|
23472
|
HCPCS
|
EKG 12 Lead
|
5
|
2
|
$507.00
|
$507.00
|
$4,320.00
|
$24,535.58
|
$24,535.58
|
2026-03-16
|
|
27703
|
HCPCS
|
Ankle 2 VIEWS,Tech Component
|
2
|
1
|
$507.00
|
$507.00
|
$20,000.00
|
$20,000.00
|
$20,000.00
|
2026-03-16
|
|
27447
|
HCPCS
|
Knee 1 2 VIEWS,Tech Component
|
5
|
4
|
$6.35
|
$6.35
|
$5,814.00
|
$31,604.12
|
$18,709.06
|
2026-03-16
|
|
24545
|
HCPCS
|
Fluoroscopic Guidance
|
5
|
2
|
$507.00
|
$507.00
|
$3,204.00
|
$17,404.06
|
$17,404.06
|
2026-03-16
|
|
27870
|
HCPCS
|
Ankle 1-2 Views OP,Tech Component
|
5
|
2
|
$417.56
|
$417.56
|
$3,204.00
|
$17,404.06
|
$17,404.06
|
2026-03-16
|
|
24515
|
HCPCS
|
Fluoroscopic Guidance
|
3
|
2
|
$507.00
|
$507.00
|
$3,204.00
|
$17,404.06
|
$17,404.06
|
2026-03-16
|
|
58552
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$14,519.26
|
$14,519.26
|
$14,519.26
|
2026-03-16
|
|
27702
|
HCPCS
|
Ankle 2 VIEWS,Tech Component
|
4
|
2
|
$581.36
|
$581.36
|
$3,403.00
|
$24,077.08
|
$13,740.04
|
2026-03-16
|
|
28705
|
HCPCS
|
Ankle 1-2 Views OP,Tech Component
|
4
|
2
|
$536.64
|
$536.64
|
$3,204.00
|
$23,977.58
|
$13,590.79
|
2026-03-16
|
|
57283
|
HCPCS
|
EKG 12 Lead
|
3
|
2
|
$655.72
|
$655.72
|
$3,403.00
|
$10,779.50
|
$10,779.50
|
2026-03-16
|
|
23412
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$10,618.60
|
$10,618.60
|
$10,618.60
|
2026-03-16
|
|
23410
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$10,388.60
|
$10,388.60
|
$10,388.60
|
2026-03-16
|
|
28730
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$3,204.00
|
$17,404.06
|
$10,304.03
|
2026-03-16
|
|
28725
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$3,204.00
|
$17,404.06
|
$10,304.03
|
2026-03-16
|
|
23615
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$3,204.00
|
$17,404.06
|
$10,304.03
|
2026-03-16
|
|
28735
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$3,204.00
|
$17,404.06
|
$10,304.03
|
2026-03-16
|
|
27871
|
HCPCS
|
Ankle 1-2 Views OP,Tech Component
|
4
|
2
|
$462.28
|
$462.28
|
$3,204.00
|
$17,404.06
|
$10,304.03
|
2026-03-16
|
|
28320
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$3,204.00
|
$17,404.06
|
$10,304.03
|
2026-03-16
|
|
29828
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$10,291.10
|
$10,291.10
|
$10,291.10
|
2026-03-16
|
|
28740
|
HCPCS
|
Ankle 1-2 Views OP,Tech Component
|
3
|
2
|
$417.56
|
$417.56
|
$3,204.00
|
$10,191.60
|
$10,191.60
|
2026-03-16
|
|
28750
|
HCPCS
|
Marcaine .25% 30ml
|
1
|
1
|
$22.05
|
$22.05
|
$10,191.60
|
$10,191.60
|
$10,191.60
|
2026-03-16
|
|
28309
|
HCPCS
|
Diprivan 10mg/ml 20ml
|
1
|
1
|
$32.25
|
$32.25
|
$10,191.60
|
$10,191.60
|
$10,191.60
|
2026-03-16
|
|
27691
|
HCPCS
|
Fentanyl .05mg/ml 5ml
|
1
|
1
|
$14.25
|
$14.25
|
$10,191.60
|
$10,191.60
|
$10,191.60
|
2026-03-16
|
|
27792
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$9,790.60
|
$9,790.60
|
$9,790.60
|
2026-03-16
|
|
27766
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$9,790.60
|
$9,790.60
|
$9,790.60
|
2026-03-16
|
|
28755
|
HCPCS
|
Diprivan 10mg/ml 20ml
|
1
|
1
|
$32.25
|
$32.25
|
$9,790.60
|
$9,790.60
|
$9,790.60
|
2026-03-16
|
|
27822
|
HCPCS
|
Cleocin 600mg/4ml
|
1
|
1
|
$19.50
|
$19.50
|
$9,790.60
|
$9,790.60
|
$9,790.60
|
2026-03-16
|
|
630
|
MS_DRG
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures W
|
4
|
4
|
$12,638.70
|
$12,638.70
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis W
|
4
|
4
|
$42,876.70
|
$42,876.70
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
464
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskel
|
4
|
4
|
$26,594.21
|
$26,594.21
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
41
|
MS_DRG
|
Peripheral, Cranial Nerve And Other Nervous System Procedure
|
4
|
4
|
$20,367.32
|
$20,367.32
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
115
|
MS_DRG
|
Extraocular Procedures Except Orbit
|
4
|
4
|
$13,808.50
|
$13,808.50
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
512
|
MS_DRG
|
Shoulder, Elbow Or Forearm Procedures, Except Major Joint Pr
|
4
|
4
|
$14,501.18
|
$14,501.18
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
465
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskel
|
4
|
4
|
$15,658.36
|
$15,658.36
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
566
|
MS_DRG
|
Other Musculoskeletal System And Connective Tissue Diagnoses
|
4
|
4
|
$6,747.32
|
$6,747.32
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
581
|
MS_DRG
|
Other Skin, Subcutaneous Tissue And Breast Procedures Withou
|
4
|
4
|
