|
2299912
|
OTHER
|
Mesh 20 X 20cm Resorbable
|
42
|
12
|
$384,000.00
|
$384,000.00
|
$2,350.00
|
$384,000.00
|
$88,320.00
|
2026-05-18
|
|
0DL68J9
|
OTHER
|
Or Procedures For Obesity
|
3
|
1
|
—
|
—
|
$29,045.00
|
$29,045.00
|
$29,045.00
|
2026-05-18
|
|
0DL60KA
|
OTHER
|
Or Procedures For Obesity
|
3
|
1
|
—
|
—
|
$29,045.00
|
$29,045.00
|
$29,045.00
|
2026-05-18
|
|
0DL64JL
|
OTHER
|
Or Procedures For Obesity
|
3
|
1
|
—
|
—
|
$29,045.00
|
$29,045.00
|
$29,045.00
|
2026-05-18
|
|
0DV6DCZ
|
OTHER
|
Or Procedures For Obesity
|
3
|
1
|
—
|
—
|
$29,045.00
|
$29,045.00
|
$29,045.00
|
2026-05-18
|
|
0DL60KB
|
OTHER
|
Or Procedures For Obesity
|
3
|
1
|
—
|
—
|
$29,045.00
|
$29,045.00
|
$29,045.00
|
2026-05-18
|
|
0D16029
|
OTHER
|
Or Procedures For Obesity
|
3
|
1
|
—
|
—
|
$29,045.00
|
$29,045.00
|
$29,045.00
|
2026-05-18
|
|
0DL64J9
|
OTHER
|
Or Procedures For Obesity
|
3
|
1
|
—
|
—
|
$29,045.00
|
$29,045.00
|
$29,045.00
|
2026-05-18
|
|
0DQ6DZZ
|
OTHER
|
Or Procedures For Obesity
|
3
|
1
|
—
|
—
|
$29,045.00
|
$29,045.00
|
$29,045.00
|
2026-05-18
|
|
0D16079
|
OTHER
|
Or Procedures For Obesity
|
3
|
1
|
—
|
—
|
$29,045.00
|
$29,045.00
|
$29,045.00
|
2026-05-18
|
|
0D1607B
|
OTHER
|
Or Procedures For Obesity
|
3
|
1
|
—
|
—
|
$29,045.00
|
$29,045.00
|
$29,045.00
|
2026-05-18
|
|
0DB6DZ3
|
OTHER
|
Or Procedures For Obesity
|
3
|
1
|
—
|
—
|
$29,045.00
|
$29,045.00
|
$29,045.00
|
2026-05-18
|
|
0D169ZA
|
OTHER
|
Or Procedures For Obesity
|
3
|
1
|
—
|
—
|
$29,045.00
|
$29,045.00
|
$29,045.00
|
2026-05-18
|
|
0DQS7ZF
|
OTHER
|
Or Procedures For Obesity
|
3
|
1
|
—
|
—
|
$29,045.00
|
$29,045.00
|
$29,045.00
|
2026-05-18
|
|
0DL60ZA
|
OTHER
|
Or Procedures For Obesity
|
3
|
1
|
—
|
—
|
$29,045.00
|
$29,045.00
|
$29,045.00
|
2026-05-18
|
|
0DL64JA
|
OTHER
|
Or Procedures For Obesity
|
3
|
1
|
—
|
—
|
$29,045.00
|
$29,045.00
|
$29,045.00
|
2026-05-18
|
|
0DL64JB
|
OTHER
|
Or Procedures For Obesity
|
3
|
1
|
—
|
—
|
$29,045.00
|
$29,045.00
|
$29,045.00
|
2026-05-18
|
|
2299745
|
OTHER
|
Lumber Fusion 4 Level
|
42
|
12
|
$83,000.00
|
$83,000.00
|
$2,350.00
|
$83,000.00
|
$21,268.75
|
2026-05-18
|
|
2733274
|
OTHER
|
Tcat Insj/rpl Perm Ldls Pm
|
80
|
27
|
$46,221.00
|
$46,221.00
|
$417.72
|
$46,221.00
|
$19,153.70
|
2026-05-18
|
|
0D160KL
|
OTHER
|
Bariatric Surgery
|
9
|
4
|
—
|
—
|
$12,201.00
|
$29,045.00
|
$18,495.00
|
2026-05-18
|
|
0D160JL
|
OTHER
|
Bariatric Surgery
|
9
|
4
|
—
|
—
|
$12,201.00
|
$29,045.00
|
$18,495.00
|
2026-05-18
|
|
0D1607L
|
OTHER
|
Bariatric Surgery
|
9
|
4
|
—
|
—
|
$12,201.00
|
$29,045.00
|
$18,495.00
|
2026-05-18
|
|
0D160J9
|
OTHER
|
Bariatric Surgery
|
9
|
4
|
—
|
—
|
$12,201.00
|
$29,045.00
|
$18,495.00
|
2026-05-18
|
|
0D1687B
|
OTHER
|
Bariatric Surgery
|
9
|
4
|
—
|
—
|
$12,201.00
|
$29,045.00
|
$18,495.00
|
2026-05-18
|
|
0D16879
|
OTHER
|
Bariatric Surgery
|
9
|
4
|
—
|
—
|
$12,201.00
|
$29,045.00
|
$18,495.00
|
2026-05-18
|
|
0D160JB
|
OTHER
|
Bariatric Surgery
|
9
|
4
|
—
|
—
|
$12,201.00
|
$29,045.00
|
$18,495.00
|
2026-05-18
|
|
0D168KB
|
OTHER
|
Bariatric Surgery
|
9
|
4
|
—
|
—
|
$12,201.00
|
$29,045.00
|
$18,495.00
|
2026-05-18
|
|
0D168KL
|
OTHER
|
Bariatric Surgery
|
9
|
4
|
—
|
—
|
$12,201.00
|
$29,045.00
|
$18,495.00
|
2026-05-18
|
|
0D160ZL
|
OTHER
|
Bariatric Surgery
|
9
|
4
|
—
|
—
|
$12,201.00
|
$29,045.00
|
$18,495.00
|
2026-05-18
|
|
0D168K9
|
OTHER
|
Bariatric Surgery
|
9
|
4
|
—
|
—
|
$12,201.00
|
$29,045.00
|
$18,495.00
|
2026-05-18
|
|
0D1687L
|
OTHER
|
Bariatric Surgery
|
9
|
4
|
—
|
—
|
$12,201.00
|
$29,045.00
|
$18,495.00
|
2026-05-18
|
|
0D160Z9
|
OTHER
|
Bariatric Surgery
|
9
|
4
|
—
|
—
|
$12,201.00
|
$29,045.00
|
$18,495.00
|
2026-05-18
|
|
0D168ZL
|
OTHER
|
Bariatric Surgery
|
9
|
4
|
—
|
—
|
$12,201.00
|
$29,045.00
|
$18,495.00
|
2026-05-18
|
|
0D168JL
|
OTHER
|
Bariatric Surgery
|
9
|
4
|
—
|
—
|
$12,201.00
|
$29,045.00
|
$18,495.00
|
2026-05-18
|
|
0D160K9
|
OTHER
|
Bariatric Surgery
|
9
|
4
|
—
|
—
|
$12,201.00
|
$29,045.00
|
$18,495.00
|
2026-05-18
|
|
0D168ZB
|
OTHER
|
Bariatric Surgery
|
9
|
4
|
—
|
—
|
$12,201.00
|
$29,045.00
|
$18,495.00
|
2026-05-18
|
|
2299753
|
OTHER
|
Lumbar Fusion 9 Level
|
42
|
12
|
$72,000.00
|
$72,000.00
|
$2,350.00
|
$72,000.00
|
$18,450.00
|
2026-05-18
|
|
2722745
|
OTHER
|
Coronary Des Stent Drug Eluting Atherect
