% of total billed charges,68.82,74% of total billed charges,29.76,32% of total billed charges,11.51,EAPG,29.76,32% of total billed charges,66.03,71% of total billed charges,66.03,71% of total billed charges,62.31,67% of total billed charges,62.31,67% of total billed charges,66.03,71% of total billed charges,70.68,76% of total billed charges,11.51,EAPG,30.65,32.96% of total billed charges,11.74,EAPG,83.7,90% of total billed charges,83.7,90% of total billed charges,11.18,EAPG,82.4,88.6% of total billed charges,11.51,EAPG,29.76,32% of total billed charges,74.4,80% of total billed charges,74.4,80% of total billed charges,11.18,EAPG,84.63,91% of total billed charges,30.36,32.64% of total billed charges,29.76,32% of total billed charges,31.25,33.6% of total billed charges,11.51,EAPG,29.76,32% of total billed charges,29.76,32% of total billed charges,85.56,92% of total billed charges,11.18,85.56,79.05
Outpatient Medical Services,Laboratory,82746,FOLATE SERUM FOLIC ACID,301,110,89.32,81.2% of total billed charges,35.9,32.64% of total billed charges,81.4,74% of total billed charges,81.4,74% of total billed charges,35.2,32% of total billed charges,11.51,EAPG,35.2,32% of total billed charges,78.1,71% of total billed charges,78.1,71% of total billed charges,73.7,67% of total billed charges,73.7,67% of total billed charges,78.1,71% of total billed charges,83.6,76% of total billed charges,11.51,EAPG,36.26,32.96% of total billed charges,11.74,EAPG,99,90% of total billed charges,99,90% of total billed charges,11.18,EAPG,97.46,88.6% of total billed charges,11.51,EAPG,35.2,32% of total billed charges,88,80% of total billed charges,88,80% of total billed charges,11.18,EAPG,100.1,91% of total billed charges,35.9,32.64% of total billed charges,35.2,32% of total billed charges,36.96,33.6% of total billed charges,11.51,EAPG,35.2,32% of total billed charges,35.2,32% of total billed charges,101.2,92% of total billed charges,11.18,101.2,93.50
Outpatient Medical Services,Laboratory,87205,GRAM STAIN BLD/CSF/SYN,306,50,40.6,81.2% of total billed charges,16.32,32.64% of total billed charges,37,74% of total billed charges,37,74% of total billed charges,16,32% of total billed charges,10.56,EAPG,16,32% of total billed charges,35.5,71% of total billed charges,35.5,71% of total billed charges,33.5,67% of total billed charges,33.5,67% of total billed charges,35.5,71% of total billed charges,38,76% of total billed charges,10.56,EAPG,16.48,32.96% of total billed charges,10.76,EAPG,45,90% of total billed charges,45,90% of total billed charges,10.25,EAPG,44.3,88.6% of total billed charges,10.56,EAPG,16,32% of total billed charges,40,80% of total billed charges,40,80% of total billed charges,10.25,EAPG,45.5,91% of total billed charges,16.32,32.64% of total billed charges,16,32% of total billed charges,16.8,33.6% of total billed charges,10.56,EAPG,16,32% of total billed charges,16,32% of total billed charges,46,92% of total billed charges,10.25,46,42.50
Outpatient Medical Services,Laboratory,86900,BB TYPE,300,83,67.4,81.2% of total billed charges,27.09,32.64% of total billed charges,61.42,74% of total billed charges,61.42,74% of total billed charges,26.56,32% of total billed charges,42.87,EAPG,26.56,32% of total billed charges,58.93,71% of total billed charges,58.93,71% of total billed charges,55.61,67% of total billed charges,55.61,67% of total billed charges,58.93,71% of total billed charges,63.08,76% of total billed charges,42.87,EAPG,27.36,32.96% of total billed charges,43.7,EAPG,74.7,90% of total billed charges,74.7,90% of total billed charges,41.62,EAPG,73.54,88.6% of total billed charges,42.87,EAPG,26.56,32% of total billed charges,66.4,80% of total billed charges,66.4,80% of total billed charges,41.62,EAPG,75.53,91% of total billed charges,27.09,32.64% of total billed charges,26.56,32% of total billed charges,27.89,33.6% of total billed charges,42.87,EAPG,26.56,32% of total billed charges,26.56,32% of total billed charges,76.36,92% of total billed charges,26.56,76.36,70.55
Outpatient Medical Services,Laboratory,83036,HEMOGLOBIN A1C GLYCOHEMOGL,301,82,66.58,81.2% of total billed charges,26.76,32.64% of total billed charges,60.68,74% of total billed charges,60.68,74% of total billed charges,26.24,32% of total billed charges,11.51,EAPG,26.24,32% of total billed charges,58.22,71% of total billed charges,58.22,71% of total billed charges,54.94,67% of total billed charges,54.94,67% of total billed charges,58.22,71% of total billed charges,62.32,76% of total billed charges,11.51,EAPG,27.03,32.96% of total billed charges,11.74,EAPG,73.8,90% of total billed charges,73.8,90% of total billed charges,11.18,EAPG,72.65,88.6% of total billed charges,11.51,EAPG,26.24,32% of total billed charges,65.6,80% of total billed charges,65.6,80% of total billed charges,11.18,EAPG,74.62,91% of total billed charges,26.76,32.64% of total billed charges,26.24,32% of total billed charges,27.55,33.6% of total billed charges,11.51,EAPG,26.24,32% of total billed charges,26.24,32% of total billed charges,75.44,92% of total billed charges,11.18,75.44,69.70
Outpatient Medical Services,Laboratory,85018,HEMOGLOBIN,305,45,36.54,81.2% of total billed charges,14.69,32.64% of total billed charges,33.3,74% of total billed charges,33.3,74% of total billed charges,14.4,32% of total billed charges,5.38,EAPG,14.4,32% of total billed charges,31.95,71% of total billed charges,31.95,71% of total billed charges,30.15,67% of total billed charges,30.15,67% of total billed charges,31.95,71% of total billed charges,34.2,76% of total billed charges,5.38,EAPG,14.83,32.96% of total billed charges,5.49,EAPG,40.5,90% of total billed charges,40.5,90% of total billed charges,5.23,EAPG,39.87,88.6% of total billed charges,5.38,EAPG,14.4,32% of total billed charges,36,80% of total billed charges,36,80% of total billed charges,5.23,EAPG,40.95,91% of total billed charges,14.69,32.64% of total billed charges,14.4,32% of total billed charges,15.12,33.6% of total billed charges,5.38,EAPG,14.4,32% of total billed charges,14.4,32% of total billed charges,41.4,92% of total billed charges,5.23,41.4,38.25
Outpatient Medical Services,Laboratory,85014,HEMATOCRIT,305,45,36.54,81.2% of total billed charges,14.69,32.64% of total billed charges,33.3,74% of total billed charges,33.3,74% of total billed charges,14.4,32% of total billed charges,5.38,EAPG,14.4,32% of total billed charges,31.95,71% of total billed charges,31.95,71% of total billed charges,30.15,67% of total billed charges,30.15,67% of total billed charges,31.95,71% of total billed charges,34.2,76% of total billed charges,5.38,EAPG,14.83,32.96% of total billed charges,5.49,EAPG,40.5,90% of total billed charges,40.5,90% of total billed charges,5.23,EAPG,39.87,88.6% of total billed charges,5.38,EAPG,14.4,32% of total billed charges,36,80% of total billed charges,36,80% of total billed charges,5.23,EAPG,40.95,91% of total billed charges,14.69,32.64% of total billed charges,14.4,32% of total billed charges,15.12,33.6% of total billed charges,5.38,EAPG,14.4,32% of total billed charges,14.4,32% of total billed charges,41.4,92% of total billed charges,5.23,41.4,38.25
Outpatient Medical Services,Laboratory,86334,IMMUNO ELECTROPHORESIS SERUM,302,176,142.91,81.2% of total billed charges,57.45,32.64% of total billed charges,130.24,74% of total billed charges,130.24,74% of total billed charges,56.32,32% of total billed charges,14.64,EAPG,56.32,32% of total billed charges,124.96,71% of total billed charges,124.96,71% of total billed charges,117.92,67% of total billed charges,117.92,67% of total billed charges,124.96,71% of total billed charges,133.76,76% of total billed charges,14.64,EAPG,58.01,32.96% of total billed charges,14.93,EAPG,158.4,90% of total billed charges,158.4,90% of total billed charges,14.22,EAPG,155.94,88.6% of total billed charges,14.64,EAPG,56.32,32% of total billed charges,140.8,80% of total billed charges,140.8,80% of total billed charges,14.22,EAPG,160.16,91% of total billed charges,57.45,32.64% of total billed charges,56.32,32% of total billed charges,59.14,33.6% of total billed charges,14.64,EAPG,56.32,32% of total billed charges,56.32,32% of total billed charges,161.92,92% of total billed charges,14.22,161.92,149.60
Outpatient Medical Services,Laboratory,82784,IGA,301,122,99.06,81.2% of total billed charges,39.82,32.64% of total billed charges,90.28,74% of total billed charges,90.28,74% of total billed charges,39.04,32% of total billed charges,11.51,EAPG,39.04,32% of total billed charges,86.62,71% of total billed charges,86.62,71% of total billed charges,81.74,67% of total billed charges,81.74,67% of total billed charges,86.62,71% of total billed charges,92.72,76% of total billed charges,11.51,EAPG,40.21,32.96% of total billed charges,11.74,EAPG,109.8,90% of total billed charges,109.8,90% of total billed charges,11.18,EAPG,108.09,88.6% of total billed charges,11.51,EAPG,39.04,32% of total billed charges,97.6,80% of total billed charges,97.6,80% of total billed charges,11.18,EAPG,111.02,91% of total billed charges,39.82,32.64% of total billed charges,39.04,32% of total billed charges,40.99,33.6% of total billed charges,11.51,EAPG,39.04,32% of total billed charges,39.04,32% of total billed charges,112.24,92% of total billed charges,11.18,112.24,103.70
Outpatient Medical Services,Laboratory,82784,IGG,301,122,99.06,81.2% of total billed charges,39.82,32.64% of total billed charges,90.28,74% of total billed charges,90.28,74% of total billed charges,39.04,32% of total billed charges,11.51,EAPG,39.04,32% of total billed charges,86.62,71% of total billed charges,86.62,71% of total billed charges,81.74,67% of total billed charges,81.74,67% of total billed charges,86.62,71% of total billed charges,92.72,76% of total billed charges,11.51,EAPG,40.21,32.96% of total billed charges,11.74,EAPG,109.8,90% of total billed charges,109.8,90% of total billed charges,11.18,EAPG,108.09,88.6% of total billed charges,11.51,EAPG,39.04,32% of total billed charges,97.6,80% of total billed charges,97.6,80% of total billed charges,11.18,EAPG,111.02,91% of total billed charges,39.82,32.64% of total billed charges,39.04,32% of total billed charges,40.99,33.6% of total billed charges,11.51,EAPG,39.04,32% of total billed charges,39.04,32% of total billed charges,112.24,92% of total billed charges,11.18,112.24,103.70
Outpatient Medical Services,Laboratory,82784,IGM,301,122,99.06,81.2% of total billed charges,39.82,32.64% of total billed charges,90.28,74% of total billed charges,90.28,74% of total billed charges,39.04,32% of total billed charges,11.51,EAPG,39.04,32% of total billed charges,86.62,71% of total billed charges,86.62,71% of total billed charges,81.74,67% of total billed charges,81.74,67% of total billed charges,86.62,71% of total billed charges,92.72,76% of total billed charges,11.51,EAPG,40.21,32.96% of total billed charges,11.74,EAPG,109.8,90% of total billed charges,109.8,90% of total billed charges,11.18,EAPG,108.09,88.6% of total billed charges,11.51,EAPG,39.04,32% of total billed charges,97.6,80% of total billed charges,97.6,80% of total billed charges,11.18,EAPG,111.02,91% of total billed charges,39.82,32.64% of total billed charges,39.04,32% of total billed charges,40.99,33.6% of total billed charges,11.51,EAPG,39.04,32% of total billed charges,39.04,32% of total billed charges,112.24,92% of total billed charges,11.18,112.24,103.70
Outpatient Medical Services,Laboratory,83550,IRON BINDING CAPACITY (TIBC),301,96,77.95,81.2% of total billed charges,31.33,32.64% of total billed charges,71.04,74% of total billed charges,71.04,74% of total billed charges,30.72,32% of total billed charges,11.51,EAPG,30.72,32% of total billed charges,68.16,71% of total billed charges,68.16,71% of total billed charges,64.32,67% of total billed charges,64.32,67% of total billed charges,68.16,71% of total billed charges,72.96,76% of total billed charges,11.51,EAPG,31.64,32.96% of total billed charges,11.74,EAPG,86.4,90% of total billed charges,86.4,90% of total billed charges,11.18,EAPG,85.06,88.6% of total billed charges,11.51,EAPG,30.72,32% of total billed charges,76.8,80% of total billed charges,76.8,80% of total billed charges,11.18,EAPG,87.36,91% of total billed charges,31.33,32.64% of total billed charges,30.72,32% of total billed charges,32.26,33.6% of total billed charges,11.51,EAPG,30.72,32% of total billed charges,30.72,32% of total billed charges,88.32,92% of total billed charges,11.18,88.32,81.60
Outpatient Medical Services,Laboratory,83540,IRON,301,93,75.52,81.2% of total billed charges,30.36,32.64% of total billed charges,68.82,74% of total billed charges,68.82,74% of total billed charges,29.76,32% of total billed charges,7.45,EAPG,29.76,32% of total billed charges,66.03,71% of total billed charges,66.03,71% of total billed charges,62.31,67% of total billed charges,62.31,67% of total billed charges,66.03,71% of total billed charges,70.68,76% of total billed charges,7.45,EAPG,30.65,32.96% of total billed charges,7.6,EAPG,83.7,90% of total billed charges,83.7,90% of total billed charges,7.24,EAPG,82.4,88.6% of total billed charges,7.45,EAPG,29.76,32% of total billed charges,74.4,80% of total billed charges,74.4,80% of total billed charges,7.24,EAPG,84.63,91% of total billed charges,30.36,32.64% of total billed charges,29.76,32% of total billed charges,31.25,33.6% of total billed charges,7.45,EAPG,29.76,32% of total billed charges,29.76,32% of total billed charges,85.56,92% of total billed charges,7.24,85.56,79.05
Outpatient Medical Services,Laboratory,83615,LDH / LDI,301,38,30.86,81.2% of total billed charges,12.4,32.64% of total billed charges,28.12,74% of total billed charges,28.12,74% of total billed charges,12.16,32% of total billed charges,7.45,EAPG,12.16,32% of total billed charges,26.98,71% of total billed charges,26.98,71% of total billed charges,25.46,67% of total billed charges,25.46,67% of total billed charges,26.98,71% of total billed charges,28.88,76% of total billed charges,7.45,EAPG,12.52,32.96% of total billed charges,7.6,EAPG,34.2,90% of total billed charges,34.2,90% of total billed charges,7.24,EAPG,33.67,88.6% of total billed charges,7.45,EAPG,12.16,32% of total billed charges,30.4,80% of total billed charges,30.4,80% of total billed charges,7.24,EAPG,34.58,91% of total billed charges,12.4,32.64% of total billed charges,12.16,32% of total billed charges,12.77,33.6% of total billed charges,7.45,EAPG,12.16,32% of total billed charges,12.16,32% of total billed charges,34.96,92% of total billed charges,7.24,34.96,32.30
Outpatient Medical Services,Laboratory,80061,LIPID PANEL,301,104,84.45,81.2% of total billed charges,33.95,32.64% of total billed charges,76.96,74% of total billed charges,76.96,74% of total billed charges,33.28,32% of total billed charges,12.48,EAPG,33.28,32% of total billed charges,73.84,71% of total billed charges,73.84,71% of total billed charges,69.68,67% of total billed charges,69.68,67% of total billed charges,73.84,71% of total billed charges,79.04,76% of total billed charges,12.48,EAPG,34.28,32.96% of total billed charges,12.72,EAPG,93.6,90% of total billed charges,93.6,90% of total billed charges,12.11,EAPG,92.14,88.6% of total billed charges,12.48,EAPG,33.28,32% of total billed charges,83.2,80% of total billed charges,83.2,80% of total billed charges,12.11,EAPG,94.64,91% of total billed charges,33.95,32.64% of total billed charges,33.28,32% of total billed charges,34.94,33.6% of total billed charges,12.48,EAPG,33.28,32% of total billed charges,33.28,32% of total billed charges,95.68,92% of total billed charges,12.11,95.68,88.40
Outpatient Medical Services,Laboratory,83735,MAGNESIUM,301,42,34.1,81.2% of total billed charges,13.71,32.64% of total billed charges,31.08,74% of total billed charges,31.08,74% of total billed charges,13.44,32% of total billed charges,7.45,EAPG,13.44,32% of total billed charges,29.82,71% of total billed charges,29.82,71% of total billed charges,28.14,67% of total billed charges,28.14,67% of total billed charges,29.82,71% of total billed charges,31.92,76% of total billed charges,7.45,EAPG,13.84,32.96% of total billed charges,7.6,EAPG,37.8,90% of total billed charges,37.8,90% of total billed charges,7.24,EAPG,37.21,88.6% of total billed charges,7.45,EAPG,13.44,32% of total billed charges,33.6,80% of total billed charges,33.6,80% of total billed charges,7.24,EAPG,38.22,91% of total billed charges,13.71,32.64% of total billed charges,13.44,32% of total billed charges,14.11,33.6% of total billed charges,7.45,EAPG,13.44,32% of total billed charges,13.44,32% of total billed charges,38.64,92% of total billed charges,7.24,38.64,35.70
Outpatient Medical Services,Laboratory,82270,OCCULT BLOOD SLIDES 1 3-CANCER SCREENING,301,48,38.98,81.2% of total billed charges,15.67,32.64% of total billed charges,35.52,74% of total billed charges,35.52,74% of total billed charges,15.36,32% of total billed charges,7.45,EAPG,15.36,32% of total billed charges,34.08,71% of total billed charges,34.08,71% of total billed charges,32.16,67% of total billed charges,32.16,67% of total billed charges,34.08,71% of total billed charges,36.48,76% of total billed charges,7.45,EAPG,15.82,32.96% of total billed charges,7.6,EAPG,43.2,90% of total billed charges,43.2,90% of total billed charges,7.24,EAPG,42.53,88.6% of total billed charges,7.45,EAPG,15.36,32% of total billed charges,38.4,80% of total billed charges,38.4,80% of total billed charges,7.24,EAPG,43.68,91% of total billed charges,15.67,32.64% of total billed charges,15.36,32% of total billed charges,16.13,33.6% of total billed charges,7.45,EAPG,15.36,32% of total billed charges,15.36,32% of total billed charges,44.16,92% of total billed charges,7.24,44.16,40.80
Outpatient Medical Services,Laboratory,83970,PARATHORMONE N,301,270,219.24,81.2% of total billed charges,88.13,32.64% of total billed charges,199.8,74% of total billed charges,199.8,74% of total billed charges,86.4,32% of total billed charges,17.57,EAPG,86.4,32% of total billed charges,191.7,71% of total billed charges,191.7,71% of total billed charges,180.9,67% of total billed charges,180.9,67% of total billed charges,191.7,71% of total billed charges,205.2,76% of total billed charges,17.57,EAPG,88.99,32.96% of total billed charges,17.91,EAPG,243,90% of total billed charges,243,90% of total billed charges,17.05,EAPG,239.22,88.6% of total billed charges,17.57,EAPG,86.4,32% of total billed charges,216,80% of total billed charges,216,80% of total billed charges,17.05,EAPG,245.7,91% of total billed charges,88.13,32.64% of total billed charges,86.4,32% of total billed charges,90.72,33.6% of total billed charges,17.57,EAPG,86.4,32% of total billed charges,86.4,32% of total billed charges,248.4,92% of total billed charges,17.05,248.4,229.50
Outpatient Medical Services,Laboratory,84100,PHOSPHORUS,301,77,62.52,81.2% of total billed charges,25.13,32.64% of total billed charges,56.98,74% of total billed charges,56.98,74% of total billed charges,24.64,32% of total billed charges,7.45,EAPG,24.64,32% of total billed charges,54.67,71% of total billed charges,54.67,71% of total billed charges,51.59,67% of total billed charges,51.59,67% of total billed charges,54.67,71% of total billed charges,58.52,76% of total billed charges,7.45,EAPG,25.38,32.96% of total billed charges,7.6,EAPG,69.3,90% of total billed charges,69.3,90% of total billed charges,7.24,EAPG,68.22,88.6% of total billed charges,7.45,EAPG,24.64,32% of total billed charges,61.6,80% of total billed charges,61.6,80% of total billed charges,7.24,EAPG,70.07,91% of total billed charges,25.13,32.64% of total billed charges,24.64,32% of total billed charges,25.87,33.6% of total billed charges,7.45,EAPG,24.64,32% of total billed charges,24.64,32% of total billed charges,70.84,92% of total billed charges,7.24,70.84,65.45
Outpatient Medical Services,Laboratory,84132,POTASSIUM,301,48,38.98,81.2% of total billed charges,15.67,32.64% of total billed charges,35.52,74% of total billed charges,35.52,74% of total billed charges,15.36,32% of total billed charges,7.45,EAPG,15.36,32% of total billed charges,34.08,71% of total billed charges,34.08,71% of total billed charges,32.16,67% of total billed charges,32.16,67% of total billed charges,34.08,71% of total billed charges,36.48,76% of total billed charges,7.45,EAPG,15.82,32.96% of total billed charges,7.6,EAPG,43.2,90% of total billed charges,43.2,90% of total billed charges,7.24,EAPG,42.53,88.6% of total billed charges,7.45,EAPG,15.36,32% of total billed charges,38.4,80% of total billed charges,38.4,80% of total billed charges,7.24,EAPG,43.68,91% of total billed charges,15.67,32.64% of total billed charges,15.36,32% of total billed charges,16.13,33.6% of total billed charges,7.45,EAPG,15.36,32% of total billed charges,15.36,32% of total billed charges,44.16,92% of total billed charges,7.24,44.16,40.80
Outpatient Medical Services,Laboratory,81025,PREGNANCY URINE,307,113,91.76,81.2% of total billed charges,36.88,32.64% of total billed charges,83.62,74% of total billed charges,83.62,74% of total billed charges,36.16,32% of total billed charges,4.04,EAPG,36.16,32% of total billed charges,80.23,71% of total billed charges,80.23,71% of total billed charges,75.71,67% of total billed charges,75.71,67% of total billed charges,80.23,71% of total billed charges,85.88,76% of total billed charges,4.04,EAPG,37.24,32.96% of total billed charges,4.12,EAPG,101.7,90% of total billed charges,101.7,90% of total billed charges,3.93,EAPG,100.12,88.6% of total billed charges,4.04,EAPG,36.16,32% of total billed charges,90.4,80% of total billed charges,90.4,80% of total billed charges,3.93,EAPG,102.83,91% of total billed charges,36.88,32.64% of total billed charges,36.16,32% of total billed charges,37.97,33.6% of total billed charges,4.04,EAPG,36.16,32% of total billed charges,36.16,32% of total billed charges,103.96,92% of total billed charges,3.93,103.96,96.05
Outpatient Medical Services,Laboratory,85610,PROTHROMBIN TIME,305,34,27.61,81.2% of total billed charges,11.1,32.64% of total billed charges,25.16,74% of total billed charges,25.16,74% of total billed charges,10.88,32% of total billed charges,6.16,EAPG,10.88,32% of total billed charges,24.14,71% of total billed charges,24.14,71% of total billed charges,22.78,67% of total billed charges,22.78,67% of total billed charges,24.14,71% of total billed charges,25.84,76% of total billed charges,6.16,EAPG,11.21,32.96% of total billed charges,6.28,EAPG,30.6,90% of total billed charges,30.6,90% of total billed charges,5.98,EAPG,30.12,88.6% of total billed charges,6.16,EAPG,10.88,32% of total billed charges,27.2,80% of total billed charges,27.2,80% of total billed charges,5.98,EAPG,30.94,91% of total billed charges,11.1,32.64% of total billed charges,10.88,32% of total billed charges,11.42,33.6% of total billed charges,6.16,EAPG,10.88,32% of total billed charges,10.88,32% of total billed charges,31.28,92% of total billed charges,5.98,31.28,28.90
Outpatient Medical Services,Laboratory,85045,RETICULOYCTE COUNT,305,46,37.35,81.2% of total billed charges,15.01,32.64% of total billed charges,34.04,74% of total billed charges,34.04,74% of total billed charges,14.72,32% of total billed charges,5.38,EAPG,14.72,32% of total billed charges,32.66,71% of total billed charges,32.66,71% of total billed charges,30.82,67% of total billed charges,30.82,67% of total billed charges,32.66,71% of total billed charges,34.96,76% of total billed charges,5.38,EAPG,15.16,32.96% of total billed charges,5.49,EAPG,41.4,90% of total billed charges,41.4,90% of total billed charges,5.23,EAPG,40.76,88.6% of total billed charges,5.38,EAPG,14.72,32% of total billed charges,36.8,80% of total billed charges,36.8,80% of total billed charges,5.23,EAPG,41.86,91% of total billed charges,15.01,32.64% of total billed charges,14.72,32% of total billed charges,15.46,33.6% of total billed charges,5.38,EAPG,14.72,32% of total billed charges,14.72,32% of total billed charges,42.32,92% of total billed charges,5.23,42.32,39.10
Outpatient Medical Services,Laboratory,80329,SALICYLATE,301,105,85.26,81.2% of total billed charges,34.27,32.64% of total billed charges,77.7,74% of total billed charges,77.7,74% of total billed charges,33.6,32% of total billed charges,11.51,EAPG,33.6,32% of total billed charges,74.55,71% of total billed charges,74.55,71% of total billed charges,70.35,67% of total billed charges,70.35,67% of total billed charges,74.55,71% of total billed charges,79.8,76% of total billed charges,11.51,EAPG,34.61,32.96% of total billed charges,11.74,EAPG,94.5,90% of total billed charges,94.5,90% of total billed charges,11.18,EAPG,93.03,88.6% of total billed charges,11.51,EAPG,33.6,32% of total billed charges,84,80% of total billed charges,84,80% of total billed charges,11.18,EAPG,95.55,91% of total billed charges,34.27,32.64% of total billed charges,33.6,32% of total billed charges,35.28,33.6% of total billed charges,11.51,EAPG,33.6,32% of total billed charges,33.6,32% of total billed charges,96.6,92% of total billed charges,11.18,96.6,89.25
Outpatient Medical Services,Laboratory,84450,SGOT AST,301,75,60.9,81.2% of total billed charges,24.48,32.64% of total billed charges,55.5,74% of total billed charges,55.5,74% of total billed charges,24,32% of total billed charges,7.45,EAPG,24,32% of total billed charges,53.25,71% of total billed charges,53.25,71% of total billed charges,50.25,67% of total billed charges,50.25,67% of total billed charges,53.25,71% of total billed charges,57,76% of total billed charges,7.45,EAPG,24.72,32.96% of total billed charges,7.6,EAPG,67.5,90% of total billed charges,67.5,90% of total billed charges,7.24,EAPG,66.45,88.6% of total billed charges,7.45,EAPG,24,32% of total billed charges,60,80% of total billed charges,60,80% of total billed charges,7.24,EAPG,68.25,91% of total billed charges,24.48,32.64% of total billed charges,24,32% of total billed charges,25.2,33.6% of total billed charges,7.45,EAPG,24,32% of total billed charges,24,32% of total billed charges,69,92% of total billed charges,7.24,69,63.75
Outpatient Medical Services,Laboratory,84460,SGPT ALTI,301,71,57.65,81.2% of total billed charges,23.17,32.64% of total billed charges,52.54,74% of total billed charges,52.54,74% of total billed charges,22.72,32% of total billed charges,7.45,EAPG,22.72,32% of total billed charges,50.41,71% of total billed charges,50.41,71% of total billed charges,47.57,67% of total billed charges,47.57,67% of total billed charges,50.41,71% of total billed charges,53.96,76% of total billed charges,7.45,EAPG,23.4,32.96% of total billed charges,7.6,EAPG,63.9,90% of total billed charges,63.9,90% of total billed charges,7.24,EAPG,62.91,88.6% of total billed charges,7.45,EAPG,22.72,32% of total billed charges,56.8,80% of total billed charges,56.8,80% of total billed charges,7.24,EAPG,64.61,91% of total billed charges,23.17,32.64% of total billed charges,22.72,32% of total billed charges,23.86,33.6% of total billed charges,7.45,EAPG,22.72,32% of total billed charges,22.72,32% of total billed charges,65.32,92% of total billed charges,7.24,65.32,60.35
Outpatient Medical Services,Laboratory,84436,T4,301,102,82.82,81.2% of total billed charges,33.29,32.64% of total billed charges,75.48,74% of total billed charges,75.48,74% of total billed charges,32.64,32% of total billed charges,13.96,EAPG,32.64,32% of total billed charges,72.42,71% of total billed charges,72.42,71% of total billed charges,68.34,67% of total billed charges,68.34,67% of total billed charges,72.42,71% of total billed charges,77.52,76% of total billed charges,13.96,EAPG,33.62,32.96% of total billed charges,14.23,EAPG,91.8,90% of total billed charges,91.8,90% of total billed charges,13.55,EAPG,90.37,88.6% of total billed charges,13.96,EAPG,32.64,32% of total billed charges,81.6,80% of total billed charges,81.6,80% of total billed charges,13.55,EAPG,92.82,91% of total billed charges,33.29,32.64% of total billed charges,32.64,32% of total billed charges,34.27,33.6% of total billed charges,13.96,EAPG,32.64,32% of total billed charges,32.64,32% of total billed charges,93.84,92% of total billed charges,13.55,93.84,86.70
Outpatient Medical Services,Laboratory,84443,TSH THYROID STIM HORMONE,301,124,100.69,81.2% of total billed charges,40.47,32.64% of total billed charges,91.76,74% of total billed charges,91.76,74% of total billed charges,39.68,32% of total billed charges,13.96,EAPG,39.68,32% of total billed charges,88.04,71% of total billed charges,88.04,71% of total billed charges,83.08,67% of total billed charges,83.08,67% of total billed charges,88.04,71% of total billed charges,94.24,76% of total billed charges,13.96,EAPG,40.87,32.96% of total billed charges,14.23,EAPG,111.6,90% of total billed charges,111.6,90% of total billed charges,13.55,EAPG,109.86,88.6% of total billed charges,13.96,EAPG,39.68,32% of total billed charges,99.2,80% of total billed charges,99.2,80% of total billed charges,13.55,EAPG,112.84,91% of total billed charges,40.47,32.64% of total billed charges,39.68,32% of total billed charges,41.66,33.6% of total billed charges,13.96,EAPG,39.68,32% of total billed charges,39.68,32% of total billed charges,114.08,92% of total billed charges,13.55,114.08,105.40
Outpatient Medical Services,Laboratory,84550,URIC ACID,301,77,62.52,81.2% of total billed charges,25.13,32.64% of total billed charges,56.98,74% of total billed charges,56.98,74% of total billed charges,24.64,32% of total billed charges,7.45,EAPG,24.64,32% of total billed charges,54.67,71% of total billed charges,54.67,71% of total billed charges,51.59,67% of total billed charges,51.59,67% of total billed charges,54.67,71% of total billed charges,58.52,76% of total billed charges,7.45,EAPG,25.38,32.96% of total billed charges,7.6,EAPG,69.3,90% of total billed charges,69.3,90% of total billed charges,7.24,EAPG,68.22,88.6% of total billed charges,7.45,EAPG,24.64,32% of total billed charges,61.6,80% of total billed charges,61.6,80% of total billed charges,7.24,EAPG,70.07,91% of total billed charges,25.13,32.64% of total billed charges,24.64,32% of total billed charges,25.87,33.6% of total billed charges,7.45,EAPG,24.64,32% of total billed charges,24.64,32% of total billed charges,70.84,92% of total billed charges,7.24,70.84,65.45
Outpatient Medical Services,Laboratory,81001,"URINALYSIS, W/MICROSCOPY",307,71,57.65,81.2% of total billed charges,23.17,32.64% of total billed charges,52.54,74% of total billed charges,52.54,74% of total billed charges,22.72,32% of total billed charges,4.04,EAPG,22.72,32% of total billed charges,50.41,71% of total billed charges,50.41,71% of total billed charges,47.57,67% of total billed charges,47.57,67% of total billed charges,50.41,71% of total billed charges,53.96,76% of total billed charges,4.04,EAPG,23.4,32.96% of total billed charges,4.12,EAPG,63.9,90% of total billed charges,63.9,90% of total billed charges,3.93,EAPG,62.91,88.6% of total billed charges,4.04,EAPG,22.72,32% of total billed charges,56.8,80% of total billed charges,56.8,80% of total billed charges,3.93,EAPG,64.61,91% of total billed charges,23.17,32.64% of total billed charges,22.72,32% of total billed charges,23.86,33.6% of total billed charges,4.04,EAPG,22.72,32% of total billed charges,22.72,32% of total billed charges,65.32,92% of total billed charges,3.93,65.32,60.35
Outpatient Medical Services,Laboratory,82607,VITAMIN B12,301,102,82.82,81.2% of total billed charges,33.29,32.64% of total billed charges,75.48,74% of total billed charges,75.48,74% of total billed charges,32.64,32% of total billed charges,13.96,EAPG,32.64,32% of total billed charges,72.42,71% of total billed charges,72.42,71% of total billed charges,68.34,67% of total billed charges,68.34,67% of total billed charges,72.42,71% of total billed charges,77.52,76% of total billed charges,13.96,EAPG,33.62,32.96% of total billed charges,14.23,EAPG,91.8,90% of total billed charges,91.8,90% of total billed charges,13.55,EAPG,90.37,88.6% of total billed charges,13.96,EAPG,32.64,32% of total billed charges,81.6,80% of total billed charges,81.6,80% of total billed charges,13.55,EAPG,92.82,91% of total billed charges,33.29,32.64% of total billed charges,32.64,32% of total billed charges,34.27,33.6% of total billed charges,13.96,EAPG,32.64,32% of total billed charges,32.64,32% of total billed charges,93.84,92% of total billed charges,13.55,93.84,86.70