$12,980.53
|
$12,980.53
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
517
|
MS_DRG
|
Other Musculoskeletal System And Connective Tissue O.r. Proc
|
4
|
4
|
$13,463.06
|
$13,463.06
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
145
|
MS_DRG
|
Other Ear, Nose, Mouth And Throat O.r. Procedures Without Cc
|
4
|
4
|
$10,686.03
|
$10,686.03
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
743
|
MS_DRG
|
Uterine And Adnexa Procedures For Non-malignancy Without Cc/
|
4
|
4
|
$10,811.39
|
$10,811.39
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
508
|
MS_DRG
|
Major Shoulder Or Elbow Joint Procedures Without Cc/mcc
|
4
|
4
|
$11,640.27
|
$11,640.27
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
501
|
MS_DRG
|
Soft Tissue Procedures With Cc
|
4
|
4
|
$16,096.68
|
$16,096.68
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
476
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue
|
4
|
4
|
$10,490.31
|
$10,490.31
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
125
|
MS_DRG
|
Other Disorders Of The Eye Without Mcc
|
4
|
4
|
$7,447.21
|
$7,447.21
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
169
|
MS_DRG
|
Major Hip And Knee Joint Replacement Or Reattachment Of Lowe
|
4
|
4
|
$29,481.29
|
$29,481.29
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
0120
|
RC
|
—
|
4
|
4
|
$2,168.25
|
$2,168.25
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
761
|
MS_DRG
|
Menstrual And Other Female Reproductive System Disorders Wit
|
4
|
4
|
$5,717.32
|
$5,717.32
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
745
|
MS_DRG
|
D&c, Conization, Laparoscopy And Tubal Interruption Without
|
4
|
4
|
$9,242.95
|
$9,242.95
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
904
|
MS_DRG
|
Skin Grafts For Injuries With Cc/mcc
|
4
|
4
|
$34,824.30
|
$34,824.30
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
0121
|
RC
|
—
|
4
|
4
|
$2,168.25
|
$2,168.25
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
690
|
MS_DRG
|
Kidney And Urinary Tract Infections Without Mcc
|
4
|
4
|
$7,238.86
|
$7,238.86
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
494
|
MS_DRG
|
Lower Extremity And Humerus Procedures Except Hip, Foot And
|
4
|
4
|
$17,004.92
|
$17,004.92
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
565
|
MS_DRG
|
Other Musculoskeletal System And Connective Tissue Diagnoses
|
4
|
4
|
$9,196.95
|
$9,196.95
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
479
|
MS_DRG
|
Biopsies Of Musculoskeletal System And Connective Tissue Wit
|
4
|
4
|
$16,016.41
|
$16,016.41
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
42
|
MS_DRG
|
Peripheral, Cranial Nerve And Other Nervous System Procedure
|
4
|
4
|
$15,852.27
|
$15,852.27
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
504
|
MS_DRG
|
Foot Procedures With Cc
|
4
|
4
|
$15,828.82
|
$15,828.82
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
561
|
MS_DRG
|
Aftercare, Musculoskeletal System And Connective Tissue With
|
4
|
4
|
$7,374.16
|
$7,374.16
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
114
|
MS_DRG
|
Orbital Procedures Without Cc/mcc
|
4
|
4
|
$10,661.67
|
$10,661.67
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
505
|
MS_DRG
|
Foot Procedures Without Cc/mcc
|
4
|
4
|
$15,828.82
|
$15,828.82
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
0122
|
RC
|
—
|
4
|
4
|
$2,168.25
|
$2,168.25
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
563
|
MS_DRG
|
Fracture, Sprain, Strain And Dislocation Except Femur, Hip,
|
4
|
4
|
$8,061.43
|
$8,061.43
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
583
|
MS_DRG
|
Mastectomy For Malignancy Without Cc/mcc
|
4
|
4
|
$14,815.95
|
$14,815.95
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
475
|
MS_DRG
|
Amputation For Musculoskeletal System And Connective Tissue
|
4
|
4
|
$19,457.26
|
$19,457.26
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
909
|
MS_DRG
|
Other O.r. Procedures For Injuries Without Cc/mcc
|
4
|
4
|
$11,439.14
|
$11,439.14
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
742
|
MS_DRG
|
Uterine And Adnexa Procedures For Non-malignancy With Cc/mcc
|
4
|
4
|
$16,475.50
|
$16,475.50
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
744
|
MS_DRG
|
D&c, Conization, Laparoscopy And Tubal Interruption With Cc/
|
4
|
4
|
$17,623.65
|
$17,623.65
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
556
|
MS_DRG
|
Signs And Symptoms Of Musculoskeletal System And Connective
|
4
|