|
90
|
26
|
$18,404.00
|
$18,404.00
|
$2,016.00
|
$38,491.28
|
$18,404.00
|
2026-05-18
|
|
2722753
|
OTHER
|
Coronary Des W/cto
|
90
|
26
|
$18,404.00
|
$18,404.00
|
$2,016.00
|
$38,491.28
|
$18,404.00
|
2026-05-18
|
|
0D160ZB
|
OTHER
|
Bariatric Surgery
|
8
|
4
|
—
|
—
|
$12,201.00
|
$29,045.00
|
$16,109.50
|
2026-05-18
|
|
0D168J9
|
OTHER
|
Bariatric Surgery
|
8
|
4
|
—
|
—
|
$12,201.00
|
$29,045.00
|
$16,109.50
|
2026-05-18
|
|
0D160KB
|
OTHER
|
Bariatric Surgery
|
8
|
4
|
—
|
—
|
$12,201.00
|
$29,045.00
|
$16,109.50
|
2026-05-18
|
|
0D168Z9
|
OTHER
|
Bariatric Surgery
|
8
|
4
|
—
|
—
|
$12,201.00
|
$29,045.00
|
$16,109.50
|
2026-05-18
|
|
0D168JB
|
OTHER
|
Bariatric Surgery
|
8
|
4
|
—
|
—
|
$12,201.00
|
$29,045.00
|
$16,109.50
|
2026-05-18
|
|
3000198
|
OTHER
|
Icatibant 30mg/3ml Inj
|
45
|
14
|
$40,681.55
|
$40,681.55
|
$2,016.00
|
$40,681.55
|
$14,645.36
|
2026-05-18
|
|
0DQ67ZZ
|
OTHER
|
Bariatric Surgery
|
15
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$14,200.00
|
2026-05-18
|
|
0D160JA
|
OTHER
|
Bariatric Surgery
|
15
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$14,200.00
|
2026-05-18
|
|
0D164JL
|
OTHER
|
Bariatric Surgery
|
15
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$14,200.00
|
2026-05-18
|
|
0D164ZL
|
OTHER
|
Bariatric Surgery
|
15
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$14,200.00
|
2026-05-18
|
|
0DQ60ZZ
|
OTHER
|
Bariatric Surgery
|
15
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$14,200.00
|
2026-05-18
|
|
0D160KA
|
OTHER
|
Bariatric Surgery
|
15
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$14,200.00
|
2026-05-18
|
|
0DQ68ZZ
|
OTHER
|
Bariatric Surgery
|
15
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$14,200.00
|
2026-05-18
|
|
0D164K9
|
OTHER
|
Bariatric Surgery
|
15
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$14,200.00
|
2026-05-18
|
|
0DW643Z
|
OTHER
|
Gastric Bypass
|
9
|
2
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$14,200.00
|
2026-05-18
|
|
0DQ63ZZ
|
OTHER
|
Bariatric Surgery
|
15
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$14,200.00
|
2026-05-18
|
|
0D164KB
|
OTHER
|
Bariatric Surgery
|
15
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$14,200.00
|
2026-05-18
|
|
0DW64CZ
|
OTHER
|
Gastric Bypass
|
9
|
2
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$14,200.00
|
2026-05-18
|
|
0D16479
|
OTHER
|
Bariatric Surgery
|
15
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$14,200.00
|
2026-05-18
|
|
0D1687A
|
OTHER
|
Bariatric Surgery
|
15
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$14,200.00
|
2026-05-18
|
|
0DQ64ZZ
|
OTHER
|
Bariatric Surgery
|
15
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$14,200.00
|
2026-05-18
|
|
0D164KL
|
OTHER
|
Bariatric Surgery
|
15
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$14,200.00
|
2026-05-18
|
|
0D164J9
|
OTHER
|
Bariatric Surgery
|
15
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$14,200.00
|
2026-05-18
|
|
0D1607A
|
OTHER
|
Gastric Bypass
|
9
|
2
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$14,200.00
|
2026-05-18
|
|
0D164ZB
|
OTHER
|
Bariatric Surgery
|
15
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$14,200.00
|
2026-05-18
|
|
0D160ZA
|
OTHER
|
Bariatric Surgery
|
15
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$14,200.00
|
2026-05-18
|
|
0D164KA
|
OTHER
|
Bariatric Surgery
|
15
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$14,200.00
|
2026-05-18
|
|
0D168JA
|
OTHER
|
Bariatric Surgery
|
15
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$14,200.00
|
2026-05-18
|
|
0D164JB
|
OTHER
|
Bariatric Surgery
|
14
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$13,962.00
|
2026-05-18
|
|
0D164JA
|
OTHER
|
Bariatric Surgery
|
14
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$13,962.00
|
2026-05-18
|
|
0D164Z9
|
OTHER
|
Bariatric Surgery
|
14
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$13,962.00
|
2026-05-18
|
|
0D1647L
|
OTHER
|
Bariatric Surgery
|
14
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$13,962.00
|
2026-05-18
|
|
0D168KA
|
OTHER
|
Bariatric Surgery
|
14
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$13,962.00
|
2026-05-18
|
|
0D1647A
|
OTHER
|
Bariatric Surgery
|
14
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$13,962.00