Outpatient Medical Services,Laboratory,87340,HEPATITIS B ANTIGEN SURFACE,306,22,17.86,81.2% of total billed charges,7.18,32.64% of total billed charges,16.28,74% of total billed charges,16.28,74% of total billed charges,7.04,32% of total billed charges,10.56,EAPG,7.04,32% of total billed charges,15.62,71% of total billed charges,15.62,71% of total billed charges,14.74,67% of total billed charges,14.74,67% of total billed charges,15.62,71% of total billed charges,16.72,76% of total billed charges,10.56,EAPG,7.25,32.96% of total billed charges,10.76,EAPG,19.8,90% of total billed charges,19.8,90% of total billed charges,10.25,EAPG,19.49,88.6% of total billed charges,10.56,EAPG,7.04,32% of total billed charges,17.6,80% of total billed charges,17.6,80% of total billed charges,10.25,EAPG,20.02,91% of total billed charges,7.18,32.64% of total billed charges,7.04,32% of total billed charges,7.39,33.6% of total billed charges,10.56,EAPG,7.04,32% of total billed charges,7.04,32% of total billed charges,20.24,92% of total billed charges,7.04,20.24,18.70
Outpatient Medical Services,Laboratory,83605,LACTIC ACID,301,46,37.35,81.2% of total billed charges,15.01,32.64% of total billed charges,34.04,74% of total billed charges,34.04,74% of total billed charges,14.72,32% of total billed charges,11.51,EAPG,14.72,32% of total billed charges,32.66,71% of total billed charges,32.66,71% of total billed charges,30.82,67% of total billed charges,30.82,67% of total billed charges,32.66,71% of total billed charges,34.96,76% of total billed charges,11.51,EAPG,15.16,32.96% of total billed charges,11.74,EAPG,41.4,90% of total billed charges,41.4,90% of total billed charges,11.18,EAPG,40.76,88.6% of total billed charges,11.51,EAPG,14.72,32% of total billed charges,36.8,80% of total billed charges,36.8,80% of total billed charges,11.18,EAPG,41.86,91% of total billed charges,15.01,32.64% of total billed charges,14.72,32% of total billed charges,15.46,33.6% of total billed charges,11.51,EAPG,14.72,32% of total billed charges,14.72,32% of total billed charges,42.32,92% of total billed charges,11.18,42.32,39.10
Outpatient Medical Services,Laboratory,83010,HAPTOGLOBIN,301,70,56.84,81.2% of total billed charges,22.85,32.64% of total billed charges,51.8,74% of total billed charges,51.8,74% of total billed charges,22.4,32% of total billed charges,11.51,EAPG,22.4,32% of total billed charges,49.7,71% of total billed charges,49.7,71% of total billed charges,46.9,67% of total billed charges,46.9,67% of total billed charges,49.7,71% of total billed charges,53.2,76% of total billed charges,11.51,EAPG,23.07,32.96% of total billed charges,11.74,EAPG,63,90% of total billed charges,63,90% of total billed charges,11.18,EAPG,62.02,88.6% of total billed charges,11.51,EAPG,22.4,32% of total billed charges,56,80% of total billed charges,56,80% of total billed charges,11.18,EAPG,63.7,91% of total billed charges,22.85,32.64% of total billed charges,22.4,32% of total billed charges,23.52,33.6% of total billed charges,11.51,EAPG,22.4,32% of total billed charges,22.4,32% of total billed charges,64.4,92% of total billed charges,11.18,64.4,59.50
Outpatient Medical Services,Laboratory,83001,FOLLICLE STIM HORMONE FSH,301,94,76.33,81.2% of total billed charges,30.68,32.64% of total billed charges,69.56,74% of total billed charges,69.56,74% of total billed charges,30.08,32% of total billed charges,13.96,EAPG,30.08,32% of total billed charges,66.74,71% of total billed charges,66.74,71% of total billed charges,62.98,67% of total billed charges,62.98,67% of total billed charges,66.74,71% of total billed charges,71.44,76% of total billed charges,13.96,EAPG,30.98,32.96% of total billed charges,14.23,EAPG,84.6,90% of total billed charges,84.6,90% of total billed charges,13.55,EAPG,83.28,88.6% of total billed charges,13.96,EAPG,30.08,32% of total billed charges,75.2,80% of total billed charges,75.2,80% of total billed charges,13.55,EAPG,85.54,91% of total billed charges,30.68,32.64% of total billed charges,30.08,32% of total billed charges,31.58,33.6% of total billed charges,13.96,EAPG,30.08,32% of total billed charges,30.08,32% of total billed charges,86.48,92% of total billed charges,13.55,86.48,79.90
Outpatient Medical Services,Laboratory,82525,COPPER PLASMA,301,77,62.52,81.2% of total billed charges,25.13,32.64% of total billed charges,56.98,74% of total billed charges,56.98,74% of total billed charges,24.64,32% of total billed charges,10.28,EAPG,24.64,32% of total billed charges,54.67,71% of total billed charges,54.67,71% of total billed charges,51.59,67% of total billed charges,51.59,67% of total billed charges,54.67,71% of total billed charges,58.52,76% of total billed charges,10.28,EAPG,25.38,32.96% of total billed charges,10.48,EAPG,69.3,90% of total billed charges,69.3,90% of total billed charges,9.98,EAPG,68.22,88.6% of total billed charges,10.28,EAPG,24.64,32% of total billed charges,61.6,80% of total billed charges,61.6,80% of total billed charges,9.98,EAPG,70.07,91% of total billed charges,25.13,32.64% of total billed charges,24.64,32% of total billed charges,25.87,33.6% of total billed charges,10.28,EAPG,24.64,32% of total billed charges,24.64,32% of total billed charges,70.84,92% of total billed charges,9.98,70.84,65.45
Outpatient Medical Services,Laboratory,87803,C DIFFICILE TOXIN A/B,306,77,62.52,81.2% of total billed charges,25.13,32.64% of total billed charges,56.98,74% of total billed charges,56.98,74% of total billed charges,24.64,32% of total billed charges,10.56,EAPG,24.64,32% of total billed charges,54.67,71% of total billed charges,54.67,71% of total billed charges,51.59,67% of total billed charges,51.59,67% of total billed charges,54.67,71% of total billed charges,58.52,76% of total billed charges,10.56,EAPG,25.38,32.96% of total billed charges,10.76,EAPG,69.3,90% of total billed charges,69.3,90% of total billed charges,10.25,EAPG,68.22,88.6% of total billed charges,10.56,EAPG,24.64,32% of total billed charges,61.6,80% of total billed charges,61.6,80% of total billed charges,10.25,EAPG,70.07,91% of total billed charges,25.13,32.64% of total billed charges,24.64,32% of total billed charges,25.87,33.6% of total billed charges,10.56,EAPG,24.64,32% of total billed charges,24.64,32% of total billed charges,70.84,92% of total billed charges,10.25,70.84,65.45
Outpatient Medical Services,Laboratory,82248,BILIRUBIN DIRECT,301,77,62.52,81.2% of total billed charges,25.13,32.64% of total billed charges,56.98,74% of total billed charges,56.98,74% of total billed charges,24.64,32% of total billed charges,7.45,EAPG,24.64,32% of total billed charges,54.67,71% of total billed charges,54.67,71% of total billed charges,51.59,67% of total billed charges,51.59,67% of total billed charges,54.67,71% of total billed charges,58.52,76% of total billed charges,7.45,EAPG,25.38,32.96% of total billed charges,7.6,EAPG,69.3,90% of total billed charges,69.3,90% of total billed charges,7.24,EAPG,68.22,88.6% of total billed charges,7.45,EAPG,24.64,32% of total billed charges,61.6,80% of total billed charges,61.6,80% of total billed charges,7.24,EAPG,70.07,91% of total billed charges,25.13,32.64% of total billed charges,24.64,32% of total billed charges,25.87,33.6% of total billed charges,7.45,EAPG,24.64,32% of total billed charges,24.64,32% of total billed charges,70.84,92% of total billed charges,7.24,70.84,65.45
Outpatient Medical Services,Laboratory,84403,TESTOSTERONE TOTAL,301,102,82.82,81.2% of total billed charges,33.29,32.64% of total billed charges,75.48,74% of total billed charges,75.48,74% of total billed charges,32.64,32% of total billed charges,13.96,EAPG,32.64,32% of total billed charges,72.42,71% of total billed charges,72.42,71% of total billed charges,68.34,67% of total billed charges,68.34,67% of total billed charges,72.42,71% of total billed charges,77.52,76% of total billed charges,13.96,EAPG,33.62,32.96% of total billed charges,14.23,EAPG,91.8,90% of total billed charges,91.8,90% of total billed charges,13.55,EAPG,90.37,88.6% of total billed charges,13.96,EAPG,32.64,32% of total billed charges,81.6,80% of total billed charges,81.6,80% of total billed charges,13.55,EAPG,92.82,91% of total billed charges,33.29,32.64% of total billed charges,32.64,32% of total billed charges,34.27,33.6% of total billed charges,13.96,EAPG,32.64,32% of total billed charges,32.64,32% of total billed charges,93.84,92% of total billed charges,13.55,93.84,86.70
Outpatient Medical Services,Laboratory,84144,PROGESTERONE SERUM,301,108,87.7,81.2% of total billed charges,35.25,32.64% of total billed charges,79.92,74% of total billed charges,79.92,74% of total billed charges,34.56,32% of total billed charges,13.96,EAPG,34.56,32% of total billed charges,76.68,71% of total billed charges,76.68,71% of total billed charges,72.36,67% of total billed charges,72.36,67% of total billed charges,76.68,71% of total billed charges,82.08,76% of total billed charges,13.96,EAPG,35.6,32.96% of total billed charges,14.23,EAPG,97.2,90% of total billed charges,97.2,90% of total billed charges,13.55,EAPG,95.69,88.6% of total billed charges,13.96,EAPG,34.56,32% of total billed charges,86.4,80% of total billed charges,86.4,80% of total billed charges,13.55,EAPG,98.28,91% of total billed charges,35.25,32.64% of total billed charges,34.56,32% of total billed charges,36.29,33.6% of total billed charges,13.96,EAPG,34.56,32% of total billed charges,34.56,32% of total billed charges,99.36,92% of total billed charges,13.55,99.36,91.80
Outpatient Medical Services,Laboratory,84146,PROLACTIN,301,149,120.99,81.2% of total billed charges,48.63,32.64% of total billed charges,110.26,74% of total billed charges,110.26,74% of total billed charges,47.68,32% of total billed charges,13.96,EAPG,47.68,32% of total billed charges,105.79,71% of total billed charges,105.79,71% of total billed charges,99.83,67% of total billed charges,99.83,67% of total billed charges,105.79,71% of total billed charges,113.24,76% of total billed charges,13.96,EAPG,49.11,32.96% of total billed charges,14.23,EAPG,134.1,90% of total billed charges,134.1,90% of total billed charges,13.55,EAPG,132.01,88.6% of total billed charges,13.96,EAPG,47.68,32% of total billed charges,119.2,80% of total billed charges,119.2,80% of total billed charges,13.55,EAPG,135.59,91% of total billed charges,48.63,32.64% of total billed charges,47.68,32% of total billed charges,50.06,33.6% of total billed charges,13.96,EAPG,47.68,32% of total billed charges,47.68,32% of total billed charges,137.08,92% of total billed charges,13.55,137.08,126.65
Outpatient Medical Services,Laboratory,82670,ESTRADIOL,300,45,36.54,81.2% of total billed charges,14.69,32.64% of total billed charges,33.3,74% of total billed charges,33.3,74% of total billed charges,14.4,32% of total billed charges,13.96,EAPG,14.4,32% of total billed charges,31.95,71% of total billed charges,31.95,71% of total billed charges,30.15,67% of total billed charges,30.15,67% of total billed charges,31.95,71% of total billed charges,34.2,76% of total billed charges,13.96,EAPG,14.83,32.96% of total billed charges,14.23,EAPG,40.5,90% of total billed charges,40.5,90% of total billed charges,13.55,EAPG,39.87,88.6% of total billed charges,13.96,EAPG,14.4,32% of total billed charges,36,80% of total billed charges,36,80% of total billed charges,13.55,EAPG,40.95,91% of total billed charges,14.69,32.64% of total billed charges,14.4,32% of total billed charges,15.12,33.6% of total billed charges,13.96,EAPG,14.4,32% of total billed charges,14.4,32% of total billed charges,41.4,92% of total billed charges,13.55,41.4,38.25
Outpatient Medical Services,Laboratory,82043,URINE MICROALBUMIN QUANT,301,64,51.97,81.2% of total billed charges,20.89,32.64% of total billed charges,47.36,74% of total billed charges,47.36,74% of total billed charges,20.48,32% of total billed charges,4.04,EAPG,20.48,32% of total billed charges,45.44,71% of total billed charges,45.44,71% of total billed charges,42.88,67% of total billed charges,42.88,67% of total billed charges,45.44,71% of total billed charges,48.64,76% of total billed charges,4.04,EAPG,21.09,32.96% of total billed charges,4.12,EAPG,57.6,90% of total billed charges,57.6,90% of total billed charges,3.93,EAPG,56.7,88.6% of total billed charges,4.04,EAPG,20.48,32% of total billed charges,51.2,80% of total billed charges,51.2,80% of total billed charges,3.93,EAPG,58.24,91% of total billed charges,20.89,32.64% of total billed charges,20.48,32% of total billed charges,21.5,33.6% of total billed charges,4.04,EAPG,20.48,32% of total billed charges,20.48,32% of total billed charges,58.88,92% of total billed charges,3.93,58.88,54.40
Outpatient Medical Services,Laboratory,82553,CPK MB,301,71,57.65,81.2% of total billed charges,23.17,32.64% of total billed charges,52.54,74% of total billed charges,52.54,74% of total billed charges,22.72,32% of total billed charges,11.51,EAPG,22.72,32% of total billed charges,50.41,71% of total billed charges,50.41,71% of total billed charges,47.57,67% of total billed charges,47.57,67% of total billed charges,50.41,71% of total billed charges,53.96,76% of total billed charges,11.51,EAPG,23.4,32.96% of total billed charges,11.74,EAPG,63.9,90% of total billed charges,63.9,90% of total billed charges,11.18,EAPG,62.91,88.6% of total billed charges,11.51,EAPG,22.72,32% of total billed charges,56.8,80% of total billed charges,56.8,80% of total billed charges,11.18,EAPG,64.61,91% of total billed charges,23.17,32.64% of total billed charges,22.72,32% of total billed charges,23.86,33.6% of total billed charges,11.51,EAPG,22.72,32% of total billed charges,22.72,32% of total billed charges,65.32,92% of total billed charges,11.18,65.32,60.35
Outpatient Medical Services,Laboratory,86803,HEPATITIS C ANTIBODY,302,79,64.15,81.2% of total billed charges,25.79,32.64% of total billed charges,58.46,74% of total billed charges,58.46,74% of total billed charges,25.28,32% of total billed charges,14.64,EAPG,25.28,32% of total billed charges,56.09,71% of total billed charges,56.09,71% of total billed charges,52.93,67% of total billed charges,52.93,67% of total billed charges,56.09,71% of total billed charges,60.04,76% of total billed charges,14.64,EAPG,26.04,32.96% of total billed charges,14.93,EAPG,71.1,90% of total billed charges,71.1,90% of total billed charges,14.22,EAPG,69.99,88.6% of total billed charges,14.64,EAPG,25.28,32% of total billed charges,63.2,80% of total billed charges,63.2,80% of total billed charges,14.22,EAPG,71.89,91% of total billed charges,25.79,32.64% of total billed charges,25.28,32% of total billed charges,26.54,33.6% of total billed charges,14.64,EAPG,25.28,32% of total billed charges,25.28,32% of total billed charges,72.68,92% of total billed charges,14.22,72.68,67.15
Outpatient Medical Services,Laboratory,84402,TESTOSTERONE FREE(includes Total),301,118,95.82,81.2% of total billed charges,38.52,32.64% of total billed charges,87.32,74% of total billed charges,87.32,74% of total billed charges,37.76,32% of total billed charges,13.96,EAPG,37.76,32% of total billed charges,83.78,71% of total billed charges,83.78,71% of total billed charges,79.06,67% of total billed charges,79.06,67% of total billed charges,83.78,71% of total billed charges,89.68,76% of total billed charges,13.96,EAPG,38.89,32.96% of total billed charges,14.23,EAPG,106.2,90% of total billed charges,106.2,90% of total billed charges,13.55,EAPG,104.55,88.6% of total billed charges,13.96,EAPG,37.76,32% of total billed charges,94.4,80% of total billed charges,94.4,80% of total billed charges,13.55,EAPG,107.38,91% of total billed charges,38.52,32.64% of total billed charges,37.76,32% of total billed charges,39.65,33.6% of total billed charges,13.96,EAPG,37.76,32% of total billed charges,37.76,32% of total billed charges,108.56,92% of total billed charges,13.55,108.56,100.30
Outpatient Medical Services,Laboratory,84439,T4 FREE,301,90,73.08,81.2% of total billed charges,29.38,32.64% of total billed charges,66.6,74% of total billed charges,66.6,74% of total billed charges,28.8,32% of total billed charges,13.96,EAPG,28.8,32% of total billed charges,63.9,71% of total billed charges,63.9,71% of total billed charges,60.3,67% of total billed charges,60.3,67% of total billed charges,63.9,71% of total billed charges,68.4,76% of total billed charges,13.96,EAPG,29.66,32.96% of total billed charges,14.23,EAPG,81,90% of total billed charges,81,90% of total billed charges,13.55,EAPG,79.74,88.6% of total billed charges,13.96,EAPG,28.8,32% of total billed charges,72,80% of total billed charges,72,80% of total billed charges,13.55,EAPG,81.9,91% of total billed charges,29.38,32.64% of total billed charges,28.8,32% of total billed charges,30.24,33.6% of total billed charges,13.96,EAPG,28.8,32% of total billed charges,28.8,32% of total billed charges,82.8,92% of total billed charges,13.55,82.8,76.50
Outpatient Medical Services,Laboratory,82668,ERYTHROPOETEIN,301,86,69.83,81.2% of total billed charges,28.07,32.64% of total billed charges,63.64,74% of total billed charges,63.64,74% of total billed charges,27.52,32% of total billed charges,11.51,EAPG,27.52,32% of total billed charges,61.06,71% of total billed charges,61.06,71% of total billed charges,57.62,67% of total billed charges,57.62,67% of total billed charges,61.06,71% of total billed charges,65.36,76% of total billed charges,11.51,EAPG,28.35,32.96% of total billed charges,11.74,EAPG,77.4,90% of total billed charges,77.4,90% of total billed charges,11.18,EAPG,76.2,88.6% of total billed charges,11.51,EAPG,27.52,32% of total billed charges,68.8,80% of total billed charges,68.8,80% of total billed charges,11.18,EAPG,78.26,91% of total billed charges,28.07,32.64% of total billed charges,27.52,32% of total billed charges,28.9,33.6% of total billed charges,11.51,EAPG,27.52,32% of total billed charges,27.52,32% of total billed charges,79.12,92% of total billed charges,11.18,79.12,73.10
Outpatient Medical Services,Laboratory,85379,D DIMER QUANTITATIVE,305,90,73.08,81.2% of total billed charges,29.38,32.64% of total billed charges,66.6,74% of total billed charges,66.6,74% of total billed charges,28.8,32% of total billed charges,6.16,EAPG,28.8,32% of total billed charges,63.9,71% of total billed charges,63.9,71% of total billed charges,60.3,67% of total billed charges,60.3,67% of total billed charges,63.9,71% of total billed charges,68.4,76% of total billed charges,6.16,EAPG,29.66,32.96% of total billed charges,6.28,EAPG,81,90% of total billed charges,81,90% of total billed charges,5.98,EAPG,79.74,88.6% of total billed charges,6.16,EAPG,28.8,32% of total billed charges,72,80% of total billed charges,72,80% of total billed charges,5.98,EAPG,81.9,91% of total billed charges,29.38,32.64% of total billed charges,28.8,32% of total billed charges,30.24,33.6% of total billed charges,6.16,EAPG,28.8,32% of total billed charges,28.8,32% of total billed charges,82.8,92% of total billed charges,5.98,82.8,76.50
Outpatient Medical Services,Laboratory,84156,URINE RANDOM PROTEIN,301,70,56.84,81.2% of total billed charges,22.85,32.64% of total billed charges,51.8,74% of total billed charges,51.8,74% of total billed charges,22.4,32% of total billed charges,7.45,EAPG,22.4,32% of total billed charges,49.7,71% of total billed charges,49.7,71% of total billed charges,46.9,67% of total billed charges,46.9,67% of total billed charges,49.7,71% of total billed charges,53.2,76% of total billed charges,7.45,EAPG,23.07,32.96% of total billed charges,7.6,EAPG,63,90% of total billed charges,63,90% of total billed charges,7.24,EAPG,62.02,88.6% of total billed charges,7.45,EAPG,22.4,32% of total billed charges,56,80% of total billed charges,56,80% of total billed charges,7.24,EAPG,63.7,91% of total billed charges,22.85,32.64% of total billed charges,22.4,32% of total billed charges,23.52,33.6% of total billed charges,7.45,EAPG,22.4,32% of total billed charges,22.4,32% of total billed charges,64.4,92% of total billed charges,7.24,64.4,59.50
Outpatient Medical Services,Laboratory,86901,BB RH FACTOR,300,36,29.23,81.2% of total billed charges,11.75,32.64% of total billed charges,26.64,74% of total billed charges,26.64,74% of total billed charges,11.52,32% of total billed charges,17.67,EAPG,11.52,32% of total billed charges,25.56,71% of total billed charges,25.56,71% of total billed charges,24.12,67% of total billed charges,24.12,67% of total billed charges,25.56,71% of total billed charges,27.36,76% of total billed charges,17.67,EAPG,11.87,32.96% of total billed charges,18.01,EAPG,32.4,90% of total billed charges,32.4,90% of total billed charges,17.15,EAPG,31.9,88.6% of total billed charges,17.67,EAPG,11.52,32% of total billed charges,28.8,80% of total billed charges,28.8,80% of total billed charges,17.15,EAPG,32.76,91% of total billed charges,11.75,32.64% of total billed charges,11.52,32% of total billed charges,12.1,33.6% of total billed charges,17.67,EAPG,11.52,32% of total billed charges,11.52,32% of total billed charges,33.12,92% of total billed charges,11.52,33.12,30.60
Outpatient Medical Services,Laboratory,80202,VANCOMYCIN TROUGH,301,108,87.7,81.2% of total billed charges,35.25,32.64% of total billed charges,79.92,74% of total billed charges,79.92,74% of total billed charges,34.56,32% of total billed charges,11.61,EAPG,34.56,32% of total billed charges,76.68,71% of total billed charges,76.68,71% of total billed charges,72.36,67% of total billed charges,72.36,67% of total billed charges,76.68,71% of total billed charges,82.08,76% of total billed charges,11.61,EAPG,35.6,32.96% of total billed charges,11.84,EAPG,97.2,90% of total billed charges,97.2,90% of total billed charges,11.28,EAPG,95.69,88.6% of total billed charges,11.61,EAPG,34.56,32% of total billed charges,86.4,80% of total billed charges,86.4,80% of total billed charges,11.28,EAPG,98.28,91% of total billed charges,35.25,32.64% of total billed charges,34.56,32% of total billed charges,36.29,33.6% of total billed charges,11.61,EAPG,34.56,32% of total billed charges,34.56,32% of total billed charges,99.36,92% of total billed charges,11.28,99.36,91.80
Outpatient Medical Services,Laboratory,84630,ZINC,301,50,40.6,81.2% of total billed charges,16.32,32.64% of total billed charges,37,74% of total billed charges,37,74% of total billed charges,16,32% of total billed charges,10.28,EAPG,16,32% of total billed charges,35.5,71% of total billed charges,35.5,71% of total billed charges,33.5,67% of total billed charges,33.5,67% of total billed charges,35.5,71% of total billed charges,38,76% of total billed charges,10.28,EAPG,16.48,32.96% of total billed charges,10.48,EAPG,45,90% of total billed charges,45,90% of total billed charges,9.98,EAPG,44.3,88.6% of total billed charges,10.28,EAPG,16,32% of total billed charges,40,80% of total billed charges,40,80% of total billed charges,9.98,EAPG,45.5,91% of total billed charges,16.32,32.64% of total billed charges,16,32% of total billed charges,16.8,33.6% of total billed charges,10.28,EAPG,16,32% of total billed charges,16,32% of total billed charges,46,92% of total billed charges,9.98,46,42.50
Outpatient Medical Services,Laboratory,87086,URINE CULTURE,306,71,57.65,81.2% of total billed charges,23.17,32.64% of total billed charges,52.54,74% of total billed charges,52.54,74% of total billed charges,22.72,32% of total billed charges,10.56,EAPG,22.72,32% of total billed charges,50.41,71% of total billed charges,50.41,71% of total billed charges,47.57,67% of total billed charges,47.57,67% of total billed charges,50.41,71% of total billed charges,53.96,76% of total billed charges,10.56,EAPG,23.4,32.96% of total billed charges,10.76,EAPG,63.9,90% of total billed charges,63.9,90% of total billed charges,10.25,EAPG,62.91,88.6% of total billed charges,10.56,EAPG,22.72,32% of total billed charges,56.8,80% of total billed charges,56.8,80% of total billed charges,10.25,EAPG,64.61,91% of total billed charges,23.17,32.64% of total billed charges,22.72,32% of total billed charges,23.86,33.6% of total billed charges,10.56,EAPG,22.72,32% of total billed charges,22.72,32% of total billed charges,65.32,92% of total billed charges,10.25,65.32,60.35
Outpatient Medical Services,Laboratory,87045,STOOL CULTURE,306,162,131.54,81.2% of total billed charges,52.88,32.64% of total billed charges,119.88,74% of total billed charges,119.88,74% of total billed charges,51.84,32% of total billed charges,10.56,EAPG,51.84,32% of total billed charges,115.02,71% of total billed charges,115.02,71% of total billed charges,108.54,67% of total billed charges,108.54,67% of total billed charges,115.02,71% of total billed charges,123.12,76% of total billed charges,10.56,EAPG,53.4,32.96% of total billed charges,10.76,EAPG,145.8,90% of total billed charges,145.8,90% of total billed charges,10.25,EAPG,143.53,88.6% of total billed charges,10.56,EAPG,51.84,32% of total billed charges,129.6,80% of total billed charges,129.6,80% of total billed charges,10.25,EAPG,147.42,91% of total billed charges,52.88,32.64% of total billed charges,51.84,32% of total billed charges,54.43,33.6% of total billed charges,10.56,EAPG,51.84,32% of total billed charges,51.84,32% of total billed charges,149.04,92% of total billed charges,10.25,149.04,137.70
Outpatient Medical Services,Laboratory,87186,SENSITIVITY MIC,306,41,33.29,81.2% of total billed charges,13.38,32.64% of total billed charges,30.34,74% of total billed charges,30.34,74% of total billed charges,13.12,32% of total billed charges,10.56,EAPG,13.12,32% of total billed charges,29.11,71% of total billed charges,29.11,71% of total billed charges,27.47,67% of total billed charges,27.47,67% of total billed charges,29.11,71% of total billed charges,31.16,76% of total billed charges,10.56,EAPG,13.51,32.96% of total billed charges,10.76,EAPG,36.9,90% of total billed charges,36.9,90% of total billed charges,10.25,EAPG,36.33,88.6% of total billed charges,10.56,EAPG,13.12,32% of total billed charges,32.8,80% of total billed charges,32.8,80% of total billed charges,10.25,EAPG,37.31,91% of total billed charges,13.38,32.64% of total billed charges,13.12,32% of total billed charges,13.78,33.6% of total billed charges,10.56,EAPG,13.12,32% of total billed charges,13.12,32% of total billed charges,37.72,92% of total billed charges,10.25,37.72,34.85
Outpatient Medical Services,Laboratory,85097,BONE MARROW PERIPHERAL SMEAR,305,108,87.7,81.2% of total billed charges,35.25,32.64% of total billed charges,79.92,74% of total billed charges,79.92,74% of total billed charges,34.56,32% of total billed charges,28.85,EAPG,34.56,32% of total billed charges,76.68,71% of total billed charges,76.68,71% of total billed charges,72.36,67% of total billed charges,72.36,67% of total billed charges,76.68,71% of total billed charges,82.08,76% of total billed charges,28.85,EAPG,35.6,32.96% of total billed charges,29.41,EAPG,97.2,90% of total billed charges,97.2,90% of total billed charges,28.01,EAPG,95.69,88.6% of total billed charges,28.85,EAPG,34.56,32% of total billed charges,86.4,80% of total billed charges,86.4,80% of total billed charges,28.01,EAPG,98.28,91% of total billed charges,35.25,32.64% of total billed charges,34.56,32% of total billed charges,36.29,33.6% of total billed charges,28.85,EAPG,34.56,32% of total billed charges,34.56,32% of total billed charges,99.36,92% of total billed charges,28.01,99.36,91.80
Outpatient Medical Services,Laboratory,88304,SURG PATH G AND M EXAM LEVEL 3,312,230,186.76,81.2% of total billed charges,75.07,32.64% of total billed charges,170.2,74% of total billed charges,170.2,74% of total billed charges,73.6,32% of total billed charges,28.85,EAPG,73.6,32% of total billed charges,163.3,71% of total billed charges,163.3,71% of total billed charges,154.1,67% of total billed charges,154.1,67% of total billed charges,163.3,71% of total billed charges,174.8,76% of total billed charges,28.85,EAPG,75.81,32.96% of total billed charges,29.41,EAPG,207,90% of total billed charges,207,90% of total billed charges,28.01,EAPG,203.78,88.6% of total billed charges,28.85,EAPG,73.6,32% of total billed charges,184,80% of total billed charges,184,80% of total billed charges,28.01,EAPG,209.3,91% of total billed charges,75.07,32.64% of total billed charges,73.6,32% of total billed charges,77.28,33.6% of total billed charges,28.85,EAPG,73.6,32% of total billed charges,73.6,32% of total billed charges,211.6,92% of total billed charges,28.01,211.6,195.50
Outpatient Medical Services,Laboratory,88305,SURG PATH G AND M EXAM LEVEL 4,312,361,293.13,81.2% of total billed charges,117.83,32.64% of total billed charges,267.14,74% of total billed charges,267.14,74% of total billed charges,115.52,32% of total billed charges,28.85,EAPG,115.52,32% of total billed charges,256.31,71% of total billed charges,256.31,71% of total billed charges,241.87,67% of total billed charges,241.87,67% of total billed charges,256.31,71% of total billed charges,274.36,76% of total billed charges,28.85,EAPG,118.99,32.96% of total billed charges,29.41,EAPG,324.9,90% of total billed charges,324.9,90% of total billed charges,28.01,EAPG,319.85,88.6% of total billed charges,28.85,EAPG,115.52,32% of total billed charges,288.8,80% of total billed charges,288.8,80% of total billed charges,28.01,EAPG,328.51,91% of total billed charges,117.83,32.64% of total billed charges,115.52,32% of total billed charges,121.3,33.6% of total billed charges,28.85,EAPG,115.52,32% of total billed charges,115.52,32% of total billed charges,332.12,92% of total billed charges,28.01,332.12,306.85
Outpatient Medical Services,Laboratory,88342,IMMUNOHISTOCHEMICAL STAIN,310,213,172.96,81.2% of total billed charges,69.52,32.64% of total billed charges,157.62,74% of total billed charges,157.62,74% of total billed charges,68.16,32% of total billed charges,28.85,EAPG,68.16,32% of total billed charges,151.23,71% of total billed charges,151.23,71% of total billed charges,142.71,67% of total billed charges,142.71,67% of total billed charges,151.23,71% of total billed charges,161.88,76% of total billed charges,28.85,EAPG,70.2,32.96% of total billed charges,29.41,EAPG,191.7,90% of total billed charges,191.7,90% of total billed charges,28.01,EAPG,188.72,88.6% of total billed charges,28.85,EAPG,68.16,32% of total billed charges,170.4,80% of total billed charges,170.4,80% of total billed charges,28.01,EAPG,193.83,91% of total billed charges,69.52,32.64% of total billed charges,68.16,32% of total billed charges,71.57,33.6% of total billed charges,28.85,EAPG,68.16,32% of total billed charges,68.16,32% of total billed charges,195.96,92% of total billed charges,28.01,195.96,181.05
Outpatient Medical Services,Laboratory,86431,RA FACTOR (rheumatoid factor),302,40,32.48,81.2% of total billed charges,13.06,32.64% of total billed charges,29.6,74% of total billed charges,29.6,74% of total billed charges,12.8,32% of total billed charges,14.64,EAPG,12.8,32% of total billed charges,28.4,71% of total billed charges,28.4,71% of total billed charges,26.8,67% of total billed charges,26.8,67% of total billed charges,28.4,71% of total billed charges,30.4,76% of total billed charges,14.64,EAPG,13.18,32.96% of total billed charges,14.93,EAPG,36,90% of total billed charges,36,90% of total billed charges,14.22,EAPG,35.44,88.6% of total billed charges,14.64,EAPG,12.8,32% of total billed charges,32,80% of total billed charges,32,80% of total billed charges,14.22,EAPG,36.4,91% of total billed charges,13.06,32.64% of total billed charges,12.8,32% of total billed charges,13.44,33.6% of total billed charges,14.64,EAPG,12.8,32% of total billed charges,12.8,32% of total billed charges,36.8,92% of total billed charges,12.8,36.8,34.00
Outpatient Medical Services,Laboratory,81003,URINALYSIS NO MICRO,307,40,32.48,81.2% of total billed charges,13.06,32.64% of total billed charges,29.6,74% of total billed charges,29.6,74% of total billed charges,12.8,32% of total billed charges,4.04,EAPG,12.8,32% of total billed charges,28.4,71% of total billed charges,28.4,71% of total billed charges,26.8,67% of total billed charges,26.8,67% of total billed charges,28.4,71% of total billed charges,30.4,76% of total billed charges,4.04,EAPG,13.18,32.96% of total billed charges,4.12,EAPG,36,90% of total billed charges,36,90% of total billed charges,3.93,EAPG,35.44,88.6% of total billed charges,4.04,EAPG,12.8,32% of total billed charges,32,80% of total billed charges,32,80% of total billed charges,3.93,EAPG,36.4,91% of total billed charges,13.06,32.64% of total billed charges,12.8,32% of total billed charges,13.44,33.6% of total billed charges,4.04,EAPG,12.8,32% of total billed charges,12.8,32% of total billed charges,36.8,92% of total billed charges,3.93,36.8,34.00