4
|
$7,364.23
|
$7,364.23
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
617
|
MS_DRG
|
Amputation Of Lower Limb For Endocrine, Nutritional And Meta
|
4
|
4
|
$17,421.62
|
$17,421.62
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
989
|
MS_DRG
|
Non-extensive O.r. Procedures Unrelated To Principal Diagnos
|
4
|
4
|
$10,421.77
|
$10,421.77
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
502
|
MS_DRG
|
Soft Tissue Procedures Without Cc/mcc
|
4
|
4
|
$12,601.72
|
$12,601.72
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
578
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis Without Cc/mc
|
4
|
4
|
$15,246.17
|
$15,246.17
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
950
|
MS_DRG
|
Aftercare Without Cc/mcc
|
4
|
4
|
$5,286.20
|
$5,286.20
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
941
|
MS_DRG
|
O.r. Procedures With Diagnoses Of Other Contact With Health
|
4
|
4
|
$17,626.36
|
$17,626.36
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
492
|
MS_DRG
|
Lower Extremity And Humerus Procedures Except Hip, Foot And
|
4
|
4
|
$32,029.23
|
$32,029.23
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
511
|
MS_DRG
|
Shoulder, Elbow Or Forearm Procedures, Except Major Joint Pr
|
4
|
4
|
$17,688.59
|
$17,688.59
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
473
|
MS_DRG
|
Cervical Spinal Fusion Without Cc/mcc
|
4
|
4
|
$21,352.21
|
$21,352.21
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
493
|
MS_DRG
|
Lower Extremity And Humerus Procedures Except Hip, Foot And
|
4
|
4
|
$21,655.27
|
$21,655.27
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
741
|
MS_DRG
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexa
|
4
|
4
|
$12,388.87
|
$12,388.87
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
30
|
MS_DRG
|
Spinal Procedures Without Cc/mcc
|
4
|
4
|
$20,071.48
|
$20,071.48
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
572
|
MS_DRG
|
Skin Debridement Without Cc/mcc
|
4
|
4
|
$10,303.61
|
$10,303.61
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
858
|
MS_DRG
|
Postoperative Or Post-traumatic Infections With O.r. Procedu
|
4
|
4
|
$11,620.42
|
$11,620.42
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
497
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Exce
|
4
|
4
|
$12,109.27
|
$12,109.27
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
496
|
MS_DRG
|
Local Excision And Removal Of Internal Fixation Devices Exce
|
4
|
4
|
$17,795.02
|
$17,795.02
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
483
|
MS_DRG
|
Major Joint Or Limb Reattachment Procedures Of Upper Extremi
|
4
|
4
|
$22,982.90
|
$22,982.90
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
489
|
MS_DRG
|
Knee Procedures Without Principal Diagnosis Of Infection Wit
|
4
|
4
|
$11,169.46
|
$11,169.46
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
558
|
MS_DRG
|
Tendonitis, Myositis And Bursitis Without Mcc
|
4
|
4
|
$7,790.84
|
$7,790.84
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
470
|
MS_DRG
|
Major Hip And Knee Joint Replacement Or Reattachment Of Lowe
|
4
|
4
|
$17,005.83
|
$17,005.83
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
123
|
MS_DRG
|
Neurological Eye Disorders
|
4
|
4
|
$7,244.28
|
$7,244.28
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
478
|
MS_DRG
|
Biopsies Of Musculoskeletal System And Connective Tissue Wit
|
4
|
4
|
$21,092.46
|
$21,092.46
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
607
|
MS_DRG
|
Minor Skin Disorders Without Mcc
|
4
|
4
|
$7,794.45
|
$7,794.45
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
903
|
MS_DRG
|
Wound Debridements For Injuries Without Cc/mcc
|
4
|
4
|
$10,995.39
|
$10,995.39
|
$4,000.00
|
$15,811.00
|
$9,711.25
|
2026-03-16
|
|
24575
|
HCPCS
|
Elbow COMPLETE,Tech Component
|
4
|
2
|
$507.00
|
$507.00
|
$2,402.00
|
$17,003.06
|
$9,702.53
|
2026-03-16
|
|
27827
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$2,402.00
|
$17,003.06
|
$9,702.53
|
2026-03-16
|
|
28300
|
HCPCS
|
EKG 12 Lead
|
5
|
2
|
$507.00
|
$507.00
|
$1,833.00
|
$9,506.10
|
$9,506.10
|
2026-03-16
|
|
63663
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$9,127.99
|
$9,127.99
|
$9,127.99
|
2026-03-16
|
|
58550
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
2
|
1
|
$71.40
|
$71.40
|
$9,087.78
|
$9,087.78
|
$9,087.78
|
2026-03-16
|
|
30410
|
HCPCS
|
Lidocaine 1% Epi 20ml
|
1
|
1
|
$25.81
|
$25.81
|
$8,732.76
|
$8,732.76
|
$8,732.76
|
2026-03-16
|
|
58662