|
2026-05-18
|
|
0D1647B
|
OTHER
|
Bariatric Surgery
|
14
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$13,962.00
|
2026-05-18
|
|
0D168ZA
|
OTHER
|
Bariatric Surgery
|
14
|
5
|
—
|
—
|
$11,438.00
|
$29,045.00
|
$13,962.00
|
2026-05-18
|
|
2722705
|
OTHER
|
Prq Cardiac Stent W/angio 1 Vsl
|
107
|
28
|
$48,656.00
|
$48,656.00
|
$483.05
|
$48,656.00
|
$13,745.22
|
2026-05-18
|
|
0D168Z4
|
OTHER
|
Bariatric Surgery
|
6
|
3
|
—
|
—
|
$12,201.00
|
$18,495.00
|
$13,724.00
|
2026-05-18
|
|
0D168K4
|
OTHER
|
Bariatric Surgery
|
6
|
3
|
—
|
—
|
$12,201.00
|
$18,495.00
|
$13,724.00
|
2026-05-18
|
|
0D164Z4
|
OTHER
|
Bariatric Surgery
|
6
|
3
|
—
|
—
|
$12,201.00
|
$18,495.00
|
$13,724.00
|
2026-05-18
|
|
0D164K4
|
OTHER
|
Bariatric Surgery
|
6
|
3
|
—
|
—
|
$12,201.00
|
$18,495.00
|
$13,724.00
|
2026-05-18
|
|
0D16874
|
OTHER
|
Bariatric Surgery
|
6
|
3
|
—
|
—
|
$12,201.00
|
$18,495.00
|
$13,724.00
|
2026-05-18
|
|
0D164J4
|
OTHER
|
Bariatric Surgery
|
6
|
3
|
—
|
—
|
$12,201.00
|
$18,495.00
|
$13,724.00
|
2026-05-18
|
|
0D168J4
|
OTHER
|
Bariatric Surgery
|
6
|
3
|
—
|
—
|
$12,201.00
|
$18,495.00
|
$13,724.00
|
2026-05-18
|
|
0D160Z4
|
OTHER
|
Bariatric Surgery
|
6
|
3
|
—
|
—
|
$12,201.00
|
$18,495.00
|
$13,724.00
|
2026-05-18
|
|
0D160K4
|
OTHER
|
Bariatric Surgery
|
6
|
3
|
—
|
—
|
$12,201.00
|
$18,495.00
|
$13,724.00
|
2026-05-18
|
|
0D160J4
|
OTHER
|
Bariatric Surgery
|
6
|
3
|
—
|
—
|
$12,201.00
|
$18,495.00
|
$13,724.00
|
2026-05-18
|
|
2722697
|
OTHER
|
Ep Tx Atrial Fib Pulm Vein Isolation
|
107
|
28
|
$33,000.00
|
$33,000.00
|
$880.47
|
$52,586.43
|
$13,200.00
|
2026-05-18
|
|
2733208
|
OTHER
|
Insrt Heart Pm Atrial & Vent
|
80
|
27
|
$30,036.00
|
$30,036.00
|
$1,068.05
|
$30,036.00
|
$13,076.78
|
2026-05-18
|
|
2733206
|
OTHER
|
Insert Heart Pm Atrial
|
80
|
27
|
$26,324.42
|
$26,324.42
|
$1,068.05
|
$26,324.42
|
$13,076.78
|
2026-05-18
|
|
2733207
|
OTHER
|
Insert Heart Pm Ventricular
|
80
|
27
|
$26,324.42
|
$26,324.42
|
$1,068.05
|
$26,324.42
|
$13,076.78
|
2026-05-18
|
|
0D763DZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DV60ZZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0D760ZZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DV60DZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DV60CZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DU687Z
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DU67KZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DU677Z
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DU64JZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DU64KZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DU60JZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DU60KZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DU607Z
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DU68KZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0D760DZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0D768ZZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0D768DZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0D767DZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DN68ZZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DN67ZZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DN64ZZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DF64ZZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DN63ZZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DU67JZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DV67ZZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DV64DZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DV63DZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DM64ZZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DM60ZZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DN60ZZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DV68ZZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DV63CZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DF68ZZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DF67ZZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0D767ZZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DV63ZZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DU68JZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DF63ZZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DF60ZZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DU647Z
