hospital_name,last_updated_on,version,hospital_location,hospital_address,license_number|GA,"To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated.",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
Monroe County Hospital,2024-07-01,2.0.0,Monroe County Hospital,"88 Martin Luther King Jr Dr Forsyth, GA 31029",586010602,TRUE,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
SERVICE DESCRIPTION,CATEGORY,BILLING MSDRG | CPT | HCPCS,ITEM/SERVICE DESCRIPTION,BILLING REVENUE CODE,GROSS CHARGES,AETNA PLAN,AETNA REIMBURSEMENT METHOD,AMERIGROUP PLAN,AMERIGROUP REIMBURSEMENT METHOD,BCBS HMO POS OPEN ACCESS PATHWAYS PLAN,BCBS HMO POS OPEN ACCESS PATHWAYS REIMBURSEMENT METHOD,BCBS MEDICARE ADVANTAGE HMO PLAN,BCBS MEDICARE ADVANTAGE HMO REIMBURSEMENT METHOD,BCBS MEDICARE ADVANTAGE PPO PLAN,BCBS MEDICARE ADVANTAGE PPO REIMBURSEMENT METHOD,BCBS PPO PLAN,BCBS PPO REIMBURSEMENT METHOD,BCBS TRADITIONAL PAR PLAN,BCBS TRADITIONAL PAR REIMBURSEMENT METHOD,CARESOURCE PLAN,CARESOURCE REIMBURSEMENT METHOD,CIGNA PLAN,CIGNA REIMBURSEMENT METHOD,HUMANA PLAN,HUMANA REIMBURSEMENT METHOD,HUMANA MEDICARE ADVANTAGE PLAN,HUMANA MEDICARE ADVANTAGE REIMBURSEMENT METHOD,SECURE HEALTH PLAN,SECURE HEALTH REIMBURSEMENT METHOD,UHC PLAN,UHC REIMBURSEMENT METHOD,WELLCARE MEDICAID ADVANTAGE PLAN,WELLCARE MEDICAID ADVANTAGE REIMBURSEMENT METHOD,WELLCARE MEDICARE ADVANTAGE PLAN,WELLCARE MEDICARE ADVANTAGE REIMBURSEMENT METHOD,De-Identified Minimum Negotiated Rate,De-Identified Maximum Negotiated Rate,DISCOUNTED CASH PRICE
Outpatient Medical Services,RADIOLOGY,70160,NASAL BONES COMPLETE,320,400,312,78% of Total Billed charges,252,63% of total billed charges,N/A,Not Applicable,152,38% of total billed charges,152,38% of total billed charges,N/A,Not Applicable,360,90% of total billed charges,140,35% of total billed charges,269.1,67.275% of total billed charges,320,80% of total billed charges,153.52,38.38% of total billed charges,320,80% of total billed charges,246.96,61.74% of total billed charges,408,102% of percent of total billed charges,152,38% of total billed charges,140,408,300
Outpatient Medical Services,RADIOLOGY,70220,SINUSES COMP MIN 3V,320,172,134.16,78% of Total Billed charges,108.36,63% of total billed charges,N/A,Not Applicable,65.36,38% of total billed charges,65.36,38% of total billed charges,N/A,Not Applicable,154.8,90% of total billed charges,60.2,35% of total billed charges,115.71,67.275% of total billed charges,137.6,80% of total billed charges,66.01,38.38% of total billed charges,137.6,80% of total billed charges,106.19,61.74% of total billed charges,175.44,102% of percent of total billed charges,65.36,38% of total billed charges,60.2,175.44,129
Outpatient Medical Services,RADIOLOGY,70360,NECK SOFT TISSUE,320,172,134.16,78% of Total Billed charges,108.36,63% of total billed charges,N/A,Not Applicable,65.36,38% of total billed charges,65.36,38% of total billed charges,N/A,Not Applicable,154.8,90% of total billed charges,60.2,35% of total billed charges,115.71,67.275% of total billed charges,137.6,80% of total billed charges,66.01,38.38% of total billed charges,137.6,80% of total billed charges,106.19,61.74% of total billed charges,175.44,102% of percent of total billed charges,65.36,38% of total billed charges,60.2,175.44,129
Outpatient Medical Services,RADIOLOGY,70450,CT scan head or brain without dye,351,1144,892.32,78% of Total Billed charges,720.72,63% of total billed charges,N/A,Not Applicable,434.72,38% of total billed charges,434.72,38% of total billed charges,N/A,Not Applicable,1029.6,90% of total billed charges,400.4,35% of total billed charges,360.18,Case rate,915.2,80% of total billed charges,439.07,38.38% of total billed charges,915.2,80% of total billed charges,706.31,61.74% of total billed charges,1166.88,102% of percent of total billed charges,434.72,38% of total billed charges,360.18,1166.88,858
Outpatient Medical Services,RADIOLOGY,70460,CT BRAIN WITH CONTRAST,351,1608,1254.24,78% of Total Billed charges,1013.04,63% of total billed charges,N/A,Not Applicable,611.04,38% of total billed charges,611.04,38% of total billed charges,N/A,Not Applicable,1447.2,90% of total billed charges,562.8,35% of total billed charges,360.18,Case rate,1286.4,80% of total billed charges,617.15,38.38% of total billed charges,1286.4,80% of total billed charges,992.78,61.74% of total billed charges,1640.16,102% of percent of total billed charges,611.04,38% of total billed charges,360.18,1640.16,1206
Outpatient Medical Services,RADIOLOGY,70470,CT BRAIN WITH AND WITHOUT CONTRAST,351,2055,1602.9,78% of Total Billed charges,1294.65,63% of total billed charges,N/A,Not Applicable,780.9,38% of total billed charges,780.9,38% of total billed charges,N/A,Not Applicable,1849.5,90% of total billed charges,719.25,35% of total billed charges,360.18,Case rate,1644,80% of total billed charges,788.71,38.38% of total billed charges,1644,80% of total billed charges,1268.76,61.74% of total billed charges,2096.1,102% of percent of total billed charges,780.9,38% of total billed charges,360.18,2096.1,1541.25
Outpatient Medical Services,RADIOLOGY,70486,CT Scan of the face and jaw without dye,351,808,630.24,78% of Total Billed charges,509.04,63% of total billed charges,N/A,Not Applicable,307.04,38% of total billed charges,307.04,38% of total billed charges,N/A,Not Applicable,727.2,90% of total billed charges,282.8,35% of total billed charges,360.18,Case rate,646.4,80% of total billed charges,310.11,38.38% of total billed charges,646.4,80% of total billed charges,498.86,61.74% of total billed charges,824.16,102% of percent of total billed charges,307.04,38% of total billed charges,282.8,824.16,606
Outpatient Medical Services,RADIOLOGY,70490,CT SOFT TISSUE NECK W/O CONTRAST,351,898,700.44,78% of Total Billed charges,565.74,63% of total billed charges,N/A,Not Applicable,341.24,38% of total billed charges,341.24,38% of total billed charges,N/A,Not Applicable,808.2,90% of total billed charges,314.3,35% of total billed charges,360.18,Case rate,718.4,80% of total billed charges,344.65,38.38% of total billed charges,718.4,80% of total billed charges,554.43,61.74% of total billed charges,915.96,102% of percent of total billed charges,341.24,38% of total billed charges,314.3,915.96,673.5
Outpatient Medical Services,RADIOLOGY,70491,CT scan of neck with dye,351,1108,864.24,78% of Total Billed charges,698.04,63% of total billed charges,N/A,Not Applicable,421.04,38% of total billed charges,421.04,38% of total billed charges,N/A,Not Applicable,997.2,90% of total billed charges,387.8,35% of total billed charges,360.18,Case rate,886.4,80% of total billed charges,425.25,38.38% of total billed charges,886.4,80% of total billed charges,684.08,61.74% of total billed charges,1130.16,102% of percent of total billed charges,421.04,38% of total billed charges,360.18,1130.16,831
Outpatient Medical Services,RADIOLOGY,70496,CT ANGIOGRAPHY HEAD W/WO CONTRAST,352,2059,1606.02,78% of Total Billed charges,1297.17,63% of total billed charges,N/A,Not Applicable,782.42,38% of total billed charges,782.42,38% of total billed charges,N/A,Not Applicable,1853.1,90% of total billed charges,720.65,35% of total billed charges,360.18,Case rate,1647.2,80% of total billed charges,790.24,38.38% of total billed charges,1647.2,80% of total billed charges,1271.23,61.74% of total billed charges,2100.18,102% of percent of total billed charges,782.42,38% of total billed charges,360.18,2100.18,1544.25
