|
J3391
|
OTHER
|
Inj Atidarsagene Autotemcel
|
9
|
8
|
—
|
—
|
$4,505,000.00
|
$4,730,250.00
|
$4,505,000.00
|
2026-05-23
|
|
C9172
|
OTHER
|
Inj- Beqvez- Per Tx Dose
|
4
|
4
|
—
|
—
|
$3,424,750.00
|
$4,506,250.00
|
$3,695,125.00
|
2026-05-23
|
|
J1411
|
OTHER
|
Inj Hemgenix Per Tx Dose
|
17
|
13
|
—
|
—
|
$3,489,255.00
|
$4,969,916.00
|
$3,685,266.67
|
2026-05-23
|
|
J1414
|
OTHER
|
Inj Beqvez Per Tx Dose
|
1
|
1
|
—
|
—
|
$3,675,000.00
|
$3,675,000.00
|
$3,675,000.00
|
2026-05-23
|
|
J1413
|
OTHER
|
Inj Delandistrogene Mox Rokl
|
18
|
14
|
—
|
—
|
$3,159,182.02
|
$4,675,409.45
|
$3,342,727.38
|
2026-05-23
|
|
J3394
|
OTHER
|
Inj Lovotibeglogene Autotem
|
14
|
12
|
—
|
—
|
$3,121,700.00
|
$4,222,979.44
|
$3,248,445.72
|
2026-05-23
|
|
J3393
|
OTHER
|
Inj Betibeglogene Autotemce
|
14
|
12
|
—
|
—
|
$2,819,600.00
|
$3,829,462.00
|
$2,945,740.00
|
2026-05-23
|
|
J3399
|
OTHER
|
Inj Onase Abepar-xioi Treat
|
18
|
13
|
—
|
—
|
$2,231,250.00
|
$4,299,505.61
|
$2,455,110.61
|
2026-05-23
|
|
J3392
|
OTHER
|
Inj Exagamglogene Autotem
|
10
|
9
|
—
|
—
|
$2,332,000.00
|
$3,031,600.00
|
$2,332,000.00
|
2026-05-23
|
|
Q2057
|
OTHER
|
Afamitresgene Autoleucel
|
11
|
9
|
—
|
—
|
$763,350.00
|
$1,001,806.00
|
$770,620.00
|
2026-05-23
|
|
Q2042
|
OTHER
|
Tisagenlecleucel Car-pos T
|
19
|
14
|
—
|
—
|
$502,733.22
|
$952,547.15
|
$591,726.20
|
2026-05-23
|
|
Q2056
|
OTHER
|
Ciltacabtagene Car-pos T
|
19
|
14
|
—
|
—
|
$500,767.26
|
$948,822.17
|
$565,868.95
|
2026-05-23
|
|
Q2054
|
OTHER
|
Lisocabtagene Mara Car Pos T
|
19
|
14
|
—
|
—
|
$490,889.78
|
$930,106.94
|
$562,538.19
|
2026-05-23
|
|
Q2055
|
OTHER
|
Idecabtagene Vicleucel Car
|
19
|
14
|
—
|
—
|
$500,258.21
|
$947,857.66
|
$557,317.93
|
2026-05-23
|
|
Q2041
|
OTHER
|
Axicabtagene Ciloleucel Car+
|
19
|
14
|
—
|
—
|
$464,983.16
|
$881,020.73
|
$533,230.17
|
2026-05-23
|
|
Q2053
|
OTHER
|
Brexucabtagene Car Pos T
|
19
|
14
|
—
|
—
|
$437,503.88
|
$828,954.72
|
$489,304.61
|
2026-05-23
|
|
MS-018
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell Immunotherapy
|
17
|
13
|
—
|
—
|
$232,863.73
|
$424,344.43
|
$282,601.25
|
2026-05-23
|
|
Q2058
|
OTHER
|
Obecbtge Autol Up To 400 Mil
|
11
|
9
|
—
|
—
|
$278,250.00
|
$551,250.00
|
$278,250.00
|
2026-05-23
|
|
510020263
|
OTHER
|
Vutrisiran 25 Mg/0.5 Ml Syringe
|
24
|
16
|
$424,153.51
|
$169,661.40
60% off
|
$76,347.63
|
$424,153.51
|
$272,836.74
|
2026-05-23
|
|
510020266
|
OTHER
|
Lumasiran 94.5 Mg/0.5 Ml Inj
|
24
|
16
|
$407,533.02
|
$163,013.21
60% off
|
$73,355.94
|
$407,533.02
|
$262,145.61
|
2026-05-23
|
|
J3403
|
OTHER
|
Revakinagene Per Implant
|
10
|
9
|
—
|
—
|
$257,500.00
|
$334,750.00
|
$257,500.00
|
2026-05-23
|
|
MS-612
|
OTHER
|
Neonate- Birth Weight <750 Grams- Discharged Alive
|
1
|
1
|
—
|
—
|
$217,286.57
|
$217,286.57
|
$217,286.57
|
2026-05-23
|
|
J3402
|
OTHER
|
Inj. Remestemcel-l-rknd/ Td
|
10
|
9
|
—
|
—
|
$205,640.00
|
$267,332.00
|
$205,640.00
|
2026-05-23
|
|
MS-636
|
OTHER
|
Neonate- Birth Weight 1500-1999 Grams- With Significant O.r. Procedures- With Mu…
|
1
|
1
|
—
|
—
|
$199,388.70
|
$199,388.70
|
$199,388.70
|
2026-05-23
|
|
MS-001
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
18
|
14
|
—
|
—
|
$20,000.00
|
$316,949.71
|
$186,147.79
|
2026-05-23
|
|
MS-633
|
OTHER
|
Neonate- Birth Weight 1000-1499 Grams- With Significant O.r. Procedures- Dischar…
|
1
|
1
|
—
|
—
|
$179,138.52
|
$179,138.52
|
$179,138.52
|
2026-05-23
|
|
MS-631
|
OTHER
|
Neonate- Birth Weight 750-999 Grams- Discharged Alive
|
1
|
1
|
—
|
—
|
$174,511.45
|
$174,511.45
|
$174,511.45
|
2026-05-23
|
|
5833
|
OTHER
|
Neonate With Ecmo
|
1
|
1
|
—
|
—
|
$162,247.62
|
$162,247.62
|
$162,247.62
|
2026-05-23
|
|
5834
|
OTHER
|
Neonate With Ecmo
|
1
|
1
|
—
|
—
|
$162,247.62
|
$162,247.62
|
$162,247.62
|
2026-05-23
|
|
5832
|
OTHER
|
Neonate With Ecmo
|
1
|
1
|
—
|
—
|
$152,626.88
|
$152,626.88
|
$152,626.88
|
2026-05-23
|
|
5831
|
OTHER
|
Neonate With Ecmo
|
1
|
1
|
—
|
—
|
$152,626.88
|
$152,626.88
|
$152,626.88
|
2026-05-23
|
|
MS-927
|
OTHER
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
18
|
14
|
—
|
—
|
$139,724.10
|
$266,928.95
|
$150,203.41
|
2026-05-23
|
|
0024
|
OTHER
|
Heart andOR Lung Transplant
|
1
|
1
|
—
|
—
|
$147,504.23
|
$147,504.23
|
$147,504.23
|
2026-05-23
|
|
MS-003
|
OTHER
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth…
|
18
|
14
|
—
|
—
|
$132,332.85
|
$241,839.93
|
$144,460.27
|
2026-05-23
|
|
5884
|
OTHER
|
Neonate Bwt 1500g W Major Procedure
|
1
|
1
|
—
|
—
|
$141,703.04
|
$141,703.04
|
$141,703.04
|
2026-05-23
|
|
6314
|
OTHER
|
Neonate Birthwt 2499g W Other Major Procedure
|
1
|
1
|
—
|
—
|
$131,839.30
|
$131,839.30
|
$131,839.30
|
2026-05-23
|
|
1614
|
OTHER
|
Implantable Heart Assist Systems
|
1
|
1
|
—
|
—
|
$129,112.29
|
$129,112.29
|
$129,112.29
|
2026-05-23
|
|
510020195
|
OTHER
|
Tebentafusp-tebn 100 Mcg/0.5 Ml Inj
|
24
|
16
|
$193,897.27
|
$77,558.91
60% off
|
$34,901.51
|
$193,897.27
|
$124,724.42
|
2026-05-23
|
|
5883
|
OTHER
|
Neonate Bwt 1500g W Major Procedure
