|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
36
|
22
|
—
|
—
|
$17,861.00
|
$221,232.17
|
$120,689.97
|
2025-09-05
|
|
231
|
MS_DRG
|
Coronary Bypass With Ptca With Mcc
|
36
|
22
|
—
|
—
|
$17,861.00
|
$194,247.21
|
$106,517.25
|
2025-09-05
|
|
233
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc
|
36
|
22
|
—
|
—
|
$17,861.00
|
$179,175.34
|
$98,601.38
|
2025-09-05
|
|
219
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
36
|
22
|
—
|
—
|
$17,861.00
|
$177,366.71
|
$97,651.47
|
2025-09-05
|
|
217
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
36
|
22
|
—
|
—
|
$17,861.00
|
$148,034.44
|
$82,245.92
|
2025-09-05
|
|
235
|
MS_DRG
|
Coronary Bypass Without Cardiac Catheterization With Mcc
|
36
|
22
|
—
|
—
|
$17,861.00
|
$134,883.52
|
$75,338.95
|
2025-09-05
|
|
234
|
MS_DRG
|
Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc
|
36
|
22
|
—
|
—
|
$17,861.00
|
$121,954.94
|
$68,548.75
|
2025-09-05
|
|
220
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…
|
36
|
22
|
—
|
—
|
$17,861.00
|
$125,517.20
|
$68,265.83
|
2025-09-05
|
|
228
|
MS_DRG
|
Other Cardiothoracic Procedures With Mcc
|
36
|
22
|
—
|
—
|
$17,861.00
|
$114,232.19
|
$64,492.70
|
2025-09-05
|
|
245
|
MS_DRG
|
Aicd Generator Procedures
|
36
|
22
|
—
|
—
|
$17,861.00
|
$112,020.12
|
$63,330.90
|
2025-09-05
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
34
|
21
|
—
|
—
|
$17,861.00
|
$864,490.51
|
$458,534.59
|
2025-09-05
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$645,701.94
|
$343,625.02
|
2025-09-05
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
34
|
21
|
—
|
—
|
$17,861.00
|
$491,276.57
|
$262,519.53
|
2025-09-05
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
34
|
21
|
—
|
—
|
$17,861.00
|
$323,901.99
|
$174,613.02
|
2025-09-05
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
34
|
21
|
—
|
—
|
$17,861.00
|
$300,332.56
|
$162,234.16
|
2025-09-05
|
|
7
|
MS_DRG
|
Lung Transplant
|
34
|
21
|
—
|
—
|
$17,861.00
|
$299,576.10
|
$161,836.86
|
2025-09-05
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$252,604.58
|
$137,167.03
|
2025-09-05
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve?procedures
|
34
|
21
|
—
|
—
|
$17,861.00
|
$249,720.87
|
$135,652.48
|
2025-09-05
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
34
|
21
|
—
|
—
|
$17,861.00
|
$244,116.20
|
$132,708.86
|
2025-09-05
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
34
|
21
|
—
|
—
|
$17,861.00
|
$242,864.60
|
$132,051.51
|
2025-09-05
|
|
456
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
34
|
21
|
—
|
—
|
$17,861.00
|
$194,139.47
|
$106,460.67
|
2025-09-05
|
|
20
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$184,784.60
|
$101,547.41
|
2025-09-05
|
|
10
|
MS_DRG
|
Pancreas Transplant
|
34
|
21
|
—
|
—
|
$17,861.00
|
$182,765.08
|
$100,486.74
|
2025-09-05
|
|
19
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant With Hemodialysis
|
34
|
21
|
—
|
—
|
$17,861.00
|
$181,717.50
|
$99,936.54
|
2025-09-05
|
|
275
|
MS_DRG
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$161,996.84
|
$89,579.09
|
2025-09-05
|
|
870
|
MS_DRG
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
34
|
21
|
—
|
—
|
$17,861.00
|
$159,463.85
|
$88,248.74
|
2025-09-05
|
|
268
|
MS_DRG
|
Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$152,841.39
|
$84,770.57
|
2025-09-05
|
|
207
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
34
|
21
|
—
|
—
|
$17,861.00
|
$148,247.63
|
$82,357.89
|
2025-09-05
|
|
276
|
MS_DRG
|
Cardiac Defibrillator Implant With Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$141,994.23
|
$79,073.55
|
2025-09-05
|
|
573
|
MS_DRG
|
Skin Graft For Skin Ulcer Or Cellulitis With Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$141,164.42
|
$78,637.73
|
2025-09-05
|
|
461
|
MS_DRG
|
Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$140,671.57
|
$78,378.88
|
2025-09-05
|
|
232
|
MS_DRG
|
Coronary Bypass With Ptca Without Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$140,029.73
|
$78,041.78
|
2025-09-05
|
|
28
|
MS_DRG
|
Spinal Procedures With Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$139,360.38
|
$77,690.23
|
2025-09-05
|
|
17
|
MS_DRG
|
Autologous Bone Marrow Transplant Without Cc/mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$138,360.94
|
$77,165.32
|
2025-09-05
|
|
16
|
MS_DRG
|
Autologous Bone Marrow Transplant With Cc/mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$138,360.94
|
$77,165.32
|
2025-09-05
|
|
266