Outpatient Medical Services,RADIOLOGY,70553,MRI scan of brain before and after contrast,611,4262,3324.36,78% of Total Billed charges,2685.06,63% of total billed charges,N/A,Not Applicable,1619.56,38% of total billed charges,1619.56,38% of total billed charges,N/A,Not Applicable,3835.8,90% of total billed charges,1491.7,35% of total billed charges,855.95,Case rate,3409.6,80% of total billed charges,1635.76,38.38% of total billed charges,3409.6,80% of total billed charges,2631.36,61.74% of total billed charges,4347.24,102% of percent of total billed charges,1619.56,38% of total billed charges,855.95,4347.24,3196.5
Outpatient Medical Services,RADIOLOGY,71045,Single view,320,155,120.9,78% of Total Billed charges,97.65,63% of total billed charges,N/A,Not Applicable,58.9,38% of total billed charges,58.9,38% of total billed charges,N/A,Not Applicable,139.5,90% of total billed charges,54.25,35% of total billed charges,104.28,67.275% of total billed charges,124,80% of total billed charges,59.49,38.38% of total billed charges,124,80% of total billed charges,95.7,61.74% of total billed charges,158.1,102% of percent of total billed charges,58.9,38% of total billed charges,54.25,158.1,116.25
Outpatient Medical Services,RADIOLOGY,71046,"2 views, front and back",320,400,312,78% of Total Billed charges,252,63% of total billed charges,N/A,Not Applicable,152,38% of total billed charges,152,38% of total billed charges,N/A,Not Applicable,360,90% of total billed charges,140,35% of total billed charges,269.1,67.275% of total billed charges,320,80% of total billed charges,153.52,38.38% of total billed charges,320,80% of total billed charges,246.96,61.74% of total billed charges,408,102% of percent of total billed charges,152,38% of total billed charges,140,408,300
Outpatient Medical Services,RADIOLOGY,71100,RIBS UNI 2 VIEWS-RT,320,272,212.16,78% of Total Billed charges,171.36,63% of total billed charges,N/A,Not Applicable,103.36,38% of total billed charges,103.36,38% of total billed charges,N/A,Not Applicable,244.8,90% of total billed charges,95.2,35% of total billed charges,182.99,67.275% of total billed charges,217.6,80% of total billed charges,104.39,38.38% of total billed charges,217.6,80% of total billed charges,167.93,61.74% of total billed charges,277.44,102% of percent of total billed charges,103.36,38% of total billed charges,95.2,277.44,204
Outpatient Medical Services,RADIOLOGY,71101,Radiologic examination of one side of the chest/ribs,320,454,354.12,78% of Total Billed charges,286.02,63% of total billed charges,N/A,Not Applicable,172.52,38% of total billed charges,172.52,38% of total billed charges,N/A,Not Applicable,408.6,90% of total billed charges,158.9,35% of total billed charges,305.43,67.275% of total billed charges,363.2,80% of total billed charges,174.25,38.38% of total billed charges,363.2,80% of total billed charges,280.3,61.74% of total billed charges,463.08,102% of percent of total billed charges,172.52,38% of total billed charges,158.9,463.08,340.5
Outpatient Medical Services,RADIOLOGY,71111,RIBS BI W/PA CHEST 4,320,636,496.08,78% of Total Billed charges,400.68,63% of total billed charges,N/A,Not Applicable,241.68,38% of total billed charges,241.68,38% of total billed charges,N/A,Not Applicable,572.4,90% of total billed charges,222.6,35% of total billed charges,427.87,67.275% of total billed charges,508.8,80% of total billed charges,244.1,38.38% of total billed charges,508.8,80% of total billed charges,392.67,61.74% of total billed charges,648.72,102% of percent of total billed charges,241.68,38% of total billed charges,222.6,648.72,477
Outpatient Medical Services,RADIOLOGY,71250,CT scan of the thorax without dye,352,1152,898.56,78% of Total Billed charges,725.76,63% of total billed charges,N/A,Not Applicable,437.76,38% of total billed charges,437.76,38% of total billed charges,N/A,Not Applicable,1036.8,90% of total billed charges,403.2,35% of total billed charges,360.18,Case rate,921.6,80% of total billed charges,442.14,38.38% of total billed charges,921.6,80% of total billed charges,711.24,61.74% of total billed charges,1175.04,102% of percent of total billed charges,437.76,38% of total billed charges,360.18,1175.04,864
Outpatient Medical Services,RADIOLOGY,71260,CT scan of the thorax with dye,352,1712,1335.36,78% of Total Billed charges,1078.56,63% of total billed charges,N/A,Not Applicable,650.56,38% of total billed charges,650.56,38% of total billed charges,N/A,Not Applicable,1540.8,90% of total billed charges,599.2,35% of total billed charges,360.18,Case rate,1369.6,80% of total billed charges,657.07,38.38% of total billed charges,1369.6,80% of total billed charges,1056.99,61.74% of total billed charges,1746.24,102% of percent of total billed charges,650.56,38% of total billed charges,360.18,1746.24,1284
Outpatient Medical Services,RADIOLOGY,71275,Diagnostic Radiology (Diagnostic Imaging) Procedures of the Chest,352,1261,983.58,78% of Total Billed charges,794.43,63% of total billed charges,N/A,Not Applicable,479.18,38% of total billed charges,479.18,38% of total billed charges,N/A,Not Applicable,1134.9,90% of total billed charges,441.35,35% of total billed charges,360.18,Case rate,1008.8,80% of total billed charges,483.97,38.38% of total billed charges,1008.8,80% of total billed charges,778.54,61.74% of total billed charges,1286.22,102% of percent of total billed charges,479.18,38% of total billed charges,360.18,1286.22,945.75
Outpatient Medical Services,RADIOLOGY,72040,"Radiologic examination of the neck/spine, 2-3 views",320,286,223.08,78% of Total Billed charges,180.18,63% of total billed charges,N/A,Not Applicable,108.68,38% of total billed charges,108.68,38% of total billed charges,N/A,Not Applicable,257.4,90% of total billed charges,100.1,35% of total billed charges,192.41,67.275% of total billed charges,228.8,80% of total billed charges,109.77,38.38% of total billed charges,228.8,80% of total billed charges,176.58,61.74% of total billed charges,291.72,102% of percent of total billed charges,108.68,38% of total billed charges,100.1,291.72,214.5
Outpatient Medical Services,RADIOLOGY,72050,"Radiologic examination of the neck/spine, 4-5 views",320,454,354.12,78% of Total Billed charges,286.02,63% of total billed charges,N/A,Not Applicable,172.52,38% of total billed charges,172.52,38% of total billed charges,N/A,Not Applicable,408.6,90% of total billed charges,158.9,35% of total billed charges,305.43,67.275% of total billed charges,363.2,80% of total billed charges,174.25,38.38% of total billed charges,363.2,80% of total billed charges,280.3,61.74% of total billed charges,463.08,102% of percent of total billed charges,172.52,38% of total billed charges,158.9,463.08,340.5
Outpatient Medical Services,RADIOLOGY,72052,SPINE C W/OBL & BENDING,320,454,354.12,78% of Total Billed charges,286.02,63% of total billed charges,N/A,Not Applicable,172.52,38% of total billed charges,172.52,38% of total billed charges,N/A,Not Applicable,408.6,90% of total billed charges,158.9,35% of total billed charges,305.43,67.275% of total billed charges,363.2,80% of total billed charges,174.25,38.38% of total billed charges,363.2,80% of total billed charges,280.3,61.74% of total billed charges,463.08,102% of percent of total billed charges,172.52,38% of total billed charges,158.9,463.08,340.5