|
1
|
1
|
—
|
—
|
$111,984.02
|
$111,984.02
|
$111,984.02
|
2026-05-23
|
|
Q0480
|
OTHER
|
Driver Pneumatic Vad Rep
|
18
|
13
|
—
|
—
|
$72,648.53
|
$195,676.14
|
$109,316.28
|
2026-05-23
|
|
0044
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
1
|
1
|
—
|
—
|
$109,115.53
|
$109,115.53
|
$109,115.53
|
2026-05-23
|
|
510018653
|
OTHER
|
Tagraxofusp-erzs (Elzonris) 1000 Mcg Inj
|
24
|
16
|
$160,681.65
|
$64,272.66
60% off
|
$28,922.70
|
$160,681.65
|
$103,358.47
|
2026-05-23
|
|
MS-681
|
OTHER
|
Neonate- Birth Weight >2499 Grams- With Significant O.r. Procedures- With Multip…
|
1
|
1
|
—
|
—
|
$102,819.68
|
$102,819.68
|
$102,819.68
|
2026-05-23
|
|
MS-004
|
OTHER
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec…
|
18
|
14
|
—
|
—
|
$87,247.95
|
$158,990.76
|
$94,273.64
|
2026-05-23
|
|
5914
|
OTHER
|
Neonate Birthwt 500749g Wo Major Procedure
|
1
|
1
|
—
|
—
|
$93,807.13
|
$93,807.13
|
$93,807.13
|
2026-05-23
|
|
0074
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
1
|
1
|
—
|
—
|
$92,412.49
|
$92,412.49
|
$92,412.49
|
2026-05-23
|
|
5934
|
OTHER
|
Neonate Birthwt 750999g Wo Major Procedure
|
1
|
1
|
—
|
—
|
$90,542.33
|
$90,542.33
|
$90,542.33
|
2026-05-23
|
|
0014
|
OTHER
|
Liver Transplant andOR Intestinal Transplant
|
1
|
1
|
—
|
—
|
$90,110.39
|
$90,110.39
|
$90,110.39
|
2026-05-23
|
|
510013649
|
OTHER
|
Ustekinumab 45 Mg/0.5 Ml Inj
|
24
|
16
|
$135,292.05
|
$54,116.82
60% off
|
$24,352.57
|
$135,292.05
|
$87,026.61
|
2026-05-23
|
|
510013713
|
OTHER
|
Ustekinumab 90 Mg/1 Ml Inj
|
24
|
16
|
$135,291.91
|
$54,116.76
60% off
|
$24,352.54
|
$135,291.91
|
$87,026.52
|
2026-05-23
|
|
MS-007
|
OTHER
|
Lung Transplant
|
18
|
14
|
—
|
—
|
$20,000.00
|
$147,050.14
|
$86,021.26
|
2026-05-23
|
|
510020157
|
OTHER
|
Loncastuximab Tesirine-lpyl 10 Mg Inj
|
24
|
16
|
$132,168.06
|
$52,867.23
60% off
|
$23,790.25
|
$132,168.06
|
$85,017.10
|
2026-05-23
|
|
MS-635
|
OTHER
|
Neonate- Birth Weight 1000-1499 Grams- Died
|
1
|
1
|
—
|
—
|
$84,974.31
|
$84,974.31
|
$84,974.31
|
2026-05-23
|
|
1613
|
OTHER
|
Implantable Heart Assist Systems
|
1
|
1
|
—
|
—
|
$83,350.94
|
$83,350.94
|
$83,350.94
|
2026-05-23
|
|
1612
|
OTHER
|
Implantable Heart Assist Systems
|
1
|
1
|
—
|
—
|
$83,331.59
|
$83,331.59
|
$83,331.59
|
2026-05-23
|
|
1611
|
OTHER
|
Implantable Heart Assist Systems
|
1
|
1
|
—
|
—
|
$82,318.94
|
$82,318.94
|
$82,318.94
|
2026-05-23
|
|
510020127
|
OTHER
|
Lanreotide 90 Mg Syringe
|
24
|
16
|
$127,939.44
|
$51,175.78
60% off
|
$23,029.10
|
$127,939.44
|
$82,297.04
|
2026-05-23
|
|
5881
|
OTHER
|
Neonate Bwt 1500g W Major Procedure
|
1
|
1
|
—
|
—
|
$82,259.54
|
$82,259.54
|
$82,259.54
|
2026-05-23
|
|
5882
|
OTHER
|
Neonate Bwt 1500g W Major Procedure
|
1
|
1
|
—
|
—
|
$82,259.54
|
$82,259.54
|
$82,259.54
|
2026-05-23
|
|
MS-014
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
18
|
14
|
—
|
—
|
$20,000.00
|
$147,421.45
|
$81,794.71
|
2026-05-23
|
|
0023
|
OTHER
|
Heart andOR Lung Transplant
|
1
|
1
|
—
|
—
|
$81,282.42
|
$81,282.42
|
$81,282.42
|
2026-05-23
|
|
MS-634
|
OTHER
|
Neonate- Birth Weight 1000-1499 Grams- Without Significant O.r. Procedures- Disc…
|
1
|
1
|
—
|
—
|
$80,655.19
|
$80,655.19
|
$80,655.19
|
2026-05-23
|
|
MS-613
|
OTHER
|
Neonate- Birth Weight <750 Grams- Died
|
1
|
1
|
—
|
—
|
$77,067.16
|
$77,067.16
|
$77,067.16
|
2026-05-23
|
|
510017501
|
OTHER
|
Ribavirin 6,000 Mg Inhalation Powder
|
24
|
16
|
$118,815.50
|
$47,526.20
60% off
|
$21,386.79
|
$118,815.50
|
$76,428.07
|
2026-05-23
|
|
MS-002
|
OTHER
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
18
|
14
|
—
|
—
|
$20,000.00
|
$123,993.66
|
$75,271.09
|
2026-05-23
|
|
510016295
|
OTHER
|
Alemtuzumab (Lemtrada) 12 Mg/1.2 Ml Inj
|
24
|
16
|
$115,660.70
|
$46,264.28
60% off
|
$20,818.93
|
$115,660.70
|
$74,398.74
|
2026-05-23
|
|
MS-209
|
OTHER
|
Kidney And Urinary Tract Signs And Symptoms Age 0-17
|
12
|
10
|
—
|
—
|
$3,693.82
|
$128,966.41
|
$74,073.64
|
2026-05-23
|
|
MS-453
|
OTHER
|
Combined Anterior/posterior Spinal Fusion W Mcc
|
3
|
3
|
—
|
—
|
$71,748.67
|
$87,340.74
|
$73,858.93
|
2026-05-23
|
|
MS-212
|
OTHER
|
Testes Procedures Age 0-17
|
18
|
14
|
—
|
—
|
$7,190.96
|
$123,899.50
|
$72,230.84
|
2026-05-23
|
|
MS-426
|
OTHER
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
16
|
13
|
—
|
—
|
$11,906.58
|
$125,575.55
|
$72,126.05
|
2026-05-23
|
|
6094
|
OTHER
|
Neonate Bwt 15002499g W Major Procedure
|
1
|
1
|
—
|
—
|
$70,877.49
|
$70,877.49
|
$70,877.49
|
2026-05-23
|
|
6024
|
OTHER
|
Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom
|
1
|
1
|
—
|
—
|
$69,929.73
|
$69,929.73
|
$69,929.73
|
2026-05-23
|
|
510018575
|
OTHER
|
Inotuzumab Ozogamicin 0.9 Mg Inj
|
24
|
16
|
$108,442.37
|
$43,376.95
60% off
|
$19,519.63
|
$108,442.37
|
$69,755.55
|
2026-05-23
|
|
L8702
|
OTHER
|
Ewhf S/d Uprt Micro Sensor
|
18
|
13
|
—
|
—
|
$62,578.15
|
$120,740.26
|
$69,320.79
|
2026-05-23
|
|
MS-005
|
OTHER
|
Liver Transplant With Mcc Or Intestinal Transplant
|
18
|
14
|
—
|
—
|
$20,000.00
|
$119,827.05