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$137,327.11
|
$76,622.34
|
2025-09-05
|
|
218
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
34
|
21
|
—
|
—
|
$17,861.00
|
$136,375.80
|
$76,122.71
|
2025-09-05
|
|
820
|
MS_DRG
|
Lymphoma And Leukemia With Major O.r. Procedures With Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$133,464.58
|
$74,593.71
|
2025-09-05
|
|
457
|
MS_DRG
|
Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…
|
34
|
21
|
—
|
—
|
$17,861.00
|
$131,564.27
|
$73,595.65
|
2025-09-05
|
|
23
|
MS_DRG
|
Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…
|
34
|
21
|
—
|
—
|
$17,861.00
|
$130,778.01
|
$73,182.70
|
2025-09-05
|
|
653
|
MS_DRG
|
Major Bladder Procedures With Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$127,786.56
|
$71,611.56
|
2025-09-05
|
|
21
|
MS_DRG
|
Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$126,702.30
|
$71,042.10
|
2025-09-05
|
|
834
|
MS_DRG
|
Acute Leukemia Without Major O.r. Procedures With Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$126,702.30
|
$71,042.10
|
2025-09-05
|
|
8
|
MS_DRG
|
Simultaneous Pancreas And Kidney Transplant
|
34
|
21
|
—
|
—
|
$17,861.00
|
$124,726.34
|
$70,004.31
|
2025-09-05
|
|
405
|
MS_DRG
|
Pancreas, Liver And Shunt Procedures With Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$124,442.09
|
$69,855.02
|
2025-09-05
|
|
463
|
MS_DRG
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
34
|
21
|
—
|
—
|
$17,861.00
|
$123,807.12
|
$69,521.53
|
2025-09-05
|
|
11
|
MS_DRG
|
Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$123,690.22
|
$69,460.13
|
2025-09-05
|
|
576
|
MS_DRG
|
Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$123,676.46
|
$69,452.91
|
2025-09-05
|
|
270
|
MS_DRG
|
Other Major Cardiovascular Procedures With Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$117,663.76
|
$66,294.99
|
2025-09-05
|
|
466
|
MS_DRG
|
Revision Of Hip Or Knee Replacement With Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$116,783.52
|
$65,832.68
|
2025-09-05
|
|
326
|
MS_DRG
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$116,425.92
|
$65,644.86
|
2025-09-05
|
|
239
|
MS_DRG
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$115,460.86
|
$65,138.01
|
2025-09-05
|
|
837
|
MS_DRG
|
Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…
|
34
|
21
|
—
|
—
|
$17,861.00
|
$114,780.05
|
$64,780.44
|
2025-09-05
|
|
278
|
MS_DRG
|
Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …
|
34
|
21
|
—
|
—
|
$17,861.00
|
$114,690.65
|
$64,733.48
|
2025-09-05
|
|
853
|
MS_DRG
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$114,644.80
|
$64,709.40
|
2025-09-05
|
|
471
|
MS_DRG
|
Cervical Spinal Fusion With Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$111,343.89
|
$62,975.74
|
2025-09-05
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$111,158.21
|
$62,878.22
|
2025-09-05
|
|
826
|
MS_DRG
|
Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …
|
34
|
21
|
—
|
—
|
$17,861.00
|
$109,468.79
|
$61,990.92
|
2025-09-05
|
|
799
|
MS_DRG
|
Splenic Procedures With Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$108,994.28
|
$61,741.70
|
2025-09-05
|
|
267
|
MS_DRG
|
Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$107,845.84
|
$61,138.53
|
2025-09-05
|
|
823
|
MS_DRG
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$107,268.18
|
$60,835.14
|
2025-09-05
|
|
277
|
MS_DRG
|
Cardiac Defibrillator Implant Without Mcc
|
34
|
21
|
—
|
—
|
$17,861.00
|
$106,635.50
|
$60,502.86
|
2025-09-05
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
33
|
20
|
—
|
—
|
$17,861.00
|
$543,797.74
|
$290,104.09
|
2025-09-05
|
|
957
|
MS_DRG
|
Other O.r. Procedures For Multiple Significant Trauma With Mcc
|
33
|
20
|
—
|
—
|
$17,861.00
|
$171,101.86
|
$94,361.12
|
2025-09-05
|
|
955
|
MS_DRG
|
Craniotomy For Multiple Significant Trauma
|
33
|
20
|
—
|
—
|
$17,861.00
|
$156,525.12
|
$86,705.30
|
2025-09-05
|
|
928
|
MS_DRG
|
Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc
|
33
|
20
|
—
|
—
|
$17,861.00
|
$153,100.42
|
$84,906.62
|
2025-09-05
|
|
969
|
MS_DRG
|
HIV With Extensive O.r. Procedures With Mcc
|
33
|
20
|
—
|
—
|
$17,861.00
|
$144,971.93
|
$80,637.46
|
2025-09-05
|
|
981
|
MS_DRG
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
33
|
20
|
—
|
—
|
$17,861.00
|
$108,973.65
|
$61,730.87
|
2025-09-05
|
|
790
|
MS_DRG
|
Extreme Immaturity Or Respiratory Distress Syndrome, Neonate
|
29
|
19
|
—
|
—
|
$17,861.00
|
$113,682.41
|
$76,068.53
|
2025-09-05
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
29
|