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$8,629.28
|
$8,629.28
|
$8,629.28
|
2026-03-16
|
|
30465
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$8,232.26
|
$8,232.26
|
$8,232.26
|
2026-03-16
|
|
58270
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$8,131.98
|
$8,131.98
|
$8,131.98
|
2026-03-16
|
|
58262
|
HCPCS
|
EKG 12 Lead
|
3
|
2
|
$655.72
|
$655.72
|
$4,320.00
|
$8,131.98
|
$8,131.98
|
2026-03-16
|
|
58260
|
HCPCS
|
Colace 100mg
|
5
|
4
|
$0.43
|
$0.43
|
$4,320.00
|
$11,943.95
|
$8,131.98
|
2026-03-16
|
|
58671
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$8,128.78
|
$8,128.78
|
$8,128.78
|
2026-03-16
|
|
58670
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$8,128.78
|
$8,128.78
|
$8,128.78
|
2026-03-16
|
|
49321
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$8,128.78
|
$8,128.78
|
$8,128.78
|
2026-03-16
|
|
21120
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$7,947.77
|
$7,947.77
|
$7,947.77
|
2026-03-16
|
|
49320
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$7,844.28
|
$7,844.28
|
$7,844.28
|
2026-03-16
|
|
58925
|
HCPCS
|
Cleocin 600mg/4ml
|
2
|
1
|
$58.27
|
$58.27
|
$7,673.48
|
$7,673.48
|
$7,673.48
|
2026-03-16
|
|
58563
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$7,573.98
|
$7,573.98
|
$7,573.98
|
2026-03-16
|
|
57288
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$6,888.48
|
$6,888.48
|
$6,888.48
|
2026-03-16
|
|
28760
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$3,204.00
|
$10,191.60
|
$6,697.80
|
2026-03-16
|
|
27720
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$3,204.00
|
$10,191.60
|
$6,697.80
|
2026-03-16
|
|
27690
|
HCPCS
|
Ankle 1-2 Views OP,Tech Component
|
4
|
2
|
$536.64
|
$536.64
|
$3,204.00
|
$10,191.60
|
$6,697.80
|
2026-03-16
|
|
28322
|
HCPCS
|
EKG 12 Lead
|
4
|
2
|
$581.36
|
$581.36
|
$3,204.00
|
$10,191.60
|
$6,697.80
|
2026-03-16
|
|
23430
|
HCPCS
|
EKG 12 Lead
|
2
|
2
|
$655.72
|
$655.72
|
$3,204.00
|
$10,191.60
|
$6,697.80
|
2026-03-16
|
|
28615
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$2,402.00
|
$9,790.60
|
$6,096.30
|
2026-03-16
|
|
28485
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$2,402.00
|
$9,790.60
|
$6,096.30
|
2026-03-16
|
|
28446
|
HCPCS
|
Ankle COMPLETE,Tech Component
|
4
|
2
|
$507.00
|
$507.00
|
$2,402.00
|
$9,790.60
|
$6,096.30
|
2026-03-16
|
|
28445
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$2,402.00
|
$9,790.60
|
$6,096.30
|
2026-03-16
|
|
28415
|
HCPCS
|
EKG 12 Lead
|
4
|
2
|
$581.36
|
$581.36
|
$2,402.00
|
$9,790.60
|
$6,096.30
|
2026-03-16
|
|
28310
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$2,402.00
|
$9,790.60
|
$6,096.30
|
2026-03-16
|
|
28305
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$2,402.00
|
$9,790.60
|
$6,096.30
|
2026-03-16
|
|
27654
|
HCPCS
|
EKG 12 Lead
|
4
|
2
|
$581.36
|
$581.36
|
$2,402.00
|
$9,790.60
|
$6,096.30
|
2026-03-16
|
|
28299
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$2,402.00
|
$9,790.60
|
$6,096.30
|
2026-03-16
|
|
27650
|
HCPCS
|
EKG 12 Lead
|
2
|
2
|
$655.72
|
$655.72
|
$2,402.00
|
$9,790.60
|
$6,096.30
|
2026-03-16
|
|
28298
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$2,402.00
|
$9,790.60
|
$6,096.30
|
2026-03-16
|
|
28291
|
HCPCS
|
EKG 12 Lead
|
4
|
2
|
$581.36
|
$581.36
|
$2,402.00
|
$9,790.60
|
$6,096.30
|
2026-03-16
|
|
28238
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$2,402.00
|
$9,790.60
|
$6,096.30
|
2026-03-16
|
|
25400
|
HCPCS
|
Elbow 2 VIEWS,Tech Component
|
4
|
2
|
$507.00
|
$507.00
|
$2,402.00
|
$9,790.60
|
$6,096.30
|
2026-03-16
|
|
24685
|
HCPCS
|
Elbow 2 VIEWS,Tech Component
|
4
|
2
|
$507.00
|
$507.00
|
$2,402.00
|
$9,790.60
|
$6,096.30
|
2026-03-16
|
|
24342
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$2,402.00
|
$9,790.60
|
$6,096.30
|
2026-03-16
|
|
29892
|
HCPCS
|
EKG 12 Lead
|
4
|
2
|
$581.36
|
$581.36
|
$2,402.00
|
$9,790.60
|
$6,096.30
|
2026-03-16
|
|
23515
|
HCPCS
|
Fluoroscopic Guidance
|
2
|
2
|
$507.00
|
$507.00
|
$2,402.00
|
$9,790.60
|
$6,096.30
|
2026-03-16
|
|
27814
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$2,402.00
|
$9,790.60
|
$6,096.30
|
2026-03-16
|
|
30420
|
HCPCS
|
EKG 12 Lead
|
2
|
2
|
$655.72
|
$655.72
|
$3,403.00
|
$8,732.76
|
$6,067.88
|
2026-03-16
|
|
30520
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$5,894.66
|
$5,894.66
|
$5,894.66
|
2026-03-16
|
|
19301
|
HCPCS
|
Cleocin 600mg/4ml
|
1
|
1
|
$19.50
|
$19.50
|
$5,777.60
|
$5,777.60
|
$5,777.60
|
2026-03-16