|
$69,271.76
|
2026-05-23
|
|
MS-215
|
OTHER
|
Other Heart Assist System Implant
|
18
|
14
|
—
|
—
|
$65,161.61
|
$119,212.69
|
$68,554.98
|
2026-05-23
|
|
1604
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
1
|
1
|
—
|
—
|
$66,951.91
|
$66,951.91
|
$66,951.91
|
2026-05-23
|
|
0022
|
OTHER
|
Health Insurance - Prospective Payment System (hipps) - Skilled Nursing Facility…
|
1
|
1
|
—
|
—
|
$66,841.49
|
$66,841.49
|
$66,841.49
|
2026-05-23
|
|
MS-216
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
18
|
14
|
—
|
—
|
$59,592.26
|
$111,465.22
|
$66,582.46
|
2026-05-23
|
|
6304
|
OTHER
|
Neonate Birthwt 2499g W Major Cardiovascular Procedure
|
1
|
1
|
—
|
—
|
$64,803.32
|
$64,803.32
|
$64,803.32
|
2026-05-23
|
|
MS-632
|
OTHER
|
Neonate- Birth Weight 750-999 Grams- Died
|
1
|
1
|
—
|
—
|
$64,772.71
|
$64,772.71
|
$64,772.71
|
2026-05-23
|
|
J9029
|
OTHER
|
Instill Adstiladrin Tx Dose
|
19
|
14
|
—
|
—
|
$60,187.03
|
$114,038.59
|
$63,945.00
|
2026-05-23
|
|
0054
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
1
|
1
|
—
|
—
|
$63,880.82
|
$63,880.82
|
$63,880.82
|
2026-05-23
|
|
A9543
|
OTHER
|
Y90 Ibritumomab Rx
|
18
|
14
|
—
|
—
|
$56,824.55
|
$117,857.84
|
$63,207.24
|
2026-05-23
|
|
6074
|
OTHER
|
Neonate Bwt 12501499g W Resp Dist Syndoth Maj Resp Or Maj Anom
|
1
|
1
|
—
|
—
|
$62,566.87
|
$62,566.87
|
$62,566.87
|
2026-05-23
|
|
510017419
|
OTHER
|
Porfimer 75 Mg Inj
|
24
|
16
|
$97,232.52
|
$38,893.01
60% off
|
$17,501.85
|
$97,232.52
|
$62,544.82
|
2026-05-23
|
|
0094
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
1
|
1
|
—
|
—
|
$62,431.22
|
$62,431.22
|
$62,431.22
|
2026-05-23
|
|
0073
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
1
|
1
|
—
|
—
|
$61,489.01
|
$61,489.01
|
$61,489.01
|
2026-05-23
|
|
0021
|
OTHER
|
Heart andOR Lung Transplant
|
1
|
1
|
—
|
—
|
$59,406.60
|
$59,406.60
|
$59,406.60
|
2026-05-23
|
|
510017356
|
OTHER
|
Pegloticase 8 Mg/1 Ml Inj
|
48
|
16
|
$106,093.21
|
$42,437.29
60% off
|
$11,995.20
|
$145,546.42
|
$59,262.95
|
2026-05-23
|
|
MS-429
|
OTHER
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
15
|
13
|
—
|
—
|
$51,500.37
|
$102,655.38
|
$58,961.54
|
2026-05-23
|
|
MS-850
|
OTHER
|
Acute Leukemia With Other Procedures
|
15
|
13
|
—
|
—
|
$56,670.38
|
$103,652.30
|
$58,370.49
|
2026-05-23
|
|
MS-231
|
OTHER
|
Coronary Bypass With Ptca With Mcc
|
18
|
14
|
—
|
—
|
$52,323.45
|
$96,050.28
|
$57,374.51
|
2026-05-23
|
|
Q2043
|
OTHER
|
Sipuleucel-t Auto Cd54+
|
21
|
14
|
—
|
—
|
$49,921.23
|
$99,027.41
|
$56,930.49
|
2026-05-23
|
|
510018667
|
OTHER
|
Polatuzumab Vedotin-piiq 140 Mg Inj
|
24
|
16
|
$88,103.08
|
$35,241.23
60% off
|
$15,858.55
|
$88,103.08
|
$56,672.31
|
2026-05-23
|
|
510018741
|
OTHER
|
Fluocinolone Acetonide Intravitreal 0.59 Mg Implant
|
24
|
16
|
$86,870.00
|
$34,748.00
60% off
|
$15,636.60
|
$86,870.00
|
$55,879.12
|
2026-05-23
|
|
0043
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
1
|
1
|
—
|
—
|
$55,840.60
|
$55,840.60
|
$55,840.60
|
2026-05-23
|
|
MS-456
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…
|
18
|
14
|
—
|
—
|
$47,959.32
|
$95,748.34
|
$55,819.29
|
2026-05-23
|
|
38240
|
OTHER
|
Transplt Allo Hct/donor
|
19
|
14
|
—
|
—
|
$1,242.31
|
$86,122.24
|
$55,441.20
|
2026-05-23
|
|
510018748
|
OTHER
|
Teprotumumab-trbw (Tepezza) 500 Mg Inj
|
24
|
16
|
$85,307.05
|
$34,122.82
60% off
|
$15,355.27
|
$85,307.05
|
$54,873.76
|
2026-05-23
|
|
0072
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
1
|
1
|
—
|
—
|
$54,798.99
|
$54,798.99
|
$54,798.99
|
2026-05-23
|
|
5933
|
OTHER
|
Neonate Birthwt 750999g Wo Major Procedure
|
1
|
1
|
—
|
—
|
$54,565.07
|
$54,565.07
|
$54,565.07
|
2026-05-23
|
|
MS-459
|
OTHER
|
Spinal Fusion Except Cervical With Mcc
|
3
|
3
|
—
|
—
|
$39,966.76
|
$55,279.59
|
$53,700.17
|
2026-05-23
|
|
MS-020
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
18
|
14
|
—
|
—
|
$49,774.55
|
$90,837.88
|
$53,555.63
|
2026-05-23
|
|
0815
|
OTHER
|
N/a
|
1
|
1
|
—
|
—
|
$52,500.00
|
$52,500.00
|
$52,500.00
|
2026-05-23
|
|
MS-361
|
OTHER
|
Cardiac Defibrillator Implant With Mcc
|
1
|
1
|
—
|
—
|
$52,473.56
|
$52,473.56
|
$52,473.56
|
2026-05-23
|
|
MS-219
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
18
|
14
|
—
|
—
|
$47,776.43
|
$87,486.55
|
$52,259.07
|
2026-05-23
|
|
8504
|
OTHER
|
Procedure With Diagnosis Of Rehabilitation Aftercare Or Other Contact With Heal
|
1
|
1
|
—
|
—
|
$52,127.35
|
$52,127.35
|
$52,127.35
|
2026-05-23
|
|
MS-647
|
OTHER
|
Neonate- Birth Weight 1500-1999 Grams- Without Significant O.r. Procedures- With…
|
1
|
1
|
—
|
—
|
$52,095.87
|
$52,095.87
|
$52,095.87
|
2026-05-23
|
|
MS-233
|
OTHER
|
Coronary Bypass With Cardiac Catheterization With Mcc
|
18
|
14
|
—
|
—
|
$48,263.62
|
$87,950.13
|
$52,033.79
|
2026-05-23
|
|
MS-957
|
OTHER
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
18
|
14
|
—
|
—
|
$46,088.90
|
$86,821.14
|
$51,861.60
|
2026-05-23
|
|
1624
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
1
|
1
|
—
|
—
|
$50,327.10
|