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0D764ZZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0D764DZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0D763ZZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0DV64ZZ
|
OTHER
|
Gastric Bypass
|
6
|
1
|
—
|
—
|
$11,438.00
|
$14,200.00
|
$12,819.00
|
2026-05-18
|
|
0D164ZA
|
OTHER
|
Bariatric Surgery
|
21
|
6
|
—
|
—
|
$10,811.00
|
$29,045.00
|
$12,558.00
|
2026-05-18
|
|
0DB64Z3
|
OTHER
|
Bariatric Surgery
|
21
|
6
|
—
|
—
|
$10,811.00
|
$29,045.00
|
$12,558.00
|
2026-05-18
|
|
8299060
|
OTHER
|
Thrmbc/nfs Dialysis Circuit
|
104
|
27
|
$29,257.29
|
$29,257.29
|
$141.30
|
$29,257.29
|
$12,504.33
|
2026-05-18
|
|
9622110
|
OTHER
|
Ir Thrombectomy Dialy Circ W/angi
|
104
|
27
|
$24,929.00
|
$24,929.00
|
$141.30
|
$24,929.00
|
$12,389.49
|
2026-05-18
|
|
5099054
|
OTHER
|
Vasc Embolize/occlude Artery
|
104
|
27
|
$21,000.00
|
$21,000.00
|
$428.15
|
$38,491.28
|
$12,380.55
|
2026-05-18
|
|
2299743
|
OTHER
|
Lumbar Fusion 2 Level
|
42
|
12
|
$48,000.00
|
$48,000.00
|
$2,350.00
|
$48,000.00
|
$12,300.00
|
2026-05-18
|
|
2299744
|
OTHER
|
Lumber Fusion 3 Level
|
42
|
12
|
$48,000.00
|
$48,000.00
|
$2,350.00
|
$48,000.00
|
$12,300.00
|
2026-05-18
|
|
2299742
|
OTHER
|
Lumbar Fusion 1 Level
|
42
|
12
|
$48,000.00
|
$48,000.00
|
$2,350.00
|
$48,000.00
|
$12,300.00
|
2026-05-18
|
|
0DV64CZ
|
OTHER
|
Bariatric Laproscopic Ip
|
21
|
6
|
—
|
—
|
$10,181.00
|
$29,045.00
|
$12,201.00
|
2026-05-18
|
|
2527029
|
OTHER
|
Pacemaker Micra Av2 Leadless System
|
38
|
13
|
$56,880.00
|
$56,880.00
|
$2,275.20
|
$56,880.00
|
$11,944.80
|
2026-05-18
|
|
9630027
|
OTHER
|
Ir Embolztn Arterial/venous Hmrg
|
105
|
28
|
$23,151.00
|
$23,151.00
|
$595.31
|
$24,309.17
|
$11,878.21
|
2026-05-18
|
|
2722749
|
OTHER
|
Coronary Des Bypass Graft
|
90
|
26
|
$18,404.00
|
$18,404.00
|
$2,016.00
|
$24,309.17
|
$11,878.21
|
2026-05-18
|
|
2722741
|
OTHER
|
Coronary Des Stent Drug Eluting
|
90
|
26
|
$18,404.00
|
$18,404.00
|
$2,016.00
|
$24,309.17
|
$11,878.21
|
2026-05-18
|
|
N4
|
OTHER
|
NICU / Level IV
|
24
|
11
|
$11,665.07
|
$11,665.07
|
$3,699.00
|
$11,665.07
|
$11,665.07
|
2026-05-18
|
|
9629400
|
OTHER
|
Ir Vasc Embolize/occlude Venous
|
104
|
27
|
$20,309.00
|
$20,309.00
|
$363.18
|
$24,309.17
|
$11,409.03
|
2026-05-18
|
|
2733228
|
OTHER
|
Remvl Perm Pm Pls Gen W/repl Plse Gen 2
|
80
|
27
|
$28,546.00
|
$28,546.00
|
$289.65
|
$28,546.00
|
$11,086.40
|
2026-05-18
|
|
N5
|
OTHER
|
NICU / Level V
|
24
|
11
|
$11,000.00
|
$11,000.00
|
$3,699.00
|
$11,000.00
|
$11,000.00
|
2026-05-18
|
|
5099033
|
OTHER
|
Vasc Emboliz/occlude Arterial
|
105
|
28
|
$18,717.00
|
$18,717.00
|
$428.15
|
$38,491.28
|
$10,895.17
|
2026-05-18
|
|
2299749
|
OTHER
|
Cervical Fusion 4 Level
|
42
|
12
|
$40,000.00
|
$40,000.00
|
$2,350.00
|
$40,000.00
|
$10,250.00
|
2026-05-18
|
|
2299750
|
OTHER
|
Rotator Cuff Implant
|
42
|
12
|
$39,000.00
|
$39,000.00
|
$2,350.00
|
$39,000.00
|
$9,993.75
|
2026-05-18
|
|
N3
|
OTHER
|
NICU / Level Iii
|
24
|
11
|
$9,725.25
|
$9,725.25
|
$3,699.00
|
$9,725.25
|
$9,725.25
|
2026-05-18
|
|
2299462
|
OTHER
|
Urolift Tranprostatic Implant
|
85
|
23
|
$3,900.00
|
$3,900.00
|
$780.00
|
$19,821.80
|
$9,208.14
|
2026-05-18
|
|
8E074CZ
|
OTHER
|
Da Vinci Surg
|
3
|
1
|
—
|
—
|
$9,042.00
|
$9,042.00
|
$9,042.00
|
2026-05-18
|
|
8E090CZ
|
OTHER
|
Da Vinci Surg
|
3
|
1
|
—
|
—
|
$9,042.00
|
$9,042.00
|
$9,042.00
|
2026-05-18
|
|
8E0W7CZ
|
OTHER
|
Da Vinci Surg
|
3
|
1
|
—
|
—
|
$9,042.00
|
$9,042.00
|
$9,042.00
|
2026-05-18
|
|
8E0Z4CZ
|
OTHER
|
Da Vinci Surg
|
3
|
1
|
—
|
—
|
$9,042.00
|
$9,042.00
|
$9,042.00
|
2026-05-18
|
|
8E0Z0CZ
|
OTHER
|
Da Vinci Surg
|
3
|
1
|
—
|
—
|
$9,042.00
|
$9,042.00
|
$9,042.00
|
2026-05-18
|
|
8E0Y0CZ
|
OTHER
|
Da Vinci Surg
|
3
|
1
|
—
|
—
|
$9,042.00
|
$9,042.00
|
$9,042.00
|
2026-05-18
|
|
8E0Y3CZ
|
OTHER
|
Da Vinci Surg
|
3
|
1
|
—
|
—
|
$9,042.00
|
$9,042.00
|
$9,042.00
|
2026-05-18
|
|
8E0YXCZ
|
OTHER
|
Da Vinci Surg
|
3
|
1
|
—
|
—
|
$9,042.00
|
$9,042.00
|
$9,042.00
|
2026-05-18
|
|
8E0XXCZ
|
OTHER
|
Da Vinci Surg
|
3
|
1
|
—
|
—
|
$9,042.00
|
$9,042.00
|
$9,042.00
|
2026-05-18
|
|
8E0W8CZ
|
OTHER
|
Da Vinci Surg
|
3
|
1
|
—
|
—
|
$9,042.00
|