18
|
—
|
—
|
$121,471.03
|
$240,127.59
|
$130,614.01
|
2025-09-05
|
|
850
|
MS_DRG
|
Acute Leukemia With Other Procedures
|
29
|
18
|
—
|
—
|
$107,324.13
|
$211,164.38
|
$115,402.29
|
2025-09-05
|
|
429
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion With Mcc
|
29
|
18
|
—
|
—
|
$97,568.54
|
$191,191.57
|
$104,912.41
|
2025-09-05
|
|
427
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
29
|
18
|
—
|
—
|
$83,708.27
|
$162,815.19
|
$90,008.89
|
2025-09-05
|
|
447
|
MS_DRG
|
Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…
|
29
|
18
|
—
|
—
|
$79,252.02
|
$153,691.84
|
$85,217.23
|
2025-09-05
|
|
317
|
MS_DRG
|
Concomitant Left Atrial Appendage Closure And Cardiac Ablation
|
29
|
18
|
—
|
—
|
$73,448.83
|
$141,810.85
|
$78,977.24
|
2025-09-05
|
|
428
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
29
|
18
|
—
|
—
|
$65,809.39
|
$126,170.48
|
$70,762.79
|
2025-09-05
|
|
430
|
MS_DRG
|
Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc
|
29
|
18
|
—
|
—
|
$65,433.19
|
$125,400.27
|
$70,358.27
|
2025-09-05
|
|
450
|
MS_DRG
|
Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …
|
29
|
18
|
—
|
—
|
$61,845.80
|
$118,055.74
|
$66,500.86
|
2025-09-05
|
|
J9029
|
HCPCS
|
Instill Adstiladrin, Tx Dose
|
32
|
17
|
—
|
—
|
$62,162.43
|
$150,123.53
|
$75,061.77
|
2025-09-05
|
|
Q2043
|
HCPCS
|
Sipuleucel-t Auto Cd54+
|
34
|
17
|
—
|
—
|
$54,827.05
|
$132,408.45
|
$66,204.22
|
2025-09-05
|
|
Q2057
|
HCPCS
|
Afamitresgene Autoleucel
|
30
|
16
|
—
|
—
|
$755,207.60
|
$1,823,841.77
|
$911,920.88
|
2025-09-05
|
|
Q2042
|
HCPCS
|
Tisagenlecleucel Car-pos T
|
31
|
16
|
—
|
—
|
$529,192.86
|
$1,368,732.35
|
$684,366.18
|
2025-09-05
|
|
Q2056
|
HCPCS
|
Ciltacabtagene Car-pos T
|
31
|
16
|
—
|
—
|
$527,123.43
|
$1,309,692.74
|
$654,846.37
|
2025-09-05
|
|
Q2054
|
HCPCS
|
Lisocabtagene Mara Car Pos T
|
31
|
16
|
—
|
—
|
$516,726.08
|
$1,281,899.95
|
$640,949.97
|
2025-09-05
|
|
Q2055
|
HCPCS
|
Idecabtagene Vicleucel Car
|
31
|
16
|
—
|
—
|
$526,587.59
|
$1,281,011.93
|
$640,505.97
|
2025-09-05
|
|
Q2041
|
HCPCS
|
Axicabtagene Ciloleucel Car+
|
31
|
16
|
—
|
—
|
$489,455.96
|
$1,261,642.77
|
$630,821.38
|
2025-09-05
|
|
Q2053
|
HCPCS
|
Brexucabtagene Car Pos T
|
31
|
16
|
—
|
—
|
$460,530.40
|
$1,159,030.12
|
$579,515.06
|
2025-09-05
|
|
0024
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$301,782.83
|
$2,023,884.20
|
$352,609.42
|
2025-09-05
|
|
5834
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$223,246.82
|
$638,262.30
|
$260,846.28
|
2025-09-05
|
|
5884
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$219,395.80
|
$843,002.42
|
$256,346.67
|
2025-09-05
|
|
5883
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$219,395.80
|
$630,070.87
|
$256,346.67
|
2025-09-05
|
|
1614
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$201,028.63
|
$840,651.57
|
$234,886.08
|
2025-09-05
|
|
0034
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$195,309.67
|
$1,916,540.60
|
$228,203.93
|
2025-09-05
|
|
5914
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$169,416.16
|
$484,541.59
|
$197,949.41
|
2025-09-05
|
|
5882
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$168,819.10
|
$613,336.49
|
$197,251.80
|
2025-09-05
|
|
5881
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$168,819.10
|
$613,336.49
|
$197,251.80
|
2025-09-05
|
|
8414
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$163,990.62
|
$1,380,740.40
|
$191,610.10
|
2025-09-05
|
|
0044
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$158,307.50
|
$679,244.67
|
$184,969.81
|
2025-09-05
|
|
0014
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$153,473.89
|
$1,582,685.00
|
$179,322.12
|
2025-09-05
|
|
5934
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$152,881.10
|
$459,027.66
|
$178,629.49
|
2025-09-05
|
|
6094
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$140,328.40
|
$572,516.23
|
$163,962.66
|
2025-09-05
|
|
6024
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$133,141.54
|
$385,249.02
|
$155,565.38
|
2025-09-05
|
|
0023
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$132,691.19
|
$1,257,217.00
|
$155,039.18
|
2025-09-05
|
|
8413
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$129,058.53
|
$491,857.60
|
$150,794.70
|
2025-09-05
|
|
5833
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$128,627.79
|
$457,124.72
|
$150,291.41
|
2025-09-05
|
|
5831
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$126,300.13
|
$455,157.56
|
$147,571.73
|
2025-09-05
|
|
5832