$50,327.10
|
$50,327.10
|
2026-05-23
|
|
8514
|
OTHER
|
Gender Related Procedures
|
1
|
1
|
—
|
—
|
$49,861.86
|
$49,861.86
|
$49,861.86
|
2026-05-23
|
|
6023
|
OTHER
|
Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom
|
1
|
1
|
—
|
—
|
$49,747.80
|
$49,747.80
|
$49,747.80
|
2026-05-23
|
|
3034
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
1
|
1
|
—
|
—
|
$49,570.91
|
$49,570.91
|
$49,570.91
|
2026-05-23
|
|
MS-454
|
OTHER
|
Combined Anterior/posterior Spinal Fusion W Cc
|
3
|
3
|
—
|
—
|
$47,811.23
|
$50,978.78
|
$49,522.24
|
2026-05-23
|
|
0013
|
OTHER
|
Liver Transplant andOR Intestinal Transplant
|
1
|
1
|
—
|
—
|
$49,313.89
|
$49,313.89
|
$49,313.89
|
2026-05-23
|
|
L7181
|
OTHER
|
Electronic Elbo Simultaneous
|
18
|
13
|
—
|
—
|
$37,858.44
|
$87,052.69
|
$49,250.20
|
2026-05-23
|
|
MS-019
|
OTHER
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
17
|
13
|
—
|
—
|
$46,690.97
|
$89,197.98
|
$49,025.52
|
2026-05-23
|
|
510016458
|
OTHER
|
vinCRIStine Liposome 5 Mg/31 Ml Kit
|
24
|
16
|
$74,552.83
|
$29,821.13
60% off
|
$13,419.51
|
$74,552.83
|
$47,956.11
|
2026-05-23
|
|
MS-928
|
OTHER
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
18
|
14
|
—
|
—
|
$37,136.45
|
$81,725.74
|
$47,644.41
|
2026-05-23
|
|
6334
|
OTHER
|
Neonate Birthwt 2499g W Major Anomaly
|
1
|
1
|
—
|
—
|
$47,510.45
|
$47,510.45
|
$47,510.45
|
2026-05-23
|
|
5932
|
OTHER
|
Neonate Birthwt 750999g Wo Major Procedure
|
1
|
1
|
—
|
—
|
$47,389.23
|
$47,389.23
|
$47,389.23
|
2026-05-23
|
|
MS-275
|
OTHER
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
18
|
14
|
—
|
—
|
$40,848.29
|
$81,243.78
|
$47,363.43
|
2026-05-23
|
|
MS-427
|
OTHER
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
16
|
13
|
—
|
—
|
$11,460.72
|
$82,248.73
|
$47,240.69
|
2026-05-23
|
|
MS-870
|
OTHER
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
18
|
14
|
—
|
—
|
$42,954.02
|
$78,753.05
|
$47,042.22
|
2026-05-23
|
|
MS-010
|
OTHER
|
Pancreas Transplant
|
18
|
14
|
—
|
—
|
$20,000.00
|
$89,712.20
|
$46,959.94
|
2026-05-23
|
|
0062
|
OTHER
|
Pancreas Transplant
|
1
|
1
|
—
|
—
|
$46,800.53
|
$46,800.53
|
$46,800.53
|
2026-05-23
|
|
0064
|
OTHER
|
Pancreas Transplant
|
1
|
1
|
—
|
—
|
$46,800.53
|
$46,800.53
|
$46,800.53
|
2026-05-23
|
|
0063
|
OTHER
|
Pancreas Transplant
|
1
|
1
|
—
|
—
|
$46,800.53
|
$46,800.53
|
$46,800.53
|
2026-05-23
|
|
MS-646
|
OTHER
|
Neonate- Birth Weight 1500-1999 Grams- With Significant O.r. Procedures- Without…
|
1
|
1
|
—
|
—
|
$46,719.69
|
$46,719.69
|
$46,719.69
|
2026-05-23
|
|
0053
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
1
|
1
|
—
|
—
|
$46,512.41
|
$46,512.41
|
$46,512.41
|
2026-05-23
|
|
J9226
|
OTHER
|
Supprelin La Implant
|
21
|
14
|
—
|
—
|
$40,379.36
|
$81,630.40
|
$46,371.27
|
2026-05-23
|
|
0084
|
OTHER
|
Autologous Bone Marrow Transplant
|
1
|
1
|
—
|
—
|
$46,186.44
|
$46,186.44
|
$46,186.44
|
2026-05-23
|
|
0083
|
OTHER
|
Autologous Bone Marrow Transplant
|
1
|
1
|
—
|
—
|
$46,025.19
|
$46,025.19
|
$46,025.19
|
2026-05-23
|
|
MS-955
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
18
|
14
|
—
|
—
|
$42,162.43
|
$98,561.68
|
$45,812.36
|
2026-05-23
|
|
MS-268
|
OTHER
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
18
|
14
|
—
|
—
|
$13,047.47
|
$78,366.79
|
$45,686.21
|
2026-05-23
|
|
V2790
|
OTHER
|
Amniotic Membrane
|
1
|
1
|
—
|
—
|
$45,176.00
|
$45,176.00
|
$45,176.00
|
2026-05-23
|
|
6093
|
OTHER
|
Neonate Bwt 15002499g W Major Procedure
|
1
|
1
|
—
|
—
|
$45,106.97
|
$45,106.97
|
$45,106.97
|
2026-05-23
|
|
MS-218
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
18
|
14
|
—
|
—
|
$36,734.91
|
$74,918.97
|
$44,751.97
|
2026-05-23
|
|
MS-217
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
18
|
14
|
—
|
—
|
$39,875.34
|
$78,193.17
|
$44,751.97
|
2026-05-23
|
|
MS-573
|
OTHER
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
18
|
14
|
—
|
—
|
$38,024.79
|
$74,646.65
|
$44,589.31
|
2026-05-23
|
|
6124
|
OTHER
|
Neonate Bwt 15001999g W Resp Dist Syndoth Maj Resp Cond
|
1
|
1
|
—
|
—
|
$44,351.21
|
$44,351.21
|
$44,351.21
|
2026-05-23
|
|
MS-317
|
OTHER
|
Endovascular Cardiac Valve Replacement With Mcc
|
16
|
13
|
—
|
—
|
$38,198.92
|
$76,185.98
|
$43,795.32
|
2026-05-23
|
|
MS-207
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
18
|
14
|
—
|
—
|
$39,932.76
|
$73,316.97
|
$43,795.04
|
2026-05-23
|
|
MS-447
|
OTHER
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
15
|
13
|
—
|
—
|
$41,399.25
|
$76,130.15
|
$43,726.40
|
2026-05-23
|
|
6114
|
OTHER
|
Neonate Birthwt 15001999g W Major Anomaly
|
1
|
1
|
—
|
—
|
$43,232.92
|
$43,232.92
|
$43,232.92
|
2026-05-23
|
|
6092
|
OTHER
|
Neonate Bwt 15002499g W Major Procedure
|
1
|
1
|
—
|
—
|
$42,551.98
|
$42,551.98
|
$42,551.98
|
2026-05-23
|
|
510018281
|
OTHER
|
Lanreotide 120 Mg Syringe (J1932/nonpreferred)
|
48
|
16
|
$69,159.61
|
$27,663.85
60% off
|
$8,602.14
|
$90,529.58
|
$42,499.33
|
2026-05-23
|
|
5913
|
OTHER
|
Neonate Birthwt 500749g Wo Major Procedure
|
1
|
1
|
—
|
—
|
$42,365.74
|