|
|
27695
|
HCPCS
|
Ankle COMPLETE,Tech Component
|
4
|
2
|
$581.36
|
$581.36
|
$1,833.00
|
$9,506.10
|
$5,669.55
|
2026-03-16
|
|
27659
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$1,833.00
|
$9,506.10
|
$5,669.55
|
2026-03-16
|
|
23405
|
HCPCS
|
EKG 12 Lead
|
4
|
2
|
$581.36
|
$581.36
|
$1,833.00
|
$9,506.10
|
$5,669.55
|
2026-03-16
|
|
20690
|
HCPCS
|
EKG 12 Lead
|
2
|
2
|
$655.72
|
$655.72
|
$1,833.00
|
$9,506.10
|
$5,669.55
|
2026-03-16
|
|
27829
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$1,833.00
|
$9,506.10
|
$5,669.55
|
2026-03-16
|
|
29823
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$5,587.85
|
$5,587.85
|
$5,587.85
|
2026-03-16
|
|
15829
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$5,508.52
|
$5,508.52
|
$5,508.52
|
2026-03-16
|
|
15828
|
HCPCS
|
EKG 12 Lead
|
3
|
3
|
$655.72
|
$655.72
|
$2,402.00
|
$6,057.68
|
$5,508.52
|
2026-03-16
|
|
63650
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$472.53
|
$472.53
|
$1,833.00
|
$9,127.99
|
$5,480.49
|
2026-03-16
|
|
29822
|
HCPCS
|
EKG 12 Lead
|
3
|
3
|
$655.72
|
$655.72
|
$3,204.00
|
$5,488.35
|
$5,465.37
|
2026-03-16
|
|
29881
|
HCPCS
|
EKG 12 Lead
|
3
|
3
|
$655.72
|
$655.72
|
$3,204.00
|
$5,488.35
|
$5,465.37
|
2026-03-16
|
|
56620
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$5,455.20
|
$5,455.20
|
$5,455.20
|
2026-03-16
|
|
28805
|
HCPCS
|
EKG 12 Lead
|
4
|
3
|
$655.72
|
$655.72
|
$2,402.00
|
$5,465.37
|
$5,087.35
|
2026-03-16
|
|
27687
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$5,087.35
|
$5,087.35
|
$5,087.35
|
2026-03-16
|
|
28308
|
HCPCS
|
EKG 12 Lead
|
5
|
3
|
$655.72
|
$655.72
|
$2,402.00
|
$5,465.37
|
$5,087.35
|
2026-03-16
|
|
28296
|
HCPCS
|
Marcaine .25% 30ml
|
1
|
1
|
$22.05
|
$22.05
|
$5,087.35
|
$5,087.35
|
$5,087.35
|
2026-03-16
|
|
27630
|
HCPCS
|
Marcaine .25% 30ml
|
1
|
1
|
$22.05
|
$22.05
|
$5,087.35
|
$5,087.35
|
$5,087.35
|
2026-03-16
|
|
28250
|
HCPCS
|
Mmc CBC,Reference Lab
|
2
|
1
|
$79.28
|
$79.28
|
$5,087.35
|
$5,087.35
|
$5,087.35
|
2026-03-16
|
|
28208
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$5,087.35
|
$5,087.35
|
$5,087.35
|
2026-03-16
|
|
28122
|
HCPCS
|
Fluoroscopic Guidance
|
5
|
2
|
$507.00
|
$507.00
|
$2,402.00
|
$5,087.35
|
$5,087.35
|
2026-03-16
|
|
28120
|
HCPCS
|
EKG 12 Lead
|
5
|
3
|
$655.72
|
$655.72
|
$2,402.00
|
$5,465.37
|
$5,087.35
|
2026-03-16
|
|
28111
|
HCPCS
|
Fluoroscopic Guidance
|
5
|
2
|
$507.00
|
$507.00
|
$2,402.00
|
$5,087.35
|
$5,087.35
|
2026-03-16
|
|
28062
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$5,087.35
|
$5,087.35
|
$5,087.35
|
2026-03-16
|
|
28005
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
4
|
2
|
$302.02
|
$302.02
|
$2,402.00
|
$5,087.35
|
$5,087.35
|
2026-03-16
|
|
29891
|
HCPCS
|
EKG 12 Lead
|
5
|
3
|
$655.72
|
$655.72
|
$2,402.00
|
$5,465.37
|
$5,087.35
|
2026-03-16
|
|
28820
|
HCPCS
|
Marcaine .25% 30ml
|
1
|
1
|
$22.05
|
$22.05
|
$4,802.85
|
$4,802.85
|
$4,802.85
|
2026-03-16
|
|
28825
|
HCPCS
|
EKG 12 Lead
|
3
|
3
|
$655.72
|
$655.72
|
$1,833.00
|
$5,465.37
|
$4,802.85
|
2026-03-16
|
|
28315
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$4,802.85
|
$4,802.85
|
$4,802.85
|
2026-03-16
|
|
27641
|
HCPCS
|
EKG 12 Lead
|
4
|
3
|
$655.72
|
$655.72
|
$1,833.00
|
$5,465.37
|
$4,802.85
|
2026-03-16
|
|
28292
|
HCPCS
|
EKG 12 Lead
|
5
|
3
|
$655.72
|
$655.72
|
$1,833.00
|
$5,465.37
|
$4,802.85
|
2026-03-16
|
|
28288
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$4,802.85
|
$4,802.85
|
$4,802.85
|
2026-03-16
|
|
28104
|
HCPCS
|
EKG 12 Lead
|
3
|
3
|
$655.72
|
$655.72
|
$1,833.00
|
$5,465.37
|
$4,802.85
|
2026-03-16
|
|
28060
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$4,802.85
|
$4,802.85
|
$4,802.85
|
2026-03-16
|
|
69300
|
HCPCS
|
Day Care Per Hour
|
1
|
1
|
$90.30
|
$90.30
|
$4,782.16
|
$4,782.16
|
$4,782.16
|
2026-03-16
|
|
30140
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$4,782.16
|
$4,782.16
|
$4,782.16
|
2026-03-16
|
|
58558
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$4,670.20
|
$4,670.20
|
$4,670.20
|
2026-03-16
|
|
20680
|
HCPCS
|
EKG 12 Lead
|
3
|
3
|
$655.72
|
$655.72
|
$2,402.00
|
$4,797.82
|
$4,612.66
|
2026-03-16
|
|
28045
|
HCPCS
|
Marcaine .25% 30ml
|
1
|
1
|
$22.05
|
$22.05
|
$4,612.66
|
$4,612.66
|
$4,612.66
|
2026-03-16
|
|
20245
|
HCPCS
|
Decalcification PROCED,Tech Component
|
5
|
3
|
$655.72
|
$655.72
|
$2,402.00
|
$4,797.82
|
$4,612.66
|
2026-03-16
|
|
27658
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$4,554.85