Outpatient Medical Services,RADIOLOGY,72074,SPINE THORACIC COMPLETE,320,286,223.08,78% of Total Billed charges,180.18,63% of total billed charges,N/A,Not Applicable,108.68,38% of total billed charges,108.68,38% of total billed charges,N/A,Not Applicable,257.4,90% of total billed charges,100.1,35% of total billed charges,192.41,67.275% of total billed charges,228.8,80% of total billed charges,109.77,38.38% of total billed charges,228.8,80% of total billed charges,176.58,61.74% of total billed charges,291.72,102% of percent of total billed charges,108.68,38% of total billed charges,100.1,291.72,214.5
Outpatient Medical Services,RADIOLOGY,72100,X-ray of the lower spine 2-3 views,320,272,212.16,78% of Total Billed charges,171.36,63% of total billed charges,N/A,Not Applicable,103.36,38% of total billed charges,103.36,38% of total billed charges,N/A,Not Applicable,244.8,90% of total billed charges,95.2,35% of total billed charges,182.99,67.275% of total billed charges,217.6,80% of total billed charges,104.39,38.38% of total billed charges,217.6,80% of total billed charges,167.93,61.74% of total billed charges,277.44,102% of percent of total billed charges,103.36,38% of total billed charges,95.2,277.44,204
Outpatient Medical Services,RADIOLOGY,72110,"X-ray of lower and sacral spine, minimum of 4 views",320,400,312,78% of Total Billed charges,252,63% of total billed charges,N/A,Not Applicable,152,38% of total billed charges,152,38% of total billed charges,N/A,Not Applicable,360,90% of total billed charges,140,35% of total billed charges,269.1,67.275% of total billed charges,320,80% of total billed charges,153.52,38.38% of total billed charges,320,80% of total billed charges,246.96,61.74% of total billed charges,408,102% of percent of total billed charges,152,38% of total billed charges,140,408,300
Outpatient Medical Services,RADIOLOGY,72125,CT CERVICAL SPINE W/O CON,352,1472,1148.16,78% of Total Billed charges,927.36,63% of total billed charges,N/A,Not Applicable,559.36,38% of total billed charges,559.36,38% of total billed charges,N/A,Not Applicable,1324.8,90% of total billed charges,515.2,35% of total billed charges,360.18,Case rate,1177.6,80% of total billed charges,564.95,38.38% of total billed charges,1177.6,80% of total billed charges,908.81,61.74% of total billed charges,1501.44,102% of percent of total billed charges,559.36,38% of total billed charges,360.18,1501.44,1104
Outpatient Medical Services,RADIOLOGY,72128,CT THORACIC SPINE W/O CON,352,839,654.42,78% of Total Billed charges,528.57,63% of total billed charges,N/A,Not Applicable,318.82,38% of total billed charges,318.82,38% of total billed charges,N/A,Not Applicable,755.1,90% of total billed charges,293.65,35% of total billed charges,360.18,Case rate,671.2,80% of total billed charges,322.01,38.38% of total billed charges,671.2,80% of total billed charges,518,61.74% of total billed charges,855.78,102% of percent of total billed charges,318.82,38% of total billed charges,293.65,855.78,629.25
Outpatient Medical Services,RADIOLOGY,72131,CT scan of lower spine without dye,352,1392,1085.76,78% of Total Billed charges,876.96,63% of total billed charges,N/A,Not Applicable,528.96,38% of total billed charges,528.96,38% of total billed charges,N/A,Not Applicable,1252.8,90% of total billed charges,487.2,35% of total billed charges,360.18,Case rate,1113.6,80% of total billed charges,534.25,38.38% of total billed charges,1113.6,80% of total billed charges,859.42,61.74% of total billed charges,1419.84,102% of percent of total billed charges,528.96,38% of total billed charges,360.18,1419.84,1044
Outpatient Medical Services,RADIOLOGY,72148,MRI scan of lower spinal canal,612,1108,864.24,78% of Total Billed charges,698.04,63% of total billed charges,N/A,Not Applicable,421.04,38% of total billed charges,421.04,38% of total billed charges,N/A,Not Applicable,997.2,90% of total billed charges,387.8,35% of total billed charges,855.95,Case rate,886.4,80% of total billed charges,425.25,38.38% of total billed charges,886.4,80% of total billed charges,684.08,61.74% of total billed charges,1130.16,102% of percent of total billed charges,421.04,38% of total billed charges,387.8,1130.16,831
Outpatient Medical Services,RADIOLOGY,72170,Radiologic examination of the pelvis,320,400,312,78% of Total Billed charges,252,63% of total billed charges,N/A,Not Applicable,152,38% of total billed charges,152,38% of total billed charges,N/A,Not Applicable,360,90% of total billed charges,140,35% of total billed charges,269.1,67.275% of total billed charges,320,80% of total billed charges,153.52,38.38% of total billed charges,320,80% of total billed charges,246.96,61.74% of total billed charges,408,102% of percent of total billed charges,152,38% of total billed charges,140,408,300
Outpatient Medical Services,RADIOLOGY,72190,PELVIS COMPLETE,320,241,187.98,78% of Total Billed charges,151.83,63% of total billed charges,N/A,Not Applicable,91.58,38% of total billed charges,91.58,38% of total billed charges,N/A,Not Applicable,216.9,90% of total billed charges,84.35,35% of total billed charges,162.13,67.275% of total billed charges,192.8,80% of total billed charges,92.5,38.38% of total billed charges,192.8,80% of total billed charges,148.79,61.74% of total billed charges,245.82,102% of percent of total billed charges,91.58,38% of total billed charges,84.35,245.82,180.75
Outpatient Medical Services,RADIOLOGY,72192,CT of pelvis without dye,352,1025,799.5,78% of Total Billed charges,645.75,63% of total billed charges,N/A,Not Applicable,389.5,38% of total billed charges,389.5,38% of total billed charges,N/A,Not Applicable,922.5,90% of total billed charges,358.75,35% of total billed charges,360.18,Case rate,820,80% of total billed charges,393.4,38.38% of total billed charges,820,80% of total billed charges,632.84,61.74% of total billed charges,1045.5,102% of percent of total billed charges,389.5,38% of total billed charges,358.75,1045.5,768.75
Outpatient Medical Services,RADIOLOGY,72193,"CT scan, pelvis, with contrast",352,1178,918.84,78% of Total Billed charges,742.14,63% of total billed charges,N/A,Not Applicable,447.64,38% of total billed charges,447.64,38% of total billed charges,N/A,Not Applicable,1060.2,90% of total billed charges,412.3,35% of total billed charges,360.18,Case rate,942.4,80% of total billed charges,452.12,38.38% of total billed charges,942.4,80% of total billed charges,727.3,61.74% of total billed charges,1201.56,102% of percent of total billed charges,447.64,38% of total billed charges,360.18,1201.56,883.5
Outpatient Medical Services,RADIOLOGY,72220,SACRUM 2 VIEWS,320,400,312,78% of Total Billed charges,252,63% of total billed charges,N/A,Not Applicable,152,38% of total billed charges,152,38% of total billed charges,N/A,Not Applicable,360,90% of total billed charges,140,35% of total billed charges,269.1,67.275% of total billed charges,320,80% of total billed charges,153.52,38.38% of total billed charges,320,80% of total billed charges,246.96,61.74% of total billed charges,408,102% of percent of total billed charges,152,38% of total billed charges,140,408,300
Outpatient Medical Services,RADIOLOGY,73000,Radiologic examination of the collar bone,320,286,223.08,78% of Total Billed charges,180.18,63% of total billed charges,N/A,Not Applicable,108.68,38% of total billed charges,108.68,38% of total billed charges,N/A,Not Applicable,257.4,90% of total billed charges,100.1,35% of total billed charges,192.41,67.275% of total billed charges,228.8,80% of total billed charges,109.77,38.38% of total billed charges,228.8,80% of total billed charges,176.58,61.74% of total billed charges,291.72,102% of percent of total billed charges,108.68,38% of total billed charges,100.1,291.72,214.5