$42,365.74
|
$42,365.74
|
2026-05-23
|
|
33276
|
OTHER
|
Insj Phrnc Nrv Stim Sys
|
17
|
13
|
—
|
—
|
$26,103.48
|
$74,434.96
|
$42,184.37
|
2026-05-23
|
|
0266T
|
OTHER
|
Implt/rpl Crtd Sns Dev Total
|
17
|
14
|
—
|
—
|
$10,917.00
|
$74,434.96
|
$42,184.37
|
2026-05-23
|
|
8634
|
OTHER
|
Neonatal Aftercare
|
1
|
1
|
—
|
—
|
$41,993.68
|
$41,993.68
|
$41,993.68
|
2026-05-23
|
|
6214
|
OTHER
|
Neonate Bwt 20002499g W Major Anomaly
|
1
|
1
|
—
|
—
|
$41,988.10
|
$41,988.10
|
$41,988.10
|
2026-05-23
|
|
MS-969
|
OTHER
|
HIV With Extensive O.r. Procedures With Mcc
|
18
|
14
|
—
|
—
|
$39,050.40
|
$71,161.02
|
$41,662.01
|
2026-05-23
|
|
6091
|
OTHER
|
Neonate Bwt 15002499g W Major Procedure
|
1
|
1
|
—
|
—
|
$41,410.33
|
$41,410.33
|
$41,410.33
|
2026-05-23
|
|
MS-232
|
OTHER
|
Coronary Bypass With Ptca Without Mcc
|
18
|
14
|
—
|
—
|
$37,719.15
|
$69,077.26
|
$41,262.49
|
2026-05-23
|
|
MS-266
|
OTHER
|
Endovascular Cardiac Valve Replacement W Mcc
|
18
|
14
|
—
|
—
|
$36,991.16
|
$69,826.99
|
$40,933.43
|
2026-05-23
|
|
MS-457
|
OTHER
|
Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…
|
18
|
14
|
—
|
—
|
$35,438.85
|
$67,943.56
|
$40,585.29
|
2026-05-23
|
|
MS-276
|
OTHER
|
Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator
|
18
|
14
|
—
|
—
|
$31,382.58
|
$69,699.39
|
$40,324.50
|
2026-05-23
|
|
MS-028
|
OTHER
|
Spinal Procedures With Mcc
|
18
|
14
|
—
|
—
|
$33,400.31
|
$68,458.57
|
$39,957.76
|
2026-05-23
|
|
MS-235
|
OTHER
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
18
|
14
|
—
|
—
|
$36,332.94
|
$66,866.83
|
$39,942.12
|
2026-05-23
|
|
MS-820
|
OTHER
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
18
|
14
|
—
|
—
|
$35,950.73
|
$66,823.53
|
$39,916.26
|
2026-05-23
|
|
L7180
|
OTHER
|
Electronic Elbow Sequential
|
18
|
13
|
—
|
—
|
$25,912.94
|
$70,183.07
|
$39,706.18
|
2026-05-23
|
|
L2006
|
OTHER
|
Kaf Sng/dbl Swg/stn Mcpr Cus
|
18
|
13
|
—
|
—
|
$35,816.41
|
$69,105.31
|
$39,675.53
|
2026-05-23
|
|
MS-016
|
OTHER
|
Autologous Bone Marrow Transplant With Cc/mcc
|
18
|
14
|
—
|
—
|
$20,000.00
|
$67,915.95
|
$39,551.51
|
2026-05-23
|
|
MS-790
|
OTHER
|
Extreme Immaturity Or Respiratory Distress Syndrome- Neonate
|
18
|
14
|
—
|
—
|
$5,463.16
|
$67,720.24
|
$39,479.50
|
2026-05-23
|
|
6022
|
OTHER
|
Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom
|
1
|
1
|
—
|
—
|
$39,097.10
|
$39,097.10
|
$39,097.10
|
2026-05-23
|
|
9504
|
OTHER
|
Extensive Procedure Unrelated To Principal Diagnosis
|
1
|
1
|
—
|
—
|
$39,095.74
|
$39,095.74
|
$39,095.74
|
2026-05-23
|
|
MS-023
|
OTHER
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
18
|
14
|
—
|
—
|
$35,227.05
|
$65,291.04
|
$39,000.84
|
2026-05-23
|
|
4404
|
OTHER
|
Kidney Transplant
|
1
|
1
|
—
|
—
|
$38,936.02
|
$38,936.02
|
$38,936.02
|
2026-05-23
|
|
3033
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
1
|
1
|
—
|
—
|
$38,890.26
|
$38,890.26
|
$38,890.26
|
2026-05-23
|
|
MS-461
|
OTHER
|
Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc
|
18
|
14
|
—
|
—
|
$36,144.18
|
$69,050.15
|
$38,854.99
|
2026-05-23
|
|
MS-463
|
OTHER
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
18
|
14
|
—
|
—
|
$33,349.34
|
$64,940.10
|
$38,791.21
|
2026-05-23
|
|
6073
|
OTHER
|
Neonate Bwt 12501499g W Resp Dist Syndoth Maj Resp Or Maj Anom
|
1
|
1
|
—
|
—
|
$38,589.90
|
$38,589.90
|
$38,589.90
|
2026-05-23
|
|
5894
|
OTHER
|
Neonate Bwt 500g Or Ga 24 Weeks
|
1
|
1
|
—
|
—
|
$38,000.63
|
$38,000.63
|
$38,000.63
|
2026-05-23
|
|
5893
|
OTHER
|
Neonate Bwt 500g Or Ga 24 Weeks
|
1
|
1
|
—
|
—
|
$38,000.63
|
$38,000.63
|
$38,000.63
|
2026-05-23
|
|
4403
|
OTHER
|
Kidney Transplant
|
1
|
1
|
—
|
—
|
$37,845.97
|
$37,845.97
|
$37,845.97
|
2026-05-23
|
|
4402
|
OTHER
|
Kidney Transplant
|
1
|
1
|
—
|
—
|
$37,762.12
|
$37,762.12
|
$37,762.12
|
2026-05-23
|
|
MS-430
|
OTHER
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
15
|
13
|
—
|
—
|
$33,778.48
|
$65,710.34
|
$37,741.64
|
2026-05-23
|
|
4401
|
OTHER
|
Kidney Transplant
|
1
|
1
|
—
|
—
|
$37,704.07
|
$37,704.07
|
$37,704.07
|
2026-05-23
|
|
MS-834
|
OTHER
|
Acute Leukemia Without Major O.r. Procedures With Mcc
|
18
|
14
|
—
|
—
|
$34,129.20
|
$66,388.46
|
$37,364.67
|
2026-05-23
|
|
MS-213
|
OTHER
|
Splenectomy Age 0-17
|
12
|
10
|
—
|
—
|
$13,686.10
|
$65,024.42
|
$37,347.67
|
2026-05-23
|
|
MS-017
|
OTHER
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
18
|
14
|
—
|
—
|
$20,000.00
|
$67,915.95
|
$37,298.88
|
2026-05-23
|
|
MS-455
|
OTHER
|
Combined Anterior/posterior Spinal Fusion Without Cc/mcc
|
3
|
3
|
—
|
—
|
$34,801.36
|
$38,387.24
|
$37,290.46
|
2026-05-23
|
|
MS-405
|
OTHER
|
Pancreas- Liver And Shunt Procedures With Mcc
|
18
|
14
|
—
|
—
|
$33,520.38
|
$62,330.88
|
$37,232.62
|
2026-05-23
|
|
MS-008
|
OTHER
|
Simultaneous Pancreas/kidney Transplant
|
18
|
14
|
—
|
—
|
$20,000.00
|
$61,223.26
|
$37,228.37
|
2026-05-23
|
|
MS-234
|
OTHER
|
Coronary Bypass With Cardiac Catheterization Without Mcc
|
18
|
14
|
—
|
—
|
$32,850.43
|
$62,242.00
|
$37,179.54
|
2026-05-23