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$126,300.13
|
$455,157.56
|
$147,571.73
|
2025-09-05
|
|
6034
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$122,976.22
|
$348,026.77
|
$143,688.00
|
2025-09-05
|
|
0054
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$121,779.55
|
$499,327.08
|
$142,289.79
|
2025-09-05
|
|
5933
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$120,316.76
|
$371,502.56
|
$140,580.63
|
2025-09-05
|
|
0022
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$113,730.37
|
$770,910.40
|
$132,884.96
|
2025-09-05
|
|
6074
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$109,463.97
|
$360,864.01
|
$127,900.01
|
2025-09-05
|
|
6304
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$108,473.71
|
$425,944.22
|
$126,742.96
|
2025-09-05
|
|
5891
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$107,700.95
|
$302,236.22
|
$125,840.06
|
2025-09-05
|
|
5892
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$107,700.95
|
$302,236.22
|
$125,840.06
|
2025-09-05
|
|
0021
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$107,370.01
|
$737,557.60
|
$125,453.38
|
2025-09-05
|
|
0033
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$105,007.37
|
$957,325.20
|
$122,692.82
|
2025-09-05
|
|
5913
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$104,936.57
|
$356,392.27
|
$122,610.10
|
2025-09-05
|
|
0904
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$99,952.00
|
$240,116.20
|
$116,786.02
|
2025-09-05
|
|
6023
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$99,369.44
|
$331,109.87
|
$116,105.35
|
2025-09-05
|
|
5932
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$99,198.86
|
$345,530.64
|
$115,906.03
|
2025-09-05
|
|
5912
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$98,173.62
|
$236,376.92
|
$114,708.12
|
2025-09-05
|
|
3034
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$97,086.98
|
$399,422.08
|
$113,438.47
|
2025-09-05
|
|
5931
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$96,304.83
|
$343,193.37
|
$112,524.60
|
2025-09-05
|
|
6314
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$93,836.43
|
$335,154.04
|
$109,640.46
|
2025-09-05
|
|
4404
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$92,733.59
|
$832,863.20
|
$108,351.87
|
2025-09-05
|
|
0043
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$90,059.62
|
$401,316.50
|
$105,227.56
|
2025-09-05
|
|
1604
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$88,978.95
|
$396,047.93
|
$103,964.88
|
2025-09-05
|
|
1613
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$88,089.33
|
$407,908.35
|
$102,925.43
|
2025-09-05
|
|
3614
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$86,049.96
|
$637,127.40
|
$100,542.58
|
2025-09-05
|
|
6022
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$85,056.28
|
$262,810.21
|
$99,381.55
|
2025-09-05
|
|
1624
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$84,209.31
|
$410,688.72
|
$98,391.93
|
2025-09-05
|
|
0053
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$82,912.85
|
$348,485.61
|
$96,877.11
|
2025-09-05
|
|
3044
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$82,482.12
|
$351,908.77
|
$96,373.84
|
2025-09-05
|
|
6073
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$82,199.79
|
$256,411.87
|
$96,043.96
|
2025-09-05
|
|
3124
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$80,947.68
|
$815,773.40
|
$94,580.97
|
2025-09-05
|
|
6033
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$80,744.68
|
$281,177.13
|
$94,343.78
|
2025-09-05
|
|
6814
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$80,682.41
|
$305,786.59
|
$94,271.02
|
2025-09-05
|
|
6804
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$80,470.04
|
$406,996.01
|
$94,022.88
|
2025-09-05
|
|
5911
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$79,984.71
|
$192,825.25
|
$93,455.82
|
2025-09-05
|
|
6904
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$78,822.16
|
$343,567.64
|
$92,097.47
|
2025-09-05
|
|
8424
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$77,837.86
|
$626,797.60
|
$90,947.39
|
2025-09-05
|
|
6124
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$76,438.19
|
$250,108.17
|
$89,311.99
|
2025-09-05
|
|
4054
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$75,708.93
|
$294,502.98
|
$88,459.91
|
2025-09-05
|
|
0013
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$75,524.70
|
$804,533.60
|
$88,244.64
|
2025-09-05
|
|
6114
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$74,221.40
|
$322,600.72
|