Outpatient Medical Services,RADIOLOGY,73020,SHOULDER 1 VIEW-RT,320,155,120.9,78% of Total Billed charges,97.65,63% of total billed charges,N/A,Not Applicable,58.9,38% of total billed charges,58.9,38% of total billed charges,N/A,Not Applicable,139.5,90% of total billed charges,54.25,35% of total billed charges,104.28,67.275% of total billed charges,124,80% of total billed charges,59.49,38.38% of total billed charges,124,80% of total billed charges,95.7,61.74% of total billed charges,158.1,102% of percent of total billed charges,58.9,38% of total billed charges,54.25,158.1,116.25
Outpatient Medical Services,RADIOLOGY,73030,Radiologic examination of the shoulder,320,286,223.08,78% of Total Billed charges,180.18,63% of total billed charges,N/A,Not Applicable,108.68,38% of total billed charges,108.68,38% of total billed charges,N/A,Not Applicable,257.4,90% of total billed charges,100.1,35% of total billed charges,192.41,67.275% of total billed charges,228.8,80% of total billed charges,109.77,38.38% of total billed charges,228.8,80% of total billed charges,176.58,61.74% of total billed charges,291.72,102% of percent of total billed charges,108.68,38% of total billed charges,100.1,291.72,214.5
Outpatient Medical Services,RADIOLOGY,73060,ARM (HUMERUS) 2V-RT,320,400,312,78% of Total Billed charges,252,63% of total billed charges,N/A,Not Applicable,152,38% of total billed charges,152,38% of total billed charges,N/A,Not Applicable,360,90% of total billed charges,140,35% of total billed charges,269.1,67.275% of total billed charges,320,80% of total billed charges,153.52,38.38% of total billed charges,320,80% of total billed charges,246.96,61.74% of total billed charges,408,102% of percent of total billed charges,152,38% of total billed charges,140,408,300
Outpatient Medical Services,RADIOLOGY,73070,"Radiologic examination, elbow; 2 views",320,155,120.9,78% of Total Billed charges,97.65,63% of total billed charges,N/A,Not Applicable,58.9,38% of total billed charges,58.9,38% of total billed charges,N/A,Not Applicable,139.5,90% of total billed charges,54.25,35% of total billed charges,104.28,67.275% of total billed charges,124,80% of total billed charges,59.49,38.38% of total billed charges,124,80% of total billed charges,95.7,61.74% of total billed charges,158.1,102% of percent of total billed charges,58.9,38% of total billed charges,54.25,158.1,116.25
Outpatient Medical Services,RADIOLOGY,73080,"Radiologic examination, elbow; 3 or more views",320,286,223.08,78% of Total Billed charges,180.18,63% of total billed charges,N/A,Not Applicable,108.68,38% of total billed charges,108.68,38% of total billed charges,N/A,Not Applicable,257.4,90% of total billed charges,100.1,35% of total billed charges,192.41,67.275% of total billed charges,228.8,80% of total billed charges,109.77,38.38% of total billed charges,228.8,80% of total billed charges,176.58,61.74% of total billed charges,291.72,102% of percent of total billed charges,108.68,38% of total billed charges,100.1,291.72,214.5
Outpatient Medical Services,RADIOLOGY,73090,Radiologic examination of the forearm,320,172,134.16,78% of Total Billed charges,108.36,63% of total billed charges,N/A,Not Applicable,65.36,38% of total billed charges,65.36,38% of total billed charges,N/A,Not Applicable,154.8,90% of total billed charges,60.2,35% of total billed charges,115.71,67.275% of total billed charges,137.6,80% of total billed charges,66.01,38.38% of total billed charges,137.6,80% of total billed charges,106.19,61.74% of total billed charges,175.44,102% of percent of total billed charges,65.36,38% of total billed charges,60.2,175.44,129
Outpatient Medical Services,RADIOLOGY,73100,3 or more views,320,258,201.24,78% of Total Billed charges,162.54,63% of total billed charges,N/A,Not Applicable,98.04,38% of total billed charges,98.04,38% of total billed charges,N/A,Not Applicable,232.2,90% of total billed charges,90.3,35% of total billed charges,173.57,67.275% of total billed charges,206.4,80% of total billed charges,99.02,38.38% of total billed charges,206.4,80% of total billed charges,159.29,61.74% of total billed charges,263.16,102% of percent of total billed charges,98.04,38% of total billed charges,90.3,263.16,193.5
Outpatient Medical Services,RADIOLOGY,73110,Up to 3 views,320,286,223.08,78% of Total Billed charges,180.18,63% of total billed charges,N/A,Not Applicable,108.68,38% of total billed charges,108.68,38% of total billed charges,N/A,Not Applicable,257.4,90% of total billed charges,100.1,35% of total billed charges,192.41,67.275% of total billed charges,228.8,80% of total billed charges,109.77,38.38% of total billed charges,228.8,80% of total billed charges,176.58,61.74% of total billed charges,291.72,102% of percent of total billed charges,108.68,38% of total billed charges,100.1,291.72,214.5
Outpatient Medical Services,RADIOLOGY,73130,X-ray of the hand with 3 or more views,320,172,134.16,78% of Total Billed charges,108.36,63% of total billed charges,N/A,Not Applicable,65.36,38% of total billed charges,65.36,38% of total billed charges,N/A,Not Applicable,154.8,90% of total billed charges,60.2,35% of total billed charges,115.71,67.275% of total billed charges,137.6,80% of total billed charges,66.01,38.38% of total billed charges,137.6,80% of total billed charges,106.19,61.74% of total billed charges,175.44,102% of percent of total billed charges,65.36,38% of total billed charges,60.2,175.44,129
Outpatient Medical Services,RADIOLOGY,73140,Radiologic examination of the finger(s),320,400,312,78% of Total Billed charges,252,63% of total billed charges,N/A,Not Applicable,152,38% of total billed charges,152,38% of total billed charges,N/A,Not Applicable,360,90% of total billed charges,140,35% of total billed charges,269.1,67.275% of total billed charges,320,80% of total billed charges,153.52,38.38% of total billed charges,320,80% of total billed charges,246.96,61.74% of total billed charges,408,102% of percent of total billed charges,152,38% of total billed charges,140,408,300
Outpatient Medical Services,RADIOLOGY,73200,CT UPPER ET WO C LT,352,835,651.3,78% of Total Billed charges,526.05,63% of total billed charges,N/A,Not Applicable,317.3,38% of total billed charges,317.3,38% of total billed charges,N/A,Not Applicable,751.5,90% of total billed charges,292.25,35% of total billed charges,360.18,Case rate,668,80% of total billed charges,320.47,38.38% of total billed charges,668,80% of total billed charges,515.53,61.74% of total billed charges,851.7,102% of percent of total billed charges,317.3,38% of total billed charges,292.25,851.7,626.25
Outpatient Medical Services,RADIOLOGY,73501,HIP W/ PELVIS 1 VIEW RIGHT,320,258,201.24,78% of Total Billed charges,162.54,63% of total billed charges,N/A,Not Applicable,98.04,38% of total billed charges,98.04,38% of total billed charges,N/A,Not Applicable,232.2,90% of total billed charges,90.3,35% of total billed charges,173.57,67.275% of total billed charges,206.4,80% of total billed charges,99.02,38.38% of total billed charges,206.4,80% of total billed charges,159.29,61.74% of total billed charges,263.16,102% of percent of total billed charges,98.04,38% of total billed charges,90.3,263.16,193.5