Outpatient Medical Services,Laboratory,80074,HEPATITIS ACUTE SCREEN,301,230,186.76,81.2% of total billed charges,75.07,32.64% of total billed charges,170.2,74% of total billed charges,170.2,74% of total billed charges,73.6,32% of total billed charges,12.48,EAPG,73.6,32% of total billed charges,163.3,71% of total billed charges,163.3,71% of total billed charges,154.1,67% of total billed charges,154.1,67% of total billed charges,163.3,71% of total billed charges,174.8,76% of total billed charges,12.48,EAPG,75.81,32.96% of total billed charges,12.72,EAPG,207,90% of total billed charges,207,90% of total billed charges,12.11,EAPG,203.78,88.6% of total billed charges,12.48,EAPG,73.6,32% of total billed charges,184,80% of total billed charges,184,80% of total billed charges,12.11,EAPG,209.3,91% of total billed charges,75.07,32.64% of total billed charges,73.6,32% of total billed charges,77.28,33.6% of total billed charges,12.48,EAPG,73.6,32% of total billed charges,73.6,32% of total billed charges,211.6,92% of total billed charges,12.11,211.6,195.50
Outpatient Medical Services,Laboratory,82540,CREATINE URINE,301,45,36.54,81.2% of total billed charges,14.69,32.64% of total billed charges,33.3,74% of total billed charges,33.3,74% of total billed charges,14.4,32% of total billed charges,7.45,EAPG,14.4,32% of total billed charges,31.95,71% of total billed charges,31.95,71% of total billed charges,30.15,67% of total billed charges,30.15,67% of total billed charges,31.95,71% of total billed charges,34.2,76% of total billed charges,7.45,EAPG,14.83,32.96% of total billed charges,7.6,EAPG,40.5,90% of total billed charges,40.5,90% of total billed charges,7.24,EAPG,39.87,88.6% of total billed charges,7.45,EAPG,14.4,32% of total billed charges,36,80% of total billed charges,36,80% of total billed charges,7.24,EAPG,40.95,91% of total billed charges,14.69,32.64% of total billed charges,14.4,32% of total billed charges,15.12,33.6% of total billed charges,7.45,EAPG,14.4,32% of total billed charges,14.4,32% of total billed charges,41.4,92% of total billed charges,7.24,41.4,38.25
Outpatient Medical Services,Laboratory,84703,"BHCG SERUM, QUALITATIVE PREGNANCY",301,113,91.76,81.2% of total billed charges,36.88,32.64% of total billed charges,83.62,74% of total billed charges,83.62,74% of total billed charges,36.16,32% of total billed charges,7.45,EAPG,36.16,32% of total billed charges,80.23,71% of total billed charges,80.23,71% of total billed charges,75.71,67% of total billed charges,75.71,67% of total billed charges,80.23,71% of total billed charges,85.88,76% of total billed charges,7.45,EAPG,37.24,32.96% of total billed charges,7.6,EAPG,101.7,90% of total billed charges,101.7,90% of total billed charges,7.24,EAPG,100.12,88.6% of total billed charges,7.45,EAPG,36.16,32% of total billed charges,90.4,80% of total billed charges,90.4,80% of total billed charges,7.24,EAPG,102.83,91% of total billed charges,36.88,32.64% of total billed charges,36.16,32% of total billed charges,37.97,33.6% of total billed charges,7.45,EAPG,36.16,32% of total billed charges,36.16,32% of total billed charges,103.96,92% of total billed charges,7.24,103.96,96.05
Outpatient Medical Services,Laboratory,84481,T3 FREE TRIODOTHYRONINE,301,149,120.99,81.2% of total billed charges,48.63,32.64% of total billed charges,110.26,74% of total billed charges,110.26,74% of total billed charges,47.68,32% of total billed charges,13.96,EAPG,47.68,32% of total billed charges,105.79,71% of total billed charges,105.79,71% of total billed charges,99.83,67% of total billed charges,99.83,67% of total billed charges,105.79,71% of total billed charges,113.24,76% of total billed charges,13.96,EAPG,49.11,32.96% of total billed charges,14.23,EAPG,134.1,90% of total billed charges,134.1,90% of total billed charges,13.55,EAPG,132.01,88.6% of total billed charges,13.96,EAPG,47.68,32% of total billed charges,119.2,80% of total billed charges,119.2,80% of total billed charges,13.55,EAPG,135.59,91% of total billed charges,48.63,32.64% of total billed charges,47.68,32% of total billed charges,50.06,33.6% of total billed charges,13.96,EAPG,47.68,32% of total billed charges,47.68,32% of total billed charges,137.08,92% of total billed charges,13.55,137.08,126.65
Outpatient Medical Services,Laboratory,83690,LIPASE,301,78,63.34,81.2% of total billed charges,25.46,32.64% of total billed charges,57.72,74% of total billed charges,57.72,74% of total billed charges,24.96,32% of total billed charges,7.45,EAPG,24.96,32% of total billed charges,55.38,71% of total billed charges,55.38,71% of total billed charges,52.26,67% of total billed charges,52.26,67% of total billed charges,55.38,71% of total billed charges,59.28,76% of total billed charges,7.45,EAPG,25.71,32.96% of total billed charges,7.6,EAPG,70.2,90% of total billed charges,70.2,90% of total billed charges,7.24,EAPG,69.11,88.6% of total billed charges,7.45,EAPG,24.96,32% of total billed charges,62.4,80% of total billed charges,62.4,80% of total billed charges,7.24,EAPG,70.98,91% of total billed charges,25.46,32.64% of total billed charges,24.96,32% of total billed charges,26.21,33.6% of total billed charges,7.45,EAPG,24.96,32% of total billed charges,24.96,32% of total billed charges,71.76,92% of total billed charges,7.24,71.76,66.30
Outpatient Medical Services,Laboratory,82010,BETA HYDROXYBUTYRATE,300,39,31.67,81.2% of total billed charges,12.73,32.64% of total billed charges,28.86,74% of total billed charges,28.86,74% of total billed charges,12.48,32% of total billed charges,11.51,EAPG,12.48,32% of total billed charges,27.69,71% of total billed charges,27.69,71% of total billed charges,26.13,67% of total billed charges,26.13,67% of total billed charges,27.69,71% of total billed charges,29.64,76% of total billed charges,11.51,EAPG,12.85,32.96% of total billed charges,11.74,EAPG,35.1,90% of total billed charges,35.1,90% of total billed charges,11.18,EAPG,34.55,88.6% of total billed charges,11.51,EAPG,12.48,32% of total billed charges,31.2,80% of total billed charges,31.2,80% of total billed charges,11.18,EAPG,35.49,91% of total billed charges,12.73,32.64% of total billed charges,12.48,32% of total billed charges,13.1,33.6% of total billed charges,11.51,EAPG,12.48,32% of total billed charges,12.48,32% of total billed charges,35.88,92% of total billed charges,11.18,35.88,33.15
Outpatient Medical Services,Laboratory,86300,CA 27.29,302,63,51.16,81.2% of total billed charges,20.56,32.64% of total billed charges,46.62,74% of total billed charges,46.62,74% of total billed charges,20.16,32% of total billed charges,10.56,EAPG,20.16,32% of total billed charges,44.73,71% of total billed charges,44.73,71% of total billed charges,42.21,67% of total billed charges,42.21,67% of total billed charges,44.73,71% of total billed charges,47.88,76% of total billed charges,10.56,EAPG,20.76,32.96% of total billed charges,10.76,EAPG,56.7,90% of total billed charges,56.7,90% of total billed charges,10.25,EAPG,55.82,88.6% of total billed charges,10.56,EAPG,20.16,32% of total billed charges,50.4,80% of total billed charges,50.4,80% of total billed charges,10.25,EAPG,57.33,91% of total billed charges,20.56,32.64% of total billed charges,20.16,32% of total billed charges,21.17,33.6% of total billed charges,10.56,EAPG,20.16,32% of total billed charges,20.16,32% of total billed charges,57.96,92% of total billed charges,10.25,57.96,53.55
Outpatient Medical Services,Laboratory,83921,METHYLMALONIC ACID SERUM QUANT,301,162,131.54,81.2% of total billed charges,52.88,32.64% of total billed charges,119.88,74% of total billed charges,119.88,74% of total billed charges,51.84,32% of total billed charges,11.51,EAPG,51.84,32% of total billed charges,115.02,71% of total billed charges,115.02,71% of total billed charges,108.54,67% of total billed charges,108.54,67% of total billed charges,115.02,71% of total billed charges,123.12,76% of total billed charges,11.51,EAPG,53.4,32.96% of total billed charges,11.74,EAPG,145.8,90% of total billed charges,145.8,90% of total billed charges,11.18,EAPG,143.53,88.6% of total billed charges,11.51,EAPG,51.84,32% of total billed charges,129.6,80% of total billed charges,129.6,80% of total billed charges,11.18,EAPG,147.42,91% of total billed charges,52.88,32.64% of total billed charges,51.84,32% of total billed charges,54.43,33.6% of total billed charges,11.51,EAPG,51.84,32% of total billed charges,51.84,32% of total billed charges,149.04,92% of total billed charges,11.18,149.04,137.70
Outpatient Medical Services,Laboratory,82306,VITAMIN D 25 HYDROXY,301,145,117.74,81.2% of total billed charges,47.33,32.64% of total billed charges,107.3,74% of total billed charges,107.3,74% of total billed charges,46.4,32% of total billed charges,13.24,EAPG,46.4,32% of total billed charges,102.95,71% of total billed charges,102.95,71% of total billed charges,97.15,67% of total billed charges,97.15,67% of total billed charges,102.95,71% of total billed charges,110.2,76% of total billed charges,13.24,EAPG,47.79,32.96% of total billed charges,13.49,EAPG,130.5,90% of total billed charges,130.5,90% of total billed charges,12.85,EAPG,128.47,88.6% of total billed charges,13.24,EAPG,46.4,32% of total billed charges,116,80% of total billed charges,116,80% of total billed charges,12.85,EAPG,131.95,91% of total billed charges,47.33,32.64% of total billed charges,46.4,32% of total billed charges,48.72,33.6% of total billed charges,13.24,EAPG,46.4,32% of total billed charges,46.4,32% of total billed charges,133.4,92% of total billed charges,12.85,133.4,123.25
Outpatient Medical Services,Laboratory,87625,HUMAN PAPILLOMA VIRUS HIGH RISK,301,245,198.94,81.2% of total billed charges,79.97,32.64% of total billed charges,181.3,74% of total billed charges,181.3,74% of total billed charges,78.4,32% of total billed charges,21.33,EAPG,78.4,32% of total billed charges,173.95,71% of total billed charges,173.95,71% of total billed charges,164.15,67% of total billed charges,164.15,67% of total billed charges,173.95,71% of total billed charges,186.2,76% of total billed charges,21.33,EAPG,80.75,32.96% of total billed charges,21.75,EAPG,220.5,90% of total billed charges,220.5,90% of total billed charges,20.71,EAPG,217.07,88.6% of total billed charges,21.33,EAPG,78.4,32% of total billed charges,196,80% of total billed charges,196,80% of total billed charges,20.71,EAPG,222.95,91% of total billed charges,79.97,32.64% of total billed charges,78.4,32% of total billed charges,82.32,33.6% of total billed charges,21.33,EAPG,78.4,32% of total billed charges,78.4,32% of total billed charges,225.4,92% of total billed charges,20.71,225.4,208.25
Outpatient Medical Services,Laboratory,84153,PSA SCREENING,301,173,140.48,81.2% of total billed charges,56.47,32.64% of total billed charges,128.02,74% of total billed charges,128.02,74% of total billed charges,55.36,32% of total billed charges,11.51,EAPG,55.36,32% of total billed charges,122.83,71% of total billed charges,122.83,71% of total billed charges,115.91,67% of total billed charges,115.91,67% of total billed charges,122.83,71% of total billed charges,131.48,76% of total billed charges,11.51,EAPG,57.02,32.96% of total billed charges,11.74,EAPG,155.7,90% of total billed charges,155.7,90% of total billed charges,11.18,EAPG,153.28,88.6% of total billed charges,11.51,EAPG,55.36,32% of total billed charges,138.4,80% of total billed charges,138.4,80% of total billed charges,11.18,EAPG,157.43,91% of total billed charges,56.47,32.64% of total billed charges,55.36,32% of total billed charges,58.13,33.6% of total billed charges,11.51,EAPG,55.36,32% of total billed charges,55.36,32% of total billed charges,159.16,92% of total billed charges,11.18,159.16,147.05
Outpatient Medical Services,Laboratory,80069,RENAL FUNCTION PANEL,301,85,69.02,81.2% of total billed charges,27.74,32.64% of total billed charges,62.9,74% of total billed charges,62.9,74% of total billed charges,27.2,32% of total billed charges,12.48,EAPG,27.2,32% of total billed charges,60.35,71% of total billed charges,60.35,71% of total billed charges,56.95,67% of total billed charges,56.95,67% of total billed charges,60.35,71% of total billed charges,64.6,76% of total billed charges,12.48,EAPG,28.02,32.96% of total billed charges,12.72,EAPG,76.5,90% of total billed charges,76.5,90% of total billed charges,12.11,EAPG,75.31,88.6% of total billed charges,12.48,EAPG,27.2,32% of total billed charges,68,80% of total billed charges,68,80% of total billed charges,12.11,EAPG,77.35,91% of total billed charges,27.74,32.64% of total billed charges,27.2,32% of total billed charges,28.56,33.6% of total billed charges,12.48,EAPG,27.2,32% of total billed charges,27.2,32% of total billed charges,78.2,92% of total billed charges,12.11,78.2,72.25
Outpatient Medical Services,Laboratory,80076,HEPATIC FUNCTION PANEL,301,106,86.07,81.2% of total billed charges,34.6,32.64% of total billed charges,78.44,74% of total billed charges,78.44,74% of total billed charges,33.92,32% of total billed charges,12.48,EAPG,33.92,32% of total billed charges,75.26,71% of total billed charges,75.26,71% of total billed charges,71.02,67% of total billed charges,71.02,67% of total billed charges,75.26,71% of total billed charges,80.56,76% of total billed charges,12.48,EAPG,34.94,32.96% of total billed charges,12.72,EAPG,95.4,90% of total billed charges,95.4,90% of total billed charges,12.11,EAPG,93.92,88.6% of total billed charges,12.48,EAPG,33.92,32% of total billed charges,84.8,80% of total billed charges,84.8,80% of total billed charges,12.11,EAPG,96.46,91% of total billed charges,34.6,32.64% of total billed charges,33.92,32% of total billed charges,35.62,33.6% of total billed charges,12.48,EAPG,33.92,32% of total billed charges,33.92,32% of total billed charges,97.52,92% of total billed charges,12.11,97.52,90.10
Outpatient Medical Services,Laboratory,80053,COMPREHENSIVE METABOLIC PANEL,301,165,133.98,81.2% of total billed charges,53.86,32.64% of total billed charges,122.1,74% of total billed charges,122.1,74% of total billed charges,52.8,32% of total billed charges,12.48,EAPG,52.8,32% of total billed charges,117.15,71% of total billed charges,117.15,71% of total billed charges,110.55,67% of total billed charges,110.55,67% of total billed charges,117.15,71% of total billed charges,125.4,76% of total billed charges,12.48,EAPG,54.38,32.96% of total billed charges,12.72,EAPG,148.5,90% of total billed charges,148.5,90% of total billed charges,12.11,EAPG,146.19,88.6% of total billed charges,12.48,EAPG,52.8,32% of total billed charges,132,80% of total billed charges,132,80% of total billed charges,12.11,EAPG,150.15,91% of total billed charges,53.86,32.64% of total billed charges,52.8,32% of total billed charges,55.44,33.6% of total billed charges,12.48,EAPG,52.8,32% of total billed charges,52.8,32% of total billed charges,151.8,92% of total billed charges,12.11,151.8,140.25
Outpatient Medical Services,Laboratory,80048,BASIC METABOLIC PANEL,301,89,72.27,81.2% of total billed charges,29.05,32.64% of total billed charges,65.86,74% of total billed charges,65.86,74% of total billed charges,28.48,32% of total billed charges,12.48,EAPG,28.48,32% of total billed charges,63.19,71% of total billed charges,63.19,71% of total billed charges,59.63,67% of total billed charges,59.63,67% of total billed charges,63.19,71% of total billed charges,67.64,76% of total billed charges,12.48,EAPG,29.33,32.96% of total billed charges,12.72,EAPG,80.1,90% of total billed charges,80.1,90% of total billed charges,12.11,EAPG,78.85,88.6% of total billed charges,12.48,EAPG,28.48,32% of total billed charges,71.2,80% of total billed charges,71.2,80% of total billed charges,12.11,EAPG,80.99,91% of total billed charges,29.05,32.64% of total billed charges,28.48,32% of total billed charges,29.9,33.6% of total billed charges,12.48,EAPG,28.48,32% of total billed charges,28.48,32% of total billed charges,81.88,92% of total billed charges,12.11,81.88,75.65
Outpatient Medical Services,Laboratory,88142,THIN PREP PAP,311,139,112.87,81.2% of total billed charges,45.37,32.64% of total billed charges,102.86,74% of total billed charges,102.86,74% of total billed charges,44.48,32% of total billed charges,9.69,EAPG,44.48,32% of total billed charges,98.69,71% of total billed charges,98.69,71% of total billed charges,93.13,67% of total billed charges,93.13,67% of total billed charges,98.69,71% of total billed charges,105.64,76% of total billed charges,9.69,EAPG,45.81,32.96% of total billed charges,9.88,EAPG,125.1,90% of total billed charges,125.1,90% of total billed charges,9.41,EAPG,123.15,88.6% of total billed charges,9.69,EAPG,44.48,32% of total billed charges,111.2,80% of total billed charges,111.2,80% of total billed charges,9.41,EAPG,126.49,91% of total billed charges,45.37,32.64% of total billed charges,44.48,32% of total billed charges,46.7,33.6% of total billed charges,9.69,EAPG,44.48,32% of total billed charges,44.48,32% of total billed charges,127.88,92% of total billed charges,9.41,127.88,118.15
Outpatient Medical Services,Laboratory,83880,B TYPE NATRIURETIC PEPTIDE,301,232,188.38,81.2% of total billed charges,75.72,32.64% of total billed charges,171.68,74% of total billed charges,171.68,74% of total billed charges,74.24,32% of total billed charges,13.24,EAPG,74.24,32% of total billed charges,164.72,71% of total billed charges,164.72,71% of total billed charges,155.44,67% of total billed charges,155.44,67% of total billed charges,164.72,71% of total billed charges,176.32,76% of total billed charges,13.24,EAPG,76.47,32.96% of total billed charges,13.49,EAPG,208.8,90% of total billed charges,208.8,90% of total billed charges,12.85,EAPG,205.55,88.6% of total billed charges,13.24,EAPG,74.24,32% of total billed charges,185.6,80% of total billed charges,185.6,80% of total billed charges,12.85,EAPG,211.12,91% of total billed charges,75.72,32.64% of total billed charges,74.24,32% of total billed charges,77.95,33.6% of total billed charges,13.24,EAPG,74.24,32% of total billed charges,74.24,32% of total billed charges,213.44,92% of total billed charges,12.85,213.44,197.20
Outpatient Medical Services,Laboratory,P9021,BB PRBC LEUKO REDUCED,390,331,268.77,81.2% of total billed charges,108.04,32.64% of total billed charges,244.94,74% of total billed charges,244.94,74% of total billed charges,105.92,32% of total billed charges,288.04,EAPG,105.92,32% of total billed charges,235.01,71% of total billed charges,235.01,71% of total billed charges,221.77,67% of total billed charges,221.77,67% of total billed charges,235.01,71% of total billed charges,251.56,76% of total billed charges,288.04,EAPG,109.1,32.96% of total billed charges,293.63,EAPG,297.9,90% of total billed charges,297.9,90% of total billed charges,279.65,EAPG,293.27,88.6% of total billed charges,288.04,EAPG,105.92,32% of total billed charges,264.8,80% of total billed charges,264.8,80% of total billed charges,279.65,EAPG,301.21,91% of total billed charges,108.04,32.64% of total billed charges,105.92,32% of total billed charges,111.22,33.6% of total billed charges,288.04,EAPG,105.92,32% of total billed charges,105.92,32% of total billed charges,304.52,92% of total billed charges,105.92,304.52,281.35
Outpatient Medical Services,Laboratory,87491,CHLAMYDIA APTIMA PROBE,300,81,65.77,81.2% of total billed charges,26.44,32.64% of total billed charges,59.94,74% of total billed charges,59.94,74% of total billed charges,25.92,32% of total billed charges,21.33,EAPG,25.92,32% of total billed charges,57.51,71% of total billed charges,57.51,71% of total billed charges,54.27,67% of total billed charges,54.27,67% of total billed charges,57.51,71% of total billed charges,61.56,76% of total billed charges,21.33,EAPG,26.7,32.96% of total billed charges,21.75,EAPG,72.9,90% of total billed charges,72.9,90% of total billed charges,20.71,EAPG,71.77,88.6% of total billed charges,21.33,EAPG,25.92,32% of total billed charges,64.8,80% of total billed charges,64.8,80% of total billed charges,20.71,EAPG,73.71,91% of total billed charges,26.44,32.64% of total billed charges,25.92,32% of total billed charges,27.22,33.6% of total billed charges,21.33,EAPG,25.92,32% of total billed charges,25.92,32% of total billed charges,74.52,92% of total billed charges,20.71,74.52,68.85
Outpatient Medical Services,Laboratory,87591,"GC  PROBE,  APTIMA",300,81,65.77,81.2% of total billed charges,26.44,32.64% of total billed charges,59.94,74% of total billed charges,59.94,74% of total billed charges,25.92,32% of total billed charges,21.33,EAPG,25.92,32% of total billed charges,57.51,71% of total billed charges,57.51,71% of total billed charges,54.27,67% of total billed charges,54.27,67% of total billed charges,57.51,71% of total billed charges,61.56,76% of total billed charges,21.33,EAPG,26.7,32.96% of total billed charges,21.75,EAPG,72.9,90% of total billed charges,72.9,90% of total billed charges,20.71,EAPG,71.77,88.6% of total billed charges,21.33,EAPG,25.92,32% of total billed charges,64.8,80% of total billed charges,64.8,80% of total billed charges,20.71,EAPG,73.71,91% of total billed charges,26.44,32.64% of total billed charges,25.92,32% of total billed charges,27.22,33.6% of total billed charges,21.33,EAPG,25.92,32% of total billed charges,25.92,32% of total billed charges,74.52,92% of total billed charges,20.71,74.52,68.85
Outpatient Medical Services,Laboratory,80307,URINE DRUG SCREEN STAT,300,404,328.05,81.2% of total billed charges,131.87,32.64% of total billed charges,298.96,74% of total billed charges,298.96,74% of total billed charges,129.28,32% of total billed charges,13.24,EAPG,129.28,32% of total billed charges,286.84,71% of total billed charges,286.84,71% of total billed charges,270.68,67% of total billed charges,270.68,67% of total billed charges,286.84,71% of total billed charges,307.04,76% of total billed charges,13.24,EAPG,133.16,32.96% of total billed charges,13.49,EAPG,363.6,90% of total billed charges,363.6,90% of total billed charges,12.85,EAPG,357.94,88.6% of total billed charges,13.24,EAPG,129.28,32% of total billed charges,323.2,80% of total billed charges,323.2,80% of total billed charges,12.85,EAPG,367.64,91% of total billed charges,131.87,32.64% of total billed charges,129.28,32% of total billed charges,135.74,33.6% of total billed charges,13.24,EAPG,129.28,32% of total billed charges,129.28,32% of total billed charges,371.68,92% of total billed charges,12.85,371.68,343.40
Outpatient Medical Services,Laboratory,88271,FISH DNA PROBE,300,332,269.58,81.2% of total billed charges,108.36,32.64% of total billed charges,245.68,74% of total billed charges,245.68,74% of total billed charges,106.24,32% of total billed charges,53.26,EAPG,106.24,32% of total billed charges,235.72,71% of total billed charges,235.72,71% of total billed charges,222.44,67% of total billed charges,222.44,67% of total billed charges,235.72,71% of total billed charges,252.32,76% of total billed charges,53.26,EAPG,109.43,32.96% of total billed charges,54.29,EAPG,298.8,90% of total billed charges,298.8,90% of total billed charges,51.71,EAPG,294.15,88.6% of total billed charges,53.26,EAPG,106.24,32% of total billed charges,265.6,80% of total billed charges,265.6,80% of total billed charges,51.71,EAPG,302.12,91% of total billed charges,108.36,32.64% of total billed charges,106.24,32% of total billed charges,111.55,33.6% of total billed charges,53.26,EAPG,106.24,32% of total billed charges,106.24,32% of total billed charges,305.44,92% of total billed charges,51.71,305.44,282.20
Outpatient Medical Services,Laboratory,83883,"FREE LIGHT CHAINS,SERUM",300,230,186.76,81.2% of total billed charges,75.07,32.64% of total billed charges,170.2,74% of total billed charges,170.2,74% of total billed charges,73.6,32% of total billed charges,14.64,EAPG,73.6,32% of total billed charges,163.3,71% of total billed charges,163.3,71% of total billed charges,154.1,67% of total billed charges,154.1,67% of total billed charges,163.3,71% of total billed charges,174.8,76% of total billed charges,14.64,EAPG,75.81,32.96% of total billed charges,14.93,EAPG,207,90% of total billed charges,207,90% of total billed charges,14.22,EAPG,203.78,88.6% of total billed charges,14.64,EAPG,73.6,32% of total billed charges,184,80% of total billed charges,184,80% of total billed charges,14.22,EAPG,209.3,91% of total billed charges,75.07,32.64% of total billed charges,73.6,32% of total billed charges,77.28,33.6% of total billed charges,14.64,EAPG,73.6,32% of total billed charges,73.6,32% of total billed charges,211.6,92% of total billed charges,14.22,211.6,195.50
Outpatient Medical Services,Laboratory,84153,PSA DIAGNOSTIC,301,173,140.48,81.2% of total billed charges,56.47,32.64% of total billed charges,128.02,74% of total billed charges,128.02,74% of total billed charges,55.36,32% of total billed charges,11.51,EAPG,55.36,32% of total billed charges,122.83,71% of total billed charges,122.83,71% of total billed charges,115.91,67% of total billed charges,115.91,67% of total billed charges,122.83,71% of total billed charges,131.48,76% of total billed charges,11.51,EAPG,57.02,32.96% of total billed charges,11.74,EAPG,155.7,90% of total billed charges,155.7,90% of total billed charges,11.18,EAPG,153.28,88.6% of total billed charges,11.51,EAPG,55.36,32% of total billed charges,138.4,80% of total billed charges,138.4,80% of total billed charges,11.18,EAPG,157.43,91% of total billed charges,56.47,32.64% of total billed charges,55.36,32% of total billed charges,58.13,33.6% of total billed charges,11.51,EAPG,55.36,32% of total billed charges,55.36,32% of total billed charges,159.16,92% of total billed charges,11.18,159.16,147.05
Outpatient Medical Services,Laboratory,87070,AEROBIC ROUTINE WITHOUT GRAM STAIN,306,163,132.36,81.2% of total billed charges,53.2,32.64% of total billed charges,120.62,74% of total billed charges,120.62,74% of total billed charges,52.16,32% of total billed charges,10.56,EAPG,52.16,32% of total billed charges,115.73,71% of total billed charges,115.73,71% of total billed charges,109.21,67% of total billed charges,109.21,67% of total billed charges,115.73,71% of total billed charges,123.88,76% of total billed charges,10.56,EAPG,53.72,32.96% of total billed charges,10.76,EAPG,146.7,90% of total billed charges,146.7,90% of total billed charges,10.25,EAPG,144.42,88.6% of total billed charges,10.56,EAPG,52.16,32% of total billed charges,130.4,80% of total billed charges,130.4,80% of total billed charges,10.25,EAPG,148.33,91% of total billed charges,53.2,32.64% of total billed charges,52.16,32% of total billed charges,54.77,33.6% of total billed charges,10.56,EAPG,52.16,32% of total billed charges,52.16,32% of total billed charges,149.96,92% of total billed charges,10.25,149.96,138.55
Outpatient Medical Services,Laboratory,87186,SUSCEPTIBILITY AEROBIC + ANAEROBIC,306,41,33.29,81.2% of total billed charges,13.38,32.64% of total billed charges,30.34,74% of total billed charges,30.34,74% of total billed charges,13.12,32% of total billed charges,10.56,EAPG,13.12,32% of total billed charges,29.11,71% of total billed charges,29.11,71% of total billed charges,27.47,67% of total billed charges,27.47,67% of total billed charges,29.11,71% of total billed charges,31.16,76% of total billed charges,10.56,EAPG,13.51,32.96% of total billed charges,10.76,EAPG,36.9,90% of total billed charges,36.9,90% of total billed charges,10.25,EAPG,36.33,88.6% of total billed charges,10.56,EAPG,13.12,32% of total billed charges,32.8,80% of total billed charges,32.8,80% of total billed charges,10.25,EAPG,37.31,91% of total billed charges,13.38,32.64% of total billed charges,13.12,32% of total billed charges,13.78,33.6% of total billed charges,10.56,EAPG,13.12,32% of total billed charges,13.12,32% of total billed charges,37.72,92% of total billed charges,10.25,37.72,34.85
Outpatient Medical Services,Laboratory,87077,"ORGANISM ID, BACTERIA",306,73,59.28,81.2% of total billed charges,23.83,32.64% of total billed charges,54.02,74% of total billed charges,54.02,74% of total billed charges,23.36,32% of total billed charges,10.56,EAPG,23.36,32% of total billed charges,51.83,71% of total billed charges,51.83,71% of total billed charges,48.91,67% of total billed charges,48.91,67% of total billed charges,51.83,71% of total billed charges,55.48,76% of total billed charges,10.56,EAPG,24.06,32.96% of total billed charges,10.76,EAPG,65.7,90% of total billed charges,65.7,90% of total billed charges,10.25,EAPG,64.68,88.6% of total billed charges,10.56,EAPG,23.36,32% of total billed charges,58.4,80% of total billed charges,58.4,80% of total billed charges,10.25,EAPG,66.43,91% of total billed charges,23.83,32.64% of total billed charges,23.36,32% of total billed charges,24.53,33.6% of total billed charges,10.56,EAPG,23.36,32% of total billed charges,23.36,32% of total billed charges,67.16,92% of total billed charges,10.25,67.16,62.05
Outpatient Medical Services,Laboratory,86920,BB COMPATIBILITY IS,309,38,30.86,81.2% of total billed charges,12.4,32.64% of total billed charges,28.12,74% of total billed charges,28.12,74% of total billed charges,12.16,32% of total billed charges,42.87,EAPG,12.16,32% of total billed charges,26.98,71% of total billed charges,26.98,71% of total billed charges,25.46,67% of total billed charges,25.46,67% of total billed charges,26.98,71% of total billed charges,28.88,76% of total billed charges,42.87,EAPG,12.52,32.96% of total billed charges,43.7,EAPG,34.2,90% of total billed charges,34.2,90% of total billed charges,41.62,EAPG,33.67,88.6% of total billed charges,42.87,EAPG,12.16,32% of total billed charges,30.4,80% of total billed charges,30.4,80% of total billed charges,41.62,EAPG,34.58,91% of total billed charges,12.4,32.64% of total billed charges,12.16,32% of total billed charges,12.77,33.6% of total billed charges,42.87,EAPG,12.16,32% of total billed charges,12.16,32% of total billed charges,34.96,92% of total billed charges,12.16,43.7,32.30
Outpatient Medical Services,Laboratory,82962,FINGER STICK GLUCOSE,301,15,12.18,81.2% of total billed charges,4.9,32.64% of total billed charges,11.1,74% of total billed charges,11.1,74% of total billed charges,4.8,32% of total billed charges,7.45,EAPG,4.8,32% of total billed charges,10.65,71% of total billed charges,10.65,71% of total billed charges,10.05,67% of total billed charges,10.05,67% of total billed charges,10.65,71% of total billed charges,11.4,76% of total billed charges,7.45,EAPG,4.94,32.96% of total billed charges,7.6,EAPG,13.5,90% of total billed charges,13.5,90% of total billed charges,7.24,EAPG,13.29,88.6% of total billed charges,7.45,EAPG,4.8,32% of total billed charges,12,80% of total billed charges,12,80% of total billed charges,7.24,EAPG,13.65,91% of total billed charges,4.9,32.64% of total billed charges,4.8,32% of total billed charges,5.04,33.6% of total billed charges,7.45,EAPG,4.8,32% of total billed charges,4.8,32% of total billed charges,13.8,92% of total billed charges,4.8,13.8,12.75
Outpatient Medical Services,Laboratory,88341,SUBSEQUENT IMMUNOHISTOCHEMICAL STAIN,310,223,181.08,81.2% of total billed charges,72.79,32.64% of total billed charges,165.02,74% of total billed charges,165.02,74% of total billed charges,71.36,32% of total billed charges,38.54,EAPG,71.36,32% of total billed charges,158.33,71% of total billed charges,158.33,71% of total billed charges,149.41,67% of total billed charges,149.41,67% of total billed charges,158.33,71% of total billed charges,169.48,76% of total billed charges,38.54,EAPG,73.5,32.96% of total billed charges,39.29,EAPG,200.7,90% of total billed charges,200.7,90% of total billed charges,37.42,EAPG,197.58,88.6% of total billed charges,38.54,EAPG,71.36,32% of total billed charges,178.4,80% of total billed charges,178.4,80% of total billed charges,37.42,EAPG,202.93,91% of total billed charges,72.79,32.64% of total billed charges,71.36,32% of total billed charges,74.93,33.6% of total billed charges,38.54,EAPG,71.36,32% of total billed charges,71.36,32% of total billed charges,205.16,92% of total billed charges,37.42,205.16,189.55
Outpatient Medical Services,Laboratory,87389,HIV Screen 4th Gen wRfx,300,113,91.76,81.2% of total billed charges,36.88,32.64% of total billed charges,83.62,74% of total billed charges,83.62,74% of total billed charges,36.16,32% of total billed charges,10.56,EAPG,36.16,32% of total billed charges,80.23,71% of total billed charges,80.23,71% of total billed charges,75.71,67% of total billed charges,75.71,67% of total billed charges,80.23,71% of total billed charges,85.88,76% of total billed charges,10.56,EAPG,37.24,32.96% of total billed charges,10.76,EAPG,101.7,90% of total billed charges,101.7,90% of total billed charges,10.25,EAPG,100.12,88.6% of total billed charges,10.56,EAPG,36.16,32% of total billed charges,90.4,80% of total billed charges,90.4,80% of total billed charges,10.25,EAPG,102.83,91% of total billed charges,36.88,32.64% of total billed charges,36.16,32% of total billed charges,37.97,33.6% of total billed charges,10.56,EAPG,36.16,32% of total billed charges,36.16,32% of total billed charges,103.96,92% of total billed charges,10.25,103.96,96.05