|
|
510020107
|
OTHER
|
Leuprolide (Lupron) *6 Month* 45 Mg *IntraMuscular*
|
24
|
16
|
$57,792.92
|
$23,117.17
60% off
|
$10,402.73
|
$57,792.92
|
$37,175.29
|
2026-05-23
|
|
510016642
|
OTHER
|
Brentuximab Vedotin 50 Mg Inj
|
24
|
16
|
$57,758.41
|
$23,103.36
60% off
|
$10,396.51
|
$57,758.41
|
$37,153.10
|
2026-05-23
|
|
MS-011
|
OTHER
|
Tracheostomy For Face- Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
18
|
14
|
—
|
—
|
$33,317.85
|
$62,144.02
|
$37,121.01
|
2026-05-23
|
|
MS-608
|
OTHER
|
Bpd And Other Chronic Respiratory Diseases Arising In Perinatal Period
|
1
|
1
|
—
|
—
|
$37,076.11
|
$37,076.11
|
$37,076.11
|
2026-05-23
|
|
510018834
|
OTHER
|
Luspatercept-aamt 75 Mg Inj
|
24
|
16
|
$57,266.99
|
$22,906.80
60% off
|
$10,308.06
|
$57,266.99
|
$36,836.99
|
2026-05-23
|
|
MS-428
|
OTHER
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
16
|
13
|
—
|
—
|
$9,066.86
|
$64,057.07
|
$36,792.06
|
2026-05-23
|
|
1634
|
OTHER
|
Cardiac Valve Procedures Wo Ami Or Complex Pdx
|
1
|
1
|
—
|
—
|
$36,692.40
|
$36,692.40
|
$36,692.40
|
2026-05-23
|
|
9124
|
OTHER
|
Musculoskeletal And Other Procedures For Multiple Significant Trauma
|
1
|
1
|
—
|
—
|
$36,472.19
|
$36,472.19
|
$36,472.19
|
2026-05-23
|
|
MS-278
|
OTHER
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
18
|
14
|
—
|
—
|
$29,346.83
|
$63,421.28
|
$36,426.89
|
2026-05-23
|
|
1674
|
OTHER
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
1
|
1
|
—
|
—
|
$36,326.66
|
$36,326.66
|
$36,326.66
|
2026-05-23
|
|
MS-220
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
18
|
14
|
—
|
—
|
$32,705.32
|
$60,761.92
|
$36,295.43
|
2026-05-23
|
|
5891
|
OTHER
|
Neonate Bwt 500g Or Ga 24 Weeks
|
1
|
1
|
—
|
—
|
$36,259.18
|
$36,259.18
|
$36,259.18
|
2026-05-23
|
|
5892
|
OTHER
|
Neonate Bwt 500g Or Ga 24 Weeks
|
1
|
1
|
—
|
—
|
$36,259.18
|
$36,259.18
|
$36,259.18
|
2026-05-23
|
|
9114
|
OTHER
|
Extensive Abdominalthoracic Procedures For Mult Significant Trauma
|
1
|
1
|
—
|
—
|
$36,203.72
|
$36,203.72
|
$36,203.72
|
2026-05-23
|
|
MS-021
|
OTHER
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
18
|
14
|
—
|
—
|
$34,129.20
|
$71,277.25
|
$36,106.04
|
2026-05-23
|
|
MS-653
|
OTHER
|
Major Bladder Procedures With Mcc
|
18
|
14
|
—
|
—
|
$34,006.81
|
$62,725.40
|
$35,924.74
|
2026-05-23
|
|
3004
|
OTHER
|
Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
1
|
1
|
—
|
—
|
$35,863.70
|
$35,863.70
|
$35,863.70
|
2026-05-23
|
|
MS-648
|
OTHER
|
Neonate- Birth Weight 1500-1999 Grams- Without Significant O.r. Procedures- With…
|
1
|
1
|
—
|
—
|
$35,817.67
|
$35,817.67
|
$35,817.67
|
2026-05-23
|
|
MS-466
|
OTHER
|
Revision Of Hip Or Knee Replacement With Mcc
|
18
|
14
|
—
|
—
|
$31,457.42
|
$59,679.41
|
$35,428.33
|
2026-05-23
|
|
L8701
|
OTHER
|
Ewh S/d Uprt Micro Sensor
|
18
|
13
|
—
|
—
|
$31,806.86
|
$61,369.15
|
$35,233.96
|
2026-05-23
|
|
9104
|
OTHER
|
Craniotomy For Multiple Significant Trauma
|
1
|
1
|
—
|
—
|
$35,220.33
|
$35,220.33
|
$35,220.33
|
2026-05-23
|
|
MS-270
|
OTHER
|
Other Major Cardiovascular Procedures With Mcc
|
18
|
14
|
—
|
—
|
$3,544.16
|
$60,118.16
|
$35,047.64
|
2026-05-23
|
|
0224
|
OTHER
|
Ventricular Shunt Procedures
|
1
|
1
|
—
|
—
|
$35,043.46
|
$35,043.46
|
$35,043.46
|
2026-05-23
|
|
MS-450
|
OTHER
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
15
|
13
|
—
|
—
|
$31,800.12
|
$60,725.46
|
$34,878.51
|
2026-05-23
|
|
1654
|
OTHER
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
1
|
1
|
—
|
—
|
$34,824.67
|
$34,824.67
|
$34,824.67
|
2026-05-23
|
|
MS-576
|
OTHER
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
18
|
14
|
—
|
—
|
$32,074.93
|
$60,707.92
|
$34,329.26
|
2026-05-23
|
|
0071
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
1
|
1
|
—
|
—
|
$34,320.66
|
$34,320.66
|
$34,320.66
|
2026-05-23
|
|
6034
|
OTHER
|
Neonate Birthwt 10001249g W Or Wo Other Significant Condition
|
1
|
1
|
—
|
—
|
$34,132.55
|
$34,132.55
|
$34,132.55
|
2026-05-23
|
|
MS-228
|
OTHER
|
Other Cardiothoracic Procedures With Mcc
|
18
|
14
|
—
|
—
|
$30,770.18
|
$56,370.68
|
$33,672.36
|
2026-05-23
|
|
MS-853
|
OTHER
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
18
|
14
|
—
|
—
|
$30,881.33
|
$56,274.63
|
$33,612.47
|
2026-05-23
|
|
MS-239
|
OTHER
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
18
|
14
|
—
|
—
|
$31,101.15
|
$56,675.20
|
$33,497.45
|
2026-05-23
|
|
MS-221
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
18
|
14
|
—
|
—
|
$28,357.75
|
$57,428.04
|
$33,479.35
|
2026-05-23
|
|
MS-326
|
OTHER
|
Stomach- Esophageal And Duodenal Procedures With Mcc
|
18
|
14
|
—
|
—
|
$31,361.10
|
$57,148.91
|
$33,439.53
|
2026-05-23
|
|
6033
|
OTHER
|
Neonate Birthwt 10001249g W Or Wo Other Significant Condition
|
1
|
1
|
—
|
—
|
$33,339.20
|
$33,339.20
|
$33,339.20
|
2026-05-23
|
|
0012
|
OTHER
|
Liver Transplant andOR Intestinal Transplant
|
1
|
1
|
—
|
—
|
$32,829.81
|
$32,829.81
|
$32,829.81
|
2026-05-23
|
|
0093
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
1
|
1
|
—
|
—
|