$9,042.00
|
$9,042.00
|
2026-05-18
|
|
8E0WXCZ
|
OTHER
|
Da Vinci Surg
|
3
|
1
|
—
|
—
|
$9,042.00
|
$9,042.00
|
$9,042.00
|
2026-05-18
|
|
8E0W4CZ
|
OTHER
|
Da Vinci Surg
|
3
|
1
|
—
|
—
|
$9,042.00
|
$9,042.00
|
$9,042.00
|
2026-05-18
|
|
8E0X3CZ
|
OTHER
|
Da Vinci Surg
|
3
|
1
|
—
|
—
|
$9,042.00
|
$9,042.00
|
$9,042.00
|
2026-05-18
|
|
8E098CZ
|
OTHER
|
Da Vinci Surg
|
3
|
1
|
—
|
—
|
$9,042.00
|
$9,042.00
|
$9,042.00
|
2026-05-18
|
|
8E09XCZ
|
OTHER
|
Da Vinci Surg
|
3
|
1
|
—
|
—
|
$9,042.00
|
$9,042.00
|
$9,042.00
|
2026-05-18
|
|
8E097CZ
|
OTHER
|
Da Vinci Surg
|
3
|
1
|
—
|
—
|
$9,042.00
|
$9,042.00
|
$9,042.00
|
2026-05-18
|
|
8E0W0CZ
|
OTHER
|
Da Vinci Surg
|
3
|
1
|
—
|
—
|
$9,042.00
|
$9,042.00
|
$9,042.00
|
2026-05-18
|
|
8E093CZ
|
OTHER
|
Da Vinci Surg
|
3
|
1
|
—
|
—
|
$9,042.00
|
$9,042.00
|
$9,042.00
|
2026-05-18
|
|
8E094CZ
|
OTHER
|
Da Vinci Surg
|
3
|
1
|
—
|
—
|
$9,042.00
|
$9,042.00
|
$9,042.00
|
2026-05-18
|
|
8E0W3CZ
|
OTHER
|
Da Vinci Surg
|
3
|
1
|
—
|
—
|
$9,042.00
|
$9,042.00
|
$9,042.00
|
2026-05-18
|
|
2737187
|
OTHER
|
Rq Transluminal Mechanical Thrombectomy
|
80
|
27
|
$12,707.00
|
$12,707.00
|
$2,016.00
|
$24,309.17
|
$8,718.60
|
2026-05-18
|
|
2722711
|
OTHER
|
Cath Inssubq Card Rhythm Monitor
|
107
|
28
|
$21,795.11
|
$21,795.11
|
$1,863.30
|
$21,795.11
|
$8,718.04
|
2026-05-18
|
|
5099034
|
OTHER
|
Vasc Emboliz/occlude Venous
|
105
|
28
|
$14,593.00
|
$14,593.00
|
$2,016.00
|
$24,309.17
|
$8,494.59
|
2026-05-18
|
|
3094846
|
OTHER
|
Idarucizumab (praxbind) 2.5gm/50ml Inj
|
45
|
14
|
$22,445.70
|
$22,445.70
|
$2,016.00
|
$22,445.70
|
$8,080.45
|
2026-05-18
|
|
2299746
|
OTHER
|
Cervical Fusion 1 Level
|
42
|
12
|
$31,000.00
|
$31,000.00
|
$2,350.00
|
$31,000.00
|
$7,943.75
|
2026-05-18
|
|
2299748
|
OTHER
|
Cervical Fusion 3 Level
|
42
|
12
|
$31,000.00
|
$31,000.00
|
$2,350.00
|
$31,000.00
|
$7,943.75
|
2026-05-18
|
|
2299747
|
OTHER
|
Cervical Fusion 2 Level
|
42
|
12
|
$31,000.00
|
$31,000.00
|
$2,350.00
|
$31,000.00
|
$7,943.75
|
2026-05-18
|
|
5099153
|
OTHER
|
Hepatic Shunt Insert (tips)
|
94
|
27
|
$12,975.38
|
$12,975.38
|
$544.88
|
$38,491.28
|
$7,911.05
|
2026-05-18
|
|
9630026
|
OTHER
|
Ir Embolization Tumor/organ
|
105
|
28
|
$13,534.22
|
$13,534.22
|
$510.05
|
$24,309.17
|
$7,878.27
|
2026-05-18
|
|
5099064
|
OTHER
|
Trancath Occlu-head Or Neck
|
107
|
28
|
$16,990.00
|
$16,990.00
|
$973.00
|
$24,309.17
|
$7,713.00
|
2026-05-18
|
|
4544123
|
OTHER
|
Endo Biliary Dil With Stent
|
107
|
28
|
$4,687.00
|
$4,687.00
|
$493.45
|
$22,317.06
|
$7,459.20
|
2026-05-18
|
|
2722701
|
OTHER
|
Prq Cardiac Angioplast 1 Art
|
107
|
28
|
$25,487.00
|
$25,487.00
|
$435.12
|
$25,487.00
|
$7,203.18
|
2026-05-18
|
|
N2
|
OTHER
|
NICU / Level Ii
|
24
|
11
|
$7,191.27
|
$7,191.27
|
$3,699.00
|
$7,191.27
|
$7,191.27
|
2026-05-18
|
|
2522077
|
OTHER
|
Memory Gel Breast Implant 635cc
|
32
|
12
|
$27,600.00
|
$27,600.00
|
$2,350.00
|
$27,600.00
|
$7,072.50
|
2026-05-18
|
|
90101997
|
OTHER
|
Breast Implant Memorygel 500 Ml
|
32
|
12
|
$27,600.00
|
$27,600.00
|
$2,350.00
|
$27,600.00
|
$7,072.50
|
2026-05-18
|
|
2299566
|
OTHER
|
Penile Prosthesis Pump 700 Lgx
|
42
|
12
|
$27,596.00
|
$27,596.00
|
$2,350.00
|
$27,596.00
|
$7,071.48
|
2026-05-18
|
|
9663244
|
OTHER
|
Ir Hepatic Shunt Removal (tips)
|
107
|
28
|
$13,122.00
|
$13,122.00
|
$249.81
|
$13,122.00
|
$7,027.09
|
2026-05-18
|
|
9629066
|
OTHER
|
Ir Kyphoplasty Lumbar
|
107
|
28
|
$11,883.00
|
$11,883.00
|
$435.59
|
$15,313.00
|
$6,923.00
|
2026-05-18
|
|
2293555
|
OTHER
|
Laparoscopic Prcdr Esophagus
|
107
|
28
|
$19,438.33
|
$19,438.33
|
$1,272.52
|
$22,317.06
|
$6,923.00
|
2026-05-18
|
|
2299884
|
OTHER
|
Diag Laparo Separate Proc
|
107
|
28
|
$9,405.50
|
$9,405.50
|
$335.91
|
$12,506.30
|
$6,889.14
|
2026-05-18
|
|
2299767
|
OTHER
|
Penile Pros Spectra
|
42
|
12
|
$26,268.00
|
$26,268.00
|
$2,350.00
|
$26,268.00
|
$6,731.18
|
2026-05-18
|
|
2299755
|
OTHER
|
Shoulder Implant
|
42
|
12
|
$26,000.00
|
$26,000.00
|
$2,350.00
|
$26,000.00
|
$6,662.50
|
2026-05-18
|
|
2527021
|
OTHER
|
Subq Car Rhythm Mntr Implantable
|
32
|
12
|
$25,980.00
|
$25,980.00
|
$2,350.00
|
$25,980.00
|
$6,657.38
|
2026-05-18
|
|
5099044
|
OTHER
|
Kyphoplasty Thoracic
|
104
|
27
|
$11,263.00
|
$11,263.00
|
$25.45
|
$15,313.00
|
$6,640.10
|