|
$4,554.85
|
$4,554.85
|
2026-03-16
|
|
28124
|
HCPCS
|
EKG 12 Lead
|
5
|
3
|
$655.72
|
$655.72
|
$1,337.00
|
$5,465.37
|
$4,554.85
|
2026-03-16
|
|
27612
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$4,554.85
|
$4,554.85
|
$4,554.85
|
2026-03-16
|
|
27606
|
HCPCS
|
Cleocin 600mg/4ml
|
1
|
1
|
$19.50
|
$19.50
|
$4,554.85
|
$4,554.85
|
$4,554.85
|
2026-03-16
|
|
24305
|
HCPCS
|
Fluoroscopic Guidance
|
2
|
2
|
$507.00
|
$507.00
|
$3,204.00
|
$5,488.35
|
$4,346.17
|
2026-03-16
|
|
22903
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$4,328.16
|
$4,328.16
|
$4,328.16
|
2026-03-16
|
|
27632
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
2
|
1
|
$71.40
|
$71.40
|
$4,328.16
|
$4,328.16
|
$4,328.16
|
2026-03-16
|
|
28041
|
HCPCS
|
Marcaine .25% 30ml
|
1
|
1
|
$22.05
|
$22.05
|
$4,328.16
|
$4,328.16
|
$4,328.16
|
2026-03-16
|
|
20240
|
HCPCS
|
EKG 12 Lead
|
7
|
3
|
$507.00
|
$507.00
|
$1,833.00
|
$4,797.82
|
$4,328.16
|
2026-03-16
|
|
10180
|
HCPCS
|
EKG 12 Lead
|
4
|
3
|
$655.72
|
$655.72
|
$1,833.00
|
$4,797.82
|
$4,328.16
|
2026-03-16
|
|
23474
|
HCPCS
|
Fluoroscopic Guidance
|
5
|
2
|
$507.00
|
$507.00
|
$4,320.00
|
$4,320.00
|
$4,320.00
|
2026-03-16
|
|
58150
|
HCPCS
|
Ankle 1-2 Views OP,Tech Component
|
3
|
2
|
$507.00
|
$507.00
|
$4,320.00
|
$4,320.00
|
$4,320.00
|
2026-03-16
|
|
67904
|
HCPCS
|
EKG 12 Lead
|
4
|
4
|
$655.72
|
$655.72
|
$3,204.00
|
$5,611.41
|
$4,176.68
|
2026-03-16
|
|
28039
|
HCPCS
|
EKG 12 Lead
|
3
|
3
|
$655.72
|
$655.72
|
$1,337.00
|
$4,797.82
|
$4,080.16
|
2026-03-16
|
|
28035
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$3,920.20
|
$3,920.20
|
$3,920.20
|
2026-03-16
|
|
27685
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$2,402.00
|
$5,087.35
|
$3,744.67
|
2026-03-16
|
|
28285
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$2,402.00
|
$5,087.35
|
$3,744.67
|
2026-03-16
|
|
28119
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$2,402.00
|
$5,087.35
|
$3,744.67
|
2026-03-16
|
|
28112
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$2,402.00
|
$5,087.35
|
$3,744.67
|
2026-03-16
|
|
28110
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$2,402.00
|
$5,087.35
|
$3,744.67
|
2026-03-16
|
|
29898
|
HCPCS
|
Ankle 1-2 Views OP,Tech Component
|
4
|
2
|
$462.28
|
$462.28
|
$2,402.00
|
$5,087.35
|
$3,744.67
|
2026-03-16
|
|
29897
|
HCPCS
|
Fluoroscopic Guidance
|
2
|
2
|
$507.00
|
$507.00
|
$2,402.00
|
$5,087.35
|
$3,744.67
|
2026-03-16
|
|
57522
|
HCPCS
|
EKG 12 Lead
|
2
|
2
|
$655.72
|
$655.72
|
$1,833.00
|
$5,278.85
|
$3,555.93
|
2026-03-16
|
|
64784
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$3,519.20
|
$3,519.20
|
$3,519.20
|
2026-03-16
|
|
67900
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$3,474.20
|
$3,474.20
|
$3,474.20
|
2026-03-16
|
|
58140
|
HCPCS
|
Ankle 1-2 Views OP,Tech Component
|
4
|
2
|
$462.28
|
$462.28
|
$3,403.00
|
$3,403.00
|
$3,403.00
|
2026-03-16
|
|
15773
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$3,390.54
|
$3,390.54
|
$3,390.54
|
2026-03-16
|
|
27640
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$1,833.00
|
$4,802.85
|
$3,317.92
|
2026-03-16
|
|
28280
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$1,833.00
|
$4,802.85
|
$3,317.92
|
2026-03-16
|
|
64721
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$3,234.70
|
$3,234.70
|
$3,234.70
|
2026-03-16
|
|
64718
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$3,234.70
|
$3,234.70
|
$3,234.70
|
2026-03-16
|
|
28715
|
HCPCS
|
Ankle 1-2 Views OP,Tech Component
|
2
|
1
|
$462.28
|
$462.28
|
$3,204.00
|
$3,204.00
|
$3,204.00
|
2026-03-16
|
|
28092
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
5
|
4
|
$507.00
|
$507.00
|
$2,402.00
|
$3,859.42
|
$3,130.71
|
2026-03-16
|
|
14040
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$3,106.04
|
$3,106.04
|
$3,106.04
|
2026-03-16
|
|
14000
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
5
|
4
|
$474.89
|
$474.89
|
$1,833.00
|
$4,379.08
|
$3,106.04
|
2026-03-16
|
|
15822
|
HCPCS
|
Tetracaine Hcl 0.5% 15
|
1
|
1
|
$104.55
|
$104.55
|
$3,106.04
|
$3,106.04
|
$3,106.04
|
2026-03-16
|
|
13160
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$3,106.04
|
$3,106.04
|
$3,106.04
|
2026-03-16
|
|
15821
|
HCPCS
|
Tetracaine Hcl 0.5% 15
|
1
|
1
|
$104.55
|
$104.55
|
$3,106.04
|
$3,106.04
|
$3,106.04
|
2026-03-16
|
|
64635
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$2,986.70
|
$2,986.70
|
$2,986.70
|
2026-03-16
|
|
63661
|
HCPCS