$86,721.85
|
2025-09-05
|
|
9504
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$73,373.58
|
$306,320.04
|
$85,731.24
|
2025-09-05
|
|
0234
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$73,098.94
|
$318,289.79
|
$85,410.34
|
2025-09-05
|
|
0032
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$70,356.73
|
$712,602.80
|
$82,206.29
|
2025-09-05
|
|
0064
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$69,318.72
|
$675,490.40
|
$80,993.45
|
2025-09-05
|
|
4474
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$69,247.92
|
$263,711.50
|
$80,910.73
|
2025-09-05
|
|
8504
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$69,214.65
|
$250,218.67
|
$80,871.86
|
2025-09-05
|
|
9124
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$68,787.33
|
$272,863.18
|
$80,372.57
|
2025-09-05
|
|
5124
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$68,162.98
|
$197,683.72
|
$79,643.07
|
2025-09-05
|
|
6072
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$67,949.75
|
$208,730.21
|
$79,393.92
|
2025-09-05
|
|
2604
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$67,507.07
|
$290,063.80
|
$78,876.68
|
2025-09-05
|
|
6954
|
APR_DRG
|
—
|
52
|
12
|
—
|
—
|
$67,168.46
|
$162,470.97
|
$78,127.52
|
2025-09-05
|
|
0063
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$66,549.22
|
$608,155.60
|
$77,757.51
|
2025-09-05
|
|
6093
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$66,283.96
|
$230,406.15
|
$77,447.57
|
2025-09-05
|
|
0924
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$66,883.57
|
$161,796.24
|
$77,444.14
|
2025-09-05
|
|
0214
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$65,928.28
|
$288,849.86
|
$77,031.99
|
2025-09-05
|
|
0041
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$65,477.93
|
$285,624.63
|
$76,505.80
|
2025-09-05
|
|
0042
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$65,477.93
|
$286,090.22
|
$76,505.80
|
2025-09-05
|
|
1694
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$65,429.31
|
$277,453.15
|
$76,448.99
|
2025-09-05
|
|
9104
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$65,425.90
|
$261,291.16
|
$76,445.00
|
2025-09-05
|
|
6084
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$65,425.05
|
$232,251.63
|
$76,444.00
|
2025-09-05
|
|
2204
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$64,617.32
|
$282,878.18
|
$75,500.24
|
2025-09-05
|
|
8412
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$64,567.84
|
$487,923.80
|
$75,442.43
|
2025-09-05
|
|
1654
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$64,522.64
|
$319,245.49
|
$75,389.61
|
2025-09-05
|
|
3214
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$64,416.88
|
$300,052.42
|
$75,266.04
|
2025-09-05
|
|
1634
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$64,270.17
|
$382,515.51
|
$75,094.62
|
2025-09-05
|
|
3033
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$63,766.94
|
$248,931.22
|
$74,506.63
|
2025-09-05
|
|
4014
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$63,764.38
|
$332,549.82
|
$74,503.64
|
2025-09-05
|
|
6032
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$63,003.55
|
$218,057.32
|
$73,614.68
|
2025-09-05
|
|
3104
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$62,523.35
|
$220,680.72
|
$73,053.60
|
2025-09-05
|
|
6083
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$62,364.71
|
$216,036.08
|
$72,868.24
|
2025-09-05
|
|
0894
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$62,322.06
|
$229,726.84
|
$72,818.41
|
2025-09-05
|
|
0244
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$62,108.82
|
$262,642.71
|
$72,569.26
|
2025-09-05
|
|
6214
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$62,096.03
|
$194,025.52
|
$72,554.31
|
2025-09-05
|
|
4414
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$61,850.39
|
$288,962.96
|
$72,267.29
|
2025-09-05
|
|
0204
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$61,225.18
|
$251,945.33
|
$71,536.79
|
2025-09-05
|
|
1674
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$60,723.65
|
$256,128.15
|
$70,950.79
|
2025-09-05
|
|
0031
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$60,675.88
|
$628,128.80
|
$70,894.98
|
2025-09-05
|
|
7914
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$60,548.80
|
$242,852.09
|
$70,746.49
|
2025-09-05
|
|
2214
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$60,528.33
|
$246,446.79
|
$70,722.57
|
2025-09-05
|
|
1814
|
APR_DRG
|
—
|
52
|
12
|
—
|
—
|
$60,598.27
|
$146,909.99
|
$70,485.35
|
2025-09-05