Outpatient Medical Services,Laboratory,87081,GROUP A STREP CULTURE,306,52,42.22,81.2% of total billed charges,16.97,32.64% of total billed charges,38.48,74% of total billed charges,38.48,74% of total billed charges,16.64,32% of total billed charges,10.56,EAPG,16.64,32% of total billed charges,36.92,71% of total billed charges,36.92,71% of total billed charges,34.84,67% of total billed charges,34.84,67% of total billed charges,36.92,71% of total billed charges,39.52,76% of total billed charges,10.56,EAPG,17.14,32.96% of total billed charges,10.76,EAPG,46.8,90% of total billed charges,46.8,90% of total billed charges,10.25,EAPG,46.07,88.6% of total billed charges,10.56,EAPG,16.64,32% of total billed charges,41.6,80% of total billed charges,41.6,80% of total billed charges,10.25,EAPG,47.32,91% of total billed charges,16.97,32.64% of total billed charges,16.64,32% of total billed charges,17.47,33.6% of total billed charges,10.56,EAPG,16.64,32% of total billed charges,16.64,32% of total billed charges,47.84,92% of total billed charges,10.25,47.84,44.20
Outpatient Medical Services,Laboratory,87081,MRSA MSSA CULTURE,306,52,42.22,81.2% of total billed charges,16.97,32.64% of total billed charges,38.48,74% of total billed charges,38.48,74% of total billed charges,16.64,32% of total billed charges,10.56,EAPG,16.64,32% of total billed charges,36.92,71% of total billed charges,36.92,71% of total billed charges,34.84,67% of total billed charges,34.84,67% of total billed charges,36.92,71% of total billed charges,39.52,76% of total billed charges,10.56,EAPG,17.14,32.96% of total billed charges,10.76,EAPG,46.8,90% of total billed charges,46.8,90% of total billed charges,10.25,EAPG,46.07,88.6% of total billed charges,10.56,EAPG,16.64,32% of total billed charges,41.6,80% of total billed charges,41.6,80% of total billed charges,10.25,EAPG,47.32,91% of total billed charges,16.97,32.64% of total billed charges,16.64,32% of total billed charges,17.47,33.6% of total billed charges,10.56,EAPG,16.64,32% of total billed charges,16.64,32% of total billed charges,47.84,92% of total billed charges,10.25,47.84,44.20
Outpatient Medical Services,Laboratory,,,301,633,514,81.2% of total billed charges,206.61,32.64% of total billed charges,468.42,74% of total billed charges,468.42,74% of total billed charges,202.56,32% of total billed charges,N/A,Not Separately reimbursable,202.56,32% of total billed charges,449.43,71% of total billed charges,449.43,71% of total billed charges,424.11,67% of total billed charges,424.11,67% of total billed charges,449.43,71% of total billed charges,481.08,76% of total billed charges,N/A,Not Separately reimbursable,208.64,32.96% of total billed charges,N/A,Not Separately reimbursable,569.7,90% of total billed charges,569.7,90% of total billed charges,N/A,Not Separately reimbursable,560.84,88.6% of total billed charges,N/A,Not Separately reimbursable,202.56,32% of total billed charges,506.4,80% of total billed charges,506.4,80% of total billed charges,N/A,Not Separately reimbursable,576.03,91% of total billed charges,206.61,32.64% of total billed charges,202.56,32% of total billed charges,212.69,33.6% of total billed charges,N/A,Not Separately reimbursable,202.56,32% of total billed charges,202.56,32% of total billed charges,582.36,92% of total billed charges,202.56,582.36,538.05
Outpatient Medical Services,Laboratory,86592,RPR REFLEX CONFIRM,302,27,21.92,81.2% of total billed charges,8.81,32.64% of total billed charges,19.98,74% of total billed charges,19.98,74% of total billed charges,8.64,32% of total billed charges,14.64,EAPG,8.64,32% of total billed charges,19.17,71% of total billed charges,19.17,71% of total billed charges,18.09,67% of total billed charges,18.09,67% of total billed charges,19.17,71% of total billed charges,20.52,76% of total billed charges,14.64,EAPG,8.9,32.96% of total billed charges,14.93,EAPG,24.3,90% of total billed charges,24.3,90% of total billed charges,14.22,EAPG,23.92,88.6% of total billed charges,14.64,EAPG,8.64,32% of total billed charges,21.6,80% of total billed charges,21.6,80% of total billed charges,14.22,EAPG,24.57,91% of total billed charges,8.81,32.64% of total billed charges,8.64,32% of total billed charges,9.07,33.6% of total billed charges,14.64,EAPG,8.64,32% of total billed charges,8.64,32% of total billed charges,24.84,92% of total billed charges,8.64,24.84,22.95
Outpatient Medical Services,Laboratory,84145,PROCALCITONIN,300,218,177.02,81.2% of total billed charges,71.16,32.64% of total billed charges,161.32,74% of total billed charges,161.32,74% of total billed charges,69.76,32% of total billed charges,13.96,EAPG,69.76,32% of total billed charges,154.78,71% of total billed charges,154.78,71% of total billed charges,146.06,67% of total billed charges,146.06,67% of total billed charges,154.78,71% of total billed charges,165.68,76% of total billed charges,13.96,EAPG,71.85,32.96% of total billed charges,14.23,EAPG,196.2,90% of total billed charges,196.2,90% of total billed charges,13.55,EAPG,193.15,88.6% of total billed charges,13.96,EAPG,69.76,32% of total billed charges,174.4,80% of total billed charges,174.4,80% of total billed charges,13.55,EAPG,198.38,91% of total billed charges,71.16,32.64% of total billed charges,69.76,32% of total billed charges,73.25,33.6% of total billed charges,13.96,EAPG,69.76,32% of total billed charges,69.76,32% of total billed charges,200.56,92% of total billed charges,13.55,200.56,185.30
Outpatient Medical Services,Laboratory,80076,HEPATIC/RENAL COMBO PANEL,301,106,86.07,81.2% of total billed charges,34.6,32.64% of total billed charges,78.44,74% of total billed charges,78.44,74% of total billed charges,33.92,32% of total billed charges,12.48,EAPG,33.92,32% of total billed charges,75.26,71% of total billed charges,75.26,71% of total billed charges,71.02,67% of total billed charges,71.02,67% of total billed charges,75.26,71% of total billed charges,80.56,76% of total billed charges,12.48,EAPG,34.94,32.96% of total billed charges,12.72,EAPG,95.4,90% of total billed charges,95.4,90% of total billed charges,12.11,EAPG,93.92,88.6% of total billed charges,12.48,EAPG,33.92,32% of total billed charges,84.8,80% of total billed charges,84.8,80% of total billed charges,12.11,EAPG,96.46,91% of total billed charges,34.6,32.64% of total billed charges,33.92,32% of total billed charges,35.62,33.6% of total billed charges,12.48,EAPG,33.92,32% of total billed charges,33.92,32% of total billed charges,97.52,92% of total billed charges,12.11,97.52,90.10
Outpatient Medical Services,Laboratory,80069,RENAL/HEPATIC COMBO PANEL,301,85,69.02,81.2% of total billed charges,27.74,32.64% of total billed charges,62.9,74% of total billed charges,62.9,74% of total billed charges,27.2,32% of total billed charges,12.48,EAPG,27.2,32% of total billed charges,60.35,71% of total billed charges,60.35,71% of total billed charges,56.95,67% of total billed charges,56.95,67% of total billed charges,60.35,71% of total billed charges,64.6,76% of total billed charges,12.48,EAPG,28.02,32.96% of total billed charges,12.72,EAPG,76.5,90% of total billed charges,76.5,90% of total billed charges,12.11,EAPG,75.31,88.6% of total billed charges,12.48,EAPG,27.2,32% of total billed charges,68,80% of total billed charges,68,80% of total billed charges,12.11,EAPG,77.35,91% of total billed charges,27.74,32.64% of total billed charges,27.2,32% of total billed charges,28.56,33.6% of total billed charges,12.48,EAPG,27.2,32% of total billed charges,27.2,32% of total billed charges,78.2,92% of total billed charges,12.11,78.2,72.25
Outpatient Medical Services,Laboratory,87040,AEROBIC BLOOD CULTURE,300,116,94.19,81.2% of total billed charges,37.86,32.64% of total billed charges,85.84,74% of total billed charges,85.84,74% of total billed charges,37.12,32% of total billed charges,10.56,EAPG,37.12,32% of total billed charges,82.36,71% of total billed charges,82.36,71% of total billed charges,77.72,67% of total billed charges,77.72,67% of total billed charges,82.36,71% of total billed charges,88.16,76% of total billed charges,10.56,EAPG,38.23,32.96% of total billed charges,10.76,EAPG,104.4,90% of total billed charges,104.4,90% of total billed charges,10.25,EAPG,102.78,88.6% of total billed charges,10.56,EAPG,37.12,32% of total billed charges,92.8,80% of total billed charges,92.8,80% of total billed charges,10.25,EAPG,105.56,91% of total billed charges,37.86,32.64% of total billed charges,37.12,32% of total billed charges,38.98,33.6% of total billed charges,10.56,EAPG,37.12,32% of total billed charges,37.12,32% of total billed charges,106.72,92% of total billed charges,10.25,106.72,98.60
Outpatient Medical Services,Laboratory,0202U,RESPIRATORY PROFILE 2.1,310,1028,834.74,81.2% of total billed charges,335.54,32.64% of total billed charges,760.72,74% of total billed charges,760.72,74% of total billed charges,328.96,32% of total billed charges,31.18,EAPG,328.96,32% of total billed charges,729.88,71% of total billed charges,729.88,71% of total billed charges,688.76,67% of total billed charges,688.76,67% of total billed charges,729.88,71% of total billed charges,781.28,76% of total billed charges,31.18,EAPG,338.83,32.96% of total billed charges,31.79,EAPG,925.2,90% of total billed charges,925.2,90% of total billed charges,30.27,EAPG,910.81,88.6% of total billed charges,31.18,EAPG,328.96,32% of total billed charges,822.4,80% of total billed charges,822.4,80% of total billed charges,30.27,EAPG,935.48,91% of total billed charges,335.54,32.64% of total billed charges,328.96,32% of total billed charges,345.41,33.6% of total billed charges,31.18,EAPG,328.96,32% of total billed charges,328.96,32% of total billed charges,945.76,92% of total billed charges,30.27,945.76,873.80
Outpatient Medical Services,Laboratory,88184,FLOW CYTOMETRY 1ST MARKER,311,1227,996.32,81.2% of total billed charges,400.49,32.64% of total billed charges,907.98,74% of total billed charges,907.98,74% of total billed charges,392.64,32% of total billed charges,28.85,EAPG,392.64,32% of total billed charges,871.17,71% of total billed charges,871.17,71% of total billed charges,822.09,67% of total billed charges,822.09,67% of total billed charges,871.17,71% of total billed charges,932.52,76% of total billed charges,28.85,EAPG,404.42,32.96% of total billed charges,29.41,EAPG,1104.3,90% of total billed charges,1104.3,90% of total billed charges,28.01,EAPG,1087.12,88.6% of total billed charges,28.85,EAPG,392.64,32% of total billed charges,981.6,80% of total billed charges,981.6,80% of total billed charges,28.01,EAPG,1116.57,91% of total billed charges,400.49,32.64% of total billed charges,392.64,32% of total billed charges,412.27,33.6% of total billed charges,28.85,EAPG,392.64,32% of total billed charges,392.64,32% of total billed charges,1128.84,92% of total billed charges,28.01,1128.84,1042.95
Outpatient Medical Services,Laboratory,88185,FLOW CYTOMETRY EA ADD MARKER,311,2325,1887.9,81.2% of total billed charges,758.88,32.64% of total billed charges,1720.5,74% of total billed charges,1720.5,74% of total billed charges,744,32% of total billed charges,38.54,EAPG,744,32% of total billed charges,1650.75,71% of total billed charges,1650.75,71% of total billed charges,1557.75,67% of total billed charges,1557.75,67% of total billed charges,1650.75,71% of total billed charges,1767,76% of total billed charges,38.54,EAPG,766.32,32.96% of total billed charges,39.29,EAPG,2092.5,90% of total billed charges,2092.5,90% of total billed charges,37.42,EAPG,2059.95,88.6% of total billed charges,38.54,EAPG,744,32% of total billed charges,1860,80% of total billed charges,1860,80% of total billed charges,37.42,EAPG,2115.75,91% of total billed charges,758.88,32.64% of total billed charges,744,32% of total billed charges,781.2,33.6% of total billed charges,38.54,EAPG,744,32% of total billed charges,744,32% of total billed charges,2139,92% of total billed charges,37.42,2139,1976.25
Outpatient Medical Services,Laboratory,87635,COVID19 RAPID TEST,306,244,198.13,81.2% of total billed charges,79.64,32.64% of total billed charges,180.56,74% of total billed charges,180.56,74% of total billed charges,78.08,32% of total billed charges,21.33,EAPG,78.08,32% of total billed charges,173.24,71% of total billed charges,173.24,71% of total billed charges,163.48,67% of total billed charges,163.48,67% of total billed charges,173.24,71% of total billed charges,185.44,76% of total billed charges,21.33,EAPG,80.42,32.96% of total billed charges,21.75,EAPG,219.6,90% of total billed charges,219.6,90% of total billed charges,20.71,EAPG,216.18,88.6% of total billed charges,21.33,EAPG,78.08,32% of total billed charges,195.2,80% of total billed charges,195.2,80% of total billed charges,20.71,EAPG,222.04,91% of total billed charges,79.64,32.64% of total billed charges,78.08,32% of total billed charges,81.98,33.6% of total billed charges,21.33,EAPG,78.08,32% of total billed charges,78.08,32% of total billed charges,224.48,92% of total billed charges,20.71,224.48,207.40
Outpatient Medical Services,Laboratory,0241U,"PCR 4-PLEX (FLU A/B, RSV, COVID)",310,439,356.47,81.2% of total billed charges,143.29,32.64% of total billed charges,324.86,74% of total billed charges,324.86,74% of total billed charges,140.48,32% of total billed charges,N/A,Not Separately reimbursable,140.48,32% of total billed charges,311.69,71% of total billed charges,311.69,71% of total billed charges,294.13,67% of total billed charges,294.13,67% of total billed charges,311.69,71% of total billed charges,333.64,76% of total billed charges,N/A,Not Separately reimbursable,144.69,32.96% of total billed charges,N/A,Not Separately reimbursable,395.1,90% of total billed charges,395.1,90% of total billed charges,N/A,Not Separately reimbursable,388.95,88.6% of total billed charges,N/A,Not Separately reimbursable,140.48,32% of total billed charges,351.2,80% of total billed charges,351.2,80% of total billed charges,N/A,Not Separately reimbursable,399.49,91% of total billed charges,143.29,32.64% of total billed charges,140.48,32% of total billed charges,147.5,33.6% of total billed charges,N/A,Not Separately reimbursable,140.48,32% of total billed charges,140.48,32% of total billed charges,403.88,92% of total billed charges,140.48,403.88,373.15
Outpatient Medical Services,Laboratory,84484,HS TROPONIN,301,122,99.06,81.2% of total billed charges,39.82,32.64% of total billed charges,90.28,74% of total billed charges,90.28,74% of total billed charges,39.04,32% of total billed charges,11.51,EAPG,39.04,32% of total billed charges,86.62,71% of total billed charges,86.62,71% of total billed charges,81.74,67% of total billed charges,81.74,67% of total billed charges,86.62,71% of total billed charges,92.72,76% of total billed charges,11.51,EAPG,40.21,32.96% of total billed charges,11.74,EAPG,109.8,90% of total billed charges,109.8,90% of total billed charges,11.18,EAPG,108.09,88.6% of total billed charges,11.51,EAPG,39.04,32% of total billed charges,97.6,80% of total billed charges,97.6,80% of total billed charges,11.18,EAPG,111.02,91% of total billed charges,39.82,32.64% of total billed charges,39.04,32% of total billed charges,40.99,33.6% of total billed charges,11.51,EAPG,39.04,32% of total billed charges,39.04,32% of total billed charges,112.24,92% of total billed charges,11.18,112.24,103.70
Outpatient Medical Services,Laboratory,87150,FILMARRAY BCID-2,300,87,70.64,81.2% of total billed charges,28.4,32.64% of total billed charges,64.38,74% of total billed charges,64.38,74% of total billed charges,27.84,32% of total billed charges,21.33,EAPG,27.84,32% of total billed charges,61.77,71% of total billed charges,61.77,71% of total billed charges,58.29,67% of total billed charges,58.29,67% of total billed charges,61.77,71% of total billed charges,66.12,76% of total billed charges,21.33,EAPG,28.68,32.96% of total billed charges,21.75,EAPG,78.3,90% of total billed charges,78.3,90% of total billed charges,20.71,EAPG,77.08,88.6% of total billed charges,21.33,EAPG,27.84,32% of total billed charges,69.6,80% of total billed charges,69.6,80% of total billed charges,20.71,EAPG,79.17,91% of total billed charges,28.4,32.64% of total billed charges,27.84,32% of total billed charges,29.23,33.6% of total billed charges,21.33,EAPG,27.84,32% of total billed charges,27.84,32% of total billed charges,80.04,92% of total billed charges,20.71,80.04,73.95
Outpatient Medical Services,Laboratory,87651,STREP GROUP A PCR,300,110,89.32,81.2% of total billed charges,35.9,32.64% of total billed charges,81.4,74% of total billed charges,81.4,74% of total billed charges,35.2,32% of total billed charges,21.33,EAPG,35.2,32% of total billed charges,78.1,71% of total billed charges,78.1,71% of total billed charges,73.7,67% of total billed charges,73.7,67% of total billed charges,78.1,71% of total billed charges,83.6,76% of total billed charges,21.33,EAPG,36.26,32.96% of total billed charges,21.75,EAPG,99,90% of total billed charges,99,90% of total billed charges,20.71,EAPG,97.46,88.6% of total billed charges,21.33,EAPG,35.2,32% of total billed charges,88,80% of total billed charges,88,80% of total billed charges,20.71,EAPG,100.1,91% of total billed charges,35.9,32.64% of total billed charges,35.2,32% of total billed charges,36.96,33.6% of total billed charges,21.33,EAPG,35.2,32% of total billed charges,35.2,32% of total billed charges,101.2,92% of total billed charges,20.71,101.2,93.50
Outpatient Medical Services,Laboratory,88275,OSU HC MCG IP SITU 100-300 CELLS,310,416,337.79,81.2% of total billed charges,135.78,32.64% of total billed charges,307.84,74% of total billed charges,307.84,74% of total billed charges,133.12,32% of total billed charges,53.26,EAPG,133.12,32% of total billed charges,295.36,71% of total billed charges,295.36,71% of total billed charges,278.72,67% of total billed charges,278.72,67% of total billed charges,295.36,71% of total billed charges,316.16,76% of total billed charges,53.26,EAPG,137.11,32.96% of total billed charges,54.29,EAPG,374.4,90% of total billed charges,374.4,90% of total billed charges,51.71,EAPG,368.58,88.6% of total billed charges,53.26,EAPG,133.12,32% of total billed charges,332.8,80% of total billed charges,332.8,80% of total billed charges,51.71,EAPG,378.56,91% of total billed charges,135.78,32.64% of total billed charges,133.12,32% of total billed charges,139.78,33.6% of total billed charges,53.26,EAPG,133.12,32% of total billed charges,133.12,32% of total billed charges,382.72,92% of total billed charges,51.71,382.72,353.60
Outpatient Medical Services,Laboratory,81001,URINALYSIS AUTOMATED,307,71,57.65,81.2% of total billed charges,23.17,32.64% of total billed charges,52.54,74% of total billed charges,52.54,74% of total billed charges,22.72,32% of total billed charges,4.04,EAPG,22.72,32% of total billed charges,50.41,71% of total billed charges,50.41,71% of total billed charges,47.57,67% of total billed charges,47.57,67% of total billed charges,50.41,71% of total billed charges,53.96,76% of total billed charges,4.04,EAPG,23.4,32.96% of total billed charges,4.12,EAPG,63.9,90% of total billed charges,63.9,90% of total billed charges,3.93,EAPG,62.91,88.6% of total billed charges,4.04,EAPG,22.72,32% of total billed charges,56.8,80% of total billed charges,56.8,80% of total billed charges,3.93,EAPG,64.61,91% of total billed charges,23.17,32.64% of total billed charges,22.72,32% of total billed charges,23.86,33.6% of total billed charges,4.04,EAPG,22.72,32% of total billed charges,22.72,32% of total billed charges,65.32,92% of total billed charges,3.93,65.32,60.35
Outpatient Medical Services,Laboratory,85025,CBC WITH DIFF,300,93,75.52,81.2% of total billed charges,30.36,32.64% of total billed charges,68.82,74% of total billed charges,68.82,74% of total billed charges,29.76,32% of total billed charges,5.38,EAPG,29.76,32% of total billed charges,66.03,71% of total billed charges,66.03,71% of total billed charges,62.31,67% of total billed charges,62.31,67% of total billed charges,66.03,71% of total billed charges,70.68,76% of total billed charges,5.38,EAPG,30.65,32.96% of total billed charges,5.49,EAPG,83.7,90% of total billed charges,83.7,90% of total billed charges,5.23,EAPG,82.4,88.6% of total billed charges,5.38,EAPG,29.76,32% of total billed charges,74.4,80% of total billed charges,74.4,80% of total billed charges,5.23,EAPG,84.63,91% of total billed charges,30.36,32.64% of total billed charges,29.76,32% of total billed charges,31.25,33.6% of total billed charges,5.38,EAPG,29.76,32% of total billed charges,29.76,32% of total billed charges,85.56,92% of total billed charges,5.23,85.56,79.05
Outpatient Medical Services,Laboratory,85027,"CBC, W/O DIFF",305,44,35.73,81.2% of total billed charges,14.36,32.64% of total billed charges,32.56,74% of total billed charges,32.56,74% of total billed charges,14.08,32% of total billed charges,5.38,EAPG,14.08,32% of total billed charges,31.24,71% of total billed charges,31.24,71% of total billed charges,29.48,67% of total billed charges,29.48,67% of total billed charges,31.24,71% of total billed charges,33.44,76% of total billed charges,5.38,EAPG,14.5,32.96% of total billed charges,5.49,EAPG,39.6,90% of total billed charges,39.6,90% of total billed charges,5.23,EAPG,38.98,88.6% of total billed charges,5.38,EAPG,14.08,32% of total billed charges,35.2,80% of total billed charges,35.2,80% of total billed charges,5.23,EAPG,40.04,91% of total billed charges,14.36,32.64% of total billed charges,14.08,32% of total billed charges,14.78,33.6% of total billed charges,5.38,EAPG,14.08,32% of total billed charges,14.08,32% of total billed charges,40.48,92% of total billed charges,5.23,40.48,37.40
Outpatient Medical Services,Outpatient Office Visits,99202,LEVEL 2 VISIT NEW PATIENT,510,187,151.84,81.2% of total billed charges,61.04,32.64% of total billed charges,138.38,74% of total billed charges,138.38,74% of total billed charges,59.84,32% of total billed charges,43.61,EAPG,59.84,32% of total billed charges,132.77,71% of total billed charges,132.77,71% of total billed charges,125.29,67% of total billed charges,125.29,67% of total billed charges,132.77,71% of total billed charges,142.12,76% of total billed charges,43.61,EAPG,61.64,32.96% of total billed charges,44.45,EAPG,168.3,90% of total billed charges,168.3,90% of total billed charges,42.34,EAPG,165.68,88.6% of total billed charges,43.61,EAPG,59.84,32% of total billed charges,149.6,80% of total billed charges,149.6,80% of total billed charges,42.34,EAPG,170.17,91% of total billed charges,61.04,32.64% of total billed charges,59.84,32% of total billed charges,62.83,33.6% of total billed charges,43.61,EAPG,59.84,32% of total billed charges,59.84,32% of total billed charges,172.04,92% of total billed charges,42.34,172.04,158.95
Outpatient Medical Services,Outpatient Office Visits,99203,LEVEL 3 VISIT NEW PATIENT,510,281,228.17,81.2% of total billed charges,91.72,32.64% of total billed charges,207.94,74% of total billed charges,207.94,74% of total billed charges,89.92,32% of total billed charges,43.61,EAPG,89.92,32% of total billed charges,199.51,71% of total billed charges,199.51,71% of total billed charges,188.27,67% of total billed charges,188.27,67% of total billed charges,199.51,71% of total billed charges,213.56,76% of total billed charges,43.61,EAPG,92.62,32.96% of total billed charges,44.45,EAPG,252.9,90% of total billed charges,252.9,90% of total billed charges,42.34,EAPG,248.97,88.6% of total billed charges,43.61,EAPG,89.92,32% of total billed charges,224.8,80% of total billed charges,224.8,80% of total billed charges,42.34,EAPG,255.71,91% of total billed charges,91.72,32.64% of total billed charges,89.92,32% of total billed charges,94.42,33.6% of total billed charges,43.61,EAPG,89.92,32% of total billed charges,89.92,32% of total billed charges,258.52,92% of total billed charges,42.34,258.52,238.85
Outpatient Medical Services,Outpatient Office Visits,99204,LEVEL 4 VISIT NEW PATIENT,510,347,281.76,81.2% of total billed charges,113.26,32.64% of total billed charges,256.78,74% of total billed charges,256.78,74% of total billed charges,111.04,32% of total billed charges,43.61,EAPG,111.04,32% of total billed charges,246.37,71% of total billed charges,246.37,71% of total billed charges,232.49,67% of total billed charges,232.49,67% of total billed charges,246.37,71% of total billed charges,263.72,76% of total billed charges,43.61,EAPG,114.37,32.96% of total billed charges,44.45,EAPG,312.3,90% of total billed charges,312.3,90% of total billed charges,42.34,EAPG,307.44,88.6% of total billed charges,43.61,EAPG,111.04,32% of total billed charges,277.6,80% of total billed charges,277.6,80% of total billed charges,42.34,EAPG,315.77,91% of total billed charges,113.26,32.64% of total billed charges,111.04,32% of total billed charges,116.59,33.6% of total billed charges,43.61,EAPG,111.04,32% of total billed charges,111.04,32% of total billed charges,319.24,92% of total billed charges,42.34,319.24,294.95
Outpatient Medical Services,Outpatient Office Visits,99205,LEVEL 5 VISIT NEW PATIENT,510,371,301.25,81.2% of total billed charges,121.09,32.64% of total billed charges,274.54,74% of total billed charges,274.54,74% of total billed charges,118.72,32% of total billed charges,43.61,EAPG,118.72,32% of total billed charges,263.41,71% of total billed charges,263.41,71% of total billed charges,248.57,67% of total billed charges,248.57,67% of total billed charges,263.41,71% of total billed charges,281.96,76% of total billed charges,43.61,EAPG,122.28,32.96% of total billed charges,44.45,EAPG,333.9,90% of total billed charges,333.9,90% of total billed charges,42.34,EAPG,328.71,88.6% of total billed charges,43.61,EAPG,118.72,32% of total billed charges,296.8,80% of total billed charges,296.8,80% of total billed charges,42.34,EAPG,337.61,91% of total billed charges,121.09,32.64% of total billed charges,118.72,32% of total billed charges,124.66,33.6% of total billed charges,43.61,EAPG,118.72,32% of total billed charges,118.72,32% of total billed charges,341.32,92% of total billed charges,42.34,341.32,315.35
Outpatient Medical Services,Outpatient Office Visits,99211,LEVEL 1 VISIT EST PATIENT,510,122,99.06,81.2% of total billed charges,39.82,32.64% of total billed charges,90.28,74% of total billed charges,90.28,74% of total billed charges,39.04,32% of total billed charges,43.61,EAPG,39.04,32% of total billed charges,86.62,71% of total billed charges,86.62,71% of total billed charges,81.74,67% of total billed charges,81.74,67% of total billed charges,86.62,71% of total billed charges,92.72,76% of total billed charges,43.61,EAPG,40.21,32.96% of total billed charges,44.45,EAPG,109.8,90% of total billed charges,109.8,90% of total billed charges,42.34,EAPG,108.09,88.6% of total billed charges,43.61,EAPG,39.04,32% of total billed charges,97.6,80% of total billed charges,97.6,80% of total billed charges,42.34,EAPG,111.02,91% of total billed charges,39.82,32.64% of total billed charges,39.04,32% of total billed charges,40.99,33.6% of total billed charges,43.61,EAPG,39.04,32% of total billed charges,39.04,32% of total billed charges,112.24,92% of total billed charges,39.04,112.24,103.70
Outpatient Medical Services,Outpatient Office Visits,99212,LEVEL 2 VISIT EST PATIENT,510,168,136.42,81.2% of total billed charges,54.84,32.64% of total billed charges,124.32,74% of total billed charges,124.32,74% of total billed charges,53.76,32% of total billed charges,43.61,EAPG,53.76,32% of total billed charges,119.28,71% of total billed charges,119.28,71% of total billed charges,112.56,67% of total billed charges,112.56,67% of total billed charges,119.28,71% of total billed charges,127.68,76% of total billed charges,43.61,EAPG,55.37,32.96% of total billed charges,44.45,EAPG,151.2,90% of total billed charges,151.2,90% of total billed charges,42.34,EAPG,148.85,88.6% of total billed charges,43.61,EAPG,53.76,32% of total billed charges,134.4,80% of total billed charges,134.4,80% of total billed charges,42.34,EAPG,152.88,91% of total billed charges,54.84,32.64% of total billed charges,53.76,32% of total billed charges,56.45,33.6% of total billed charges,43.61,EAPG,53.76,32% of total billed charges,53.76,32% of total billed charges,154.56,92% of total billed charges,42.34,154.56,142.80
Outpatient Medical Services,Outpatient Office Visits,99213,LEVEL 3 VISIT EST PATIENT,510,248,201.38,81.2% of total billed charges,80.95,32.64% of total billed charges,183.52,74% of total billed charges,183.52,74% of total billed charges,79.36,32% of total billed charges,43.61,EAPG,79.36,32% of total billed charges,176.08,71% of total billed charges,176.08,71% of total billed charges,166.16,67% of total billed charges,166.16,67% of total billed charges,176.08,71% of total billed charges,188.48,76% of total billed charges,43.61,EAPG,81.74,32.96% of total billed charges,44.45,EAPG,223.2,90% of total billed charges,223.2,90% of total billed charges,42.34,EAPG,219.73,88.6% of total billed charges,43.61,EAPG,79.36,32% of total billed charges,198.4,80% of total billed charges,198.4,80% of total billed charges,42.34,EAPG,225.68,91% of total billed charges,80.95,32.64% of total billed charges,79.36,32% of total billed charges,83.33,33.6% of total billed charges,43.61,EAPG,79.36,32% of total billed charges,79.36,32% of total billed charges,228.16,92% of total billed charges,42.34,228.16,210.80
Outpatient Medical Services,Outpatient Office Visits,99214,LEVEL 4 VISIT EST PATIENT,510,291,236.29,81.2% of total billed charges,94.98,32.64% of total billed charges,215.34,74% of total billed charges,215.34,74% of total billed charges,93.12,32% of total billed charges,43.61,EAPG,93.12,32% of total billed charges,206.61,71% of total billed charges,206.61,71% of total billed charges,194.97,67% of total billed charges,194.97,67% of total billed charges,206.61,71% of total billed charges,221.16,76% of total billed charges,43.61,EAPG,95.91,32.96% of total billed charges,44.45,EAPG,261.9,90% of total billed charges,261.9,90% of total billed charges,42.34,EAPG,257.83,88.6% of total billed charges,43.61,EAPG,93.12,32% of total billed charges,232.8,80% of total billed charges,232.8,80% of total billed charges,42.34,EAPG,264.81,91% of total billed charges,94.98,32.64% of total billed charges,93.12,32% of total billed charges,97.78,33.6% of total billed charges,43.61,EAPG,93.12,32% of total billed charges,93.12,32% of total billed charges,267.72,92% of total billed charges,42.34,267.72,247.35
Outpatient Medical Services,Outpatient Office Visits,99215,LEVEL 5 VISIT EST PATIENT,510,341,276.89,81.2% of total billed charges,111.3,32.64% of total billed charges,252.34,74% of total billed charges,252.34,74% of total billed charges,109.12,32% of total billed charges,43.61,EAPG,109.12,32% of total billed charges,242.11,71% of total billed charges,242.11,71% of total billed charges,228.47,67% of total billed charges,228.47,67% of total billed charges,242.11,71% of total billed charges,259.16,76% of total billed charges,43.61,EAPG,112.39,32.96% of total billed charges,44.45,EAPG,306.9,90% of total billed charges,306.9,90% of total billed charges,42.34,EAPG,302.13,88.6% of total billed charges,43.61,EAPG,109.12,32% of total billed charges,272.8,80% of total billed charges,272.8,80% of total billed charges,42.34,EAPG,310.31,91% of total billed charges,111.3,32.64% of total billed charges,109.12,32% of total billed charges,114.58,33.6% of total billed charges,43.61,EAPG,109.12,32% of total billed charges,109.12,32% of total billed charges,313.72,92% of total billed charges,42.34,313.72,289.85
Outpatient Medical Services,Radiology,74176,CT STONE SEARCH,352,2665,2163.98,81.2% of total billed charges,869.86,32.64% of total billed charges,1027,Case rate,1027,Case rate,852.8,32% of total billed charges,249.83,EAPG,852.8,32% of total billed charges,976,Case rate,976,Case rate,925,Case rate,925,Case rate,976,Case rate,2025.4,Case rate,249.83,EAPG,878.38,32.96% of total billed charges,254.68,EAPG,2398.5,90% of total billed charges,2398.5,90% of total billed charges,242.56,EAPG,2361.19,88.6% of total billed charges,249.83,EAPG,852.8,32% of total billed charges,2132,80% of total billed charges,2132,80% of total billed charges,242.56,EAPG,2425.15,91% of total billed charges,869.86,32.64% of total billed charges,852.8,32% of total billed charges,895.44,33.6% of total billed charges,249.83,EAPG,852.8,32% of total billed charges,852.8,32% of total billed charges,2451.8,92% of total billed charges,242.56,2451.8,2265.25