2026-05-18
|
|
2722747
|
OTHER
|
Coronary Des Stent Drug Eluting Athr Add
|
45
|
14
|
$18,404.00
|
$18,404.00
|
$539.00
|
$18,404.00
|
$6,625.44
|
2026-05-18
|
|
2722743
|
OTHER
|
Coronary Des Stent Drug Eluting Addl Art
|
45
|
14
|
$18,404.00
|
$18,404.00
|
$539.00
|
$18,404.00
|
$6,625.44
|
2026-05-18
|
|
2722751
|
OTHER
|
Coronary Des W/ami
|
45
|
14
|
$18,404.00
|
$18,404.00
|
$1,715.00
|
$18,404.00
|
$6,625.44
|
2026-05-18
|
|
2599219
|
OTHER
|
Xenmatrix Ab Surgical Graft
|
45
|
14
|
$18,312.00
|
$18,312.00
|
$2,016.00
|
$18,312.00
|
$6,592.32
|
2026-05-18
|
|
4544310
|
OTHER
|
Ercp Destr Calculi Any Method
|
90
|
26
|
$5,174.00
|
$5,174.00
|
$2,020.00
|
$12,760.19
|
$6,582.31
|
2026-05-18
|
|
5099107
|
OTHER
|
Ir Treat Ectopic Pregnancy
|
104
|
27
|
$13,578.00
|
$13,578.00
|
$569.82
|
$13,578.00
|
$6,554.80
|
2026-05-18
|
|
LT
|
OTHER
|
Labor Delivery Telemetry
|
24
|
11
|
$6,514.71
|
$6,514.71
|
$3,699.00
|
$6,514.71
|
$6,514.71
|
2026-05-18
|
|
TC
|
OTHER
|
Telecwing
|
24
|
11
|
$6,514.71
|
$6,514.71
|
$3,699.00
|
$6,514.71
|
$6,514.71
|
2026-05-18
|
|
9663260
|
OTHER
|
Ir Intro Cath Dialysis Circuit
|
101
|
27
|
$14,475.60
|
$14,475.60
|
$1,112.06
|
$14,475.60
|
$6,485.79
|
2026-05-18
|
|
2299576
|
OTHER
|
Penile Prosthesis Pump 700 Cx
|
42
|
12
|
$25,200.00
|
$25,200.00
|
$2,350.00
|
$25,200.00
|
$6,457.50
|
2026-05-18
|
|
90000227
|
OTHER
|
Coflex Sz 12
|
42
|
12
|
$25,060.00
|
$25,060.00
|
$2,350.00
|
$25,060.00
|
$6,421.62
|
2026-05-18
|
|
9662413
|
OTHER
|
Ir Trluml Balo Angiop 1st Vein
|
105
|
28
|
$14,475.60
|
$14,475.60
|
$1,351.82
|
$14,475.60
|
$6,267.93
|
2026-05-18
|
|
5099175
|
OTHER
|
Trluml Balo Angiop 1st Vein
|
105
|
28
|
$14,475.60
|
$14,475.60
|
$1,351.82
|
$14,475.60
|
$6,267.93
|
2026-05-18
|
|
9662275
|
OTHER
|
Ir Repair Venous Blockage
|
104
|
27
|
$7,985.00
|
$7,985.00
|
$271.33
|
$38,491.28
|
$6,259.85
|
2026-05-18
|
|
5099158
|
OTHER
|
Repair Venous Blockage
|
104
|
27
|
$7,985.00
|
$7,985.00
|
$271.33
|
$38,491.28
|
$6,259.85
|
2026-05-18
|
|
9629414
|
OTHER
|
Ir Intro Transhepatic Stent
|
101
|
27
|
$12,084.50
|
$12,084.50
|
$2,016.00
|
$12,506.30
|
$6,253.73
|
2026-05-18
|
|
2299885
|
OTHER
|
Lap Enterolysis
|
107
|
28
|
$12,369.21
|
$12,369.21
|
$679.82
|
$12,506.30
|
$6,231.00
|
2026-05-18
|
|
2722709
|
OTHER
|
Cath Ins/replace Ele/pm Cth Sngl
|
107
|
28
|
$6,211.00
|
$6,211.00
|
$373.82
|
$17,740.05
|
$6,211.00
|
2026-05-18
|
|
9628263
|
OTHER
|
Ir Insert Cath Renal 2nd Ordr Uni
|
105
|
28
|
$13,478.00
|
$13,478.00
|
$316.27
|
$13,478.00
|
$6,169.00
|
2026-05-18
|
|
2236562
|
OTHER
|
Major Surgery Ii 1st Hr Computer Assist
|
48
|
17
|
$16,874.77
|
$16,874.77
|
$146.17
|
$16,874.77
|
$6,121.96
|
2026-05-18
|
|
2299793
|
OTHER
|
Vivigen Formable Large
|
42
|
12
|
$23,684.00
|
$23,684.00
|
$2,350.00
|
$23,684.00
|
$6,069.02
|
2026-05-18
|
|
N1
|
OTHER
|
NICU / Level I
|
24
|
11
|
$6,055.66
|
$6,055.66
|
$3,699.00
|
$6,055.66
|
$6,055.66
|
2026-05-18
|
|
5099025
|
OTHER
|
Angio Int Carotid Intra Extrac
|
104
|
27
|
$12,706.00
|
$12,706.00
|
$280.71
|
$12,706.00
|
$6,033.23
|
2026-05-18
|
|
2299807
|
OTHER
|
Stimulator Spinal Impantable
|
42
|
12
|
$23,400.00
|
$23,400.00
|
$2,350.00
|
$23,400.00
|
$5,996.25
|
2026-05-18
|
|
2299596
|
OTHER
|
Guidant Pacemaker Generator Al
|
42
|
12
|
$23,200.00
|
$23,200.00
|
$2,350.00
|
$23,200.00
|
$5,945.00
|
2026-05-18
|
|
2299562
|
OTHER
|
Dpy Shoulder Humeral Stem W/pr
|
42
|
12
|
$23,101.60
|
$23,101.60
|
$2,350.00
|
$23,101.60
|
$5,919.78
|
2026-05-18
|
|
IC
|
OTHER
|
Intensive Care Unit
|
32
|
13
|
$16,866.49
|
$16,866.49
|
$2,016.00
|
$16,866.49
|
$5,881.97
|
2026-05-18
|
|
2299709
|
OTHER
|
Dpy Femoral Component Sigma Cr
|
42
|
12
|
$22,329.52
|
$22,329.52
|
$2,350.00
|
$22,329.52
|
$5,721.94
|
2026-05-18
|
|
2299549
|
OTHER
|
Devex Cage Depuy
|
42
|
12
|
$22,032.00
|
$22,032.00
|
$2,350.00
|
$22,032.00
|
$5,645.70
|
2026-05-18
|
|
9661138
|
OTHER
|
Explore Parathyroid Gland
|
107
|
28
|
$3,531.38
|
$3,531.38
|
$1,088.88
|
$12,680.56
|
$5,549.32
|
2026-05-18
|
|
9628326
|
OTHER
|
Ir Angiography Visceral
|
107
|
28
|
$4,414.58
|
$4,414.58
|
$370.41
|
$20,319.72
|
$5,492.86
|
2026-05-18
|
|
5099077
|
OTHER
|
Angiography Pelvis
|
107
|
28
|
$4,414.58
|
$4,414.58
|
$370.41
|
$20,319.72
|
$5,492.86
|
2026-05-18
|
|
2236560
|