|
|
4034
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$60,258.80
|
$266,742.58
|
$70,407.66
|
2025-09-05
|
|
6021
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$59,542.33
|
$258,422.97
|
$69,570.52
|
2025-09-05
|
|
9114
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$59,521.86
|
$249,837.90
|
$69,546.59
|
2025-09-05
|
|
3134
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$59,359.80
|
$265,174.26
|
$69,357.24
|
2025-09-05
|
|
5104
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$58,830.98
|
$207,517.77
|
$68,739.36
|
2025-09-05
|
|
4424
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$58,546.10
|
$243,651.33
|
$68,406.49
|
2025-09-05
|
|
6123
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$58,265.49
|
$179,533.77
|
$68,078.62
|
2025-09-05
|
|
1774
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$58,193.84
|
$268,111.09
|
$67,994.90
|
2025-09-05
|
|
6914
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$58,178.48
|
$225,704.25
|
$67,976.97
|
2025-09-05
|
|
7104
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$58,072.72
|
$254,214.87
|
$67,853.39
|
2025-09-05
|
|
3174
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$58,052.25
|
$258,970.73
|
$67,829.47
|
2025-09-05
|
|
3054
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$57,914.07
|
$267,326.93
|
$67,668.02
|
2025-09-05
|
|
0264
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$57,693.16
|
$247,257.34
|
$67,409.90
|
2025-09-05
|
|
9514
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$57,686.34
|
$248,561.76
|
$67,401.93
|
2025-09-05
|
|
6113
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$57,607.01
|
$183,949.74
|
$67,309.25
|
2025-09-05
|
|
1824
|
APR_DRG
|
—
|
52
|
12
|
—
|
—
|
$57,659.90
|
$139,950.70
|
$67,067.57
|
2025-09-05
|
|
1664
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$57,311.89
|
$335,784.48
|
$66,964.42
|
2025-09-05
|
|
5114
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$57,270.96
|
$219,455.47
|
$66,916.59
|
2025-09-05
|
|
4444
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$56,925.52
|
$239,751.27
|
$66,512.98
|
2025-09-05
|
|
0011
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$56,732.76
|
$782,844.40
|
$66,287.75
|
2025-09-05
|
|
0012
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$56,732.76
|
$797,529.20
|
$66,287.75
|
2025-09-05
|
|
2644
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$56,658.55
|
$270,337.28
|
$66,201.04
|
2025-09-05
|
|
2614
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$56,539.14
|
$216,062.47
|
$66,061.52
|
2025-09-05
|
|
1612
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$56,428.25
|
$245,342.18
|
$65,931.96
|
2025-09-05
|
|
1204
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$56,114.37
|
$247,836.03
|
$65,565.21
|
2025-09-05
|
|
1304
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$55,960.84
|
$227,106.69
|
$65,385.83
|
2025-09-05
|
|
6903
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$55,876.41
|
$194,831.72
|
$65,287.17
|
2025-09-05
|
|
1214
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$55,826.93
|
$236,124.53
|
$65,229.36
|
2025-09-05
|
|
3014
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$55,797.93
|
$207,238.79
|
$65,195.47
|
2025-09-05
|
|
2624
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$55,797.08
|
$187,730.92
|
$65,194.48
|
2025-09-05
|
|
5194
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$55,756.14
|
$135,441.79
|
$65,146.64
|
2025-09-05
|
|
6071
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$55,691.32
|
$178,660.04
|
$65,070.91
|
2025-09-05
|
|
7114
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$55,646.11
|
$252,591.89
|
$65,018.08
|
2025-09-05
|
|
5184
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$55,151.40
|
$165,690.98
|
$64,440.06
|
2025-09-05
|
|
0494
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$55,062.70
|
$190,748.81
|
$64,336.42
|
2025-09-05
|
|
1714
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$55,031.14
|
$222,454.51
|
$64,299.55
|
2025-09-05
|
|
9524
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$54,756.49
|
$224,201.90
|
$63,978.64
|
2025-09-05
|
|
6303
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$54,704.47
|
$198,760.90
|
$63,917.85
|
2025-09-05
|
|
0434
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$54,637.94
|
$155,527.32
|
$63,840.12
|
2025-09-05
|
|
3814
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$54,510.85
|
$132,492.42
|
$63,691.62
|
2025-09-05
|