Outpatient Medical Services,Radiology,74018,ABD 1V,320,285,231.42,81.2% of total billed charges,93.02,32.64% of total billed charges,210.9,74% of total billed charges,210.9,74% of total billed charges,91.2,32% of total billed charges,36.03,EAPG,91.2,32% of total billed charges,202.35,71% of total billed charges,202.35,71% of total billed charges,190.95,67% of total billed charges,190.95,67% of total billed charges,202.35,71% of total billed charges,216.6,76% of total billed charges,36.03,EAPG,93.94,32.96% of total billed charges,36.73,EAPG,256.5,90% of total billed charges,256.5,90% of total billed charges,34.98,EAPG,252.51,88.6% of total billed charges,36.03,EAPG,91.2,32% of total billed charges,228,80% of total billed charges,228,80% of total billed charges,34.98,EAPG,259.35,91% of total billed charges,93.02,32.64% of total billed charges,91.2,32% of total billed charges,95.76,33.6% of total billed charges,36.03,EAPG,91.2,32% of total billed charges,91.2,32% of total billed charges,262.2,92% of total billed charges,34.98,262.2,242.25
Outpatient Medical Services,Radiology,71045,CHEST 1V,320,227,184.32,81.2% of total billed charges,74.09,32.64% of total billed charges,167.98,74% of total billed charges,167.98,74% of total billed charges,72.64,32% of total billed charges,36.03,EAPG,72.64,32% of total billed charges,161.17,71% of total billed charges,161.17,71% of total billed charges,152.09,67% of total billed charges,152.09,67% of total billed charges,161.17,71% of total billed charges,172.52,76% of total billed charges,36.03,EAPG,74.82,32.96% of total billed charges,36.73,EAPG,204.3,90% of total billed charges,204.3,90% of total billed charges,34.98,EAPG,201.12,88.6% of total billed charges,36.03,EAPG,72.64,32% of total billed charges,181.6,80% of total billed charges,181.6,80% of total billed charges,34.98,EAPG,206.57,91% of total billed charges,74.09,32.64% of total billed charges,72.64,32% of total billed charges,76.27,33.6% of total billed charges,36.03,EAPG,72.64,32% of total billed charges,72.64,32% of total billed charges,208.84,92% of total billed charges,34.98,208.84,192.95
Outpatient Medical Services,Radiology,71046,CHEST 2V,320,243,197.32,81.2% of total billed charges,79.32,32.64% of total billed charges,179.82,74% of total billed charges,179.82,74% of total billed charges,77.76,32% of total billed charges,36.03,EAPG,77.76,32% of total billed charges,172.53,71% of total billed charges,172.53,71% of total billed charges,162.81,67% of total billed charges,162.81,67% of total billed charges,172.53,71% of total billed charges,184.68,76% of total billed charges,36.03,EAPG,80.09,32.96% of total billed charges,36.73,EAPG,218.7,90% of total billed charges,218.7,90% of total billed charges,34.98,EAPG,215.3,88.6% of total billed charges,36.03,EAPG,77.76,32% of total billed charges,194.4,80% of total billed charges,194.4,80% of total billed charges,34.98,EAPG,221.13,91% of total billed charges,79.32,32.64% of total billed charges,77.76,32% of total billed charges,81.65,33.6% of total billed charges,36.03,EAPG,77.76,32% of total billed charges,77.76,32% of total billed charges,223.56,92% of total billed charges,34.98,223.56,206.55
Outpatient Medical Services,Radiology,72100,LUMBAR SPINE 2 OR 3V,320,401,325.61,81.2% of total billed charges,130.89,32.64% of total billed charges,296.74,74% of total billed charges,296.74,74% of total billed charges,128.32,32% of total billed charges,36.03,EAPG,128.32,32% of total billed charges,284.71,71% of total billed charges,284.71,71% of total billed charges,268.67,67% of total billed charges,268.67,67% of total billed charges,284.71,71% of total billed charges,304.76,76% of total billed charges,36.03,EAPG,132.17,32.96% of total billed charges,36.73,EAPG,360.9,90% of total billed charges,360.9,90% of total billed charges,34.98,EAPG,355.29,88.6% of total billed charges,36.03,EAPG,128.32,32% of total billed charges,320.8,80% of total billed charges,320.8,80% of total billed charges,34.98,EAPG,364.91,91% of total billed charges,130.89,32.64% of total billed charges,128.32,32% of total billed charges,134.74,33.6% of total billed charges,36.03,EAPG,128.32,32% of total billed charges,128.32,32% of total billed charges,368.92,92% of total billed charges,34.98,368.92,340.85
Outpatient Medical Services,Radiology,72110,LUMBAR SPINE MIN 4V,320,447,362.96,81.2% of total billed charges,145.9,32.64% of total billed charges,330.78,74% of total billed charges,330.78,74% of total billed charges,143.04,32% of total billed charges,36.03,EAPG,143.04,32% of total billed charges,317.37,71% of total billed charges,317.37,71% of total billed charges,299.49,67% of total billed charges,299.49,67% of total billed charges,317.37,71% of total billed charges,339.72,76% of total billed charges,36.03,EAPG,147.33,32.96% of total billed charges,36.73,EAPG,402.3,90% of total billed charges,402.3,90% of total billed charges,34.98,EAPG,396.04,88.6% of total billed charges,36.03,EAPG,143.04,32% of total billed charges,357.6,80% of total billed charges,357.6,80% of total billed charges,34.98,EAPG,406.77,91% of total billed charges,145.9,32.64% of total billed charges,143.04,32% of total billed charges,150.19,33.6% of total billed charges,36.03,EAPG,143.04,32% of total billed charges,143.04,32% of total billed charges,411.24,92% of total billed charges,34.98,411.24,379.95
Outpatient Medical Services,Radiology,72170,PELVIS AP 1 OR 2V,320,210,170.52,81.2% of total billed charges,68.54,32.64% of total billed charges,155.4,74% of total billed charges,155.4,74% of total billed charges,67.2,32% of total billed charges,36.03,EAPG,67.2,32% of total billed charges,149.1,71% of total billed charges,149.1,71% of total billed charges,140.7,67% of total billed charges,140.7,67% of total billed charges,149.1,71% of total billed charges,159.6,76% of total billed charges,36.03,EAPG,69.22,32.96% of total billed charges,36.73,EAPG,189,90% of total billed charges,189,90% of total billed charges,34.98,EAPG,186.06,88.6% of total billed charges,36.03,EAPG,67.2,32% of total billed charges,168,80% of total billed charges,168,80% of total billed charges,34.98,EAPG,191.1,91% of total billed charges,68.54,32.64% of total billed charges,67.2,32% of total billed charges,70.56,33.6% of total billed charges,36.03,EAPG,67.2,32% of total billed charges,67.2,32% of total billed charges,193.2,92% of total billed charges,34.98,193.2,178.50
Outpatient Medical Services,Radiology,76000,FLUORO W/O RAD,320,584,474.21,81.2% of total billed charges,190.62,32.64% of total billed charges,432.16,74% of total billed charges,432.16,74% of total billed charges,186.88,32% of total billed charges,90.49,EAPG,186.88,32% of total billed charges,414.64,71% of total billed charges,414.64,71% of total billed charges,391.28,67% of total billed charges,391.28,67% of total billed charges,414.64,71% of total billed charges,443.84,76% of total billed charges,90.49,EAPG,192.49,32.96% of total billed charges,92.25,EAPG,525.6,90% of total billed charges,525.6,90% of total billed charges,87.85,EAPG,517.42,88.6% of total billed charges,90.49,EAPG,186.88,32% of total billed charges,467.2,80% of total billed charges,467.2,80% of total billed charges,87.85,EAPG,531.44,91% of total billed charges,190.62,32.64% of total billed charges,186.88,32% of total billed charges,196.22,33.6% of total billed charges,90.49,EAPG,186.88,32% of total billed charges,186.88,32% of total billed charges,537.28,92% of total billed charges,87.85,537.28,496.40
Outpatient Medical Services,Radiology,74022,AAS,320,401,325.61,81.2% of total billed charges,130.89,32.64% of total billed charges,296.74,74% of total billed charges,296.74,74% of total billed charges,128.32,32% of total billed charges,36.03,EAPG,128.32,32% of total billed charges,284.71,71% of total billed charges,284.71,71% of total billed charges,268.67,67% of total billed charges,268.67,67% of total billed charges,284.71,71% of total billed charges,304.76,76% of total billed charges,36.03,EAPG,132.17,32.96% of total billed charges,36.73,EAPG,360.9,90% of total billed charges,360.9,90% of total billed charges,34.98,EAPG,355.29,88.6% of total billed charges,36.03,EAPG,128.32,32% of total billed charges,320.8,80% of total billed charges,320.8,80% of total billed charges,34.98,EAPG,364.91,91% of total billed charges,130.89,32.64% of total billed charges,128.32,32% of total billed charges,134.74,33.6% of total billed charges,36.03,EAPG,128.32,32% of total billed charges,128.32,32% of total billed charges,368.92,92% of total billed charges,34.98,368.92,340.85
Outpatient Medical Services,Radiology,73610,EXT ANKLE MIN 3V LT,320,233,189.2,81.2% of total billed charges,76.05,32.64% of total billed charges,172.42,74% of total billed charges,172.42,74% of total billed charges,74.56,32% of total billed charges,36.03,EAPG,74.56,32% of total billed charges,165.43,71% of total billed charges,165.43,71% of total billed charges,156.11,67% of total billed charges,156.11,67% of total billed charges,165.43,71% of total billed charges,177.08,76% of total billed charges,36.03,EAPG,76.8,32.96% of total billed charges,36.73,EAPG,209.7,90% of total billed charges,209.7,90% of total billed charges,34.98,EAPG,206.44,88.6% of total billed charges,36.03,EAPG,74.56,32% of total billed charges,186.4,80% of total billed charges,186.4,80% of total billed charges,34.98,EAPG,212.03,91% of total billed charges,76.05,32.64% of total billed charges,74.56,32% of total billed charges,78.29,33.6% of total billed charges,36.03,EAPG,74.56,32% of total billed charges,74.56,32% of total billed charges,214.36,92% of total billed charges,34.98,214.36,198.05
Outpatient Medical Services,Radiology,73630,EXT FOOT MIN 3V LT,320,327,265.52,81.2% of total billed charges,106.73,32.64% of total billed charges,241.98,74% of total billed charges,241.98,74% of total billed charges,104.64,32% of total billed charges,36.03,EAPG,104.64,32% of total billed charges,232.17,71% of total billed charges,232.17,71% of total billed charges,219.09,67% of total billed charges,219.09,67% of total billed charges,232.17,71% of total billed charges,248.52,76% of total billed charges,36.03,EAPG,107.78,32.96% of total billed charges,36.73,EAPG,294.3,90% of total billed charges,294.3,90% of total billed charges,34.98,EAPG,289.72,88.6% of total billed charges,36.03,EAPG,104.64,32% of total billed charges,261.6,80% of total billed charges,261.6,80% of total billed charges,34.98,EAPG,297.57,91% of total billed charges,106.73,32.64% of total billed charges,104.64,32% of total billed charges,109.87,33.6% of total billed charges,36.03,EAPG,104.64,32% of total billed charges,104.64,32% of total billed charges,300.84,92% of total billed charges,34.98,300.84,277.95
Outpatient Medical Services,Radiology,73130,EXT HAND 3V LT,320,327,265.52,81.2% of total billed charges,106.73,32.64% of total billed charges,241.98,74% of total billed charges,241.98,74% of total billed charges,104.64,32% of total billed charges,36.03,EAPG,104.64,32% of total billed charges,232.17,71% of total billed charges,232.17,71% of total billed charges,219.09,67% of total billed charges,219.09,67% of total billed charges,232.17,71% of total billed charges,248.52,76% of total billed charges,36.03,EAPG,107.78,32.96% of total billed charges,36.73,EAPG,294.3,90% of total billed charges,294.3,90% of total billed charges,34.98,EAPG,289.72,88.6% of total billed charges,36.03,EAPG,104.64,32% of total billed charges,261.6,80% of total billed charges,261.6,80% of total billed charges,34.98,EAPG,297.57,91% of total billed charges,106.73,32.64% of total billed charges,104.64,32% of total billed charges,109.87,33.6% of total billed charges,36.03,EAPG,104.64,32% of total billed charges,104.64,32% of total billed charges,300.84,92% of total billed charges,34.98,300.84,277.95
Outpatient Medical Services,Radiology,73502,EXT HIP 2-3V LT,320,298,241.98,81.2% of total billed charges,97.27,32.64% of total billed charges,220.52,74% of total billed charges,220.52,74% of total billed charges,95.36,32% of total billed charges,36.03,EAPG,95.36,32% of total billed charges,211.58,71% of total billed charges,211.58,71% of total billed charges,199.66,67% of total billed charges,199.66,67% of total billed charges,211.58,71% of total billed charges,226.48,76% of total billed charges,36.03,EAPG,98.22,32.96% of total billed charges,36.73,EAPG,268.2,90% of total billed charges,268.2,90% of total billed charges,34.98,EAPG,264.03,88.6% of total billed charges,36.03,EAPG,95.36,32% of total billed charges,238.4,80% of total billed charges,238.4,80% of total billed charges,34.98,EAPG,271.18,91% of total billed charges,97.27,32.64% of total billed charges,95.36,32% of total billed charges,100.13,33.6% of total billed charges,36.03,EAPG,95.36,32% of total billed charges,95.36,32% of total billed charges,274.16,92% of total billed charges,34.98,274.16,253.30
Outpatient Medical Services,Radiology,73562,EXT KNEE 3V LT,320,285,231.42,81.2% of total billed charges,93.02,32.64% of total billed charges,210.9,74% of total billed charges,210.9,74% of total billed charges,91.2,32% of total billed charges,36.03,EAPG,91.2,32% of total billed charges,202.35,71% of total billed charges,202.35,71% of total billed charges,190.95,67% of total billed charges,190.95,67% of total billed charges,202.35,71% of total billed charges,216.6,76% of total billed charges,36.03,EAPG,93.94,32.96% of total billed charges,36.73,EAPG,256.5,90% of total billed charges,256.5,90% of total billed charges,34.98,EAPG,252.51,88.6% of total billed charges,36.03,EAPG,91.2,32% of total billed charges,228,80% of total billed charges,228,80% of total billed charges,34.98,EAPG,259.35,91% of total billed charges,93.02,32.64% of total billed charges,91.2,32% of total billed charges,95.76,33.6% of total billed charges,36.03,EAPG,91.2,32% of total billed charges,91.2,32% of total billed charges,262.2,92% of total billed charges,34.98,262.2,242.25
Outpatient Medical Services,Radiology,73560,EXT KNEE 1-2V LT,320,324,263.09,81.2% of total billed charges,105.75,32.64% of total billed charges,239.76,74% of total billed charges,239.76,74% of total billed charges,103.68,32% of total billed charges,36.03,EAPG,103.68,32% of total billed charges,230.04,71% of total billed charges,230.04,71% of total billed charges,217.08,67% of total billed charges,217.08,67% of total billed charges,230.04,71% of total billed charges,246.24,76% of total billed charges,36.03,EAPG,106.79,32.96% of total billed charges,36.73,EAPG,291.6,90% of total billed charges,291.6,90% of total billed charges,34.98,EAPG,287.06,88.6% of total billed charges,36.03,EAPG,103.68,32% of total billed charges,259.2,80% of total billed charges,259.2,80% of total billed charges,34.98,EAPG,294.84,91% of total billed charges,105.75,32.64% of total billed charges,103.68,32% of total billed charges,108.86,33.6% of total billed charges,36.03,EAPG,103.68,32% of total billed charges,103.68,32% of total billed charges,298.08,92% of total billed charges,34.98,298.08,275.40
Outpatient Medical Services,Radiology,73030,EXT SHOULDER 3V LT,320,290,235.48,81.2% of total billed charges,94.66,32.64% of total billed charges,214.6,74% of total billed charges,214.6,74% of total billed charges,92.8,32% of total billed charges,36.03,EAPG,92.8,32% of total billed charges,205.9,71% of total billed charges,205.9,71% of total billed charges,194.3,67% of total billed charges,194.3,67% of total billed charges,205.9,71% of total billed charges,220.4,76% of total billed charges,36.03,EAPG,95.58,32.96% of total billed charges,36.73,EAPG,261,90% of total billed charges,261,90% of total billed charges,34.98,EAPG,256.94,88.6% of total billed charges,36.03,EAPG,92.8,32% of total billed charges,232,80% of total billed charges,232,80% of total billed charges,34.98,EAPG,263.9,91% of total billed charges,94.66,32.64% of total billed charges,92.8,32% of total billed charges,97.44,33.6% of total billed charges,36.03,EAPG,92.8,32% of total billed charges,92.8,32% of total billed charges,266.8,92% of total billed charges,34.98,266.8,246.50
Outpatient Medical Services,Radiology,73110,EXT WRIST MIN 3V LT,320,285,231.42,81.2% of total billed charges,93.02,32.64% of total billed charges,210.9,74% of total billed charges,210.9,74% of total billed charges,91.2,32% of total billed charges,36.03,EAPG,91.2,32% of total billed charges,202.35,71% of total billed charges,202.35,71% of total billed charges,190.95,67% of total billed charges,190.95,67% of total billed charges,202.35,71% of total billed charges,216.6,76% of total billed charges,36.03,EAPG,93.94,32.96% of total billed charges,36.73,EAPG,256.5,90% of total billed charges,256.5,90% of total billed charges,34.98,EAPG,252.51,88.6% of total billed charges,36.03,EAPG,91.2,32% of total billed charges,228,80% of total billed charges,228,80% of total billed charges,34.98,EAPG,259.35,91% of total billed charges,93.02,32.64% of total billed charges,91.2,32% of total billed charges,95.76,33.6% of total billed charges,36.03,EAPG,91.2,32% of total billed charges,91.2,32% of total billed charges,262.2,92% of total billed charges,34.98,262.2,242.25
Outpatient Medical Services,Radiology,73610,EXT ANKLE MIN 3V RT,320,233,189.2,81.2% of total billed charges,76.05,32.64% of total billed charges,172.42,74% of total billed charges,172.42,74% of total billed charges,74.56,32% of total billed charges,36.03,EAPG,74.56,32% of total billed charges,165.43,71% of total billed charges,165.43,71% of total billed charges,156.11,67% of total billed charges,156.11,67% of total billed charges,165.43,71% of total billed charges,177.08,76% of total billed charges,36.03,EAPG,76.8,32.96% of total billed charges,36.73,EAPG,209.7,90% of total billed charges,209.7,90% of total billed charges,34.98,EAPG,206.44,88.6% of total billed charges,36.03,EAPG,74.56,32% of total billed charges,186.4,80% of total billed charges,186.4,80% of total billed charges,34.98,EAPG,212.03,91% of total billed charges,76.05,32.64% of total billed charges,74.56,32% of total billed charges,78.29,33.6% of total billed charges,36.03,EAPG,74.56,32% of total billed charges,74.56,32% of total billed charges,214.36,92% of total billed charges,34.98,214.36,198.05
Outpatient Medical Services,Radiology,73630,EXT FOOT MIN 3V RT,320,327,265.52,81.2% of total billed charges,106.73,32.64% of total billed charges,241.98,74% of total billed charges,241.98,74% of total billed charges,104.64,32% of total billed charges,36.03,EAPG,104.64,32% of total billed charges,232.17,71% of total billed charges,232.17,71% of total billed charges,219.09,67% of total billed charges,219.09,67% of total billed charges,232.17,71% of total billed charges,248.52,76% of total billed charges,36.03,EAPG,107.78,32.96% of total billed charges,36.73,EAPG,294.3,90% of total billed charges,294.3,90% of total billed charges,34.98,EAPG,289.72,88.6% of total billed charges,36.03,EAPG,104.64,32% of total billed charges,261.6,80% of total billed charges,261.6,80% of total billed charges,34.98,EAPG,297.57,91% of total billed charges,106.73,32.64% of total billed charges,104.64,32% of total billed charges,109.87,33.6% of total billed charges,36.03,EAPG,104.64,32% of total billed charges,104.64,32% of total billed charges,300.84,92% of total billed charges,34.98,300.84,277.95
Outpatient Medical Services,Radiology,73130,EXT HAND 3V RT,320,327,265.52,81.2% of total billed charges,106.73,32.64% of total billed charges,241.98,74% of total billed charges,241.98,74% of total billed charges,104.64,32% of total billed charges,36.03,EAPG,104.64,32% of total billed charges,232.17,71% of total billed charges,232.17,71% of total billed charges,219.09,67% of total billed charges,219.09,67% of total billed charges,232.17,71% of total billed charges,248.52,76% of total billed charges,36.03,EAPG,107.78,32.96% of total billed charges,36.73,EAPG,294.3,90% of total billed charges,294.3,90% of total billed charges,34.98,EAPG,289.72,88.6% of total billed charges,36.03,EAPG,104.64,32% of total billed charges,261.6,80% of total billed charges,261.6,80% of total billed charges,34.98,EAPG,297.57,91% of total billed charges,106.73,32.64% of total billed charges,104.64,32% of total billed charges,109.87,33.6% of total billed charges,36.03,EAPG,104.64,32% of total billed charges,104.64,32% of total billed charges,300.84,92% of total billed charges,34.98,300.84,277.95
Outpatient Medical Services,Radiology,73502,EXT HIP 2-3V RT,320,298,241.98,81.2% of total billed charges,97.27,32.64% of total billed charges,220.52,74% of total billed charges,220.52,74% of total billed charges,95.36,32% of total billed charges,36.03,EAPG,95.36,32% of total billed charges,211.58,71% of total billed charges,211.58,71% of total billed charges,199.66,67% of total billed charges,199.66,67% of total billed charges,211.58,71% of total billed charges,226.48,76% of total billed charges,36.03,EAPG,98.22,32.96% of total billed charges,36.73,EAPG,268.2,90% of total billed charges,268.2,90% of total billed charges,34.98,EAPG,264.03,88.6% of total billed charges,36.03,EAPG,95.36,32% of total billed charges,238.4,80% of total billed charges,238.4,80% of total billed charges,34.98,EAPG,271.18,91% of total billed charges,97.27,32.64% of total billed charges,95.36,32% of total billed charges,100.13,33.6% of total billed charges,36.03,EAPG,95.36,32% of total billed charges,95.36,32% of total billed charges,274.16,92% of total billed charges,34.98,274.16,253.30
Outpatient Medical Services,Radiology,73562,EXT KNEE 3V RT,320,285,231.42,81.2% of total billed charges,93.02,32.64% of total billed charges,210.9,74% of total billed charges,210.9,74% of total billed charges,91.2,32% of total billed charges,36.03,EAPG,91.2,32% of total billed charges,202.35,71% of total billed charges,202.35,71% of total billed charges,190.95,67% of total billed charges,190.95,67% of total billed charges,202.35,71% of total billed charges,216.6,76% of total billed charges,36.03,EAPG,93.94,32.96% of total billed charges,36.73,EAPG,256.5,90% of total billed charges,256.5,90% of total billed charges,34.98,EAPG,252.51,88.6% of total billed charges,36.03,EAPG,91.2,32% of total billed charges,228,80% of total billed charges,228,80% of total billed charges,34.98,EAPG,259.35,91% of total billed charges,93.02,32.64% of total billed charges,91.2,32% of total billed charges,95.76,33.6% of total billed charges,36.03,EAPG,91.2,32% of total billed charges,91.2,32% of total billed charges,262.2,92% of total billed charges,34.98,262.2,242.25
Outpatient Medical Services,Radiology,73560,EXT KNEE 1-2V RT,320,324,263.09,81.2% of total billed charges,105.75,32.64% of total billed charges,239.76,74% of total billed charges,239.76,74% of total billed charges,103.68,32% of total billed charges,36.03,EAPG,103.68,32% of total billed charges,230.04,71% of total billed charges,230.04,71% of total billed charges,217.08,67% of total billed charges,217.08,67% of total billed charges,230.04,71% of total billed charges,246.24,76% of total billed charges,36.03,EAPG,106.79,32.96% of total billed charges,36.73,EAPG,291.6,90% of total billed charges,291.6,90% of total billed charges,34.98,EAPG,287.06,88.6% of total billed charges,36.03,EAPG,103.68,32% of total billed charges,259.2,80% of total billed charges,259.2,80% of total billed charges,34.98,EAPG,294.84,91% of total billed charges,105.75,32.64% of total billed charges,103.68,32% of total billed charges,108.86,33.6% of total billed charges,36.03,EAPG,103.68,32% of total billed charges,103.68,32% of total billed charges,298.08,92% of total billed charges,34.98,298.08,275.40
Outpatient Medical Services,Radiology,73030,EXT SHOULDER 3V RT,320,290,235.48,81.2% of total billed charges,94.66,32.64% of total billed charges,214.6,74% of total billed charges,214.6,74% of total billed charges,92.8,32% of total billed charges,36.03,EAPG,92.8,32% of total billed charges,205.9,71% of total billed charges,205.9,71% of total billed charges,194.3,67% of total billed charges,194.3,67% of total billed charges,205.9,71% of total billed charges,220.4,76% of total billed charges,36.03,EAPG,95.58,32.96% of total billed charges,36.73,EAPG,261,90% of total billed charges,261,90% of total billed charges,34.98,EAPG,256.94,88.6% of total billed charges,36.03,EAPG,92.8,32% of total billed charges,232,80% of total billed charges,232,80% of total billed charges,34.98,EAPG,263.9,91% of total billed charges,94.66,32.64% of total billed charges,92.8,32% of total billed charges,97.44,33.6% of total billed charges,36.03,EAPG,92.8,32% of total billed charges,92.8,32% of total billed charges,266.8,92% of total billed charges,34.98,266.8,246.50
Outpatient Medical Services,Radiology,73110,EXT WRIST MIN 3V RT,320,285,231.42,81.2% of total billed charges,93.02,32.64% of total billed charges,210.9,74% of total billed charges,210.9,74% of total billed charges,91.2,32% of total billed charges,36.03,EAPG,91.2,32% of total billed charges,202.35,71% of total billed charges,202.35,71% of total billed charges,190.95,67% of total billed charges,190.95,67% of total billed charges,202.35,71% of total billed charges,216.6,76% of total billed charges,36.03,EAPG,93.94,32.96% of total billed charges,36.73,EAPG,256.5,90% of total billed charges,256.5,90% of total billed charges,34.98,EAPG,252.51,88.6% of total billed charges,36.03,EAPG,91.2,32% of total billed charges,228,80% of total billed charges,228,80% of total billed charges,34.98,EAPG,259.35,91% of total billed charges,93.02,32.64% of total billed charges,91.2,32% of total billed charges,95.76,33.6% of total billed charges,36.03,EAPG,91.2,32% of total billed charges,91.2,32% of total billed charges,262.2,92% of total billed charges,34.98,262.2,242.25
Outpatient Medical Services,Radiology,72040,CERVICAL SPINE 2-3V,320,285,231.42,81.2% of total billed charges,93.02,32.64% of total billed charges,210.9,74% of total billed charges,210.9,74% of total billed charges,91.2,32% of total billed charges,36.03,EAPG,91.2,32% of total billed charges,202.35,71% of total billed charges,202.35,71% of total billed charges,190.95,67% of total billed charges,190.95,67% of total billed charges,202.35,71% of total billed charges,216.6,76% of total billed charges,36.03,EAPG,93.94,32.96% of total billed charges,36.73,EAPG,256.5,90% of total billed charges,256.5,90% of total billed charges,34.98,EAPG,252.51,88.6% of total billed charges,36.03,EAPG,91.2,32% of total billed charges,228,80% of total billed charges,228,80% of total billed charges,34.98,EAPG,259.35,91% of total billed charges,93.02,32.64% of total billed charges,91.2,32% of total billed charges,95.76,33.6% of total billed charges,36.03,EAPG,91.2,32% of total billed charges,91.2,32% of total billed charges,262.2,92% of total billed charges,34.98,262.2,242.25
Outpatient Medical Services,Radiology,73564,EXT KNEE 4V OR > RT,320,442,358.9,81.2% of total billed charges,144.27,32.64% of total billed charges,327.08,74% of total billed charges,327.08,74% of total billed charges,141.44,32% of total billed charges,36.03,EAPG,141.44,32% of total billed charges,313.82,71% of total billed charges,313.82,71% of total billed charges,296.14,67% of total billed charges,296.14,67% of total billed charges,313.82,71% of total billed charges,335.92,76% of total billed charges,36.03,EAPG,145.68,32.96% of total billed charges,36.73,EAPG,397.8,90% of total billed charges,397.8,90% of total billed charges,34.98,EAPG,391.61,88.6% of total billed charges,36.03,EAPG,141.44,32% of total billed charges,353.6,80% of total billed charges,353.6,80% of total billed charges,34.98,EAPG,402.22,91% of total billed charges,144.27,32.64% of total billed charges,141.44,32% of total billed charges,148.51,33.6% of total billed charges,36.03,EAPG,141.44,32% of total billed charges,141.44,32% of total billed charges,406.64,92% of total billed charges,34.98,406.64,375.70
Outpatient Medical Services,Radiology,73564,EXT KNEE 4V OR > LT,320,442,358.9,81.2% of total billed charges,144.27,32.64% of total billed charges,327.08,74% of total billed charges,327.08,74% of total billed charges,141.44,32% of total billed charges,36.03,EAPG,141.44,32% of total billed charges,313.82,71% of total billed charges,313.82,71% of total billed charges,296.14,67% of total billed charges,296.14,67% of total billed charges,313.82,71% of total billed charges,335.92,76% of total billed charges,36.03,EAPG,145.68,32.96% of total billed charges,36.73,EAPG,397.8,90% of total billed charges,397.8,90% of total billed charges,34.98,EAPG,391.61,88.6% of total billed charges,36.03,EAPG,141.44,32% of total billed charges,353.6,80% of total billed charges,353.6,80% of total billed charges,34.98,EAPG,402.22,91% of total billed charges,144.27,32.64% of total billed charges,141.44,32% of total billed charges,148.51,33.6% of total billed charges,36.03,EAPG,141.44,32% of total billed charges,141.44,32% of total billed charges,406.64,92% of total billed charges,34.98,406.64,375.70
Outpatient Medical Services,Radiology,73030,EXT SHOULDER 4V OR > RT,320,327,265.52,81.2% of total billed charges,106.73,32.64% of total billed charges,241.98,74% of total billed charges,241.98,74% of total billed charges,104.64,32% of total billed charges,36.03,EAPG,104.64,32% of total billed charges,232.17,71% of total billed charges,232.17,71% of total billed charges,219.09,67% of total billed charges,219.09,67% of total billed charges,232.17,71% of total billed charges,248.52,76% of total billed charges,36.03,EAPG,107.78,32.96% of total billed charges,36.73,EAPG,294.3,90% of total billed charges,294.3,90% of total billed charges,34.98,EAPG,289.72,88.6% of total billed charges,36.03,EAPG,104.64,32% of total billed charges,261.6,80% of total billed charges,261.6,80% of total billed charges,34.98,EAPG,297.57,91% of total billed charges,106.73,32.64% of total billed charges,104.64,32% of total billed charges,109.87,33.6% of total billed charges,36.03,EAPG,104.64,32% of total billed charges,104.64,32% of total billed charges,300.84,92% of total billed charges,34.98,300.84,277.95
Outpatient Medical Services,Radiology,77080,DEXA SPINE/HIPS,320,596,483.95,81.2% of total billed charges,194.53,32.64% of total billed charges,441.04,74% of total billed charges,441.04,74% of total billed charges,190.72,32% of total billed charges,46.28,EAPG,190.72,32% of total billed charges,423.16,71% of total billed charges,423.16,71% of total billed charges,399.32,67% of total billed charges,399.32,67% of total billed charges,423.16,71% of total billed charges,452.96,76% of total billed charges,46.28,EAPG,196.44,32.96% of total billed charges,47.18,EAPG,536.4,90% of total billed charges,536.4,90% of total billed charges,44.93,EAPG,528.06,88.6% of total billed charges,46.28,EAPG,190.72,32% of total billed charges,476.8,80% of total billed charges,476.8,80% of total billed charges,44.93,EAPG,542.36,91% of total billed charges,194.53,32.64% of total billed charges,190.72,32% of total billed charges,200.26,33.6% of total billed charges,46.28,EAPG,190.72,32% of total billed charges,190.72,32% of total billed charges,548.32,92% of total billed charges,44.93,548.32,506.60
Outpatient Medical Services,Radiology,74177,CT ABD/PEL W,350,3350,2720.2,81.2% of total billed charges,1093.44,32.64% of total billed charges,1027,Case rate,1027,Case rate,1072,32% of total billed charges,249.83,EAPG,1072,32% of total billed charges,976,Case rate,976,Case rate,925,Case rate,925,Case rate,976,Case rate,2546,Case rate,249.83,EAPG,1104.16,32.96% of total billed charges,254.68,EAPG,3015,90% of total billed charges,3015,90% of total billed charges,242.56,EAPG,2968.1,88.6% of total billed charges,249.83,EAPG,1072,32% of total billed charges,2680,80% of total billed charges,2680,80% of total billed charges,242.56,EAPG,3048.5,91% of total billed charges,1093.44,32.64% of total billed charges,1072,32% of total billed charges,1125.6,33.6% of total billed charges,249.83,EAPG,1072,32% of total billed charges,1072,32% of total billed charges,3082,92% of total billed charges,242.56,3082,2847.50
Outpatient Medical Services,Radiology,71045,CHEST PORTABLE 1V,324,227,184.32,81.2% of total billed charges,74.09,32.64% of total billed charges,167.98,74% of total billed charges,167.98,74% of total billed charges,72.64,32% of total billed charges,36.03,EAPG,72.64,32% of total billed charges,161.17,71% of total billed charges,161.17,71% of total billed charges,152.09,67% of total billed charges,152.09,67% of total billed charges,161.17,71% of total billed charges,172.52,76% of total billed charges,36.03,EAPG,74.82,32.96% of total billed charges,36.73,EAPG,204.3,90% of total billed charges,204.3,90% of total billed charges,34.98,EAPG,201.12,88.6% of total billed charges,36.03,EAPG,72.64,32% of total billed charges,181.6,80% of total billed charges,181.6,80% of total billed charges,34.98,EAPG,206.57,91% of total billed charges,74.09,32.64% of total billed charges,72.64,32% of total billed charges,76.27,33.6% of total billed charges,36.03,EAPG,72.64,32% of total billed charges,72.64,32% of total billed charges,208.84,92% of total billed charges,34.98,208.84,192.95