Outpatient Medical Services,RADIOLOGY,73521,HIP W/ PELVIS BILATERAL 2 VIEWS,320,286,223.08,78% of Total Billed charges,180.18,63% of total billed charges,N/A,Not Applicable,108.68,38% of total billed charges,108.68,38% of total billed charges,N/A,Not Applicable,257.4,90% of total billed charges,100.1,35% of total billed charges,192.41,67.275% of total billed charges,228.8,80% of total billed charges,109.77,38.38% of total billed charges,228.8,80% of total billed charges,176.58,61.74% of total billed charges,291.72,102% of percent of total billed charges,108.68,38% of total billed charges,100.1,291.72,214.5
Outpatient Medical Services,RADIOLOGY,73552,LEG FEMUR 2 VIEW RIGHT,320,172,134.16,78% of Total Billed charges,108.36,63% of total billed charges,N/A,Not Applicable,65.36,38% of total billed charges,65.36,38% of total billed charges,N/A,Not Applicable,154.8,90% of total billed charges,60.2,35% of total billed charges,115.71,67.275% of total billed charges,137.6,80% of total billed charges,66.01,38.38% of total billed charges,137.6,80% of total billed charges,106.19,61.74% of total billed charges,175.44,102% of percent of total billed charges,65.36,38% of total billed charges,60.2,175.44,129
Outpatient Medical Services,RADIOLOGY,73560,Radiologic examination of the knee with 1 or 2 views,320,172,134.16,78% of Total Billed charges,108.36,63% of total billed charges,N/A,Not Applicable,65.36,38% of total billed charges,65.36,38% of total billed charges,N/A,Not Applicable,154.8,90% of total billed charges,60.2,35% of total billed charges,115.71,67.275% of total billed charges,137.6,80% of total billed charges,66.01,38.38% of total billed charges,137.6,80% of total billed charges,106.19,61.74% of total billed charges,175.44,102% of percent of total billed charges,65.36,38% of total billed charges,60.2,175.44,129
Outpatient Medical Services,RADIOLOGY,73562,Radiologic examination of the knee with 3 views,320,314,244.92,78% of Total Billed charges,197.82,63% of total billed charges,N/A,Not Applicable,119.32,38% of total billed charges,119.32,38% of total billed charges,N/A,Not Applicable,282.6,90% of total billed charges,109.9,35% of total billed charges,211.24,67.275% of total billed charges,251.2,80% of total billed charges,120.51,38.38% of total billed charges,251.2,80% of total billed charges,193.86,61.74% of total billed charges,320.28,102% of percent of total billed charges,119.32,38% of total billed charges,109.9,320.28,235.5
Outpatient Medical Services,RADIOLOGY,73564,Radiologic examination of the knee with 4 or more views,320,314,244.92,78% of Total Billed charges,197.82,63% of total billed charges,N/A,Not Applicable,119.32,38% of total billed charges,119.32,38% of total billed charges,N/A,Not Applicable,282.6,90% of total billed charges,109.9,35% of total billed charges,211.24,67.275% of total billed charges,251.2,80% of total billed charges,120.51,38.38% of total billed charges,251.2,80% of total billed charges,193.86,61.74% of total billed charges,320.28,102% of percent of total billed charges,119.32,38% of total billed charges,109.9,320.28,235.5
Outpatient Medical Services,RADIOLOGY,73590,Radiologic examination of the lower leg,320,172,134.16,78% of Total Billed charges,108.36,63% of total billed charges,N/A,Not Applicable,65.36,38% of total billed charges,65.36,38% of total billed charges,N/A,Not Applicable,154.8,90% of total billed charges,60.2,35% of total billed charges,115.71,67.275% of total billed charges,137.6,80% of total billed charges,66.01,38.38% of total billed charges,137.6,80% of total billed charges,106.19,61.74% of total billed charges,175.44,102% of percent of total billed charges,65.36,38% of total billed charges,60.2,175.44,129
Outpatient Medical Services,RADIOLOGY,73600,Radiologic examination of the ankle with 2 views,320,258,201.24,78% of Total Billed charges,162.54,63% of total billed charges,N/A,Not Applicable,98.04,38% of total billed charges,98.04,38% of total billed charges,N/A,Not Applicable,232.2,90% of total billed charges,90.3,35% of total billed charges,173.57,67.275% of total billed charges,206.4,80% of total billed charges,99.02,38.38% of total billed charges,206.4,80% of total billed charges,159.29,61.74% of total billed charges,263.16,102% of percent of total billed charges,98.04,38% of total billed charges,90.3,263.16,193.5
Outpatient Medical Services,RADIOLOGY,73610,Radiologic examination of the ankle with 3 views,320,172,134.16,78% of Total Billed charges,108.36,63% of total billed charges,N/A,Not Applicable,65.36,38% of total billed charges,65.36,38% of total billed charges,N/A,Not Applicable,154.8,90% of total billed charges,60.2,35% of total billed charges,115.71,67.275% of total billed charges,137.6,80% of total billed charges,66.01,38.38% of total billed charges,137.6,80% of total billed charges,106.19,61.74% of total billed charges,175.44,102% of percent of total billed charges,65.36,38% of total billed charges,60.2,175.44,129
Outpatient Medical Services,RADIOLOGY,73620,"Radiologic examination, foot; 2 views",320,361,281.58,78% of Total Billed charges,227.43,63% of total billed charges,N/A,Not Applicable,137.18,38% of total billed charges,137.18,38% of total billed charges,N/A,Not Applicable,324.9,90% of total billed charges,126.35,35% of total billed charges,242.86,67.275% of total billed charges,288.8,80% of total billed charges,138.55,38.38% of total billed charges,288.8,80% of total billed charges,222.88,61.74% of total billed charges,368.22,102% of percent of total billed charges,137.18,38% of total billed charges,126.35,368.22,270.75
Outpatient Medical Services,RADIOLOGY,73630,Radiologic examination of the foot with 3 or more views,320,286,223.08,78% of Total Billed charges,180.18,63% of total billed charges,N/A,Not Applicable,108.68,38% of total billed charges,108.68,38% of total billed charges,N/A,Not Applicable,257.4,90% of total billed charges,100.1,35% of total billed charges,192.41,67.275% of total billed charges,228.8,80% of total billed charges,109.77,38.38% of total billed charges,228.8,80% of total billed charges,176.58,61.74% of total billed charges,291.72,102% of percent of total billed charges,108.68,38% of total billed charges,100.1,291.72,214.5
Outpatient Medical Services,RADIOLOGY,73660,Radiologic examination of the toe(s),320,292,227.76,78% of Total Billed charges,183.96,63% of total billed charges,N/A,Not Applicable,110.96,38% of total billed charges,110.96,38% of total billed charges,N/A,Not Applicable,262.8,90% of total billed charges,102.2,35% of total billed charges,196.44,67.275% of total billed charges,233.6,80% of total billed charges,112.07,38.38% of total billed charges,233.6,80% of total billed charges,180.28,61.74% of total billed charges,297.84,102% of percent of total billed charges,110.96,38% of total billed charges,102.2,297.84,219
Outpatient Medical Services,RADIOLOGY,73700,CT scan of leg without dye,352,864,673.92,78% of Total Billed charges,544.32,63% of total billed charges,N/A,Not Applicable,328.32,38% of total billed charges,328.32,38% of total billed charges,N/A,Not Applicable,777.6,90% of total billed charges,302.4,35% of total billed charges,360.18,Case rate,691.2,80% of total billed charges,331.6,38.38% of total billed charges,691.2,80% of total billed charges,533.43,61.74% of total billed charges,881.28,102% of percent of total billed charges,328.32,38% of total billed charges,302.4,881.28,648
Outpatient Medical Services,RADIOLOGY,73721,MRI of lower extremity joint (knee/ankle) without dye,610,1171,913.38,78% of Total Billed charges,737.73,63% of total billed charges,N/A,Not Applicable,444.98,38% of total billed charges,444.98,38% of total billed charges,N/A,Not Applicable,1053.9,90% of total billed charges,409.85,35% of total billed charges,855.95,Case rate,936.8,80% of total billed charges,449.43,38.38% of total billed charges,936.8,80% of total billed charges,722.98,61.74% of total billed charges,1194.42,102% of percent of total billed charges,444.98,38% of total billed charges,409.85,1194.42,878.25