|
0052
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$54,005.90
|
$237,061.37
|
$63,101.64
|
2025-09-05
|
|
2294
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$53,521.44
|
$224,164.20
|
$62,535.58
|
2025-09-05
|
|
3084
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$53,367.91
|
$177,487.83
|
$62,356.19
|
2025-09-05
|
|
3094
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$53,165.76
|
$211,076.65
|
$62,120.00
|
2025-09-05
|
|
1623
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$53,094.11
|
$215,438.54
|
$62,036.28
|
2025-09-05
|
|
6504
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$52,806.67
|
$247,513.70
|
$61,700.43
|
2025-09-05
|
|
0051
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$52,747.82
|
$230,360.20
|
$61,631.66
|
2025-09-05
|
|
6082
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$52,661.67
|
$177,823.49
|
$61,531.01
|
2025-09-05
|
|
4403
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$52,545.68
|
$571,740.00
|
$61,395.48
|
2025-09-05
|
|
2234
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$51,744.77
|
$222,906.91
|
$60,459.68
|
2025-09-05
|
|
2244
|
APR_DRG
|
—
|
53
|
12
|
—
|
—
|
$51,660.33
|
$166,713.17
|
$60,361.01
|
2025-09-05
|
|
B0407
|
OTHER
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
16
|
11
|
—
|
—
|
$122,323.14
|
$177,243.73
|
$124,819.53
|
2025-09-05
|
|
B1904
|
OTHER
|
Guillain-barr? M <38.50
|
16
|
11
|
—
|
—
|
$113,073.69
|
$163,841.47
|
$115,381.32
|
2025-09-05
|
|
C0407
|
OTHER
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
16
|
11
|
—
|
—
|
$97,890.31
|
$141,841.06
|
$99,888.07
|
2025-09-05
|
|
D0407
|
OTHER
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
16
|
11
|
—
|
—
|
$95,348.70
|
$138,158.32
|
$97,294.59
|
2025-09-05
|
|
B1806
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
16
|
11
|
—
|
—
|
$93,819.50
|
$135,942.54
|
$95,734.18
|
2025-09-05
|
|
B0406
|
OTHER
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
16
|
11
|
—
|
—
|
$89,393.55
|
$129,529.43
|
$91,217.91
|
2025-09-05
|
|
B0404
|
OTHER
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
16
|
11
|
—
|
—
|
$86,510.06
|
$125,351.31
|
$88,275.57
|
2025-09-05
|
|
A0407
|
OTHER
|
Traumatic Spinal Cord Injury M <24.50 And A >=61.50
|
16
|
11
|
—
|
—
|
$86,043.61
|
$124,675.43
|
$87,799.60
|
2025-09-05
|
|
B0505
|
OTHER
|
Non-traumatic Spinal Cord Injury M <39.50
|
16
|
11
|
—
|
—
|
$82,367.69
|
$119,349.10
|
$84,048.66
|
2025-09-05
|
|
C1904
|
OTHER
|
Guillain-barr? M <38.50
|
16
|
11
|
—
|
—
|
$79,309.27
|
$114,917.52
|
$80,927.83
|
2025-09-05
|
|
C1806
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
16
|
11
|
—
|
—
|
$77,141.36
|
$111,776.25
|
$78,715.67
|
2025-09-05
|
|
B0106
|
OTHER
|
Stroke M <41.50 And A <84.50
|
16
|
11
|
—
|
—
|
$75,257.02
|
$109,045.89
|
$76,792.88
|
2025-09-05
|
|
B1903
|
OTHER
|
Guillain-barr? M >=38.50 And M <51.50
|
16
|
11
|
—
|
—
|
$73,648.30
|
$106,714.89
|
$75,151.33
|
2025-09-05
|
|
B0205
|
OTHER
|
Traumatic Brain Injury M <35.50
|
16
|
11
|
—
|
—
|
$72,023.69
|
$104,360.86
|
$73,493.56
|
2025-09-05
|
|
C0406
|
OTHER
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
16
|
11
|
—
|
—
|
$71,538.69
|
$103,658.10
|
$72,998.66
|
2025-09-05
|
|
D1806
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
16
|
11
|
—
|
—
|
$70,568.69
|
$102,252.60
|
$72,008.87
|
2025-09-05
|
|
D0406
|
OTHER
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
16
|
11
|
—
|
—
|
$69,680.85
|
$100,966.13
|
$71,102.91
|
2025-09-05
|
|
D1904
|
OTHER
|
Guillain-barr? M <38.50
|
16
|
11
|
—
|
—
|
$69,402.57
|
$100,562.91
|
$70,818.95
|
2025-09-05
|
|
C0404
|
OTHER
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
16
|
11
|
—
|
—
|
$69,230.31
|
$100,313.30
|
$70,643.17
|
2025-09-05
|
|
A1904
|
OTHER
|
Guillain-barr? M <38.50
|
16
|
11
|
—
|
—
|
$68,933.47
|
$99,883.20
|
$70,340.28
|
2025-09-05
|
|
A9543
|
HCPCS
|
Y90 Ibritumomab, Rx
|
15
|
11
|
—
|
—
|
$14,774.74
|
$134,487.80
|
$69,933.66
|
2025-09-05
|
|
B0405
|
OTHER
|
Traumatic Spinal Cord Injury M >=31.50 And M <41.50
|
16
|
11
|
—
|
—
|
$68,339.82
|
$99,023.00
|
$69,734.51
|
2025-09-05
|
|
B1705
|
OTHER
|
Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50
|
16
|
11
|
—
|
—
|
$67,454.63
|
$97,740.38
|
$68,831.25
|
2025-09-05
|
|
D0404
|
OTHER
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
16
|
11
|
—
|
—
|
$67,433.43
|
$97,709.66
|
$68,809.62
|
2025-09-05
|
|
B0105
|
OTHER
|
Stroke M <41.50 And A >=84.50
|
16
|
11
|
—
|
—
|
$66,707.25
|
$96,657.44
|
$68,068.62