|
EKG 12 Lead
|
7
|
4
|
$655.72
|
$655.72
|
$1,337.00
|
$4,634.41
|
$2,985.70
|
2026-03-16
|
|
28270
|
HCPCS
|
Fluoroscopic Guidance
|
4
|
2
|
$507.00
|
$507.00
|
$1,337.00
|
$4,554.85
|
$2,945.92
|
2026-03-16
|
|
28090
|
HCPCS
|
EKG 12 Lead
|
4
|
4
|
$655.72
|
$655.72
|
$2,402.00
|
$3,859.42
|
$2,922.22
|
2026-03-16
|
|
11044
|
HCPCS
|
Ankle 1-2 Views OP,Tech Component
|
9
|
4
|
$417.56
|
$417.56
|
$1,833.00
|
$3,893.21
|
$2,863.11
|
2026-03-16
|
|
21555
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$2,863.11
|
$2,863.11
|
$2,863.11
|
2026-03-16
|
|
20225
|
HCPCS
|
Ankle COMPLETE,Tech Component
|
9
|
4
|
$507.00
|
$507.00
|
$1,833.00
|
$3,893.21
|
$2,863.11
|
2026-03-16
|
|
28002
|
HCPCS
|
Fentanyl .05mg/ml 2ml
|
1
|
1
|
$45.75
|
$45.75
|
$2,846.21
|
$2,846.21
|
$2,846.21
|
2026-03-16
|
|
27618
|
HCPCS
|
EKG 12 Lead
|
4
|
4
|
$655.72
|
$655.72
|
$1,833.00
|
$3,893.21
|
$2,800.31
|
2026-03-16
|
|
28080
|
HCPCS
|
Fluoroscopic Guidance
|
6
|
3
|
$507.00
|
$507.00
|
$2,402.00
|
$3,859.42
|
$2,713.74
|
2026-03-16
|
|
21013
|
HCPCS
|
EKG 12 Lead
|
4
|
4
|
$655.72
|
$655.72
|
$1,337.00
|
$3,893.21
|
$2,676.31
|
2026-03-16
|
|
27605
|
HCPCS
|
EKG 12 Lead
|
4
|
4
|
$655.72
|
$655.72
|
$1,337.00
|
$3,859.42
|
$2,655.97
|
2026-03-16
|
|
20694
|
HCPCS
|
Fluoroscopic Guidance
|
8
|
4
|
$507.00
|
$507.00
|
$1,337.00
|
$3,859.42
|
$2,655.97
|
2026-03-16
|
|
28010
|
HCPCS
|
Fluoroscopic Guidance
|
8
|
4
|
$507.00
|
$507.00
|
$1,337.00
|
$3,859.42
|
$2,655.97
|
2026-03-16
|
|
64640
|
HCPCS
|
Fluoroscopic Guidance
|
8
|
4
|
$411.74
|
$411.74
|
$1,337.00
|
$2,188.74
|
$1,650.94
|
2026-03-16
|
|
11603
|
HCPCS
|
Level IV Path Gross MI,Tech Component
|
5
|
4
|
$474.89
|
$474.89
|
$1,187.96
|
$1,833.00
|
$1,510.48
|
2026-03-16
|
|
11750
|
HCPCS
|
EKG 12 Lead
|
4
|
4
|
$655.72
|
$655.72
|
$673.29
|
$1,337.00
|
$981.34
|
2026-03-16
|
|
56405
|
HCPCS
|
Colace 100mg
|
6
|
4
|
$0.43
|
$0.43
|
$541.67
|
$1,337.00
|
$854.84
|
2026-03-16
|
|
17999
|
HCPCS
|
Hydralazine 20mg/ml 1m
|
3
|
3
|
$48.60
|
$48.60
|
$338.03
|
$480.72
|
$409.38
|
2026-03-16
|
|
72083
|
HCPCS
|
EKG 12 Lead
|
3
|
3
|
$655.72
|
$655.72
|
$185.65
|
$264.02
|
$224.84
|
2026-03-16
|
|
82247
|
HCPCS
|
Bilirubin Total
|
0
|
0
|
$95.29
|
$95.29
|
—
|
—
|
—
|
2026-03-16
|
|
82150
|
HCPCS
|
Mmc AMYLASE,Reference Lab
|
0
|
0
|
$141.90
|
$141.90
|
—
|
—
|
—
|
2026-03-16
|
|
82140
|
HCPCS
|
Mmc Ammonia Level
|
0
|
0
|
$21.28
|
$21.28
|
—
|
—
|
—
|
2026-03-16
|
|
82003
|
HCPCS
|
Acetaminophen Level
|
0
|
0
|
$384.15
|
$384.15
|
—
|
—
|
—
|
2026-03-16
|
|
81025
|
HCPCS
|
Pregnancy Urine
|
0
|
0
|
$120.75
|
$120.75
|
—
|
—
|
—
|
2026-03-16
|
|
81003
|
HCPCS
|
Mmc Ua Without Micro
|
0
|
0
|
$49.20
|
$49.20
|
—
|
—
|
—
|
2026-03-16
|
|
81001
|
HCPCS
|
Mmc Urinalysis
|
0
|
0
|
$46.20
|
$46.20
|
—
|
—
|
—
|
2026-03-16
|
|
81000
|
HCPCS
|
Urinalysis
|
0
|
0
|
$69.45
|
$69.45
|
—
|
—
|
—
|
2026-03-16
|
|
80202
|
HCPCS
|
Mmc Vancomycin
|
0
|
0
|
$257.14
|
$257.14
|
—
|
—
|
—
|
2026-03-16
|
|
80170
|
HCPCS
|
Mmc Gentamicin
|
0
|
0
|
$311.09
|
$311.09
|
—
|
—
|
—
|
2026-03-16
|
|
80162
|
HCPCS
|
Mmc Thera Digoxin
|
0
|
0
|
$244.40
|
$244.40
|
—
|
—
|
—
|
2026-03-16
|
|
80100
|
HCPCS
|
Drug Screen Qualitative
|
0
|
0
|
$275.99
|
$275.99
|
—
|
—
|
—
|
2026-03-16
|
|
81002
|
HCPCS
|
Urinalysis Dip
|
0
|
0
|
$56.10
|
$56.10
|
—
|
—
|
—
|
2026-03-16
|
|
80076
|
HCPCS
|
Liver Panel
|
0
|
0
|
$138.82
|
$138.82
|
—
|
—
|
—
|
2026-03-16
|
|
80074
|
HCPCS
|
Hepatitis Acute Panel
|
0
|
0
|
$904.02
|
$904.02
|
—
|
—
|
—
|
2026-03-16
|
|
80061
|
HCPCS
|
Mmc Lipid Panel
|
0
|
0
|
$174.07
|
$174.07
|
—
|
—
|
—
|
2026-03-16
|
|
82105
|
HCPCS
|
Mmc Afpt Alphafetoprotn
|
0
|
0
|
$306.93
|
$306.93
|
—
|
—
|
—
|
2026-03-16
|
|
80053
|
HCPCS
|
Mmc Comp Metabolic Panel
|
0
|
0
|
$137.28
|
$137.28
|
—
|
—
|
—
|
2026-03-16
|
|
80051
|
HCPCS
|
Mmc Electrolyte Panel
|
0
|
0
|
$133.12
|
$133.12
|
—
|
—
|
—
|
2026-03-16
|
|
80048
|
HCPCS
|
Mmc Basic Metabolic Pnl
|
0
|
0
|
$126.90
|
$126.90
|
—
|
—
|
—
|
2026-03-16
|
|
82248
|
HCPCS
|
Mmc Bili Direct
|
0
|
0
|
$202.50
|
$202.50
|
—
|
—
|
—
|
2026-03-16
|
|
74019
|
HCPCS
|
Abdomen 2 3 Views
|
0
|
0
|
$507.00
|
$507.00
|
—
|
—
|
—
|
2026-03-16
|
|
74018
|
HCPCS
|
Abdomen 1 View
|
0
|
0
|
$507.00
|
$507.00
|
—
|
—
|
—
|
2026-03-16
|
|
73660
|
HCPCS
|
Toe 2 VIEWS,Tech Component
|
0
|
0
|
$507.00
|
$507.00
|
—
|
—
|
—
|
2026-03-16
|
|
73630
|
HCPCS
|
Foot COMPLETE,Tech Component
|
0
|
0
|
$507.00
|
$507.00
|
—
|
—
|
—
|
2026-03-16
|
|
73620