Outpatient Medical Services,RADIOLOGY,74018,ABDOMEN 1 VIEW,320,172,134.16,78% of Total Billed charges,108.36,63% of total billed charges,N/A,Not Applicable,65.36,38% of total billed charges,65.36,38% of total billed charges,N/A,Not Applicable,154.8,90% of total billed charges,60.2,35% of total billed charges,115.71,67.275% of total billed charges,137.6,80% of total billed charges,66.01,38.38% of total billed charges,137.6,80% of total billed charges,106.19,61.74% of total billed charges,175.44,102% of percent of total billed charges,65.36,38% of total billed charges,60.2,175.44,129
Outpatient Medical Services,RADIOLOGY,74019,ABDOMEN FLAT AND UPRIGHT 2 VIEWS,320,241,187.98,78% of Total Billed charges,151.83,63% of total billed charges,N/A,Not Applicable,91.58,38% of total billed charges,91.58,38% of total billed charges,N/A,Not Applicable,216.9,90% of total billed charges,84.35,35% of total billed charges,162.13,67.275% of total billed charges,192.8,80% of total billed charges,92.5,38.38% of total billed charges,192.8,80% of total billed charges,148.79,61.74% of total billed charges,245.82,102% of percent of total billed charges,91.58,38% of total billed charges,84.35,245.82,180.75
Outpatient Medical Services,RADIOLOGY,74022,Serial radiologic examination of the abdomen,320,272,212.16,78% of Total Billed charges,171.36,63% of total billed charges,N/A,Not Applicable,103.36,38% of total billed charges,103.36,38% of total billed charges,N/A,Not Applicable,244.8,90% of total billed charges,95.2,35% of total billed charges,182.99,67.275% of total billed charges,217.6,80% of total billed charges,104.39,38.38% of total billed charges,217.6,80% of total billed charges,167.93,61.74% of total billed charges,277.44,102% of percent of total billed charges,103.36,38% of total billed charges,95.2,277.44,204
Outpatient Medical Services,RADIOLOGY,74160,CT of abdomen with dye,352,1608,1254.24,78% of Total Billed charges,1013.04,63% of total billed charges,N/A,Not Applicable,611.04,38% of total billed charges,611.04,38% of total billed charges,N/A,Not Applicable,1447.2,90% of total billed charges,562.8,35% of total billed charges,360.18,Case rate,1286.4,80% of total billed charges,617.15,38.38% of total billed charges,1286.4,80% of total billed charges,992.78,61.74% of total billed charges,1640.16,102% of percent of total billed charges,611.04,38% of total billed charges,360.18,1640.16,1206
Outpatient Medical Services,RADIOLOGY,74170,CT of abdomen with and without dye,352,1907,1487.46,78% of Total Billed charges,1201.41,63% of total billed charges,N/A,Not Applicable,724.66,38% of total billed charges,724.66,38% of total billed charges,N/A,Not Applicable,1716.3,90% of total billed charges,667.45,35% of total billed charges,360.18,Case rate,1525.6,80% of total billed charges,731.91,38.38% of total billed charges,1525.6,80% of total billed charges,1177.38,61.74% of total billed charges,1945.14,102% of percent of total billed charges,724.66,38% of total billed charges,360.18,1945.14,1430.25
Outpatient Medical Services,RADIOLOGY,74176,CT of abdomen and pelvis without dye,352,1347,1050.66,78% of Total Billed charges,848.61,63% of total billed charges,N/A,Not Applicable,511.86,38% of total billed charges,511.86,38% of total billed charges,N/A,Not Applicable,1212.3,90% of total billed charges,471.45,35% of total billed charges,360.18,Case rate,1077.6,80% of total billed charges,516.98,38.38% of total billed charges,1077.6,80% of total billed charges,831.64,61.74% of total billed charges,1373.94,102% of percent of total billed charges,511.86,38% of total billed charges,360.18,1373.94,1010.25
Outpatient Medical Services,RADIOLOGY,74177,CT scan of abdomen and pelvis with contrast,352,1546,1205.88,78% of Total Billed charges,973.98,63% of total billed charges,N/A,Not Applicable,587.48,38% of total billed charges,587.48,38% of total billed charges,N/A,Not Applicable,1391.4,90% of total billed charges,541.1,35% of total billed charges,360.18,Case rate,1236.8,80% of total billed charges,593.35,38.38% of total billed charges,1236.8,80% of total billed charges,954.5,61.74% of total billed charges,1576.92,102% of percent of total billed charges,587.48,38% of total billed charges,360.18,1576.92,1159.5
Outpatient Medical Services,RADIOLOGY,76536,Ultrasound of head and neck,402,672,524.16,78% of Total Billed charges,423.36,63% of total billed charges,N/A,Not Applicable,255.36,38% of total billed charges,255.36,38% of total billed charges,N/A,Not Applicable,604.8,90% of total billed charges,235.2,35% of total billed charges,452.09,67.275% of total billed charges,537.6,80% of total billed charges,257.91,38.38% of total billed charges,537.6,80% of total billed charges,414.89,61.74% of total billed charges,685.44,102% of percent of total billed charges,255.36,38% of total billed charges,235.2,685.44,504
Outpatient Medical Services,RADIOLOGY,76642,Limited ultrasound of the breast,402,379,295.62,78% of Total Billed charges,238.77,63% of total billed charges,N/A,Not Applicable,144.02,38% of total billed charges,144.02,38% of total billed charges,N/A,Not Applicable,341.1,90% of total billed charges,132.65,35% of total billed charges,254.97,67.275% of total billed charges,303.2,80% of total billed charges,145.46,38.38% of total billed charges,303.2,80% of total billed charges,233.99,61.74% of total billed charges,386.58,102% of percent of total billed charges,144.02,38% of total billed charges,132.65,386.58,284.25
Outpatient Medical Services,RADIOLOGY,76700,Ultrasound of abdomen with all areas scanned,402,413,322.14,78% of Total Billed charges,260.19,63% of total billed charges,N/A,Not Applicable,156.94,38% of total billed charges,156.94,38% of total billed charges,N/A,Not Applicable,371.7,90% of total billed charges,144.55,35% of total billed charges,277.85,67.275% of total billed charges,330.4,80% of total billed charges,158.51,38.38% of total billed charges,330.4,80% of total billed charges,254.99,61.74% of total billed charges,421.26,102% of percent of total billed charges,156.94,38% of total billed charges,144.55,421.26,309.75
Outpatient Medical Services,RADIOLOGY,76705,A diagnostic procedure that allows a provider to see the organs and other structures in the abdomen,402,864,673.92,78% of Total Billed charges,544.32,63% of total billed charges,N/A,Not Applicable,328.32,38% of total billed charges,328.32,38% of total billed charges,N/A,Not Applicable,777.6,90% of total billed charges,302.4,35% of total billed charges,581.26,67.275% of total billed charges,691.2,80% of total billed charges,331.6,38.38% of total billed charges,691.2,80% of total billed charges,533.43,61.74% of total billed charges,881.28,102% of percent of total billed charges,328.32,38% of total billed charges,302.4,881.28,648
Outpatient Medical Services,RADIOLOGY,76706,US AAA SCREENING,402,630,491.4,78% of Total Billed charges,396.9,63% of total billed charges,N/A,Not Applicable,239.4,38% of total billed charges,239.4,38% of total billed charges,N/A,Not Applicable,567,90% of total billed charges,220.5,35% of total billed charges,423.83,67.275% of total billed charges,504,80% of total billed charges,241.79,38.38% of total billed charges,504,80% of total billed charges,388.96,61.74% of total billed charges,642.6,102% of percent of total billed charges,239.4,38% of total billed charges,220.5,642.6,472.5