|
2025-09-05
|
|
C0106
|
OTHER
|
Stroke M <41.50 And A <84.50
|
16
|
11
|
—
|
—
|
$66,641.00
|
$96,561.45
|
$68,001.02
|
2025-09-05
|
|
A1806
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50
|
16
|
11
|
—
|
—
|
$66,293.81
|
$96,058.37
|
$67,646.74
|
2025-09-05
|
|
B1805
|
OTHER
|
Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50
|
16
|
11
|
—
|
—
|
$65,726.65
|
$95,236.57
|
$67,068.01
|
2025-09-05
|
|
B2102
|
OTHER
|
Burns M <52.50
|
16
|
11
|
—
|
—
|
$65,625.95
|
$95,090.66
|
$66,965.25
|
2025-09-05
|
|
B0604
|
OTHER
|
Neurological M <43.50
|
16
|
11
|
—
|
—
|
$64,931.58
|
$94,084.53
|
$66,256.71
|
2025-09-05
|
|
C0505
|
OTHER
|
Non-traumatic Spinal Cord Injury M <39.50
|
16
|
11
|
—
|
—
|
$63,383.81
|
$91,841.85
|
$64,677.36
|
2025-09-05
|
|
B0305
|
OTHER
|
Non-traumatic Brain Injury M <42.50 And A <78.50
|
16
|
11
|
—
|
—
|
$62,938.57
|
$91,196.70
|
$64,223.03
|
2025-09-05
|
|
A0406
|
OTHER
|
Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50
|
16
|
11
|
—
|
—
|
$62,880.26
|
$91,112.21
|
$64,163.53
|
2025-09-05
|
|
B1004
|
OTHER
|
Amputation Lower Extremity M <47.50
|
16
|
11
|
—
|
—
|
$62,803.41
|
$91,000.86
|
$64,085.11
|
2025-09-05
|
|
B1504
|
OTHER
|
Pulmonary M <45.50
|
16
|
11
|
—
|
—
|
$61,899.66
|
$89,691.35
|
$63,162.92
|
2025-09-05
|
|
B0704
|
OTHER
|
Fracture Of Lower Extremity M <41.50
|
16
|
11
|
—
|
—
|
$61,048.92
|
$88,458.64
|
$62,294.82
|
2025-09-05
|
|
A0404
|
OTHER
|
Traumatic Spinal Cord Injury M <31.50 And A <61.50
|
16
|
11
|
—
|
—
|
$60,850.16
|
$88,170.64
|
$62,092.00
|
2025-09-05
|
|
D0106
|
OTHER
|
Stroke M <41.50 And A <84.50
|
16
|
11
|
—
|
—
|
$60,439.36
|
$87,575.40
|
$61,672.82
|
2025-09-05
|
|
B1304
|
OTHER
|
Rheumatoid Other Arthritis M <44.50 And A >=64.50
|
16
|
11
|
—
|
—
|
$60,039.18
|
$86,995.55
|
$61,264.47
|
2025-09-05
|
|
B1305
|
OTHER
|
Rheumatoid Other Arthritis M <51.50 And A <64.50
|
16
|
11
|
—
|
—
|
$59,949.07
|
$86,864.98
|
$61,172.52
|
2025-09-05
|
|
B0904
|
OTHER
|
Other Orthopedic M <44.5
|
16
|
11
|
—
|
—
|
$59,750.30
|
$86,576.96
|
$60,969.69
|
2025-09-05
|
|
C0105
|
OTHER
|
Stroke M <41.50 And A >=84.50
|
16
|
11
|
—
|
—
|
$59,069.18
|
$85,590.03
|
$60,274.67
|
2025-09-05
|
|
J3399
|
HCPCS
|
Inj Onase Abepar-xioi Treat
|
9
|
8
|
—
|
—
|
$2,388,614.23
|
$4,352,603.27
|
$2,901,735.52
|
2025-09-05
|
|
J3392
|
HCPCS
|
Inj, Exagamglogene Autotem
|
9
|
8
|
—
|
—
|
$2,332,000.00
|
$4,139,393.28
|
$2,759,595.52
|
2025-09-05
|
|
Q2058
|
HCPCS
|
Obecbtge Autol Up To 400 Mil
|
8
|
7
|
—
|
—
|
$319,950.96
|
$639,901.92
|
$326,349.98
|
2025-09-05
|
|
J1413
|
HCPCS
|
Inj Delandistrogene Mox Rokl
|
7
|
6
|
—
|
—
|
$3,325,454.76
|
$4,722,145.76
|
$3,934,165.40
|
2025-09-05
|
|
J3394
|
HCPCS
|
Inj, Lovotibeglogene Autotem
|
7
|
6
|
—
|
—
|
$3,286,000.00
|
$4,666,120.00
|
$3,859,357.05
|
2025-09-05
|
|
J3393
|
HCPCS
|
Inj, Betibeglogene Autotemce
|
7
|
6
|
—
|
—
|
$2,968,000.00
|
$4,214,560.00
|
$3,491,724.58
|
2025-09-05
|
|
J1414
|
HCPCS
|
Inj, Beqvez, Per Tx Dose
|
6
|
5
|
—
|
—
|
$3,605,000.00
|
$4,565,876.22
|
$4,390,265.60
|
2025-09-05
|
|
J1411
|
HCPCS
|
Inj, Hemgenix, Per Tx Dose
|
6
|
5
|
—
|
—
|
$3,672,900.00
|
$4,535,437.05
|
$4,360,997.17
|
2025-09-05
|
|
Q0480
|
HCPCS
|
Driver Pneumatic Vad, Rep
|
8
|
3
|
—
|
—
|
$35,858.53
|
$122,219.08
|
$97,904.99
|
2025-09-05
|
|
69930
|
CPT
|
Implant Cochlear Device
|
4
|
2
|
—
|
—
|
$50,424.74
|
$74,900.36
|
$74,900.36
|
2025-09-05
|
|
1734
|
APR_DRG
|
—
|
1
|
1
|
—
|
—
|
$270,814.18
|
$270,814.18
|
$270,814.18
|
2025-09-05
|
|
6934
|
APR_DRG
|
—
|
1
|
1
|
—
|
—
|
$250,278.99
|
$250,278.99
|
$250,278.99
|
2025-09-05
|
|
C1833
|
HCPCS
|
Cardiac Monitor Sys
|
1
|
1
|
—
|
—
|
$187,725.00
|
$187,725.00
|
$187,725.00
|
2025-09-05
|
|
E0766NU
|
HCPCS
|
Elec Stim Cancer Treatment
|
3
|
1
|
—
|
—
|
$185,002.22
|
$185,002.22
|
$185,002.22
|
2025-09-05
|
|
1733
|
APR_DRG
|
—
|
1
|
1
|
—
|
—
|
$129,491.96
|
$129,491.96
|
$129,491.96
|
2025-09-05
|
|
4604
|
APR_DRG
|
—
|
1
|
1
|
—
|
—
|
$95,937.92
|
$95,937.92
|
$95,937.92
|
2025-09-05
|
|
K1007
|
HCPCS
|
Bil Hkaf Pc S/d Micro Sensor
|
2
|
1
|
—
|
—
|
$67,727.85
|
$111,750.95
|
$89,739.40
|
2025-09-05
|
|
1732
|
APR_DRG
|
—
|
1
|
1
|
—
|
—
|
$85,871.18
|
$85,871.18
|
$85,871.18
|
2025-09-05
|
|
6933
|
APR_DRG
|
—
|
1
|
1
|
—
|
—
|
$78,316.10
|
$78,316.10
|
$78,316.10
|
2025-09-05
|
|
1731
|
APR_DRG
|
—
|
1
|
1
|
—
|
—
|
$66,148.42
|
$66,148.42
|
$66,148.42
|
2025-09-05
|
|
90288
|
HCPCS
|
Botulism Ig IV
|
2
|
1
|
—
|
—
|
$48,705.00
|
$80,363.25
|
$64,534.12
|
2025-09-05
|