Outpatient Medical Services,Radiology,72050,CERVICAL SPINE 4 OR 5 VIEW,320,543,440.92,81.2% of total billed charges,177.24,32.64% of total billed charges,401.82,74% of total billed charges,401.82,74% of total billed charges,173.76,32% of total billed charges,36.03,EAPG,173.76,32% of total billed charges,385.53,71% of total billed charges,385.53,71% of total billed charges,363.81,67% of total billed charges,363.81,67% of total billed charges,385.53,71% of total billed charges,412.68,76% of total billed charges,36.03,EAPG,178.97,32.96% of total billed charges,36.73,EAPG,488.7,90% of total billed charges,488.7,90% of total billed charges,34.98,EAPG,481.1,88.6% of total billed charges,36.03,EAPG,173.76,32% of total billed charges,434.4,80% of total billed charges,434.4,80% of total billed charges,34.98,EAPG,494.13,91% of total billed charges,177.24,32.64% of total billed charges,173.76,32% of total billed charges,182.45,33.6% of total billed charges,36.03,EAPG,173.76,32% of total billed charges,173.76,32% of total billed charges,499.56,92% of total billed charges,34.98,499.56,461.55
Outpatient Medical Services,Radiology,70450,CT HEAD OR BRAIN WO,350,1410,1144.92,81.2% of total billed charges,460.22,32.64% of total billed charges,1027,Case rate,1027,Case rate,451.2,32% of total billed charges,249.83,EAPG,451.2,32% of total billed charges,976,Case rate,976,Case rate,925,Case rate,925,Case rate,976,Case rate,1071.6,Case rate,249.83,EAPG,464.74,32.96% of total billed charges,254.68,EAPG,1269,90% of total billed charges,1269,90% of total billed charges,242.56,EAPG,1249.26,88.6% of total billed charges,249.83,EAPG,451.2,32% of total billed charges,1128,80% of total billed charges,1128,80% of total billed charges,242.56,EAPG,1283.1,91% of total billed charges,460.22,32.64% of total billed charges,451.2,32% of total billed charges,473.76,33.6% of total billed charges,249.83,EAPG,451.2,32% of total billed charges,451.2,32% of total billed charges,1297.2,92% of total billed charges,242.56,1297.2,1198.50
Outpatient Medical Services,Radiology,72125,CT CERVICAL SPINE WO,350,1410,1144.92,81.2% of total billed charges,460.22,32.64% of total billed charges,1027,Case rate,1027,Case rate,451.2,32% of total billed charges,116.54,EAPG,451.2,32% of total billed charges,976,Case rate,976,Case rate,925,Case rate,925,Case rate,976,Case rate,1071.6,Case rate,116.54,EAPG,464.74,32.96% of total billed charges,118.8,EAPG,1269,90% of total billed charges,1269,90% of total billed charges,113.15,EAPG,1249.26,88.6% of total billed charges,116.54,EAPG,451.2,32% of total billed charges,1128,80% of total billed charges,1128,80% of total billed charges,113.15,EAPG,1283.1,91% of total billed charges,460.22,32.64% of total billed charges,451.2,32% of total billed charges,473.76,33.6% of total billed charges,116.54,EAPG,451.2,32% of total billed charges,451.2,32% of total billed charges,1297.2,92% of total billed charges,113.15,1297.2,1198.50
Outpatient Medical Services,Radiology,72128,CT THORACIC SPINE WO,350,1410,1144.92,81.2% of total billed charges,460.22,32.64% of total billed charges,1027,Case rate,1027,Case rate,451.2,32% of total billed charges,116.54,EAPG,451.2,32% of total billed charges,976,Case rate,976,Case rate,925,Case rate,925,Case rate,976,Case rate,1071.6,Case rate,116.54,EAPG,464.74,32.96% of total billed charges,118.8,EAPG,1269,90% of total billed charges,1269,90% of total billed charges,113.15,EAPG,1249.26,88.6% of total billed charges,116.54,EAPG,451.2,32% of total billed charges,1128,80% of total billed charges,1128,80% of total billed charges,113.15,EAPG,1283.1,91% of total billed charges,460.22,32.64% of total billed charges,451.2,32% of total billed charges,473.76,33.6% of total billed charges,116.54,EAPG,451.2,32% of total billed charges,451.2,32% of total billed charges,1297.2,92% of total billed charges,113.15,1297.2,1198.50
Outpatient Medical Services,Radiology,72131,CT LUMBAR SPINE WO,350,1517,1231.8,81.2% of total billed charges,495.15,32.64% of total billed charges,1027,Case rate,1027,Case rate,485.44,32% of total billed charges,116.54,EAPG,485.44,32% of total billed charges,976,Case rate,976,Case rate,925,Case rate,925,Case rate,976,Case rate,1152.92,Case rate,116.54,EAPG,500,32.96% of total billed charges,118.8,EAPG,1365.3,90% of total billed charges,1365.3,90% of total billed charges,113.15,EAPG,1344.06,88.6% of total billed charges,116.54,EAPG,485.44,32% of total billed charges,1213.6,80% of total billed charges,1213.6,80% of total billed charges,113.15,EAPG,1380.47,91% of total billed charges,495.15,32.64% of total billed charges,485.44,32% of total billed charges,509.71,33.6% of total billed charges,116.54,EAPG,485.44,32% of total billed charges,485.44,32% of total billed charges,1395.64,92% of total billed charges,113.15,1395.64,1289.45
Outpatient Medical Services,Radiology,71260,CT CHEST W,350,1517,1231.8,81.2% of total billed charges,495.15,32.64% of total billed charges,1027,Case rate,1027,Case rate,485.44,32% of total billed charges,249.83,EAPG,485.44,32% of total billed charges,976,Case rate,976,Case rate,925,Case rate,925,Case rate,976,Case rate,1152.92,Case rate,249.83,EAPG,500,32.96% of total billed charges,254.68,EAPG,1365.3,90% of total billed charges,1365.3,90% of total billed charges,242.56,EAPG,1344.06,88.6% of total billed charges,249.83,EAPG,485.44,32% of total billed charges,1213.6,80% of total billed charges,1213.6,80% of total billed charges,242.56,EAPG,1380.47,91% of total billed charges,495.15,32.64% of total billed charges,485.44,32% of total billed charges,509.71,33.6% of total billed charges,249.83,EAPG,485.44,32% of total billed charges,485.44,32% of total billed charges,1395.64,92% of total billed charges,242.56,1395.64,1289.45
Outpatient Medical Services,Radiology,71250,CT CHEST WO,350,1410,1144.92,81.2% of total billed charges,460.22,32.64% of total billed charges,1027,Case rate,1027,Case rate,451.2,32% of total billed charges,116.54,EAPG,451.2,32% of total billed charges,976,Case rate,976,Case rate,925,Case rate,925,Case rate,976,Case rate,1071.6,Case rate,116.54,EAPG,464.74,32.96% of total billed charges,118.8,EAPG,1269,90% of total billed charges,1269,90% of total billed charges,113.15,EAPG,1249.26,88.6% of total billed charges,116.54,EAPG,451.2,32% of total billed charges,1128,80% of total billed charges,1128,80% of total billed charges,113.15,EAPG,1283.1,91% of total billed charges,460.22,32.64% of total billed charges,451.2,32% of total billed charges,473.76,33.6% of total billed charges,116.54,EAPG,451.2,32% of total billed charges,451.2,32% of total billed charges,1297.2,92% of total billed charges,113.15,1297.2,1198.50
Outpatient Medical Services,Radiology,70496,CTA HEAD/BRAIN WWO,350,1852,1503.82,81.2% of total billed charges,604.49,32.64% of total billed charges,1027,Case rate,1027,Case rate,592.64,32% of total billed charges,287.72,EAPG,592.64,32% of total billed charges,976,Case rate,976,Case rate,925,Case rate,925,Case rate,976,Case rate,1407.52,Case rate,287.72,EAPG,610.42,32.96% of total billed charges,293.31,EAPG,1666.8,90% of total billed charges,1666.8,90% of total billed charges,279.34,EAPG,1640.87,88.6% of total billed charges,287.72,EAPG,592.64,32% of total billed charges,1481.6,80% of total billed charges,1481.6,80% of total billed charges,279.34,EAPG,1685.32,91% of total billed charges,604.49,32.64% of total billed charges,592.64,32% of total billed charges,622.27,33.6% of total billed charges,287.72,EAPG,592.64,32% of total billed charges,592.64,32% of total billed charges,1703.84,92% of total billed charges,279.34,1703.84,1574.20
Outpatient Medical Services,Radiology,70498,CTA CAROTIDS W,350,3442,2794.9,81.2% of total billed charges,1123.47,32.64% of total billed charges,1027,Case rate,1027,Case rate,1101.44,32% of total billed charges,287.72,EAPG,1101.44,32% of total billed charges,976,Case rate,976,Case rate,925,Case rate,925,Case rate,976,Case rate,2615.92,Case rate,287.72,EAPG,1134.48,32.96% of total billed charges,293.31,EAPG,3097.8,90% of total billed charges,3097.8,90% of total billed charges,279.34,EAPG,3049.61,88.6% of total billed charges,287.72,EAPG,1101.44,32% of total billed charges,2753.6,80% of total billed charges,2753.6,80% of total billed charges,279.34,EAPG,3132.22,91% of total billed charges,1123.47,32.64% of total billed charges,1101.44,32% of total billed charges,1156.51,33.6% of total billed charges,287.72,EAPG,1101.44,32% of total billed charges,1101.44,32% of total billed charges,3166.64,92% of total billed charges,279.34,3166.64,2925.70
Outpatient Medical Services,Radiology,71275,CTA CHEST PE W,350,1814,1472.97,81.2% of total billed charges,592.09,32.64% of total billed charges,1027,Case rate,1027,Case rate,580.48,32% of total billed charges,287.72,EAPG,580.48,32% of total billed charges,976,Case rate,976,Case rate,925,Case rate,925,Case rate,976,Case rate,1378.64,Case rate,287.72,EAPG,597.89,32.96% of total billed charges,293.31,EAPG,1632.6,90% of total billed charges,1632.6,90% of total billed charges,279.34,EAPG,1607.2,88.6% of total billed charges,287.72,EAPG,580.48,32% of total billed charges,1451.2,80% of total billed charges,1451.2,80% of total billed charges,279.34,EAPG,1650.74,91% of total billed charges,592.09,32.64% of total billed charges,580.48,32% of total billed charges,609.5,33.6% of total billed charges,287.72,EAPG,580.48,32% of total billed charges,580.48,32% of total billed charges,1668.88,92% of total billed charges,279.34,1668.88,1541.90
Outpatient Medical Services,Radiology,74176,CT ABD/PEL WO,352,2437,1978.84,81.2% of total billed charges,795.44,32.64% of total billed charges,1027,Case rate,1027,Case rate,779.84,32% of total billed charges,249.83,EAPG,779.84,32% of total billed charges,976,Case rate,976,Case rate,925,Case rate,925,Case rate,976,Case rate,1852.12,Case rate,249.83,EAPG,803.24,32.96% of total billed charges,254.68,EAPG,2193.3,90% of total billed charges,2193.3,90% of total billed charges,242.56,EAPG,2159.18,88.6% of total billed charges,249.83,EAPG,779.84,32% of total billed charges,1949.6,80% of total billed charges,1949.6,80% of total billed charges,242.56,EAPG,2217.67,91% of total billed charges,795.44,32.64% of total billed charges,779.84,32% of total billed charges,818.83,33.6% of total billed charges,249.83,EAPG,779.84,32% of total billed charges,779.84,32% of total billed charges,2242.04,92% of total billed charges,242.56,2242.04,2071.45
Outpatient Medical Services,Radiology,74174,CTA ABD/PEL W,350,2571,2087.65,81.2% of total billed charges,839.17,32.64% of total billed charges,1027,Case rate,1027,Case rate,822.72,32% of total billed charges,287.72,EAPG,822.72,32% of total billed charges,976,Case rate,976,Case rate,925,Case rate,925,Case rate,976,Case rate,1953.96,Case rate,287.72,EAPG,847.4,32.96% of total billed charges,293.31,EAPG,2313.9,90% of total billed charges,2313.9,90% of total billed charges,279.34,EAPG,2277.91,88.6% of total billed charges,287.72,EAPG,822.72,32% of total billed charges,2056.8,80% of total billed charges,2056.8,80% of total billed charges,279.34,EAPG,2339.61,91% of total billed charges,839.17,32.64% of total billed charges,822.72,32% of total billed charges,863.86,33.6% of total billed charges,287.72,EAPG,822.72,32% of total billed charges,822.72,32% of total billed charges,2365.32,92% of total billed charges,279.34,2365.32,2185.35
Outpatient Medical Services,Radiology,70486,CT FACIAL BONES WO,350,1814,1472.97,81.2% of total billed charges,592.09,32.64% of total billed charges,1027,Case rate,1027,Case rate,580.48,32% of total billed charges,116.54,EAPG,580.48,32% of total billed charges,976,Case rate,976,Case rate,925,Case rate,925,Case rate,976,Case rate,1378.64,Case rate,116.54,EAPG,597.89,32.96% of total billed charges,118.8,EAPG,1632.6,90% of total billed charges,1632.6,90% of total billed charges,113.15,EAPG,1607.2,88.6% of total billed charges,116.54,EAPG,580.48,32% of total billed charges,1451.2,80% of total billed charges,1451.2,80% of total billed charges,113.15,EAPG,1650.74,91% of total billed charges,592.09,32.64% of total billed charges,580.48,32% of total billed charges,609.5,33.6% of total billed charges,116.54,EAPG,580.48,32% of total billed charges,580.48,32% of total billed charges,1668.88,92% of total billed charges,113.15,1668.88,1541.90
Outpatient Medical Services,Radiology,77065,MAMMO DIG 2V LT,401,234,190.01,81.2% of total billed charges,76.38,32.64% of total billed charges,196,Case rate,196,Case rate,74.88,32% of total billed charges,32.89,EAPG,74.88,32% of total billed charges,186,Case rate,186,Case rate,177,Case rate,177,Case rate,186,Case rate,177.84,Case rate,32.89,EAPG,77.13,32.96% of total billed charges,33.53,EAPG,210.6,90% of total billed charges,210.6,90% of total billed charges,31.93,EAPG,207.32,88.6% of total billed charges,32.89,EAPG,74.88,32% of total billed charges,187.2,80% of total billed charges,187.2,80% of total billed charges,31.93,EAPG,212.94,91% of total billed charges,76.38,32.64% of total billed charges,74.88,32% of total billed charges,78.62,33.6% of total billed charges,32.89,EAPG,74.88,32% of total billed charges,74.88,32% of total billed charges,215.28,92% of total billed charges,31.93,215.28,198.90
Outpatient Medical Services,Radiology,77065,MAMMO DIG 2V RT,401,234,190.01,81.2% of total billed charges,76.38,32.64% of total billed charges,196,Case rate,196,Case rate,74.88,32% of total billed charges,32.89,EAPG,74.88,32% of total billed charges,186,Case rate,186,Case rate,177,Case rate,177,Case rate,186,Case rate,177.84,Case rate,32.89,EAPG,77.13,32.96% of total billed charges,33.53,EAPG,210.6,90% of total billed charges,210.6,90% of total billed charges,31.93,EAPG,207.32,88.6% of total billed charges,32.89,EAPG,74.88,32% of total billed charges,187.2,80% of total billed charges,187.2,80% of total billed charges,31.93,EAPG,212.94,91% of total billed charges,76.38,32.64% of total billed charges,74.88,32% of total billed charges,78.62,33.6% of total billed charges,32.89,EAPG,74.88,32% of total billed charges,74.88,32% of total billed charges,215.28,92% of total billed charges,31.93,215.28,198.90
Outpatient Medical Services,Radiology,77066,MAMMO DIG DIAG BILAT,401,387,314.24,81.2% of total billed charges,126.32,32.64% of total billed charges,196,Case rate,196,Case rate,123.84,32% of total billed charges,32.89,EAPG,123.84,32% of total billed charges,186,Case rate,186,Case rate,177,Case rate,177,Case rate,186,Case rate,294.12,Case rate,32.89,EAPG,127.56,32.96% of total billed charges,33.53,EAPG,348.3,90% of total billed charges,348.3,90% of total billed charges,31.93,EAPG,342.88,88.6% of total billed charges,32.89,EAPG,123.84,32% of total billed charges,309.6,80% of total billed charges,309.6,80% of total billed charges,31.93,EAPG,352.17,91% of total billed charges,126.32,32.64% of total billed charges,123.84,32% of total billed charges,130.03,33.6% of total billed charges,32.89,EAPG,123.84,32% of total billed charges,123.84,32% of total billed charges,356.04,92% of total billed charges,31.93,356.04,328.95
Outpatient Medical Services,Radiology,77067,MAMMO DIG SCREEN 4V,403,241,195.69,81.2% of total billed charges,78.66,32.64% of total billed charges,196,Case rate,196,Case rate,77.12,32% of total billed charges,32.89,EAPG,77.12,32% of total billed charges,186,Case rate,186,Case rate,177,Case rate,177,Case rate,186,Case rate,183.16,Case rate,32.89,EAPG,79.43,32.96% of total billed charges,33.53,EAPG,216.9,90% of total billed charges,216.9,90% of total billed charges,31.93,EAPG,213.53,88.6% of total billed charges,32.89,EAPG,77.12,32% of total billed charges,192.8,80% of total billed charges,192.8,80% of total billed charges,31.93,EAPG,219.31,91% of total billed charges,78.66,32.64% of total billed charges,77.12,32% of total billed charges,80.98,33.6% of total billed charges,32.89,EAPG,77.12,32% of total billed charges,77.12,32% of total billed charges,221.72,92% of total billed charges,31.93,221.72,204.85
Outpatient Medical Services,Radiology,77062,MAMMO TOMO DIAG BILAT,401,88,71.46,81.2% of total billed charges,28.72,32.64% of total billed charges,65.12,74% of total billed charges,65.12,74% of total billed charges,28.16,32% of total billed charges,32.89,EAPG,28.16,32% of total billed charges,62.48,71% of total billed charges,62.48,71% of total billed charges,58.96,67% of total billed charges,58.96,67% of total billed charges,62.48,71% of total billed charges,66.88,76% of total billed charges,32.89,EAPG,29,32.96% of total billed charges,33.53,EAPG,79.2,90% of total billed charges,79.2,90% of total billed charges,31.93,EAPG,77.97,88.6% of total billed charges,32.89,EAPG,28.16,32% of total billed charges,70.4,80% of total billed charges,70.4,80% of total billed charges,31.93,EAPG,80.08,91% of total billed charges,28.72,32.64% of total billed charges,28.16,32% of total billed charges,29.57,33.6% of total billed charges,32.89,EAPG,28.16,32% of total billed charges,28.16,32% of total billed charges,80.96,92% of total billed charges,28.16,80.96,74.80
Outpatient Medical Services,Radiology,77063,MAMMO TOMO SCREEN BILAT,403,88,71.46,81.2% of total billed charges,28.72,32.64% of total billed charges,65.12,74% of total billed charges,65.12,74% of total billed charges,28.16,32% of total billed charges,32.89,EAPG,28.16,32% of total billed charges,62.48,71% of total billed charges,62.48,71% of total billed charges,58.96,67% of total billed charges,58.96,67% of total billed charges,62.48,71% of total billed charges,66.88,76% of total billed charges,32.89,EAPG,29,32.96% of total billed charges,33.53,EAPG,79.2,90% of total billed charges,79.2,90% of total billed charges,31.93,EAPG,77.97,88.6% of total billed charges,32.89,EAPG,28.16,32% of total billed charges,70.4,80% of total billed charges,70.4,80% of total billed charges,31.93,EAPG,80.08,91% of total billed charges,28.72,32.64% of total billed charges,28.16,32% of total billed charges,29.57,33.6% of total billed charges,32.89,EAPG,28.16,32% of total billed charges,28.16,32% of total billed charges,80.96,92% of total billed charges,28.16,80.96,74.80
Outpatient Medical Services,Radiology,76830,US TRANSVAGINAL NON OB,402,667,541.6,81.2% of total billed charges,217.71,32.64% of total billed charges,493.58,74% of total billed charges,493.58,74% of total billed charges,213.44,32% of total billed charges,61.99,EAPG,213.44,32% of total billed charges,473.57,71% of total billed charges,473.57,71% of total billed charges,446.89,67% of total billed charges,446.89,67% of total billed charges,473.57,71% of total billed charges,506.92,76% of total billed charges,61.99,EAPG,219.84,32.96% of total billed charges,63.2,EAPG,600.3,90% of total billed charges,600.3,90% of total billed charges,60.19,EAPG,590.96,88.6% of total billed charges,61.99,EAPG,213.44,32% of total billed charges,533.6,80% of total billed charges,533.6,80% of total billed charges,60.19,EAPG,606.97,91% of total billed charges,217.71,32.64% of total billed charges,213.44,32% of total billed charges,224.11,33.6% of total billed charges,61.99,EAPG,213.44,32% of total billed charges,213.44,32% of total billed charges,613.64,92% of total billed charges,60.19,613.64,566.95
Outpatient Medical Services,Radiology,76705,US ABD LTD,402,541,439.29,81.2% of total billed charges,176.58,32.64% of total billed charges,400.34,74% of total billed charges,400.34,74% of total billed charges,173.12,32% of total billed charges,61.99,EAPG,173.12,32% of total billed charges,384.11,71% of total billed charges,384.11,71% of total billed charges,362.47,67% of total billed charges,362.47,67% of total billed charges,384.11,71% of total billed charges,411.16,76% of total billed charges,61.99,EAPG,178.31,32.96% of total billed charges,63.2,EAPG,486.9,90% of total billed charges,486.9,90% of total billed charges,60.19,EAPG,479.33,88.6% of total billed charges,61.99,EAPG,173.12,32% of total billed charges,432.8,80% of total billed charges,432.8,80% of total billed charges,60.19,EAPG,492.31,91% of total billed charges,176.58,32.64% of total billed charges,173.12,32% of total billed charges,181.78,33.6% of total billed charges,61.99,EAPG,173.12,32% of total billed charges,173.12,32% of total billed charges,497.72,92% of total billed charges,60.19,497.72,459.85
Outpatient Medical Services,Radiology,76700,US ABD COMP,402,784,636.61,81.2% of total billed charges,255.9,32.64% of total billed charges,580.16,74% of total billed charges,580.16,74% of total billed charges,250.88,32% of total billed charges,95.34,EAPG,250.88,32% of total billed charges,556.64,71% of total billed charges,556.64,71% of total billed charges,525.28,67% of total billed charges,525.28,67% of total billed charges,556.64,71% of total billed charges,595.84,76% of total billed charges,95.34,EAPG,258.41,32.96% of total billed charges,97.2,EAPG,705.6,90% of total billed charges,705.6,90% of total billed charges,92.57,EAPG,694.62,88.6% of total billed charges,95.34,EAPG,250.88,32% of total billed charges,627.2,80% of total billed charges,627.2,80% of total billed charges,92.57,EAPG,713.44,91% of total billed charges,255.9,32.64% of total billed charges,250.88,32% of total billed charges,263.42,33.6% of total billed charges,95.34,EAPG,250.88,32% of total billed charges,250.88,32% of total billed charges,721.28,92% of total billed charges,92.57,721.28,666.40
Outpatient Medical Services,Radiology,76770,US RENAL/BLADDER,402,557,452.28,81.2% of total billed charges,181.8,32.64% of total billed charges,412.18,74% of total billed charges,412.18,74% of total billed charges,178.24,32% of total billed charges,95.34,EAPG,178.24,32% of total billed charges,395.47,71% of total billed charges,395.47,71% of total billed charges,373.19,67% of total billed charges,373.19,67% of total billed charges,395.47,71% of total billed charges,423.32,76% of total billed charges,95.34,EAPG,183.59,32.96% of total billed charges,97.2,EAPG,501.3,90% of total billed charges,501.3,90% of total billed charges,92.57,EAPG,493.5,88.6% of total billed charges,95.34,EAPG,178.24,32% of total billed charges,445.6,80% of total billed charges,445.6,80% of total billed charges,92.57,EAPG,506.87,91% of total billed charges,181.8,32.64% of total billed charges,178.24,32% of total billed charges,187.15,33.6% of total billed charges,95.34,EAPG,178.24,32% of total billed charges,178.24,32% of total billed charges,512.44,92% of total billed charges,92.57,512.44,473.45
Outpatient Medical Services,Radiology,76856,US PELVIS,402,674,547.29,81.2% of total billed charges,219.99,32.64% of total billed charges,498.76,74% of total billed charges,498.76,74% of total billed charges,215.68,32% of total billed charges,95.34,EAPG,215.68,32% of total billed charges,478.54,71% of total billed charges,478.54,71% of total billed charges,451.58,67% of total billed charges,451.58,67% of total billed charges,478.54,71% of total billed charges,512.24,76% of total billed charges,95.34,EAPG,222.15,32.96% of total billed charges,97.2,EAPG,606.6,90% of total billed charges,606.6,90% of total billed charges,92.57,EAPG,597.16,88.6% of total billed charges,95.34,EAPG,215.68,32% of total billed charges,539.2,80% of total billed charges,539.2,80% of total billed charges,92.57,EAPG,613.34,91% of total billed charges,219.99,32.64% of total billed charges,215.68,32% of total billed charges,226.46,33.6% of total billed charges,95.34,EAPG,215.68,32% of total billed charges,215.68,32% of total billed charges,620.08,92% of total billed charges,92.57,620.08,572.90
Outpatient Medical Services,Radiology,76536,US THYROID,402,667,541.6,81.2% of total billed charges,217.71,32.64% of total billed charges,493.58,74% of total billed charges,493.58,74% of total billed charges,213.44,32% of total billed charges,61.99,EAPG,213.44,32% of total billed charges,473.57,71% of total billed charges,473.57,71% of total billed charges,446.89,67% of total billed charges,446.89,67% of total billed charges,473.57,71% of total billed charges,506.92,76% of total billed charges,61.99,EAPG,219.84,32.96% of total billed charges,63.2,EAPG,600.3,90% of total billed charges,600.3,90% of total billed charges,60.19,EAPG,590.96,88.6% of total billed charges,61.99,EAPG,213.44,32% of total billed charges,533.6,80% of total billed charges,533.6,80% of total billed charges,60.19,EAPG,606.97,91% of total billed charges,217.71,32.64% of total billed charges,213.44,32% of total billed charges,224.11,33.6% of total billed charges,61.99,EAPG,213.44,32% of total billed charges,213.44,32% of total billed charges,613.64,92% of total billed charges,60.19,613.64,566.95
Outpatient Medical Services,Radiology,76642,US BREAST LTD LT,402,235,190.82,81.2% of total billed charges,76.7,32.64% of total billed charges,173.9,74% of total billed charges,173.9,74% of total billed charges,75.2,32% of total billed charges,61.99,EAPG,75.2,32% of total billed charges,166.85,71% of total billed charges,166.85,71% of total billed charges,157.45,67% of total billed charges,157.45,67% of total billed charges,166.85,71% of total billed charges,178.6,76% of total billed charges,61.99,EAPG,77.46,32.96% of total billed charges,63.2,EAPG,211.5,90% of total billed charges,211.5,90% of total billed charges,60.19,EAPG,208.21,88.6% of total billed charges,61.99,EAPG,75.2,32% of total billed charges,188,80% of total billed charges,188,80% of total billed charges,60.19,EAPG,213.85,91% of total billed charges,76.7,32.64% of total billed charges,75.2,32% of total billed charges,78.96,33.6% of total billed charges,61.99,EAPG,75.2,32% of total billed charges,75.2,32% of total billed charges,216.2,92% of total billed charges,60.19,216.2,199.75
Outpatient Medical Services,Radiology,76642,US BREAST LTD RT,402,235,190.82,81.2% of total billed charges,76.7,32.64% of total billed charges,173.9,74% of total billed charges,173.9,74% of total billed charges,75.2,32% of total billed charges,61.99,EAPG,75.2,32% of total billed charges,166.85,71% of total billed charges,166.85,71% of total billed charges,157.45,67% of total billed charges,157.45,67% of total billed charges,166.85,71% of total billed charges,178.6,76% of total billed charges,61.99,EAPG,77.46,32.96% of total billed charges,63.2,EAPG,211.5,90% of total billed charges,211.5,90% of total billed charges,60.19,EAPG,208.21,88.6% of total billed charges,61.99,EAPG,75.2,32% of total billed charges,188,80% of total billed charges,188,80% of total billed charges,60.19,EAPG,213.85,91% of total billed charges,76.7,32.64% of total billed charges,75.2,32% of total billed charges,78.96,33.6% of total billed charges,61.99,EAPG,75.2,32% of total billed charges,75.2,32% of total billed charges,216.2,92% of total billed charges,60.19,216.2,199.75
Outpatient Medical Services,Radiology,76775,US RENAL LTD KIDNEYS ONLY,402,541,439.29,81.2% of total billed charges,176.58,32.64% of total billed charges,400.34,74% of total billed charges,400.34,74% of total billed charges,173.12,32% of total billed charges,61.99,EAPG,173.12,32% of total billed charges,384.11,71% of total billed charges,384.11,71% of total billed charges,362.47,67% of total billed charges,362.47,67% of total billed charges,384.11,71% of total billed charges,411.16,76% of total billed charges,61.99,EAPG,178.31,32.96% of total billed charges,63.2,EAPG,486.9,90% of total billed charges,486.9,90% of total billed charges,60.19,EAPG,479.33,88.6% of total billed charges,61.99,EAPG,173.12,32% of total billed charges,432.8,80% of total billed charges,432.8,80% of total billed charges,60.19,EAPG,492.31,91% of total billed charges,176.58,32.64% of total billed charges,173.12,32% of total billed charges,181.78,33.6% of total billed charges,61.99,EAPG,173.12,32% of total billed charges,173.12,32% of total billed charges,497.72,92% of total billed charges,60.19,497.72,459.85
Outpatient Medical Services,Radiology,70551,MRI BRAIN (W/STEM) W/O,611,2744,2228.13,81.2% of total billed charges,895.64,32.64% of total billed charges,1817,Case rate,1817,Case rate,878.08,32% of total billed charges,162.1,EAPG,878.08,32% of total billed charges,1726,Case rate,1726,Case rate,1635,Case rate,1635,Case rate,1726,Case rate,2085.44,Case rate,162.1,EAPG,904.42,32.96% of total billed charges,165.25,EAPG,2469.6,90% of total billed charges,2469.6,90% of total billed charges,157.38,EAPG,2431.18,88.6% of total billed charges,162.1,EAPG,878.08,32% of total billed charges,2195.2,80% of total billed charges,2195.2,80% of total billed charges,157.38,EAPG,2497.04,91% of total billed charges,895.64,32.64% of total billed charges,878.08,32% of total billed charges,921.98,33.6% of total billed charges,162.1,EAPG,878.08,32% of total billed charges,878.08,32% of total billed charges,2524.48,92% of total billed charges,157.38,2524.48,2332.40
Outpatient Medical Services,Radiology,72148,MRI LUMBAR W/O,612,2744,2228.13,81.2% of total billed charges,895.64,32.64% of total billed charges,1817,Case rate,1817,Case rate,878.08,32% of total billed charges,162.1,EAPG,878.08,32% of total billed charges,1726,Case rate,1726,Case rate,1635,Case rate,1635,Case rate,1726,Case rate,2085.44,Case rate,162.1,EAPG,904.42,32.96% of total billed charges,165.25,EAPG,2469.6,90% of total billed charges,2469.6,90% of total billed charges,157.38,EAPG,2431.18,88.6% of total billed charges,162.1,EAPG,878.08,32% of total billed charges,2195.2,80% of total billed charges,2195.2,80% of total billed charges,157.38,EAPG,2497.04,91% of total billed charges,895.64,32.64% of total billed charges,878.08,32% of total billed charges,921.98,33.6% of total billed charges,162.1,EAPG,878.08,32% of total billed charges,878.08,32% of total billed charges,2524.48,92% of total billed charges,157.38,2524.48,2332.40
Outpatient Medical Services,Radiology,70553,MRI BRAIN (W/STEM) W/WO,611,3112,2526.94,81.2% of total billed charges,1015.76,32.64% of total billed charges,1817,Case rate,1817,Case rate,995.84,32% of total billed charges,244.97,EAPG,995.84,32% of total billed charges,1726,Case rate,1726,Case rate,1635,Case rate,1635,Case rate,1726,Case rate,2365.12,Case rate,244.97,EAPG,1025.72,32.96% of total billed charges,249.73,EAPG,2800.8,90% of total billed charges,2800.8,90% of total billed charges,237.83,EAPG,2757.23,88.6% of total billed charges,244.97,EAPG,995.84,32% of total billed charges,2489.6,80% of total billed charges,2489.6,80% of total billed charges,237.83,EAPG,2831.92,91% of total billed charges,1015.76,32.64% of total billed charges,995.84,32% of total billed charges,1045.63,33.6% of total billed charges,244.97,EAPG,995.84,32% of total billed charges,995.84,32% of total billed charges,2863.04,92% of total billed charges,237.83,2863.04,2645.20
Outpatient Medical Services,Radiology,78452,NM MYOCARD PERF SPECT MULT.STU,340,3515,2854.18,81.2% of total billed charges,1147.3,32.64% of total billed charges,2601.1,74% of total billed charges,2601.1,74% of total billed charges,1124.8,32% of total billed charges,563.89,EAPG,1124.8,32% of total billed charges,2495.65,71% of total billed charges,2495.65,71% of total billed charges,2355.05,67% of total billed charges,2355.05,67% of total billed charges,2495.65,71% of total billed charges,2671.4,76% of total billed charges,563.89,EAPG,1158.54,32.96% of total billed charges,574.84,EAPG,3163.5,90% of total billed charges,3163.5,90% of total billed charges,547.47,EAPG,3114.29,88.6% of total billed charges,563.89,EAPG,1124.8,32% of total billed charges,2812,80% of total billed charges,2812,80% of total billed charges,547.47,EAPG,3198.65,91% of total billed charges,1147.3,32.64% of total billed charges,1124.8,32% of total billed charges,1181.04,33.6% of total billed charges,563.89,EAPG,1124.8,32% of total billed charges,1124.8,32% of total billed charges,3233.8,92% of total billed charges,547.47,3233.8,2987.75
Outpatient Medical Services,Rehabilitation,97035,PT US EA 15 MIN,420,173,140.48,81.2% of total billed charges,56.47,32.64% of total billed charges,128.02,74% of total billed charges,128.02,74% of total billed charges,55.36,32% of total billed charges,19.73,EAPG,55.36,32% of total billed charges,122.83,71% of total billed charges,122.83,71% of total billed charges,115.91,67% of total billed charges,115.91,67% of total billed charges,122.83,71% of total billed charges,131.48,76% of total billed charges,19.73,EAPG,57.02,32.96% of total billed charges,20.11,EAPG,155.7,90% of total billed charges,155.7,90% of total billed charges,19.16,EAPG,153.28,88.6% of total billed charges,19.73,EAPG,55.36,32% of total billed charges,138.4,80% of total billed charges,138.4,80% of total billed charges,19.16,EAPG,157.43,91% of total billed charges,56.47,32.64% of total billed charges,55.36,32% of total billed charges,58.13,33.6% of total billed charges,19.73,EAPG,55.36,32% of total billed charges,55.36,32% of total billed charges,159.16,92% of total billed charges,19.16,159.16,147.05