Outpatient Medical Services,RADIOLOGY,76770,Ultrasound of back wall of the abdomen with all areas viewed,402,941,733.98,78% of Total Billed charges,592.83,63% of total billed charges,N/A,Not Applicable,357.58,38% of total billed charges,357.58,38% of total billed charges,N/A,Not Applicable,846.9,90% of total billed charges,329.35,35% of total billed charges,633.06,67.275% of total billed charges,752.8,80% of total billed charges,361.16,38.38% of total billed charges,752.8,80% of total billed charges,580.97,61.74% of total billed charges,959.82,102% of percent of total billed charges,357.58,38% of total billed charges,329.35,959.82,705.75
Outpatient Medical Services,RADIOLOGY,76801,Abdominal ultrasound of pregnant uterus (less than 14 weeks) single or first fetus,402,672,524.16,78% of Total Billed charges,423.36,63% of total billed charges,N/A,Not Applicable,255.36,38% of total billed charges,255.36,38% of total billed charges,N/A,Not Applicable,604.8,90% of total billed charges,235.2,35% of total billed charges,452.09,67.275% of total billed charges,537.6,80% of total billed charges,257.91,38.38% of total billed charges,537.6,80% of total billed charges,414.89,61.74% of total billed charges,685.44,102% of percent of total billed charges,255.36,38% of total billed charges,235.2,685.44,504
Outpatient Medical Services,RADIOLOGY,76805,Abdominal ultrasound of pregnant uterus (greater or equal to 14 weeks 0 days) single or first fetus,402,672,524.16,78% of Total Billed charges,423.36,63% of total billed charges,N/A,Not Applicable,255.36,38% of total billed charges,255.36,38% of total billed charges,N/A,Not Applicable,604.8,90% of total billed charges,235.2,35% of total billed charges,452.09,67.275% of total billed charges,537.6,80% of total billed charges,257.91,38.38% of total billed charges,537.6,80% of total billed charges,414.89,61.74% of total billed charges,685.44,102% of percent of total billed charges,255.36,38% of total billed charges,235.2,685.44,504
Outpatient Medical Services,RADIOLOGY,76817,Transvaginal ultrasound of uterus,402,672,524.16,78% of Total Billed charges,423.36,63% of total billed charges,N/A,Not Applicable,255.36,38% of total billed charges,255.36,38% of total billed charges,N/A,Not Applicable,604.8,90% of total billed charges,235.2,35% of total billed charges,452.09,67.275% of total billed charges,537.6,80% of total billed charges,257.91,38.38% of total billed charges,537.6,80% of total billed charges,414.89,61.74% of total billed charges,685.44,102% of percent of total billed charges,255.36,38% of total billed charges,235.2,685.44,504
Outpatient Medical Services,RADIOLOGY,76830,Ultrasound of the pelvis through vagina,402,403,314.34,78% of Total Billed charges,253.89,63% of total billed charges,N/A,Not Applicable,153.14,38% of total billed charges,153.14,38% of total billed charges,N/A,Not Applicable,362.7,90% of total billed charges,141.05,35% of total billed charges,271.12,67.275% of total billed charges,322.4,80% of total billed charges,154.67,38.38% of total billed charges,322.4,80% of total billed charges,248.81,61.74% of total billed charges,411.06,102% of percent of total billed charges,153.14,38% of total billed charges,141.05,411.06,302.25
Outpatient Medical Services,RADIOLOGY,76856,Complete ultrasound of the pelvis,402,672,524.16,78% of Total Billed charges,423.36,63% of total billed charges,N/A,Not Applicable,255.36,38% of total billed charges,255.36,38% of total billed charges,N/A,Not Applicable,604.8,90% of total billed charges,235.2,35% of total billed charges,452.09,67.275% of total billed charges,537.6,80% of total billed charges,257.91,38.38% of total billed charges,537.6,80% of total billed charges,414.89,61.74% of total billed charges,685.44,102% of percent of total billed charges,255.36,38% of total billed charges,235.2,685.44,504
Outpatient Medical Services,RADIOLOGY,76870,Ultrasound of the scrotum,402,672,524.16,78% of Total Billed charges,423.36,63% of total billed charges,N/A,Not Applicable,255.36,38% of total billed charges,255.36,38% of total billed charges,N/A,Not Applicable,604.8,90% of total billed charges,235.2,35% of total billed charges,452.09,67.275% of total billed charges,537.6,80% of total billed charges,257.91,38.38% of total billed charges,537.6,80% of total billed charges,414.89,61.74% of total billed charges,685.44,102% of percent of total billed charges,255.36,38% of total billed charges,235.2,685.44,504
Outpatient Medical Services,RADIOLOGY,76881,US EXT NON-VAS-RT,402,450,351,78% of Total Billed charges,283.5,63% of total billed charges,N/A,Not Applicable,171,38% of total billed charges,171,38% of total billed charges,N/A,Not Applicable,405,90% of total billed charges,157.5,35% of total billed charges,302.74,67.275% of total billed charges,360,80% of total billed charges,172.71,38.38% of total billed charges,360,80% of total billed charges,277.83,61.74% of total billed charges,459,102% of percent of total billed charges,171,38% of total billed charges,157.5,459,337.5
Outpatient Medical Services,RADIOLOGY,76882,"Diagnostic ultrasound of an extremity excluding the bone, joints or vessels",402,450,351,78% of Total Billed charges,283.5,63% of total billed charges,N/A,Not Applicable,171,38% of total billed charges,171,38% of total billed charges,N/A,Not Applicable,405,90% of total billed charges,157.5,35% of total billed charges,302.74,67.275% of total billed charges,360,80% of total billed charges,172.71,38.38% of total billed charges,360,80% of total billed charges,277.83,61.74% of total billed charges,459,102% of percent of total billed charges,171,38% of total billed charges,157.5,459,337.5
Outpatient Medical Services,RADIOLOGY,77065,"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral",401,410,319.8,78% of Total Billed charges,258.3,63% of total billed charges,N/A,Not Applicable,155.8,38% of total billed charges,155.8,38% of total billed charges,N/A,Not Applicable,369,90% of total billed charges,143.5,35% of total billed charges,275.83,67.275% of total billed charges,328,80% of total billed charges,157.36,38.38% of total billed charges,328,80% of total billed charges,253.13,61.74% of total billed charges,418.2,102% of percent of total billed charges,155.8,38% of total billed charges,143.5,418.2,307.5
Outpatient Medical Services,RADIOLOGY,77066,"Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral",401,450,351,78% of Total Billed charges,283.5,63% of total billed charges,N/A,Not Applicable,171,38% of total billed charges,171,38% of total billed charges,N/A,Not Applicable,405,90% of total billed charges,157.5,35% of total billed charges,302.74,67.275% of total billed charges,360,80% of total billed charges,172.71,38.38% of total billed charges,360,80% of total billed charges,277.83,61.74% of total billed charges,459,102% of percent of total billed charges,171,38% of total billed charges,157.5,459,337.5
Outpatient Medical Services,RADIOLOGY,77067,Mammography of both breasts-2 or more views,403,375,292.5,78% of Total Billed charges,236.25,63% of total billed charges,N/A,Not Applicable,142.5,38% of total billed charges,142.5,38% of total billed charges,N/A,Not Applicable,337.5,90% of total billed charges,131.25,35% of total billed charges,252.28,67.275% of total billed charges,300,80% of total billed charges,143.93,38.38% of total billed charges,300,80% of total billed charges,231.53,61.74% of total billed charges,382.5,102% of percent of total billed charges,142.5,38% of total billed charges,131.25,382.5,281.25