|
HCPCS
|
Foot 2 VIEWS,Tech Component
|
0
|
0
|
$507.00
|
$507.00
|
—
|
—
|
—
|
2026-03-16
|
|
73610
|
HCPCS
|
Ankle 3> Views OP,Tech Component
|
0
|
0
|
$239.28
|
$239.28
|
—
|
—
|
—
|
2026-03-16
|
|
73600
|
HCPCS
|
Ankle 1-2 Views OP,Tech Component
|
0
|
0
|
$417.56
|
$417.56
|
—
|
—
|
—
|
2026-03-16
|
|
73590
|
HCPCS
|
Tibia And Fibula 2 VIEWS,Tech Component
|
0
|
0
|
$507.00
|
$507.00
|
—
|
—
|
—
|
2026-03-16
|
|
73564
|
HCPCS
|
Knee COMPLETE,Tech Component
|
0
|
0
|
$507.00
|
$507.00
|
—
|
—
|
—
|
2026-03-16
|
|
73560
|
HCPCS
|
Knee 1 2 VIEWS,Tech Component
|
0
|
0
|
$507.00
|
$507.00
|
—
|
—
|
—
|
2026-03-16
|
|
73550
|
HCPCS
|
Femur 2 VIEWS,Tech Component
|
0
|
0
|
$507.00
|
$507.00
|
—
|
—
|
—
|
2026-03-16
|
|
73523
|
HCPCS
|
Hip Bi 5>vw OP,Tech Component
|
0
|
0
|
$453.21
|
$453.21
|
—
|
—
|
—
|
2026-03-16
|
|
73522
|
HCPCS
|
Hip Bi 3-4vw OP,Tech Component
|
0
|
0
|
$449.97
|
$449.97
|
—
|
—
|
—
|
2026-03-16
|
|
73521
|
HCPCS
|
Hip Bi 2vw OP,Tech Component
|
0
|
0
|
$438.06
|
$438.06
|
—
|
—
|
—
|
2026-03-16
|
|
73520
|
HCPCS
|
Hip Bilateral Min 2 VIEWS,Tech Component
|
0
|
0
|
$507.00
|
$507.00
|
—
|
—
|
—
|
2026-03-16
|
|
73510
|
HCPCS
|
Hip Unilateral 2 VIEWS,Tech Component
|
0
|
0
|
$507.00
|
$507.00
|
—
|
—
|
—
|
2026-03-16
|
|
73503
|
HCPCS
|
Hip Uni 4>vw OP,Tech Component
|
0
|
0
|
$446.73
|
$446.73
|
—
|
—
|
—
|
2026-03-16
|
|
73502
|
HCPCS
|
Hip Uni 2-3vw OP,Tech Component
|
0
|
0
|
$321.87
|
$321.87
|
—
|
—
|
—
|
2026-03-16
|
|
73501
|
HCPCS
|
Hip Uni 1vw OP,Tech Component
|
0
|
0
|
$316.47
|
$316.47
|
—
|
—
|
—
|
2026-03-16
|
|
73500
|
HCPCS
|
Hip Unilateral 1 VIEW,Tech Component
|
0
|
0
|
$507.00
|
$507.00
|
—
|
—
|
—
|
2026-03-16
|
|
73140
|
HCPCS
|
Fingers Min 2 VIEWS,Tech Component
|
0
|
0
|
$507.00
|
$507.00
|
—
|
—
|
—
|
2026-03-16
|
|
73130
|
HCPCS
|
Hand Min 3 VIEWS,Tech Component
|
0
|
0
|
$507.00
|
$507.00
|
—
|
—
|
—
|
2026-03-16
|
|
73120
|
HCPCS
|
Hand 2 VIEWS,Tech Component
|
0
|
0
|
$507.00
|
$507.00
|
—
|
—
|
—
|
2026-03-16
|
|
73110
|
HCPCS
|
Wrist COMPLETE,Tech Component
|
0
|
0
|
$316.83
|
$316.83
|
—
|
—
|
—
|
2026-03-16
|
|
73100
|
HCPCS
|
Wrist 2 VIEWS,Tech Component
|
0
|
0
|
$307.08
|
$307.08
|
—
|
—
|
—
|
2026-03-16
|
|
73090
|
HCPCS
|
Forearm 2 VIEWS,Tech Component
|
0
|
0
|
$507.00
|
$507.00
|
—
|
—
|
—
|
2026-03-16
|
|
73080
|
HCPCS
|
Elbow COMPLETE,Tech Component
|
0
|
0
|
$507.00
|
$507.00
|
—
|
—
|
—
|
2026-03-16
|
|
73070
|
HCPCS
|
Elbow 2 VIEWS,Tech Component
|
0
|
0
|
$507.00
|
$507.00
|
—
|
—
|
—
|
2026-03-16
|
|
73060
|
HCPCS
|
Humerous Min 2 VIEW,Tech Component
|
0
|
0
|
$507.00
|
$507.00
|
—
|
—
|
—
|
2026-03-16
|
|
73050
|
HCPCS
|
Ac Joints BILATERAL,Tech Component
|
0
|
0
|
$507.00
|
$507.00
|
—
|
—
|
—
|
2026-03-16
|
|
73030
|
HCPCS
|
Shoulder COMPLETE,Tech Component
|
0
|
0
|
$387.33
|
$387.33
|
—
|
—
|
—
|
2026-03-16
|
|
73020
|
HCPCS
|
Shoulder 1 VIEW,Tech Component
|
0
|
0
|
$384.72
|
$384.72
|
—
|
—
|
—
|
2026-03-16
|
|
72265
|
HCPCS
|
Myelography Lumbosacral
|
0
|
0
|
$1,950.00
|
$1,950.00
|
—
|
—
|
—
|
2026-03-16
|
|
72240
|
HCPCS
|
Myelography Cervical
|
0
|
0
|
$1,950.00
|
$1,950.00
|
—
|
—
|
—
|
2026-03-16
|
|
72220
|
HCPCS
|
Sacrum Coccyx Min 2 VIEWS,Tech Component
|
0
|
0
|
$507.00
|
$507.00
|
—
|
—
|
—
|
2026-03-16
|
|
72190
|
HCPCS
|
Pelvis Compl Min 3 Views- OP,Tech Component
|
0
|
0
|
$365.34
|
$365.34
|
—
|
—
|
—
|
2026-03-16
|
|
72170
|
HCPCS
|
Pelvis 1-2 View OP,Tech Component
|
0
|
0
|
$353.82
|
$353.82
|
—
|
—
|
—
|
2026-03-16
|
|
72148
|
HCPCS
|
MRI Lumbar Spine Without CONTRAST,Tech Component
|
0
|
0
|
$6,500.00
|
$6,500.00
|
—
|
—
|
—
|
2026-03-16
|
|
72114
|
HCPCS
|
Lumbr Spine Flex Ext OP,Tech Component
|
0
|
0
|
$180.81
|
$180.81
|
—
|
—
|
—
|
2026-03-16
|
|
72110
|
HCPCS
|
Lumbar Min 4 VIEWS,Tech Component
|
0
|
0
|
$507.00
|
$507.00
|
—
|
—
|
—
|
2026-03-16
|
|
72100
|
HCPCS
|
Lumbar 2 3 VIEWS,Tech Component
|
0
|
0
|
$507.00
|
$507.00
|
—
|
—
|
—
|
2026-03-16
|
|
72074
|
HCPCS
|
Thorac Spine 4>vw OP,Tech Component
|
0
|
0
|
$436.98
|
$436.98
|
—
|
—
|
—
|
2026-03-16
|
|
72072
|
HCPCS
|
Thorac Spine 3vw OP,Tech Component
|
0
|
0
|
$436.98
|
$436.98
|
—
|
—
|
—
|
2026-03-16
|
|
72070
|
HCPCS
|
Thoracic 2 VIEWS,Tech Component
|
0
|
0
|
$507.00
|
$507.00
|
—
|
—
|
—
|
2026-03-16
|
|
72052
|
HCPCS
|
Cervical Spine Flex Etx OP,Tech Component
|
0
|
0
|
$180.81
|
$180.81
|
—
|
—
|
—
|
2026-03-16
|
|
72050
|
HCPCS
|
Cervical Min 4 VIEWS,Tech Component
|
0
|
0
|
$507.00
|
$507.00
|
—
|
—
|
—
|
2026-03-16
|