Outpatient Medical Services,Rehabilitation,97012,PT TRACTION MECH,420,185,150.22,81.2% of total billed charges,60.38,32.64% of total billed charges,136.9,74% of total billed charges,136.9,74% of total billed charges,59.2,32% of total billed charges,19.73,EAPG,59.2,32% of total billed charges,131.35,71% of total billed charges,131.35,71% of total billed charges,123.95,67% of total billed charges,123.95,67% of total billed charges,131.35,71% of total billed charges,140.6,76% of total billed charges,19.73,EAPG,60.98,32.96% of total billed charges,20.11,EAPG,166.5,90% of total billed charges,166.5,90% of total billed charges,19.16,EAPG,163.91,88.6% of total billed charges,19.73,EAPG,59.2,32% of total billed charges,148,80% of total billed charges,148,80% of total billed charges,19.16,EAPG,168.35,91% of total billed charges,60.38,32.64% of total billed charges,59.2,32% of total billed charges,62.16,33.6% of total billed charges,19.73,EAPG,59.2,32% of total billed charges,59.2,32% of total billed charges,170.2,92% of total billed charges,19.16,170.2,157.25
Outpatient Medical Services,Rehabilitation,97014,PT ELEC STIM (SUPV),420,142,115.3,81.2% of total billed charges,46.35,32.64% of total billed charges,105.08,74% of total billed charges,105.08,74% of total billed charges,45.44,32% of total billed charges,19.73,EAPG,45.44,32% of total billed charges,100.82,71% of total billed charges,100.82,71% of total billed charges,95.14,67% of total billed charges,95.14,67% of total billed charges,100.82,71% of total billed charges,107.92,76% of total billed charges,19.73,EAPG,46.8,32.96% of total billed charges,20.11,EAPG,127.8,90% of total billed charges,127.8,90% of total billed charges,19.16,EAPG,125.81,88.6% of total billed charges,19.73,EAPG,45.44,32% of total billed charges,113.6,80% of total billed charges,113.6,80% of total billed charges,19.16,EAPG,129.22,91% of total billed charges,46.35,32.64% of total billed charges,45.44,32% of total billed charges,47.71,33.6% of total billed charges,19.73,EAPG,45.44,32% of total billed charges,45.44,32% of total billed charges,130.64,92% of total billed charges,19.16,130.64,120.70
Outpatient Medical Services,Rehabilitation,97016,PT VASOPNEUMATIC DEVICE,420,77,62.52,81.2% of total billed charges,25.13,32.64% of total billed charges,56.98,74% of total billed charges,56.98,74% of total billed charges,24.64,32% of total billed charges,19.73,EAPG,24.64,32% of total billed charges,54.67,71% of total billed charges,54.67,71% of total billed charges,51.59,67% of total billed charges,51.59,67% of total billed charges,54.67,71% of total billed charges,58.52,76% of total billed charges,19.73,EAPG,25.38,32.96% of total billed charges,20.11,EAPG,69.3,90% of total billed charges,69.3,90% of total billed charges,19.16,EAPG,68.22,88.6% of total billed charges,19.73,EAPG,24.64,32% of total billed charges,61.6,80% of total billed charges,61.6,80% of total billed charges,19.16,EAPG,70.07,91% of total billed charges,25.13,32.64% of total billed charges,24.64,32% of total billed charges,25.87,33.6% of total billed charges,19.73,EAPG,24.64,32% of total billed charges,24.64,32% of total billed charges,70.84,92% of total billed charges,19.16,70.84,65.45
Outpatient Medical Services,Rehabilitation,97140,PT MAN TECH W/MASS/15M,420,145,117.74,81.2% of total billed charges,47.33,32.64% of total billed charges,107.3,74% of total billed charges,107.3,74% of total billed charges,46.4,32% of total billed charges,53.98,EAPG,46.4,32% of total billed charges,102.95,71% of total billed charges,102.95,71% of total billed charges,97.15,67% of total billed charges,97.15,67% of total billed charges,102.95,71% of total billed charges,110.2,76% of total billed charges,53.98,EAPG,47.79,32.96% of total billed charges,55.03,EAPG,130.5,90% of total billed charges,130.5,90% of total billed charges,52.41,EAPG,128.47,88.6% of total billed charges,53.98,EAPG,46.4,32% of total billed charges,116,80% of total billed charges,116,80% of total billed charges,52.41,EAPG,131.95,91% of total billed charges,47.33,32.64% of total billed charges,46.4,32% of total billed charges,48.72,33.6% of total billed charges,53.98,EAPG,46.4,32% of total billed charges,46.4,32% of total billed charges,133.4,92% of total billed charges,46.4,133.4,123.25
Outpatient Medical Services,Rehabilitation,97116,PT GT TRNG EA 15 MIN,420,105,85.26,81.2% of total billed charges,34.27,32.64% of total billed charges,77.7,74% of total billed charges,77.7,74% of total billed charges,33.6,32% of total billed charges,19.73,EAPG,33.6,32% of total billed charges,74.55,71% of total billed charges,74.55,71% of total billed charges,70.35,67% of total billed charges,70.35,67% of total billed charges,74.55,71% of total billed charges,79.8,76% of total billed charges,19.73,EAPG,34.61,32.96% of total billed charges,20.11,EAPG,94.5,90% of total billed charges,94.5,90% of total billed charges,19.16,EAPG,93.03,88.6% of total billed charges,19.73,EAPG,33.6,32% of total billed charges,84,80% of total billed charges,84,80% of total billed charges,19.16,EAPG,95.55,91% of total billed charges,34.27,32.64% of total billed charges,33.6,32% of total billed charges,35.28,33.6% of total billed charges,19.73,EAPG,33.6,32% of total billed charges,33.6,32% of total billed charges,96.6,92% of total billed charges,19.16,96.6,89.25
Outpatient Medical Services,Rehabilitation,97110,PT EX (THERA) EA 15 MIN,420,144,116.93,81.2% of total billed charges,47,32.64% of total billed charges,106.56,74% of total billed charges,106.56,74% of total billed charges,46.08,32% of total billed charges,53.98,EAPG,46.08,32% of total billed charges,102.24,71% of total billed charges,102.24,71% of total billed charges,96.48,67% of total billed charges,96.48,67% of total billed charges,102.24,71% of total billed charges,109.44,76% of total billed charges,53.98,EAPG,47.46,32.96% of total billed charges,55.03,EAPG,129.6,90% of total billed charges,129.6,90% of total billed charges,52.41,EAPG,127.58,88.6% of total billed charges,53.98,EAPG,46.08,32% of total billed charges,115.2,80% of total billed charges,115.2,80% of total billed charges,52.41,EAPG,131.04,91% of total billed charges,47,32.64% of total billed charges,46.08,32% of total billed charges,48.38,33.6% of total billed charges,53.98,EAPG,46.08,32% of total billed charges,46.08,32% of total billed charges,132.48,92% of total billed charges,46.08,132.48,122.40
Outpatient Medical Services,Rehabilitation,97112,PT NEUROMUSC RE-ED/15M,420,135,109.62,81.2% of total billed charges,44.06,32.64% of total billed charges,99.9,74% of total billed charges,99.9,74% of total billed charges,43.2,32% of total billed charges,53.98,EAPG,43.2,32% of total billed charges,95.85,71% of total billed charges,95.85,71% of total billed charges,90.45,67% of total billed charges,90.45,67% of total billed charges,95.85,71% of total billed charges,102.6,76% of total billed charges,53.98,EAPG,44.5,32.96% of total billed charges,55.03,EAPG,121.5,90% of total billed charges,121.5,90% of total billed charges,52.41,EAPG,119.61,88.6% of total billed charges,53.98,EAPG,43.2,32% of total billed charges,108,80% of total billed charges,108,80% of total billed charges,52.41,EAPG,122.85,91% of total billed charges,44.06,32.64% of total billed charges,43.2,32% of total billed charges,45.36,33.6% of total billed charges,53.98,EAPG,43.2,32% of total billed charges,43.2,32% of total billed charges,124.2,92% of total billed charges,43.2,124.2,114.75
Outpatient Medical Services,Rehabilitation,97530,PT THERAPEUTIC ACT/15M,420,185,150.22,81.2% of total billed charges,60.38,32.64% of total billed charges,136.9,74% of total billed charges,136.9,74% of total billed charges,59.2,32% of total billed charges,53.98,EAPG,59.2,32% of total billed charges,131.35,71% of total billed charges,131.35,71% of total billed charges,123.95,67% of total billed charges,123.95,67% of total billed charges,131.35,71% of total billed charges,140.6,76% of total billed charges,53.98,EAPG,60.98,32.96% of total billed charges,55.03,EAPG,166.5,90% of total billed charges,166.5,90% of total billed charges,52.41,EAPG,163.91,88.6% of total billed charges,53.98,EAPG,59.2,32% of total billed charges,148,80% of total billed charges,148,80% of total billed charges,52.41,EAPG,168.35,91% of total billed charges,60.38,32.64% of total billed charges,59.2,32% of total billed charges,62.16,33.6% of total billed charges,53.98,EAPG,59.2,32% of total billed charges,59.2,32% of total billed charges,170.2,92% of total billed charges,52.41,170.2,157.25
Outpatient Medical Services,Rehabilitation,97161,PT EVAL PT-LOW COMPLEXITY,424,296,240.35,81.2% of total billed charges,96.61,32.64% of total billed charges,219.04,74% of total billed charges,219.04,74% of total billed charges,94.72,32% of total billed charges,59.13,EAPG,94.72,32% of total billed charges,210.16,71% of total billed charges,210.16,71% of total billed charges,198.32,67% of total billed charges,198.32,67% of total billed charges,210.16,71% of total billed charges,224.96,76% of total billed charges,59.13,EAPG,97.56,32.96% of total billed charges,60.27,EAPG,266.4,90% of total billed charges,266.4,90% of total billed charges,57.4,EAPG,262.26,88.6% of total billed charges,59.13,EAPG,94.72,32% of total billed charges,236.8,80% of total billed charges,236.8,80% of total billed charges,57.4,EAPG,269.36,91% of total billed charges,96.61,32.64% of total billed charges,94.72,32% of total billed charges,99.46,33.6% of total billed charges,59.13,EAPG,94.72,32% of total billed charges,94.72,32% of total billed charges,272.32,92% of total billed charges,57.4,272.32,251.60
Outpatient Medical Services,Rehabilitation,97162,PT EVAL PT-MODERATE COMPLEXITY,424,303,246.04,81.2% of total billed charges,98.9,32.64% of total billed charges,224.22,74% of total billed charges,224.22,74% of total billed charges,96.96,32% of total billed charges,59.13,EAPG,96.96,32% of total billed charges,215.13,71% of total billed charges,215.13,71% of total billed charges,203.01,67% of total billed charges,203.01,67% of total billed charges,215.13,71% of total billed charges,230.28,76% of total billed charges,59.13,EAPG,99.87,32.96% of total billed charges,60.27,EAPG,272.7,90% of total billed charges,272.7,90% of total billed charges,57.4,EAPG,268.46,88.6% of total billed charges,59.13,EAPG,96.96,32% of total billed charges,242.4,80% of total billed charges,242.4,80% of total billed charges,57.4,EAPG,275.73,91% of total billed charges,98.9,32.64% of total billed charges,96.96,32% of total billed charges,101.81,33.6% of total billed charges,59.13,EAPG,96.96,32% of total billed charges,96.96,32% of total billed charges,278.76,92% of total billed charges,57.4,278.76,257.55
Outpatient Medical Services,Rehabilitation,92507,ST SPCH THER,441,167,135.6,81.2% of total billed charges,54.51,32.64% of total billed charges,123.58,74% of total billed charges,123.58,74% of total billed charges,53.44,32% of total billed charges,44.88,EAPG,53.44,32% of total billed charges,118.57,71% of total billed charges,118.57,71% of total billed charges,111.89,67% of total billed charges,111.89,67% of total billed charges,118.57,71% of total billed charges,126.92,76% of total billed charges,44.88,EAPG,55.04,32.96% of total billed charges,45.75,EAPG,150.3,90% of total billed charges,150.3,90% of total billed charges,43.57,EAPG,147.96,88.6% of total billed charges,44.88,EAPG,53.44,32% of total billed charges,133.6,80% of total billed charges,133.6,80% of total billed charges,43.57,EAPG,151.97,91% of total billed charges,54.51,32.64% of total billed charges,53.44,32% of total billed charges,56.11,33.6% of total billed charges,44.88,EAPG,53.44,32% of total billed charges,53.44,32% of total billed charges,153.64,92% of total billed charges,43.57,153.64,141.95
Outpatient Medical Services,Rehabilitation,97129,ST COGN RETRG INITIAL 15 MIN,441,72,58.46,81.2% of total billed charges,23.5,32.64% of total billed charges,53.28,74% of total billed charges,53.28,74% of total billed charges,23.04,32% of total billed charges,53.98,EAPG,23.04,32% of total billed charges,51.12,71% of total billed charges,51.12,71% of total billed charges,48.24,67% of total billed charges,48.24,67% of total billed charges,51.12,71% of total billed charges,54.72,76% of total billed charges,53.98,EAPG,23.73,32.96% of total billed charges,55.03,EAPG,64.8,90% of total billed charges,64.8,90% of total billed charges,52.41,EAPG,63.79,88.6% of total billed charges,53.98,EAPG,23.04,32% of total billed charges,57.6,80% of total billed charges,57.6,80% of total billed charges,52.41,EAPG,65.52,91% of total billed charges,23.5,32.64% of total billed charges,23.04,32% of total billed charges,24.19,33.6% of total billed charges,53.98,EAPG,23.04,32% of total billed charges,23.04,32% of total billed charges,66.24,92% of total billed charges,23.04,66.24,61.20
Outpatient Medical Services,Rehabilitation,92526,ST SWALL THER,441,167,135.6,81.2% of total billed charges,54.51,32.64% of total billed charges,123.58,74% of total billed charges,123.58,74% of total billed charges,53.44,32% of total billed charges,53.98,EAPG,53.44,32% of total billed charges,118.57,71% of total billed charges,118.57,71% of total billed charges,111.89,67% of total billed charges,111.89,67% of total billed charges,118.57,71% of total billed charges,126.92,76% of total billed charges,53.98,EAPG,55.04,32.96% of total billed charges,55.03,EAPG,150.3,90% of total billed charges,150.3,90% of total billed charges,52.41,EAPG,147.96,88.6% of total billed charges,53.98,EAPG,53.44,32% of total billed charges,133.6,80% of total billed charges,133.6,80% of total billed charges,52.41,EAPG,151.97,91% of total billed charges,54.51,32.64% of total billed charges,53.44,32% of total billed charges,56.11,33.6% of total billed charges,53.98,EAPG,53.44,32% of total billed charges,53.44,32% of total billed charges,153.64,92% of total billed charges,52.41,153.64,141.95
Outpatient Medical Services,Rehabilitation,97130,ST COGN RETRG ADDTL15 MIN,441,72,58.46,81.2% of total billed charges,23.5,32.64% of total billed charges,53.28,74% of total billed charges,53.28,74% of total billed charges,23.04,32% of total billed charges,53.98,EAPG,23.04,32% of total billed charges,51.12,71% of total billed charges,51.12,71% of total billed charges,48.24,67% of total billed charges,48.24,67% of total billed charges,51.12,71% of total billed charges,54.72,76% of total billed charges,53.98,EAPG,23.73,32.96% of total billed charges,55.03,EAPG,64.8,90% of total billed charges,64.8,90% of total billed charges,52.41,EAPG,63.79,88.6% of total billed charges,53.98,EAPG,23.04,32% of total billed charges,57.6,80% of total billed charges,57.6,80% of total billed charges,52.41,EAPG,65.52,91% of total billed charges,23.5,32.64% of total billed charges,23.04,32% of total billed charges,24.19,33.6% of total billed charges,53.98,EAPG,23.04,32% of total billed charges,23.04,32% of total billed charges,66.24,92% of total billed charges,23.04,66.24,61.20
Outpatient Medical Services,Rehabilitation,97535,OT ADL TRAINING EA 15 MIN,430,104,84.45,81.2% of total billed charges,33.95,32.64% of total billed charges,76.96,74% of total billed charges,76.96,74% of total billed charges,33.28,32% of total billed charges,19.73,EAPG,33.28,32% of total billed charges,73.84,71% of total billed charges,73.84,71% of total billed charges,69.68,67% of total billed charges,69.68,67% of total billed charges,73.84,71% of total billed charges,79.04,76% of total billed charges,19.73,EAPG,34.28,32.96% of total billed charges,20.11,EAPG,93.6,90% of total billed charges,93.6,90% of total billed charges,19.16,EAPG,92.14,88.6% of total billed charges,19.73,EAPG,33.28,32% of total billed charges,83.2,80% of total billed charges,83.2,80% of total billed charges,19.16,EAPG,94.64,91% of total billed charges,33.95,32.64% of total billed charges,33.28,32% of total billed charges,34.94,33.6% of total billed charges,19.73,EAPG,33.28,32% of total billed charges,33.28,32% of total billed charges,95.68,92% of total billed charges,19.16,95.68,88.40
Outpatient Medical Services,Rehabilitation,97110,OT EX (THERA) EA 15 MIN,430,133,108,81.2% of total billed charges,43.41,32.64% of total billed charges,98.42,74% of total billed charges,98.42,74% of total billed charges,42.56,32% of total billed charges,53.98,EAPG,42.56,32% of total billed charges,94.43,71% of total billed charges,94.43,71% of total billed charges,89.11,67% of total billed charges,89.11,67% of total billed charges,94.43,71% of total billed charges,101.08,76% of total billed charges,53.98,EAPG,43.84,32.96% of total billed charges,55.03,EAPG,119.7,90% of total billed charges,119.7,90% of total billed charges,52.41,EAPG,117.84,88.6% of total billed charges,53.98,EAPG,42.56,32% of total billed charges,106.4,80% of total billed charges,106.4,80% of total billed charges,52.41,EAPG,121.03,91% of total billed charges,43.41,32.64% of total billed charges,42.56,32% of total billed charges,44.69,33.6% of total billed charges,53.98,EAPG,42.56,32% of total billed charges,42.56,32% of total billed charges,122.36,92% of total billed charges,42.56,122.36,113.05
Outpatient Medical Services,Rehabilitation,97140,OT MYOFACL REL/15M,430,135,109.62,81.2% of total billed charges,44.06,32.64% of total billed charges,99.9,74% of total billed charges,99.9,74% of total billed charges,43.2,32% of total billed charges,53.98,EAPG,43.2,32% of total billed charges,95.85,71% of total billed charges,95.85,71% of total billed charges,90.45,67% of total billed charges,90.45,67% of total billed charges,95.85,71% of total billed charges,102.6,76% of total billed charges,53.98,EAPG,44.5,32.96% of total billed charges,55.03,EAPG,121.5,90% of total billed charges,121.5,90% of total billed charges,52.41,EAPG,119.61,88.6% of total billed charges,53.98,EAPG,43.2,32% of total billed charges,108,80% of total billed charges,108,80% of total billed charges,52.41,EAPG,122.85,91% of total billed charges,44.06,32.64% of total billed charges,43.2,32% of total billed charges,45.36,33.6% of total billed charges,53.98,EAPG,43.2,32% of total billed charges,43.2,32% of total billed charges,124.2,92% of total billed charges,43.2,124.2,114.75
Outpatient Medical Services,Rehabilitation,97018,OT PARAFFIN BATH,430,135,109.62,81.2% of total billed charges,44.06,32.64% of total billed charges,99.9,74% of total billed charges,99.9,74% of total billed charges,43.2,32% of total billed charges,19.73,EAPG,43.2,32% of total billed charges,95.85,71% of total billed charges,95.85,71% of total billed charges,90.45,67% of total billed charges,90.45,67% of total billed charges,95.85,71% of total billed charges,102.6,76% of total billed charges,19.73,EAPG,44.5,32.96% of total billed charges,20.11,EAPG,121.5,90% of total billed charges,121.5,90% of total billed charges,19.16,EAPG,119.61,88.6% of total billed charges,19.73,EAPG,43.2,32% of total billed charges,108,80% of total billed charges,108,80% of total billed charges,19.16,EAPG,122.85,91% of total billed charges,44.06,32.64% of total billed charges,43.2,32% of total billed charges,45.36,33.6% of total billed charges,19.73,EAPG,43.2,32% of total billed charges,43.2,32% of total billed charges,124.2,92% of total billed charges,19.16,124.2,114.75
Outpatient Medical Services,Rehabilitation,97530,OT THERAPEUTIC ACT/15M,430,185,150.22,81.2% of total billed charges,60.38,32.64% of total billed charges,136.9,74% of total billed charges,136.9,74% of total billed charges,59.2,32% of total billed charges,53.98,EAPG,59.2,32% of total billed charges,131.35,71% of total billed charges,131.35,71% of total billed charges,123.95,67% of total billed charges,123.95,67% of total billed charges,131.35,71% of total billed charges,140.6,76% of total billed charges,53.98,EAPG,60.98,32.96% of total billed charges,55.03,EAPG,166.5,90% of total billed charges,166.5,90% of total billed charges,52.41,EAPG,163.91,88.6% of total billed charges,53.98,EAPG,59.2,32% of total billed charges,148,80% of total billed charges,148,80% of total billed charges,52.41,EAPG,168.35,91% of total billed charges,60.38,32.64% of total billed charges,59.2,32% of total billed charges,62.16,33.6% of total billed charges,53.98,EAPG,59.2,32% of total billed charges,59.2,32% of total billed charges,170.2,92% of total billed charges,52.41,170.2,157.25
Outpatient Medical Services,Rehabilitation,97166,OT EVAL OT MODERATE COMPLEXITY,434,303,246.04,81.2% of total billed charges,98.9,32.64% of total billed charges,224.22,74% of total billed charges,224.22,74% of total billed charges,96.96,32% of total billed charges,82.08,EAPG,96.96,32% of total billed charges,215.13,71% of total billed charges,215.13,71% of total billed charges,203.01,67% of total billed charges,203.01,67% of total billed charges,215.13,71% of total billed charges,230.28,76% of total billed charges,82.08,EAPG,99.87,32.96% of total billed charges,83.67,EAPG,272.7,90% of total billed charges,272.7,90% of total billed charges,79.68,EAPG,268.46,88.6% of total billed charges,82.08,EAPG,96.96,32% of total billed charges,242.4,80% of total billed charges,242.4,80% of total billed charges,79.68,EAPG,275.73,91% of total billed charges,98.9,32.64% of total billed charges,96.96,32% of total billed charges,101.81,33.6% of total billed charges,82.08,EAPG,96.96,32% of total billed charges,96.96,32% of total billed charges,278.76,92% of total billed charges,79.68,278.76,257.55
Outpatient Medical Services,Rehabilitation,97165,OT EVAL OT LOW COMPLEXITY,434,296,240.35,81.2% of total billed charges,96.61,32.64% of total billed charges,219.04,74% of total billed charges,219.04,74% of total billed charges,94.72,32% of total billed charges,82.08,EAPG,94.72,32% of total billed charges,210.16,71% of total billed charges,210.16,71% of total billed charges,198.32,67% of total billed charges,198.32,67% of total billed charges,210.16,71% of total billed charges,224.96,76% of total billed charges,82.08,EAPG,97.56,32.96% of total billed charges,83.67,EAPG,266.4,90% of total billed charges,266.4,90% of total billed charges,79.68,EAPG,262.26,88.6% of total billed charges,82.08,EAPG,94.72,32% of total billed charges,236.8,80% of total billed charges,236.8,80% of total billed charges,79.68,EAPG,269.36,91% of total billed charges,96.61,32.64% of total billed charges,94.72,32% of total billed charges,99.46,33.6% of total billed charges,82.08,EAPG,94.72,32% of total billed charges,94.72,32% of total billed charges,272.32,92% of total billed charges,79.68,272.32,251.60
Outpatient Medical Services,Room Charges,G0378,OBSERVATION PER HOUR,762,51,41.41,81.2% of total billed charges,16.65,32.64% of total billed charges,37.74,74% of total billed charges,37.74,74% of total billed charges,16.32,32% of total billed charges,N/A,Not Separately reimbursable,16.32,32% of total billed charges,36.21,71% of total billed charges,36.21,71% of total billed charges,34.17,67% of total billed charges,34.17,67% of total billed charges,36.21,71% of total billed charges,38.76,76% of total billed charges,N/A,Not Separately reimbursable,16.81,32.96% of total billed charges,N/A,Not Separately reimbursable,45.9,90% of total billed charges,45.9,90% of total billed charges,N/A,Not Separately reimbursable,45.19,88.6% of total billed charges,N/A,Not Separately reimbursable,16.32,32% of total billed charges,40.8,80% of total billed charges,40.8,80% of total billed charges,N/A,Not Separately reimbursable,46.41,91% of total billed charges,16.65,32.64% of total billed charges,16.32,32% of total billed charges,22.29,33.6% of total billed charges,N/A,Not Separately reimbursable,16.32,32% of total billed charges,16.32,32% of total billed charges,46.92,92% of total billed charges,16.32,46.92,43.35
Outpatient Medical Services,Surgery,,,360,2094,1700.33,81.2% of total billed charges,683.48,32.64% of total billed charges,1549.56,74% of total billed charges,1549.56,74% of total billed charges,670.08,32% of total billed charges,N/A,Not Separately reimbursable,670.08,32% of total billed charges,1486.74,71% of total billed charges,1486.74,71% of total billed charges,1402.98,67% of total billed charges,1402.98,67% of total billed charges,1486.74,71% of total billed charges,1591.44,76% of total billed charges,N/A,Not Separately reimbursable,690.18,32.96% of total billed charges,N/A,Not Separately reimbursable,1884.6,90% of total billed charges,1884.6,90% of total billed charges,N/A,Not Separately reimbursable,1855.28,88.6% of total billed charges,N/A,Not Separately reimbursable,670.08,32% of total billed charges,1675.2,80% of total billed charges,1675.2,80% of total billed charges,N/A,Not Separately reimbursable,1905.54,91% of total billed charges,683.48,32.64% of total billed charges,670.08,32% of total billed charges,703.58,33.6% of total billed charges,N/A,Not Separately reimbursable,670.08,32% of total billed charges,670.08,32% of total billed charges,1926.48,92% of total billed charges,670.08,1926.48,1779.90
Outpatient Medical Services,Surgery,,,360,4416,3585.79,81.2% of total billed charges,1441.38,32.64% of total billed charges,3267.84,74% of total billed charges,3267.84,74% of total billed charges,1413.12,32% of total billed charges,N/A,Not Separately reimbursable,1413.12,32% of total billed charges,3135.36,71% of total billed charges,3135.36,71% of total billed charges,2958.72,67% of total billed charges,2958.72,67% of total billed charges,3135.36,71% of total billed charges,3356.16,76% of total billed charges,N/A,Not Separately reimbursable,1455.51,32.96% of total billed charges,N/A,Not Separately reimbursable,3974.4,90% of total billed charges,3974.4,90% of total billed charges,N/A,Not Separately reimbursable,3912.58,88.6% of total billed charges,N/A,Not Separately reimbursable,1413.12,32% of total billed charges,3532.8,80% of total billed charges,3532.8,80% of total billed charges,N/A,Not Separately reimbursable,4018.56,91% of total billed charges,1441.38,32.64% of total billed charges,1413.12,32% of total billed charges,1483.78,33.6% of total billed charges,N/A,Not Separately reimbursable,1413.12,32% of total billed charges,1413.12,32% of total billed charges,4062.72,92% of total billed charges,1413.12,4062.72,3753.60
Outpatient Medical Services,Surgery,,,360,5391,4377.49,81.2% of total billed charges,1759.62,32.64% of total billed charges,3989.34,74% of total billed charges,3989.34,74% of total billed charges,1725.12,32% of total billed charges,N/A,Not Separately reimbursable,1725.12,32% of total billed charges,3827.61,71% of total billed charges,3827.61,71% of total billed charges,3611.97,67% of total billed charges,3611.97,67% of total billed charges,3827.61,71% of total billed charges,4097.16,76% of total billed charges,N/A,Not Separately reimbursable,1776.87,32.96% of total billed charges,N/A,Not Separately reimbursable,4851.9,90% of total billed charges,4851.9,90% of total billed charges,N/A,Not Separately reimbursable,4776.43,88.6% of total billed charges,N/A,Not Separately reimbursable,1725.12,32% of total billed charges,4312.8,80% of total billed charges,4312.8,80% of total billed charges,N/A,Not Separately reimbursable,4905.81,91% of total billed charges,1759.62,32.64% of total billed charges,1725.12,32% of total billed charges,1811.38,33.6% of total billed charges,N/A,Not Separately reimbursable,1725.12,32% of total billed charges,1725.12,32% of total billed charges,4959.72,92% of total billed charges,1725.12,4959.72,4582.35
Outpatient Medical Services,Surgery,,,360,1245,1010.94,81.2% of total billed charges,406.37,32.64% of total billed charges,921.3,74% of total billed charges,921.3,74% of total billed charges,398.4,32% of total billed charges,N/A,Not Separately reimbursable,398.4,32% of total billed charges,883.95,71% of total billed charges,883.95,71% of total billed charges,834.15,67% of total billed charges,834.15,67% of total billed charges,883.95,71% of total billed charges,946.2,76% of total billed charges,N/A,Not Separately reimbursable,410.35,32.96% of total billed charges,N/A,Not Separately reimbursable,1120.5,90% of total billed charges,1120.5,90% of total billed charges,N/A,Not Separately reimbursable,1103.07,88.6% of total billed charges,N/A,Not Separately reimbursable,398.4,32% of total billed charges,996,80% of total billed charges,996,80% of total billed charges,N/A,Not Separately reimbursable,1132.95,91% of total billed charges,406.37,32.64% of total billed charges,398.4,32% of total billed charges,418.32,33.6% of total billed charges,N/A,Not Separately reimbursable,398.4,32% of total billed charges,398.4,32% of total billed charges,1145.4,92% of total billed charges,398.4,1145.4,1058.25
Outpatient Medical Services,Surgery,,,360,1571,1275.65,81.2% of total billed charges,512.77,32.64% of total billed charges,1162.54,74% of total billed charges,1162.54,74% of total billed charges,502.72,32% of total billed charges,N/A,Not Separately reimbursable,502.72,32% of total billed charges,1115.41,71% of total billed charges,1115.41,71% of total billed charges,1052.57,67% of total billed charges,1052.57,67% of total billed charges,1115.41,71% of total billed charges,1193.96,76% of total billed charges,N/A,Not Separately reimbursable,517.8,32.96% of total billed charges,N/A,Not Separately reimbursable,1413.9,90% of total billed charges,1413.9,90% of total billed charges,N/A,Not Separately reimbursable,1391.91,88.6% of total billed charges,N/A,Not Separately reimbursable,502.72,32% of total billed charges,1256.8,80% of total billed charges,1256.8,80% of total billed charges,N/A,Not Separately reimbursable,1429.61,91% of total billed charges,512.77,32.64% of total billed charges,502.72,32% of total billed charges,527.86,33.6% of total billed charges,N/A,Not Separately reimbursable,502.72,32% of total billed charges,502.72,32% of total billed charges,1445.32,92% of total billed charges,502.72,1445.32,1335.35
Outpatient Medical Services,Surgery,,,360,2043,1658.92,81.2% of total billed charges,666.84,32.64% of total billed charges,1511.82,74% of total billed charges,1511.82,74% of total billed charges,653.76,32% of total billed charges,N/A,Not Separately reimbursable,653.76,32% of total billed charges,1450.53,71% of total billed charges,1450.53,71% of total billed charges,1368.81,67% of total billed charges,1368.81,67% of total billed charges,1450.53,71% of total billed charges,1552.68,76% of total billed charges,N/A,Not Separately reimbursable,673.37,32.96% of total billed charges,N/A,Not Separately reimbursable,1838.7,90% of total billed charges,1838.7,90% of total billed charges,N/A,Not Separately reimbursable,1810.1,88.6% of total billed charges,N/A,Not Separately reimbursable,653.76,32% of total billed charges,1634.4,80% of total billed charges,1634.4,80% of total billed charges,N/A,Not Separately reimbursable,1859.13,91% of total billed charges,666.84,32.64% of total billed charges,653.76,32% of total billed charges,686.45,33.6% of total billed charges,N/A,Not Separately reimbursable,653.76,32% of total billed charges,653.76,32% of total billed charges,1879.56,92% of total billed charges,653.76,1879.56,1736.55
Outpatient Medical Services,Surgery,,,360,7886,6403.43,81.2% of total billed charges,2573.99,32.64% of total billed charges,5835.64,74% of total billed charges,5835.64,74% of total billed charges,2523.52,32% of total billed charges,N/A,Not Separately reimbursable,2523.52,32% of total billed charges,5599.06,71% of total billed charges,5599.06,71% of total billed charges,5283.62,67% of total billed charges,5283.62,67% of total billed charges,5599.06,71% of total billed charges,5993.36,76% of total billed charges,N/A,Not Separately reimbursable,2599.23,32.96% of total billed charges,N/A,Not Separately reimbursable,7097.4,90% of total billed charges,7097.4,90% of total billed charges,N/A,Not Separately reimbursable,6987,88.6% of total billed charges,N/A,Not Separately reimbursable,2523.52,32% of total billed charges,6308.8,80% of total billed charges,6308.8,80% of total billed charges,N/A,Not Separately reimbursable,7176.26,91% of total billed charges,2573.99,32.64% of total billed charges,2523.52,32% of total billed charges,2649.7,33.6% of total billed charges,N/A,Not Separately reimbursable,2523.52,32% of total billed charges,2523.52,32% of total billed charges,7255.12,92% of total billed charges,2523.52,7255.12,6703.10