OTHER
|
Major Surgery Ii 1st Hr
|
64
|
17
|
$13,652.32
|
$13,652.32
|
$146.17
|
$13,652.32
|
$5,460.93
|
2026-05-18
|
|
2233656
|
OTHER
|
Major Surgery 1st Hr
|
64
|
17
|
$11,556.31
|
$11,556.31
|
$146.17
|
$11,556.31
|
$5,439.00
|
2026-05-18
|
|
2222000
|
OTHER
|
Serofuse Implant Fastener Kit
|
42
|
12
|
$20,992.00
|
$20,992.00
|
$2,350.00
|
$20,992.00
|
$5,417.20
|
2026-05-18
|
|
5099082
|
OTHER
|
Arterial Mech Thromb-init Vess
|
105
|
28
|
$8,842.00
|
$8,842.00
|
$2,016.00
|
$38,491.28
|
$5,324.00
|
2026-05-18
|
|
3044799
|
OTHER
|
Digoxin Immune Fab (digifab) 40mg Inj
|
104
|
28
|
$20,845.80
|
$20,845.80
|
$706.32
|
$20,845.80
|
$5,166.99
|
2026-05-18
|
|
2299441
|
OTHER
|
Misc Mesh (implantable)
|
42
|
12
|
$19,200.00
|
$19,200.00
|
$2,350.00
|
$19,200.00
|
$5,160.00
|
2026-05-18
|
|
2299623
|
OTHER
|
Djo Hip Femoral Hip
|
42
|
12
|
$18,885.00
|
$18,885.00
|
$2,350.00
|
$18,885.00
|
$5,075.35
|
2026-05-18
|
|
2299548
|
OTHER
|
X-stop Ipd Implant
|
42
|
12
|
$18,500.00
|
$18,500.00
|
$2,350.00
|
$18,500.00
|
$4,971.88
|
2026-05-18
|
|
2299886
|
OTHER
|
Lap Rmvl Gastr Adj Device
|
107
|
28
|
$9,053.00
|
$9,053.00
|
$705.14
|
$17,254.00
|
$4,888.62
|
2026-05-18
|
|
2527023
|
OTHER
|
Pacemaker Dual AzureS Dr Mr SureScan
|
38
|
13
|
$23,200.00
|
$23,200.00
|
$928.00
|
$23,200.00
|
$4,872.00
|
2026-05-18
|
|
2299687
|
OTHER
|
Valeo Tl Spacer
|
42
|
12
|
$18,000.00
|
$18,000.00
|
$2,350.00
|
$18,000.00
|
$4,837.50
|
2026-05-18
|
|
2244607
|
OTHER
|
Allograft Moldable Putty
|
14
|
9
|
$21,000.00
|
$10,500.00
50% off
|
$40.70
|
$21,000.00
|
$4,830.00
|
2026-05-09
|
|
2280538
|
OTHER
|
Lap Gastric Rest Remove Band
|
107
|
28
|
$1,907.40
|
$1,907.40
|
$707.74
|
$17,254.00
|
$4,781.85
|
2026-05-18
|
|
2236564
|
OTHER
|
Major Ii Surg Ea Add'l 30min Mako
|
48
|
17
|
$9,026.16
|
$9,026.16
|
$58.47
|
$9,026.16
|
$4,772.59
|
2026-05-18
|
|
10A07Z6
|
OTHER
|
Vaginal Delivery
|
6
|
1
|
—
|
—
|
$4,115.00
|
$5,364.00
|
$4,739.50
|
2026-05-18
|
|
0W3R8ZZ
|
OTHER
|
Vaginal Delivery
|
6
|
1
|
—
|
—
|
$4,115.00
|
$5,364.00
|
$4,739.50
|
2026-05-18
|
|
0W3R7ZZ
|
OTHER
|
Vaginal Delivery
|
6
|
1
|
—
|
—
|
$4,115.00
|
$5,364.00
|
$4,739.50
|
2026-05-18
|
|
0W3R4ZZ
|
OTHER
|
Vaginal Delivery
|
6
|
1
|
—
|
—
|
$4,115.00
|
$5,364.00
|
$4,739.50
|
2026-05-18
|
|
0W3R3ZZ
|
OTHER
|
Vaginal Delivery
|
6
|
1
|
—
|
—
|
$4,115.00
|
$5,364.00
|
$4,739.50
|
2026-05-18
|
|
0W3R0ZZ
|
OTHER
|
Vaginal Delivery
|
6
|
1
|
—
|
—
|
$4,115.00
|
$5,364.00
|
$4,739.50
|
2026-05-18
|
|
0UQG7ZZ
|
OTHER
|
Vaginal Delivery
|
6
|
1
|
—
|
—
|
$4,115.00
|
$5,364.00
|
$4,739.50
|
2026-05-18
|
|
0UQG4ZZ
|
OTHER
|
Vaginal Delivery
|
6
|
1
|
—
|
—
|
$4,115.00
|
$5,364.00
|
$4,739.50
|
2026-05-18
|
|
0UQG3ZZ
|
OTHER
|
Vaginal Delivery
|
6
|
1
|
—
|
—
|
$4,115.00
|
$5,364.00
|
$4,739.50
|
2026-05-18
|
|
0UQG0ZZ
|
OTHER
|
Vaginal Delivery
|
6
|
1
|
—
|
—
|
$4,115.00
|
$5,364.00
|
$4,739.50
|
2026-05-18
|
|
0UJD7ZZ
|
OTHER
|
Vaginal Delivery
|
6
|
1
|
—
|
—
|
$4,115.00
|
$5,364.00
|
$4,739.50
|
2026-05-18
|
|
0TQD4ZZ
|
OTHER
|
Vaginal Delivery
|
6
|
1
|
—
|
—
|
$4,115.00
|
$5,364.00
|
$4,739.50
|
2026-05-18
|
|
0TQD0ZZ
|
OTHER
|
Vaginal Delivery
|
6
|
1
|
—
|
—
|
$4,115.00
|
$5,364.00
|
$4,739.50
|
2026-05-18
|
|
0TQD3ZZ
|
OTHER
|
Vaginal Delivery
|
6
|
1
|
—
|
—
|
$4,115.00
|
$5,364.00
|
$4,739.50
|
2026-05-18
|
|
2Y44X5Z
|
OTHER
|
Vaginal Delivery
|
6
|
1
|
—
|
—
|
$4,115.00
|
$5,364.00
|
$4,739.50
|
2026-05-18
|
|
5099084
|
OTHER
|
Cannula Insert-hemodialys
|
107
|
28
|
$4,539.58
|
$4,539.58
|
$181.57
|
$11,587.43
|
$4,707.00
|
2026-05-18
|
|
9650008
|
OTHER
|
Angio Seal Closure Set
|
48
|
14
|
$12,800.00
|
$12,800.00
|
$2,016.00
|
$12,800.00
|
$4,608.00
|
2026-05-18
|
|
2527042
|
OTHER
|
Catheter Thrombectomy Embolect Triever
|
36
|
14
|
$12,000.00
|
$12,000.00
|
$2,016.00
|
$12,000.00
|
$4,560.00
|
2026-05-18
|
|
2527043
|
OTHER
|
Intro-sheath Nonlaser Clottriever
|
36
|
14
|
$12,000.00
|
$12,000.00
|
$2,016.00
|
$12,000.00
|
$4,560.00
|
2026-05-18
|
|
3099614
|
OTHER
|
Aripiprazole Lauro 882mg Inj
|
45
|
14
|
$11,290.38
|
$11,290.38
|
$2,016.00
|
$11,290.38
|
$4,516.15
|
2026-05-18
|
|
2522013
|
OTHER
|
Enroute Tcar Neuroprotection Sys
|
42
|
12
|
$16,796.00
|
$16,796.00
|
$2,350.00
|
$16,796.00
|
$4,513.92
|
2026-05-18
|
|
10D00Z1
|
OTHER
|
Cesarean Section