$32,822.81
|
$32,822.81
|
$32,822.81
|
2026-05-23
|
|
0620T
|
OTHER
|
Evasc Ven Artlz Tibl/prnl Vn
|
17
|
14
|
—
|
—
|
$11,288.00
|
$45,488.35
|
$32,810.17
|
2026-05-23
|
|
MS-837
|
OTHER
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
18
|
14
|
—
|
—
|
$30,917.76
|
$56,341.01
|
$32,738.24
|
2026-05-23
|
|
MS-471
|
OTHER
|
Cervical Spinal Fusion With Mcc
|
18
|
14
|
—
|
—
|
$29,992.18
|
$55,018.21
|
$32,622.57
|
2026-05-23
|
|
MS-677
|
OTHER
|
Neonate- Birth Weight 2000-2499 Grams- Without Significant O.r. Procedures- With…
|
1
|
1
|
—
|
—
|
$32,617.51
|
$32,617.51
|
$32,617.51
|
2026-05-23
|
|
MS-691
|
OTHER
|
Urinary Stones W Esw Lithotripsy W Cc/mcc
|
1
|
1
|
—
|
—
|
$32,581.47
|
$32,581.47
|
$32,581.47
|
2026-05-23
|
|
5912
|
OTHER
|
Neonate Birthwt 500749g Wo Major Procedure
|
1
|
1
|
—
|
—
|
$32,506.92
|
$32,506.92
|
$32,506.92
|
2026-05-23
|
|
MS-362
|
OTHER
|
Cardiac Defibrillator Implant Without Mcc
|
1
|
1
|
—
|
—
|
$32,398.11
|
$32,398.11
|
$32,398.11
|
2026-05-23
|
|
1784
|
OTHER
|
External Heart Assist Devices
|
1
|
1
|
—
|
—
|
$32,392.76
|
$32,392.76
|
$32,392.76
|
2026-05-23
|
|
6814
|
OTHER
|
Other Or Procedures For Lymphatichematopoieticother Neoplasms
|
1
|
1
|
—
|
—
|
$32,328.70
|
$32,328.70
|
$32,328.70
|
2026-05-23
|
|
8633
|
OTHER
|
Neonatal Aftercare
|
1
|
1
|
—
|
—
|
$32,119.16
|
$32,119.16
|
$32,119.16
|
2026-05-23
|
|
MS-981
|
OTHER
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
18
|
14
|
—
|
—
|
$29,353.72
|
$53,490.88
|
$31,932.74
|
2026-05-23
|
|
0042
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
1
|
1
|
—
|
—
|
$31,859.36
|
$31,859.36
|
$31,859.36
|
2026-05-23
|
|
MS-826
|
OTHER
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
18
|
14
|
—
|
—
|
$29,487.09
|
$53,733.93
|
$31,837.45
|
2026-05-23
|
|
6123
|
OTHER
|
Neonate Bwt 15001999g W Resp Dist Syndoth Maj Resp Cond
|
1
|
1
|
—
|
—
|
$31,717.13
|
$31,717.13
|
$31,717.13
|
2026-05-23
|
|
MS-267
|
OTHER
|
Endovascular Cardiac Valve Replacement Without Mcc
|
18
|
14
|
—
|
—
|
$3,357.66
|
$54,244.56
|
$31,623.45
|
2026-05-23
|
|
2994
|
OTHER
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
1
|
1
|
—
|
—
|
$31,579.92
|
$31,579.92
|
$31,579.92
|
2026-05-23
|
|
MS-396
|
OTHER
|
Major Head And Neck Procedures With Mcc
|
1
|
1
|
—
|
—
|
$31,551.05
|
$31,551.05
|
$31,551.05
|
2026-05-23
|
|
MS-245
|
OTHER
|
Aicd Generator Procedures
|
18
|
14
|
—
|
—
|
$29,857.72
|
$54,986.27
|
$31,516.83
|
2026-05-23
|
|
5931
|
OTHER
|
Neonate Birthwt 750999g Wo Major Procedure
|
1
|
1
|
—
|
—
|
$31,468.80
|
$31,468.80
|
$31,468.80
|
2026-05-23
|
|
2993
|
OTHER
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical
|
1
|
1
|
—
|
—
|
$31,463.82
|
$31,463.82
|
$31,463.82
|
2026-05-23
|
|
6344
|
OTHER
|
Neonate Birthwt 2499g W Resp Dist Syndoth Maj Resp Cond
|
1
|
1
|
—
|
—
|
$31,437.15
|
$31,437.15
|
$31,437.15
|
2026-05-23
|
|
MS-277
|
OTHER
|
Other Major Cardiovascular Procedures With Mcc
|
18
|
14
|
—
|
—
|
$28,723.90
|
$52,623.19
|
$31,433.85
|
2026-05-23
|
|
MS-006
|
OTHER
|
Liver Transplant Without Mcc
|
18
|
14
|
—
|
—
|
$20,000.00
|
$57,117.08
|
$31,347.78
|
2026-05-23
|
|
0344
|
OTHER
|
Nuclear Medicine - Therapeutic Radiopharmaceuticals
|
2
|
1
|
—
|
—
|
$29.50
|
$62,654.01
|
$31,341.76
|
2026-05-23
|
|
1834
|
OTHER
|
Percutaneous Structural Cardiac Procedures
|
1
|
1
|
—
|
—
|
$31,301.68
|
$31,301.68
|
$31,301.68
|
2026-05-23
|
|
MS-329
|
OTHER
|
Major Small And Large Bowel Procedures With Mcc
|
18
|
14
|
—
|
—
|
$28,353.42
|
$52,372.52
|
$31,284.11
|
2026-05-23
|
|
MS-823
|
OTHER
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
18
|
14
|
—
|
—
|
$28,894.32
|
$52,653.73
|
$31,204.49
|
2026-05-23
|
|
6954
|
OTHER
|
Chemotherapy For Acute Leukemia
|
1
|
1
|
—
|
—
|
$31,058.52
|
$31,058.52
|
$31,058.52
|
2026-05-23
|
|
MS-799
|
OTHER
|
Splenic Procedures With Mcc
|
18
|
14
|
—
|
—
|
$29,359.28
|
$53,501.01
|
$30,973.83
|
2026-05-23
|
|
MS-025
|
OTHER
|
Craniotomy And Endovascular Intracranial Procedures With Mcc
|
18
|
14
|
—
|
—
|
$27,614.93
|
$51,805.10
|
$30,945.17
|
2026-05-23
|
|
6804
|
OTHER
|
Major Or Procedures For Lymphatichematopoieticother Neoplasms
|
1
|
1
|
—
|
—
|
$30,865.43
|
$30,865.43
|
$30,865.43
|
2026-05-23
|
|
MS-650
|
OTHER
|
Neonate Birthwt 1500-1999g Without Signif O.r. Proc With Other Prob
|
17
|
13
|
—
|
—
|
$16,746.00
|
$51,841.34
|
$30,767.38
|
2026-05-23
|
|
3044
|
OTHER
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
1
|
1
|
—
|
—
|
$30,649.98
|
$30,649.98
|
$30,649.98
|
2026-05-23
|
|
2604
|
OTHER
|
Major Pancreas Liver And Shunt Procedures
|
1
|
1
|
—
|
—
|
$30,605.37
|
$30,605.37
|
$30,605.37
|
2026-05-23
|
|
510011289
|
OTHER
|
Gemtuzumab Ozogamicin 4.5 Mg Inj
|
24
|
16
|
$47,551.21
|
$19,020.48
60% off
|
$8,559.22
|
$47,551.21
|
$30,587.32
|
2026-05-23
|
|
MS-319
|
OTHER
|
Other Endovascular Cardiac Valve Procedures With Mcc
|
18
|
14
|
—
|
—
|
$27,124.05
|
$50,850.28
|
$30,374.82
|
2026-05-23
|
|
MS-856
|
OTHER
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