Outpatient Medical Services,Surgery,,,360,2576,2091.71,81.2% of total billed charges,840.81,32.64% of total billed charges,1906.24,74% of total billed charges,1906.24,74% of total billed charges,824.32,32% of total billed charges,N/A,Not Separately reimbursable,824.32,32% of total billed charges,1828.96,71% of total billed charges,1828.96,71% of total billed charges,1725.92,67% of total billed charges,1725.92,67% of total billed charges,1828.96,71% of total billed charges,1957.76,76% of total billed charges,N/A,Not Separately reimbursable,849.05,32.96% of total billed charges,N/A,Not Separately reimbursable,2318.4,90% of total billed charges,2318.4,90% of total billed charges,N/A,Not Separately reimbursable,2282.34,88.6% of total billed charges,N/A,Not Separately reimbursable,824.32,32% of total billed charges,2060.8,80% of total billed charges,2060.8,80% of total billed charges,N/A,Not Separately reimbursable,2344.16,91% of total billed charges,840.81,32.64% of total billed charges,824.32,32% of total billed charges,865.54,33.6% of total billed charges,N/A,Not Separately reimbursable,824.32,32% of total billed charges,824.32,32% of total billed charges,2369.92,92% of total billed charges,824.32,2369.92,2189.60
Outpatient Medical Services,Surgery,,,370,150,121.8,81.2% of total billed charges,48.96,32.64% of total billed charges,111,74% of total billed charges,111,74% of total billed charges,48,32% of total billed charges,N/A,Not Separately reimbursable,48,32% of total billed charges,106.5,71% of total billed charges,106.5,71% of total billed charges,100.5,67% of total billed charges,100.5,67% of total billed charges,106.5,71% of total billed charges,114,76% of total billed charges,N/A,Not Separately reimbursable,49.44,32.96% of total billed charges,N/A,Not Separately reimbursable,135,90% of total billed charges,135,90% of total billed charges,N/A,Not Separately reimbursable,132.9,88.6% of total billed charges,N/A,Not Separately reimbursable,48,32% of total billed charges,120,80% of total billed charges,120,80% of total billed charges,N/A,Not Separately reimbursable,136.5,91% of total billed charges,48.96,32.64% of total billed charges,48,32% of total billed charges,50.4,33.6% of total billed charges,N/A,Not Separately reimbursable,48,32% of total billed charges,48,32% of total billed charges,138,92% of total billed charges,48,138,127.50
Outpatient Medical Services,Surgery,,,370,45,36.54,81.2% of total billed charges,14.69,32.64% of total billed charges,33.3,74% of total billed charges,33.3,74% of total billed charges,14.4,32% of total billed charges,N/A,Not Separately reimbursable,14.4,32% of total billed charges,31.95,71% of total billed charges,31.95,71% of total billed charges,30.15,67% of total billed charges,30.15,67% of total billed charges,31.95,71% of total billed charges,34.2,76% of total billed charges,N/A,Not Separately reimbursable,14.83,32.96% of total billed charges,N/A,Not Separately reimbursable,40.5,90% of total billed charges,40.5,90% of total billed charges,N/A,Not Separately reimbursable,39.87,88.6% of total billed charges,N/A,Not Separately reimbursable,14.4,32% of total billed charges,36,80% of total billed charges,36,80% of total billed charges,N/A,Not Separately reimbursable,40.95,91% of total billed charges,14.69,32.64% of total billed charges,14.4,32% of total billed charges,15.12,33.6% of total billed charges,N/A,Not Separately reimbursable,14.4,32% of total billed charges,14.4,32% of total billed charges,41.4,92% of total billed charges,14.4,41.4,38.25
Outpatient Medical Services,Surgery,,,370,122,99.06,81.2% of total billed charges,39.82,32.64% of total billed charges,90.28,74% of total billed charges,90.28,74% of total billed charges,39.04,32% of total billed charges,N/A,Not Separately reimbursable,39.04,32% of total billed charges,86.62,71% of total billed charges,86.62,71% of total billed charges,81.74,67% of total billed charges,81.74,67% of total billed charges,86.62,71% of total billed charges,92.72,76% of total billed charges,N/A,Not Separately reimbursable,40.21,32.96% of total billed charges,N/A,Not Separately reimbursable,109.8,90% of total billed charges,109.8,90% of total billed charges,N/A,Not Separately reimbursable,108.09,88.6% of total billed charges,N/A,Not Separately reimbursable,39.04,32% of total billed charges,97.6,80% of total billed charges,97.6,80% of total billed charges,N/A,Not Separately reimbursable,111.02,91% of total billed charges,39.82,32.64% of total billed charges,39.04,32% of total billed charges,40.99,33.6% of total billed charges,N/A,Not Separately reimbursable,39.04,32% of total billed charges,39.04,32% of total billed charges,112.24,92% of total billed charges,39.04,112.24,103.70
Outpatient Medical Services,Surgery,,,370,38,30.86,81.2% of total billed charges,12.4,32.64% of total billed charges,28.12,74% of total billed charges,28.12,74% of total billed charges,12.16,32% of total billed charges,N/A,Not Separately reimbursable,12.16,32% of total billed charges,26.98,71% of total billed charges,26.98,71% of total billed charges,25.46,67% of total billed charges,25.46,67% of total billed charges,26.98,71% of total billed charges,28.88,76% of total billed charges,N/A,Not Separately reimbursable,12.52,32.96% of total billed charges,N/A,Not Separately reimbursable,34.2,90% of total billed charges,34.2,90% of total billed charges,N/A,Not Separately reimbursable,33.67,88.6% of total billed charges,N/A,Not Separately reimbursable,12.16,32% of total billed charges,30.4,80% of total billed charges,30.4,80% of total billed charges,N/A,Not Separately reimbursable,34.58,91% of total billed charges,12.4,32.64% of total billed charges,12.16,32% of total billed charges,12.77,33.6% of total billed charges,N/A,Not Separately reimbursable,12.16,32% of total billed charges,12.16,32% of total billed charges,34.96,92% of total billed charges,12.16,34.96,32.30
Outpatient Medical Services,Surgery,,,370,39,31.67,81.2% of total billed charges,12.73,32.64% of total billed charges,28.86,74% of total billed charges,28.86,74% of total billed charges,12.48,32% of total billed charges,N/A,Not Separately reimbursable,12.48,32% of total billed charges,27.69,71% of total billed charges,27.69,71% of total billed charges,26.13,67% of total billed charges,26.13,67% of total billed charges,27.69,71% of total billed charges,29.64,76% of total billed charges,N/A,Not Separately reimbursable,12.85,32.96% of total billed charges,N/A,Not Separately reimbursable,35.1,90% of total billed charges,35.1,90% of total billed charges,N/A,Not Separately reimbursable,34.55,88.6% of total billed charges,N/A,Not Separately reimbursable,12.48,32% of total billed charges,31.2,80% of total billed charges,31.2,80% of total billed charges,N/A,Not Separately reimbursable,35.49,91% of total billed charges,12.73,32.64% of total billed charges,12.48,32% of total billed charges,13.1,33.6% of total billed charges,N/A,Not Separately reimbursable,12.48,32% of total billed charges,12.48,32% of total billed charges,35.88,92% of total billed charges,12.48,35.88,33.15
Outpatient Medical Services,Surgery,,,710,871,707.25,81.2% of total billed charges,284.29,32.64% of total billed charges,644.54,74% of total billed charges,644.54,74% of total billed charges,278.72,32% of total billed charges,N/A,Not Separately reimbursable,278.72,32% of total billed charges,618.41,71% of total billed charges,618.41,71% of total billed charges,583.57,67% of total billed charges,583.57,67% of total billed charges,618.41,71% of total billed charges,661.96,76% of total billed charges,N/A,Not Separately reimbursable,287.08,32.96% of total billed charges,N/A,Not Separately reimbursable,783.9,90% of total billed charges,783.9,90% of total billed charges,N/A,Not Separately reimbursable,771.71,88.6% of total billed charges,N/A,Not Separately reimbursable,278.72,32% of total billed charges,696.8,80% of total billed charges,696.8,80% of total billed charges,N/A,Not Separately reimbursable,792.61,91% of total billed charges,284.29,32.64% of total billed charges,278.72,32% of total billed charges,292.66,33.6% of total billed charges,N/A,Not Separately reimbursable,278.72,32% of total billed charges,278.72,32% of total billed charges,801.32,92% of total billed charges,278.72,801.32,740.35
Outpatient Medical Services,Surgery,,,710,422,342.66,81.2% of total billed charges,137.74,32.64% of total billed charges,312.28,74% of total billed charges,312.28,74% of total billed charges,135.04,32% of total billed charges,N/A,Not Separately reimbursable,135.04,32% of total billed charges,299.62,71% of total billed charges,299.62,71% of total billed charges,282.74,67% of total billed charges,282.74,67% of total billed charges,299.62,71% of total billed charges,320.72,76% of total billed charges,N/A,Not Separately reimbursable,139.09,32.96% of total billed charges,N/A,Not Separately reimbursable,379.8,90% of total billed charges,379.8,90% of total billed charges,N/A,Not Separately reimbursable,373.89,88.6% of total billed charges,N/A,Not Separately reimbursable,135.04,32% of total billed charges,337.6,80% of total billed charges,337.6,80% of total billed charges,N/A,Not Separately reimbursable,384.02,91% of total billed charges,137.74,32.64% of total billed charges,135.04,32% of total billed charges,141.79,33.6% of total billed charges,N/A,Not Separately reimbursable,135.04,32% of total billed charges,135.04,32% of total billed charges,388.24,92% of total billed charges,135.04,388.24,358.70
Outpatient Medical Services,Surgery,,,710,398,323.18,81.2% of total billed charges,129.91,32.64% of total billed charges,294.52,74% of total billed charges,294.52,74% of total billed charges,127.36,32% of total billed charges,N/A,Not Separately reimbursable,127.36,32% of total billed charges,282.58,71% of total billed charges,282.58,71% of total billed charges,266.66,67% of total billed charges,266.66,67% of total billed charges,282.58,71% of total billed charges,302.48,76% of total billed charges,N/A,Not Separately reimbursable,131.18,32.96% of total billed charges,N/A,Not Separately reimbursable,358.2,90% of total billed charges,358.2,90% of total billed charges,N/A,Not Separately reimbursable,352.63,88.6% of total billed charges,N/A,Not Separately reimbursable,127.36,32% of total billed charges,318.4,80% of total billed charges,318.4,80% of total billed charges,N/A,Not Separately reimbursable,362.18,91% of total billed charges,129.91,32.64% of total billed charges,127.36,32% of total billed charges,133.73,33.6% of total billed charges,N/A,Not Separately reimbursable,127.36,32% of total billed charges,127.36,32% of total billed charges,366.16,92% of total billed charges,127.36,366.16,338.30
Outpatient Medical Services,Vascular Echo,93880,DUPLX EXTRACRN ART COMPLT BILAT,921,979,794.95,81.2% of total billed charges,319.55,32.64% of total billed charges,724.46,74% of total billed charges,724.46,74% of total billed charges,313.28,32% of total billed charges,61.99,EAPG,313.28,32% of total billed charges,695.09,71% of total billed charges,695.09,71% of total billed charges,655.93,67% of total billed charges,655.93,67% of total billed charges,695.09,71% of total billed charges,744.04,76% of total billed charges,61.99,EAPG,322.68,32.96% of total billed charges,63.2,EAPG,881.1,90% of total billed charges,881.1,90% of total billed charges,60.19,EAPG,867.39,88.6% of total billed charges,61.99,EAPG,313.28,32% of total billed charges,783.2,80% of total billed charges,783.2,80% of total billed charges,60.19,EAPG,890.89,91% of total billed charges,319.55,32.64% of total billed charges,313.28,32% of total billed charges,328.94,33.6% of total billed charges,61.99,EAPG,313.28,32% of total billed charges,313.28,32% of total billed charges,900.68,92% of total billed charges,60.19,900.68,832.15
Outpatient Medical Services,Vascular Echo,93970,DUPLX VEIN COMPLT BILAT,921,463,375.96,81.2% of total billed charges,151.12,32.64% of total billed charges,342.62,74% of total billed charges,342.62,74% of total billed charges,148.16,32% of total billed charges,95.34,EAPG,148.16,32% of total billed charges,328.73,71% of total billed charges,328.73,71% of total billed charges,310.21,67% of total billed charges,310.21,67% of total billed charges,328.73,71% of total billed charges,351.88,76% of total billed charges,95.34,EAPG,152.6,32.96% of total billed charges,97.2,EAPG,416.7,90% of total billed charges,416.7,90% of total billed charges,92.57,EAPG,410.22,88.6% of total billed charges,95.34,EAPG,148.16,32% of total billed charges,370.4,80% of total billed charges,370.4,80% of total billed charges,92.57,EAPG,421.33,91% of total billed charges,151.12,32.64% of total billed charges,148.16,32% of total billed charges,155.57,33.6% of total billed charges,95.34,EAPG,148.16,32% of total billed charges,148.16,32% of total billed charges,425.96,92% of total billed charges,92.57,425.96,393.55
Outpatient Medical Services,Vascular Echo,93306,ECHO TTE W/ DOPPLER CMPLT,483,1211,983.33,81.2% of total billed charges,395.27,32.64% of total billed charges,896.14,74% of total billed charges,896.14,74% of total billed charges,387.52,32% of total billed charges,224.2,EAPG,387.52,32% of total billed charges,859.81,71% of total billed charges,859.81,71% of total billed charges,811.37,67% of total billed charges,811.37,67% of total billed charges,859.81,71% of total billed charges,920.36,76% of total billed charges,224.2,EAPG,399.15,32.96% of total billed charges,228.56,EAPG,1089.9,90% of total billed charges,1089.9,90% of total billed charges,217.67,EAPG,1072.95,88.6% of total billed charges,224.2,EAPG,387.52,32% of total billed charges,968.8,80% of total billed charges,968.8,80% of total billed charges,217.67,EAPG,1102.01,91% of total billed charges,395.27,32.64% of total billed charges,387.52,32% of total billed charges,406.9,33.6% of total billed charges,224.2,EAPG,387.52,32% of total billed charges,387.52,32% of total billed charges,1114.12,92% of total billed charges,217.67,1114.12,1029.35
Outpatient Medical Services,Vascular Echo,93971,DUPLX VEIN LMTD/UNILAT LT,921,463,375.96,81.2% of total billed charges,151.12,32.64% of total billed charges,342.62,74% of total billed charges,342.62,74% of total billed charges,148.16,32% of total billed charges,61.99,EAPG,148.16,32% of total billed charges,328.73,71% of total billed charges,328.73,71% of total billed charges,310.21,67% of total billed charges,310.21,67% of total billed charges,328.73,71% of total billed charges,351.88,76% of total billed charges,61.99,EAPG,152.6,32.96% of total billed charges,63.2,EAPG,416.7,90% of total billed charges,416.7,90% of total billed charges,60.19,EAPG,410.22,88.6% of total billed charges,61.99,EAPG,148.16,32% of total billed charges,370.4,80% of total billed charges,370.4,80% of total billed charges,60.19,EAPG,421.33,91% of total billed charges,151.12,32.64% of total billed charges,148.16,32% of total billed charges,155.57,33.6% of total billed charges,61.99,EAPG,148.16,32% of total billed charges,148.16,32% of total billed charges,425.96,92% of total billed charges,60.19,425.96,393.55
Outpatient Medical Services,Vascular Echo,93971,DUPLX VEIN LMTD/UNILAT RT,921,463,375.96,81.2% of total billed charges,151.12,32.64% of total billed charges,342.62,74% of total billed charges,342.62,74% of total billed charges,148.16,32% of total billed charges,61.99,EAPG,148.16,32% of total billed charges,328.73,71% of total billed charges,328.73,71% of total billed charges,310.21,67% of total billed charges,310.21,67% of total billed charges,328.73,71% of total billed charges,351.88,76% of total billed charges,61.99,EAPG,152.6,32.96% of total billed charges,63.2,EAPG,416.7,90% of total billed charges,416.7,90% of total billed charges,60.19,EAPG,410.22,88.6% of total billed charges,61.99,EAPG,148.16,32% of total billed charges,370.4,80% of total billed charges,370.4,80% of total billed charges,60.19,EAPG,421.33,91% of total billed charges,151.12,32.64% of total billed charges,148.16,32% of total billed charges,155.57,33.6% of total billed charges,61.99,EAPG,148.16,32% of total billed charges,148.16,32% of total billed charges,425.96,92% of total billed charges,60.19,425.96,393.55
Outpatient Medical Services,Vascular Echo,93306,ECHO TTE W/ DOPPLER CMPLT W/ CONTRAST,483,1211,983.33,81.2% of total billed charges,395.27,32.64% of total billed charges,896.14,74% of total billed charges,896.14,74% of total billed charges,387.52,32% of total billed charges,224.2,EAPG,387.52,32% of total billed charges,859.81,71% of total billed charges,859.81,71% of total billed charges,811.37,67% of total billed charges,811.37,67% of total billed charges,859.81,71% of total billed charges,920.36,76% of total billed charges,224.2,EAPG,399.15,32.96% of total billed charges,228.56,EAPG,1089.9,90% of total billed charges,1089.9,90% of total billed charges,217.67,EAPG,1072.95,88.6% of total billed charges,224.2,EAPG,387.52,32% of total billed charges,968.8,80% of total billed charges,968.8,80% of total billed charges,217.67,EAPG,1102.01,91% of total billed charges,395.27,32.64% of total billed charges,387.52,32% of total billed charges,406.9,33.6% of total billed charges,224.2,EAPG,387.52,32% of total billed charges,387.52,32% of total billed charges,1114.12,92% of total billed charges,217.67,1114.12,1029.35
Outpatient Medical Services,Other,95886,NEEDLE EMG W PARASPINALS/NCV CMPLT,922,180,146.16,81.2% of total billed charges,58.75,32.64% of total billed charges,133.2,74% of total billed charges,133.2,74% of total billed charges,57.6,32% of total billed charges,248.57,EAPG,57.6,32% of total billed charges,127.8,71% of total billed charges,127.8,71% of total billed charges,120.6,67% of total billed charges,120.6,67% of total billed charges,127.8,71% of total billed charges,136.8,76% of total billed charges,248.57,EAPG,59.33,32.96% of total billed charges,253.4,EAPG,162,90% of total billed charges,162,90% of total billed charges,241.33,EAPG,159.48,88.6% of total billed charges,248.57,EAPG,57.6,32% of total billed charges,144,80% of total billed charges,144,80% of total billed charges,241.33,EAPG,163.8,91% of total billed charges,58.75,32.64% of total billed charges,57.6,32% of total billed charges,60.48,33.6% of total billed charges,248.57,EAPG,57.6,32% of total billed charges,57.6,32% of total billed charges,165.6,92% of total billed charges,57.6,253.4,153.00
Outpatient Medical Services,Other,95910,NERVE CONDUCTION 7-8 STUDIES,922,842,683.7,81.2% of total billed charges,274.83,32.64% of total billed charges,623.08,74% of total billed charges,623.08,74% of total billed charges,269.44,32% of total billed charges,248.57,EAPG,269.44,32% of total billed charges,597.82,71% of total billed charges,597.82,71% of total billed charges,564.14,67% of total billed charges,564.14,67% of total billed charges,597.82,71% of total billed charges,639.92,76% of total billed charges,248.57,EAPG,277.52,32.96% of total billed charges,253.4,EAPG,757.8,90% of total billed charges,757.8,90% of total billed charges,241.33,EAPG,746.01,88.6% of total billed charges,248.57,EAPG,269.44,32% of total billed charges,673.6,80% of total billed charges,673.6,80% of total billed charges,241.33,EAPG,766.22,91% of total billed charges,274.83,32.64% of total billed charges,269.44,32% of total billed charges,282.91,33.6% of total billed charges,248.57,EAPG,269.44,32% of total billed charges,269.44,32% of total billed charges,774.64,92% of total billed charges,241.33,774.64,715.70
Outpatient Medical Services,Other,90853,GROUP THERAPY,915,258,209.5,81.2% of total billed charges,84.21,32.64% of total billed charges,190.92,74% of total billed charges,190.92,74% of total billed charges,82.56,32% of total billed charges,73.3,EAPG,82.56,32% of total billed charges,183.18,71% of total billed charges,183.18,71% of total billed charges,172.86,67% of total billed charges,172.86,67% of total billed charges,183.18,71% of total billed charges,196.08,76% of total billed charges,73.3,EAPG,85.04,32.96% of total billed charges,74.73,EAPG,232.2,90% of total billed charges,232.2,90% of total billed charges,71.17,EAPG,228.59,88.6% of total billed charges,73.3,EAPG,82.56,32% of total billed charges,206.4,80% of total billed charges,206.4,80% of total billed charges,71.17,EAPG,234.78,91% of total billed charges,84.21,32.64% of total billed charges,82.56,32% of total billed charges,86.69,33.6% of total billed charges,73.3,EAPG,82.56,32% of total billed charges,82.56,32% of total billed charges,237.36,92% of total billed charges,71.17,237.36,219.30
Outpatient Medical Services,Other,96413,CHEMO/HIGH COMPLX IV INFUSION UP TO 1 HR,335,1041,845.29,81.2% of total billed charges,339.78,32.64% of total billed charges,770.34,74% of total billed charges,770.34,74% of total billed charges,333.12,32% of total billed charges,176.12,EAPG,333.12,32% of total billed charges,739.11,71% of total billed charges,739.11,71% of total billed charges,697.47,67% of total billed charges,697.47,67% of total billed charges,739.11,71% of total billed charges,791.16,76% of total billed charges,176.12,EAPG,343.11,32.96% of total billed charges,179.54,EAPG,936.9,90% of total billed charges,936.9,90% of total billed charges,170.99,EAPG,922.33,88.6% of total billed charges,176.12,EAPG,333.12,32% of total billed charges,832.8,80% of total billed charges,832.8,80% of total billed charges,170.99,EAPG,947.31,91% of total billed charges,339.78,32.64% of total billed charges,333.12,32% of total billed charges,349.78,33.6% of total billed charges,176.12,EAPG,333.12,32% of total billed charges,333.12,32% of total billed charges,957.72,92% of total billed charges,170.99,957.72,884.85
Outpatient Medical Services,Other,96415,CHEMO/HIGH COMPLX IV INFUSION EA ADDL HR,335,151,122.61,81.2% of total billed charges,49.29,32.64% of total billed charges,111.74,74% of total billed charges,111.74,74% of total billed charges,48.32,32% of total billed charges,248.1,EAPG,48.32,32% of total billed charges,107.21,71% of total billed charges,107.21,71% of total billed charges,101.17,67% of total billed charges,101.17,67% of total billed charges,107.21,71% of total billed charges,114.76,76% of total billed charges,248.1,EAPG,49.77,32.96% of total billed charges,252.92,EAPG,135.9,90% of total billed charges,135.9,90% of total billed charges,240.87,EAPG,133.79,88.6% of total billed charges,248.1,EAPG,48.32,32% of total billed charges,120.8,80% of total billed charges,120.8,80% of total billed charges,240.87,EAPG,137.41,91% of total billed charges,49.29,32.64% of total billed charges,48.32,32% of total billed charges,50.74,33.6% of total billed charges,248.1,EAPG,48.32,32% of total billed charges,48.32,32% of total billed charges,138.92,92% of total billed charges,48.32,252.92,128.35
Outpatient Medical Services,Other,36591,COLLECT BLOOD COMPL IMPLANT VAD,510,513,416.56,81.2% of total billed charges,167.44,32.64% of total billed charges,379.62,74% of total billed charges,379.62,74% of total billed charges,164.16,32% of total billed charges,22.66,EAPG,164.16,32% of total billed charges,364.23,71% of total billed charges,364.23,71% of total billed charges,343.71,67% of total billed charges,343.71,67% of total billed charges,364.23,71% of total billed charges,389.88,76% of total billed charges,22.66,EAPG,169.08,32.96% of total billed charges,23.1,EAPG,461.7,90% of total billed charges,461.7,90% of total billed charges,22,EAPG,454.52,88.6% of total billed charges,22.66,EAPG,164.16,32% of total billed charges,410.4,80% of total billed charges,410.4,80% of total billed charges,22,EAPG,466.83,91% of total billed charges,167.44,32.64% of total billed charges,164.16,32% of total billed charges,172.37,33.6% of total billed charges,22.66,EAPG,164.16,32% of total billed charges,164.16,32% of total billed charges,471.96,92% of total billed charges,22,471.96,436.05
Outpatient Medical Services,Other,51798,BLADDER SCAN,761,66,53.59,81.2% of total billed charges,21.54,32.64% of total billed charges,48.84,74% of total billed charges,48.84,74% of total billed charges,21.12,32% of total billed charges,31.52,EAPG,21.12,32% of total billed charges,46.86,71% of total billed charges,46.86,71% of total billed charges,44.22,67% of total billed charges,44.22,67% of total billed charges,46.86,71% of total billed charges,50.16,76% of total billed charges,31.52,EAPG,21.75,32.96% of total billed charges,32.13,EAPG,59.4,90% of total billed charges,59.4,90% of total billed charges,30.6,EAPG,58.48,88.6% of total billed charges,31.52,EAPG,21.12,32% of total billed charges,52.8,80% of total billed charges,52.8,80% of total billed charges,30.6,EAPG,60.06,91% of total billed charges,21.54,32.64% of total billed charges,21.12,32% of total billed charges,22.18,33.6% of total billed charges,31.52,EAPG,21.12,32% of total billed charges,21.12,32% of total billed charges,60.72,92% of total billed charges,21.12,60.72,56.10
Inpatient Medical Services,Room Charges,,,110,1215,N/A,Not separately reimbursable,1723.08,CMS Medicare per diem,N/A,Not separately reimbursable,N/A,Not separately reimbursable,1723.08,CMS Medicare per diem,N/A,Not separately reimbursable,1723.08,CMS Medicare per diem,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,1723.08,CMS Medicare per diem,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,1723.08,CMS Medicare per diem,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,1723.08,CMS Medicare per diem,1723.08,CMS Medicare per diem,N/A,Not separately reimbursable,N/A,Not separately reimbursable,1723.08,CMS Medicare per diem,N/A,Not separately reimbursable,N/A,Not separately reimbursable,1723.08,1723.08,1032.75
Inpatient Medical Services,Room Charges,,,206,1788,N/A,Not separately reimbursable,1723.08,CMS Medicare per diem,N/A,Not separately reimbursable,N/A,Not separately reimbursable,1723.08,CMS Medicare per diem,N/A,Not separately reimbursable,1723.08,CMS Medicare per diem,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,1723.08,CMS Medicare per diem,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,1723.08,CMS Medicare per diem,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,1723.08,CMS Medicare per diem,1723.08,CMS Medicare per diem,N/A,Not separately reimbursable,N/A,Not separately reimbursable,1723.08,CMS Medicare per diem,N/A,Not separately reimbursable,N/A,Not separately reimbursable,1723.08,1723.08,1519.80
Inpatient Medical Services,Room Charges,,,100,1215,N/A,Not separately reimbursable,1723.08,CMS Medicare per diem,N/A,Not separately reimbursable,N/A,Not separately reimbursable,1723.08,CMS Medicare per diem,N/A,Not separately reimbursable,1723.08,CMS Medicare per diem,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,1723.08,CMS Medicare per diem,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,1723.08,CMS Medicare per diem,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,N/A,Not separately reimbursable,1723.08,CMS Medicare per diem,1723.08,CMS Medicare per diem,N/A,Not separately reimbursable,N/A,Not separately reimbursable,1723.08,CMS Medicare per diem,N/A,Not separately reimbursable,N/A,Not separately reimbursable,1723.08,1723.08,1032.75
Outpatient Medical Services,BEHAVIORAL,90832,"Psychotherapy, 30 minute",900,SERVICE NOT OFFERED,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,BEHAVIORAL,90834,"Psychotherapy, 45 minutes",900,SERVICE NOT OFFERED,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,BEHAVIORAL,90837,"Psychotherapy, 60 minutes",900,SERVICE NOT OFFERED,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,BEHAVIORAL,90846,"Family psychotherapy, not including patient, 50 minutes",900,SERVICE NOT OFFERED,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. 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 separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OFFICE VISIT,99243,"Patient office consultation, typically 40 min",761,SERVICE NOT OFFERED,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OFFICE VISIT,99244,"Patient office consultation, typically 60 min",761,SERVICE NOT OFFERED,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OFFICE VISIT,99385,"Initial new patient preventive medicine evaluation, for those ages 18 to 39",761,SERVICE NOT OFFERED,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OFFICE VISIT,99386,"Initial new patient preventive medicine evaluation, for those ages 40 to 64",761,SERVICE NOT OFFERED,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. 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 separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. 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 separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,LAB,81002,Automated urinalysis test,300,SERVICE NOT OFFERED,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,RADIOLOGY,72193,"CT scan, pelvis, with contrast",350,SERVICE NOT OFFERED,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,RADIOLOGY,73721,MRI scan of leg joint,610,SERVICE NOT OFFERED,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,RADIOLOGY,76805,"Abdominal ultrasound of pregnant uterus, greater or equal to 14 weeks 0 days, single or first fetus",402,SERVICE NOT OFFERED,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,RADIOLOGY,19120,"Removal of 1 or more breast growth, open procedure",360,SERVICE NOT OFFERED,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,29826,Shaving of shoulder bone using an endoscope,360,SERVICE NOT OFFERED,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,29881,Removal of one knee cartilage using an endoscope,360,SERVICE NOT OFFERED,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,42820,Removal of tonsils and adenoid glands patient younger than age 12,360,SERVICE NOT OFFERED,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,43235,"Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscop",360,SERVICE NOT OFFERED,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. 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 separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,47562,Removal of gallbladder using an endoscope,360,SERVICE NOT OFFERED,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,49505,Repair of groin hernia patient age 5 or older,360,SERVICE NOT OFFERED,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,55700,Biopsy of prostate gland,360,SERVICE NOT OFFERED,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. 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 separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. 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 separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. 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 separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. 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 separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,62323,Injection of substance into spinal canal of lower back or sacrum using imaging guidanc,360,SERVICE NOT OFFERED,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,62322,Injection of substance into spinal canal of lower back or sacrum using imaging guidanc,360,SERVICE NOT OFFERED,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,64483,Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance,360,SERVICE NOT OFFERED,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. 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 separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,66984,Removal of cataract with insertion of lens,360,SERVICE NOT OFFERED,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. 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 separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. 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 separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,SLEEP STUDY,95810,Sleep study,920,SERVICE NOT OFFERED,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. 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 separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. 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 separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. 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 separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. 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 separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. 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 separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,Not separately reimbursable. Service not offered,N/A,N/A,N/A