|
12
|
4
|
—
|
—
|
$2,443.00
|
$6,705.00
|
$4,423.00
|
2026-05-18
|
|
10D00Z2
|
OTHER
|
Cesarean Section
|
12
|
4
|
—
|
—
|
$2,443.00
|
$6,705.00
|
$4,423.00
|
2026-05-18
|
|
10D00Z0
|
OTHER
|
Cesarean Section
|
12
|
4
|
—
|
—
|
$2,443.00
|
$6,705.00
|
$4,423.00
|
2026-05-18
|
|
2722715
|
OTHER
|
Cath Ins I-aort Balloon Ass Dev
|
62
|
17
|
$12,280.00
|
$12,280.00
|
$216.68
|
$12,280.00
|
$4,420.80
|
2026-05-18
|
|
2299795
|
OTHER
|
Osteovive 10cc
|
42
|
12
|
$16,400.00
|
$16,400.00
|
$2,350.00
|
$16,400.00
|
$4,407.50
|
2026-05-18
|
|
OI
|
OTHER
|
OB Isolation
|
24
|
11
|
$4,402.36
|
$4,402.36
|
$3,699.00
|
$4,402.36
|
$4,402.36
|
2026-05-18
|
|
2299557
|
OTHER
|
Sn Hip Femoral Compon Antholog
|
42
|
12
|
$16,275.28
|
$16,275.28
|
$2,350.00
|
$16,275.28
|
$4,373.98
|
2026-05-18
|
|
9694002
|
OTHER
|
Ir Plmt Ureteral Stent Prq
|
107
|
28
|
$6,730.47
|
$6,730.47
|
$973.94
|
$7,393.06
|
$4,355.72
|
2026-05-18
|
|
5025143
|
OTHER
|
Xr Cystoscopy And Stent
|
105
|
28
|
$8,605.00
|
$8,605.00
|
$789.82
|
$8,605.00
|
$4,355.72
|
2026-05-18
|
|
2299442
|
OTHER
|
Viabahn Endo Hep Cath 18ro 8mm
|
42
|
12
|
$16,116.00
|
$16,116.00
|
$2,350.00
|
$16,116.00
|
$4,331.17
|
2026-05-18
|
|
2299564
|
OTHER
|
Sn Knee Femoral Comp Genesisii
|
42
|
12
|
$16,091.36
|
$16,091.36
|
$2,350.00
|
$16,091.36
|
$4,324.55
|
2026-05-18
|
|
9662287
|
OTHER
|
Stent Fluency Plus
|
56
|
15
|
$17,296.00
|
$17,296.00
|
$691.84
|
$17,296.00
|
$4,324.00
|
2026-05-18
|
|
5099161
|
OTHER
|
Stent Fluency Plus
|
56
|
15
|
$17,296.00
|
$17,296.00
|
$691.84
|
$17,296.00
|
$4,324.00
|
2026-05-18
|
|
9629433
|
OTHER
|
Ir Insert Tun Intraperiton Cath
|
105
|
28
|
$7,614.00
|
$7,614.00
|
$194.93
|
$7,614.00
|
$4,322.62
|
2026-05-18
|
|
4544315
|
OTHER
|
Ercp W/stent Bili Or Pancr
|
107
|
28
|
$4,285.00
|
$4,285.00
|
$414.74
|
$12,760.19
|
$4,285.00
|
2026-05-18
|
|
6407227
|
OTHER
|
Bronchoscopy Diagnostics Transbronch Bx
|
107
|
28
|
$5,021.00
|
$5,021.00
|
$302.26
|
$7,903.19
|
$4,248.62
|
2026-05-18
|
|
2299444
|
OTHER
|
Viabahn Eno Hep Cath 35ro 9mm
|
42
|
12
|
$15,692.00
|
$15,692.00
|
$2,350.00
|
$15,692.00
|
$4,217.23
|
2026-05-18
|
|
4544049
|
OTHER
|
Ercp W/specimen Collection
|
107
|
28
|
$7,787.00
|
$7,787.00
|
$443.24
|
$8,155.24
|
$4,204.98
|
2026-05-18
|
|
2299568
|
OTHER
|
Sn Hip Femoral Comp Synergy
|
42
|
12
|
$15,627.04
|
$15,627.04
|
$2,350.00
|
$15,627.04
|
$4,199.77
|
2026-05-18
|
|
2722703
|
OTHER
|
Prq Cardiac Angioplast Addl Art
|
66
|
18
|
$11,000.00
|
$11,000.00
|
$440.00
|
$11,000.00
|
$4,164.50
|
2026-05-18
|
|
4544309
|
OTHER
|
Ercp W/stent Exchange
|
107
|
28
|
$5,936.00
|
$5,936.00
|
$431.50
|
$12,760.19
|
$4,164.46
|
2026-05-18
|
|
9628284
|
OTHER
|
Ir Angioplasty
|
101
|
27
|
$6,937.72
|
$6,937.72
|
$1,112.06
|
$12,221.55
|
$4,141.82
|
2026-05-18
|
|
2722692
|
OTHER
|
Cath Rt & Lt Hc W/lv & Coros & Grafts
|
107
|
28
|
$16,693.00
|
$16,693.00
|
$925.62
|
$16,693.00
|
$4,108.02
|
2026-05-18
|
|
2722684
|
OTHER
|
Cath Rt< Hc W/lv No Coros (new)
|
107
|
28
|
$16,693.00
|
$16,693.00
|
$718.88
|
$16,693.00
|
$4,108.02
|
2026-05-18
|
|
2722689
|
OTHER
|
Cath Lt Cath For Angio
|
107
|
28
|
$21,249.15
|
$21,249.15
|
$693.51
|
$21,249.15
|
$4,108.02
|
2026-05-18
|
|
2722682
|
OTHER
|
Cath Rt Heart W/ox Sat & Card Op
|
107
|
28
|
$16,693.00
|
$16,693.00
|
$579.86
|
$16,693.00
|
$4,108.02
|
2026-05-18
|
|
2722691
|
OTHER
|
Cath Rt & Lt Hc W/lv & Coros
|
107
|
28
|
$23,414.85
|
$23,414.85
|
$795.41
|
$23,414.85
|
$4,108.02
|
2026-05-18
|
|
2722685
|
OTHER
|
Cath Coro Angio Placement
|
107
|
28
|
$16,693.00
|
$16,693.00
|
$574.98
|
$16,693.00
|
$4,108.02
|
2026-05-18
|
|
2722688
|
OTHER
|
Cath Rt Hc With Coros & Grafts
|
107
|
28
|
$16,693.00
|
$16,693.00
|
$804.05
|
$16,693.00
|
$4,108.02
|
2026-05-18
|
|
2722683
|
OTHER
|
Cath Lt, No Coros (new)
|
107
|
28
|
$16,693.00
|
$16,693.00
|
$549.26
|
$16,693.00
|
$4,108.02
|
2026-05-18
|
|
2722687
|
OTHER
|
Cath Rt Hc W/coros
|
107
|
28
|
$16,693.00
|
$16,693.00
|
$709.21
|
$16,693.00
|
$4,108.02
|
2026-05-18
|
|
2722690
|
OTHER
|
Cath Lt Cath W/lv & Grafts
|
107
|
28
|
$23,409.10
|
$23,409.10
|
$754.97
|
$23,409.10
|
$4,108.02
|
2026-05-18
|
|
2722693
|
OTHER
|
Csth Coro Art/grft Angio S&i
|
107
|
28
|
$16,693.00
|
$16,693.00
|
$671.23
|
$16,693.00
|
$4,108.02
|
2026-05-18
|