18
|
14
|
—
|
—
|
$24,859.24
|
$51,827.89
|
$30,214.58
|
2026-05-23
|
|
6072
|
OTHER
|
Neonate Bwt 12501499g W Resp Dist Syndoth Maj Resp Or Maj Anom
|
1
|
1
|
—
|
—
|
$30,102.51
|
$30,102.51
|
$30,102.51
|
2026-05-23
|
|
J7330
|
OTHER
|
Cultured Chondrocytes Implnt
|
3
|
1
|
—
|
—
|
$409.50
|
$30,099.57
|
$30,099.57
|
2026-05-23
|
|
2004
|
OTHER
|
Cardiac Structural And Valvular Disorders
|
1
|
1
|
—
|
—
|
$30,061.78
|
$30,061.78
|
$30,061.78
|
2026-05-23
|
|
0571T
|
OTHER
|
Insj/rplcmt Icds Ss Eltrd
|
18
|
14
|
—
|
—
|
$26,103.48
|
$51,849.13
|
$30,055.17
|
2026-05-23
|
|
0408T
|
OTHER
|
Insj/rplc Cardiac Modulj Sys
|
17
|
14
|
—
|
—
|
$28,054.00
|
$51,849.13
|
$30,055.17
|
2026-05-23
|
|
33270
|
OTHER
|
Ins/rep Subq Defibrillator
|
19
|
14
|
—
|
—
|
$26,103.48
|
$54,342.00
|
$30,055.17
|
2026-05-23
|
|
33264
|
OTHER
|
Rmvl & Rplcmt Dfb Gen Mlt Ld
|
19
|
14
|
—
|
—
|
$13,051.74
|
$54,342.00
|
$30,055.17
|
2026-05-23
|
|
33231
|
OTHER
|
Insrt Pulse Gen W/mult Leads
|
19
|
14
|
—
|
—
|
$13,051.74
|
$54,342.00
|
$30,055.17
|
2026-05-23
|
|
0915T
|
OTHER
|
Insj Perm Ccm-d Sys Pg&eltrd
|
10
|
9
|
—
|
—
|
$30,055.17
|
$39,071.71
|
$30,055.17
|
2026-05-23
|
|
33249
|
OTHER
|
Insj/rplcmt Defib W/lead(s)
|
19
|
14
|
—
|
—
|
$13,051.74
|
$54,342.00
|
$30,055.17
|
2026-05-23
|
|
MS-163
|
OTHER
|
Major Chest Procedures With Mcc
|
18
|
14
|
—
|
—
|
$28,460.24
|
$51,862.72
|
$30,046.71
|
2026-05-23
|
|
5911
|
OTHER
|
Neonate Birthwt 500749g Wo Major Procedure
|
1
|
1
|
—
|
—
|
$29,939.82
|
$29,939.82
|
$29,939.82
|
2026-05-23
|
|
69930
|
OTHER
|
Implant Cochlear Device
|
19
|
14
|
—
|
—
|
$3,957.76
|
$52,850.56
|
$29,817.29
|
2026-05-23
|
|
MS-031
|
OTHER
|
Ventricular Shunt Procedures With Mcc
|
18
|
14
|
—
|
—
|
$18,965.11
|
$51,050.82
|
$29,761.57
|
2026-05-23
|
|
MS-356
|
OTHER
|
Other Digestive System O.r. Procedures With Mcc
|
18
|
14
|
—
|
—
|
$26,339.25
|
$50,051.56
|
$29,697.15
|
2026-05-23
|
|
MS-460
|
OTHER
|
Spinal Fusion Except Cervical Without Mcc
|
3
|
3
|
—
|
—
|
$28,262.35
|
$30,488.25
|
$29,617.16
|
2026-05-23
|
|
L5856
|
OTHER
|
Elec Knee-shin Swing/stance
|
18
|
13
|
—
|
—
|
$17,323.21
|
$52,155.62
|
$29,507.13
|
2026-05-23
|
|
MS-323
|
OTHER
|
Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc
|
18
|
14
|
—
|
—
|
$26,300.35
|
$50,279.52
|
$29,452.60
|
2026-05-23
|
|
MS-363
|
OTHER
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
1
|
1
|
—
|
—
|
$29,440.07
|
$29,440.07
|
$29,440.07
|
2026-05-23
|
|
L6880
|
OTHER
|
Elec Hand Ind Art Digits
|
18
|
13
|
—
|
—
|
$22,574.88
|
$51,909.43
|
$29,367.84
|
2026-05-23
|
|
MS-474
|
OTHER
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc
|
18
|
14
|
—
|
—
|
$27,691.50
|
$50,461.84
|
$29,287.40
|
2026-05-23
|
|
L6700
|
OTHER
|
Ue Add Ext Power Myoel
|
11
|
9
|
—
|
—
|
$28,931.56
|
$51,787.49
|
$28,931.56
|
2026-05-23
|
|
MS-901
|
OTHER
|
Wound Debridements For Injuries With Mcc
|
18
|
14
|
—
|
—
|
$27,356.83
|
$49,851.99
|
$28,780.83
|
2026-05-23
|
|
1814
|
OTHER
|
Lower Extremity Vascular Procedures
|
1
|
1
|
—
|
—
|
$28,777.64
|
$28,777.64
|
$28,777.64
|
2026-05-23
|
|
1694
|
OTHER
|
Major Abdominal Vascular Procedures
|
1
|
1
|
—
|
—
|
$28,773.77
|
$28,773.77
|
$28,773.77
|
2026-05-23
|
|
MS-958
|
OTHER
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
18
|
14
|
—
|
—
|
$25,376.62
|
$48,013.18
|
$28,680.11
|
2026-05-23
|
|
MS-673
|
OTHER
|
Other Kidney And Urinary Tract Procedures With Mcc
|
18
|
14
|
—
|
—
|
$25,869.36
|
$47,873.03
|
$28,596.40
|
2026-05-23
|
|
0674T
|
OTHER
|
Laps Insj Nw/rpcmt Prm Isdss
|
12
|
10
|
—
|
—
|
$4,641.00
|
$37,136.51
|
$28,566.55
|
2026-05-23
|
|
63685
|
OTHER
|
Ins/rplc Spi Npg/rcvr Pocket
|
19
|
14
|
—
|
—
|
$1,728.79
|
$48,938.44
|
$28,566.55
|
2026-05-23
|
|
61886
|
OTHER
|
Implant Neurostim Arrays
|
19
|
14
|
—
|
—
|
$1,728.79
|
$48,938.44
|
$28,566.55
|
2026-05-23
|
|
33287
|
OTHER
|
Rmv&rplcmt Phrnc Nrv Stim Pg
|
18
|
13
|
—
|
—
|
$25,828.62
|
$48,938.44
|
$28,566.55
|
2026-05-23
|
|
64568
|
OTHER
|
Opn Impltj Crnl Nrv Nea&pg
|
19
|
14
|
—
|
—
|
$13,051.74
|
$48,938.44
|
$28,566.55
|
2026-05-23
|
|
64582
|
OTHER
|
Opn Mpltj Hpglsl Nstm Ary Pg
|
19
|
14
|
—
|
—
|
$16,088.00
|
$48,938.44
|
$28,566.55
|
2026-05-23
|
|
0268T
|
OTHER
|
Implt/rpl Crtd Sns Dev Gen
|
17
|
14
|
—
|
—
|
$10,917.00
|
$48,938.44
|
$28,566.55
|
2026-05-23
|
|
6084
|
OTHER
|
Neonate Bwt 12501499g W Or Wo Other Significant Condition
|
1
|
1
|
—
|
—
|
$28,520.06
|
$28,520.06
|
$28,520.06
|
2026-05-23
|
|
MS-236
|
OTHER
|
Coronary Bypass Without Cardiac Catheterization Without Mcc
|
18
|
14
|
—
|
—
|
$25,390.82
|
$47,727.19
|
$28,509.28
|
2026-05-23
|
|
510016253
|
OTHER
|
Vedolizumab 300 Mg Inj
|
24
|
16
|
$44,308.13
|
$17,723.25
60% off
|
$7,975.46
|
$44,308.13
|
$28,501.21
|
2026-05-23
|
|
J9266
|
OTHER
|
Pegaspargase Injection
|
21
|
14
|
—
|
—
|
$20,340.61
|
$48,726.95
|
$28,424.06
|
2026-05-23
|
|
1304
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
1
|
1
|
—
|
—
|
$28,420.12
|
$28,420.12
|
$28,420.12
|
2026-05-23
|