Outpatient Medical Services,LABORATORY,80048,Basic metabolic panel,301,124,96.72,78% of Total Billed charges,10.65,100% of GA Medicaid Rate,N/A,Not Applicable,8.46,100% of CMS Medicare OPPS rate,8.46,100% of CMS Medicare OPPS rate,N/A,Not Applicable,111.6,90% of total billed charges,11.18,105% of GA Medicaid Rate,83.42,67.275% of total billed charges,99.2,80% of total billed charges,8.54,38.38% of total billed charges,99.2,80% of total billed charges,76.56,61.74% of total billed charges,10.86,102% of GA Medicaid Rate,8.46,100% of CMS Medicare OPPS rate,8.46,111.6,93
Outpatient Medical Services,LABORATORY,80051,"Blood test panel for electrolytes (sodium potassium, chloride, carbon dioxide)",301,115,89.7,78% of Total Billed charges,8.82,100% of GA Medicaid Rate,N/A,Not Applicable,7.01,100% of CMS Medicare OPPS rate,7.01,100% of CMS Medicare OPPS rate,N/A,Not Applicable,103.5,90% of total billed charges,9.26,105% of GA Medicaid Rate,77.37,67.275% of total billed charges,92,80% of total billed charges,7.08,38.38% of total billed charges,92,80% of total billed charges,71,61.74% of total billed charges,9,102% of GA Medicaid Rate,7.01,100% of CMS Medicare OPPS rate,7.01,103.5,86.25
Outpatient Medical Services,LABORATORY,80053,"Blood test, comprehensive group of blood chemicals",301,123,95.94,78% of Total Billed charges,13.29,100% of GA Medicaid Rate,N/A,Not Applicable,10.56,100% of CMS Medicare OPPS rate,10.56,100% of CMS Medicare OPPS rate,N/A,Not Applicable,110.7,90% of total billed charges,13.95,105% of GA Medicaid Rate,82.75,67.275% of total billed charges,98.4,80% of total billed charges,10.67,38.38% of total billed charges,98.4,80% of total billed charges,75.94,61.74% of total billed charges,13.56,102% of GA Medicaid Rate,10.56,100% of CMS Medicare OPPS rate,10.56,110.7,92.25
Outpatient Medical Services,LABORATORY,80055,Obstetric blood test panel,301,260,202.8,78% of Total Billed charges,28.08,100% of GA Medicaid Rate,N/A,Not Applicable,47.81,100% of CMS Medicare OPPS rate,47.81,100% of CMS Medicare OPPS rate,N/A,Not Applicable,234,90% of total billed charges,29.48,105% of GA Medicaid Rate,174.92,67.275% of total billed charges,208,80% of total billed charges,48.29,38.38% of total billed charges,208,80% of total billed charges,160.52,61.74% of total billed charges,28.64,102% of GA Medicaid Rate,47.81,100% of CMS Medicare OPPS rate,28.08,234,195
Outpatient Medical Services,LABORATORY,80061,"Blood test, lipids (cholesterol and triglycerides)",301,99,77.22,78% of Total Billed charges,16.85,100% of GA Medicaid Rate,N/A,Not Applicable,13.39,100% of CMS Medicare OPPS rate,13.39,100% of CMS Medicare OPPS rate,N/A,Not Applicable,89.1,90% of total billed charges,17.69,105% of GA Medicaid Rate,66.6,67.275% of total billed charges,79.2,80% of total billed charges,13.52,38.38% of total billed charges,79.2,80% of total billed charges,61.12,61.74% of total billed charges,17.19,102% of GA Medicaid Rate,13.39,100% of CMS Medicare OPPS rate,13.39,89.1,74.25
Outpatient Medical Services,LABORATORY,80069,Kidney function panel test,301,122,95.16,78% of Total Billed charges,10.92,100% of GA Medicaid Rate,N/A,Not Applicable,8.68,100% of CMS Medicare OPPS rate,8.68,100% of CMS Medicare OPPS rate,N/A,Not Applicable,109.8,90% of total billed charges,11.47,105% of GA Medicaid Rate,82.08,67.275% of total billed charges,97.6,80% of total billed charges,8.77,38.38% of total billed charges,97.6,80% of total billed charges,75.32,61.74% of total billed charges,11.14,102% of GA Medicaid Rate,8.68,100% of CMS Medicare OPPS rate,8.68,109.8,91.5
Outpatient Medical Services,LABORATORY,80074,Acute hepatitis panel,301,261,203.58,78% of Total Billed charges,59.89,100% of GA Medicaid Rate,N/A,Not Applicable,47.63,100% of CMS Medicare OPPS rate,47.63,100% of CMS Medicare OPPS rate,N/A,Not Applicable,234.9,90% of total billed charges,62.88,105% of GA Medicaid Rate,175.59,67.275% of total billed charges,208.8,80% of total billed charges,48.11,38.38% of total billed charges,208.8,80% of total billed charges,161.14,61.74% of total billed charges,61.09,102% of GA Medicaid Rate,47.63,100% of CMS Medicare OPPS rate,47.63,234.9,195.75
Outpatient Medical Services,LABORATORY,80076,Liver function blood test panel,301,115,89.7,78% of Total Billed charges,10.28,100% of GA Medicaid Rate,N/A,Not Applicable,8.17,100% of CMS Medicare OPPS rate,8.17,100% of CMS Medicare OPPS rate,N/A,Not Applicable,103.5,90% of total billed charges,10.79,105% of GA Medicaid Rate,77.37,67.275% of total billed charges,92,80% of total billed charges,8.25,38.38% of total billed charges,92,80% of total billed charges,71,61.74% of total billed charges,10.49,102% of GA Medicaid Rate,8.17,100% of CMS Medicare OPPS rate,8.17,103.5,86.25
Outpatient Medical Services,LABORATORY,80164,VALPROIC ACID,301,123,95.94,78% of Total Billed charges,14.27,100% of GA Medicaid Rate,N/A,Not Applicable,13.54,100% of CMS Medicare OPPS rate,13.54,100% of CMS Medicare OPPS rate,N/A,Not Applicable,110.7,90% of total billed charges,14.98,105% of GA Medicaid Rate,82.75,67.275% of total billed charges,98.4,80% of total billed charges,13.68,38.38% of total billed charges,98.4,80% of total billed charges,75.94,61.74% of total billed charges,14.56,102% of GA Medicaid Rate,13.54,100% of CMS Medicare OPPS rate,13.54,110.7,92.25
Outpatient Medical Services,LABORATORY,80185,DILANTIN LEVEL,301,144,112.32,78% of Total Billed charges,16.67,100% of GA Medicaid Rate,N/A,Not Applicable,13.25,100% of CMS Medicare OPPS rate,13.25,100% of CMS Medicare OPPS rate,N/A,Not Applicable,129.6,90% of total billed charges,17.5,105% of GA Medicaid Rate,96.88,67.275% of total billed charges,115.2,80% of total billed charges,13.38,38.38% of total billed charges,115.2,80% of total billed charges,88.91,61.74% of total billed charges,17,102% of GA Medicaid Rate,13.25,100% of CMS Medicare OPPS rate,13.25,129.6,108
Outpatient Medical Services,LABORATORY,80197,Test is used to measure the amount of the drug in the blood to determine whether the concentration has reached a therapeutic level and is below the to,301,261,203.58,78% of Total Billed charges,17.25,100% of GA Medicaid Rate,N/A,Not Applicable,13.73,100% of CMS Medicare OPPS rate,13.73,100% of CMS Medicare OPPS rate,N/A,Not Applicable,234.9,90% of total billed charges,18.11,105% of GA Medicaid Rate,175.59,67.275% of total billed charges,208.8,80% of total billed charges,13.87,38.38% of total billed charges,208.8,80% of total billed charges,161.14,61.74% of total billed charges,17.6,102% of GA Medicaid Rate,13.73,100% of CMS Medicare OPPS rate,13.73,234.9,195.75
Outpatient Medical Services,LABORATORY,80202,VANCOMYCIN PEAK,301,137,106.86,78% of Total Billed charges,14.27,100% of GA Medicaid Rate,N/A,Not Applicable,13.54,100% of CMS Medicare OPPS rate,13.54,100% of CMS Medicare OPPS rate,N/A,Not Applicable,123.3,90% of total billed charges,14.98,105% of GA Medicaid Rate,92.17,67.275% of total billed charges,109.6,80% of total billed charges,13.68,38.38% of total billed charges,109.6,80% of total billed charges,84.58,61.74% of total billed charges,14.56,102% of GA Medicaid Rate,13.54,100% of CMS Medicare OPPS rate,13.54,123.3,102.75
Outpatient Medical Services,LABORATORY,80299,CATAPRES LEVEL,301,218,170.04,78% of Total Billed charges,15.14,100% of GA Medicaid Rate,N/A,Not Applicable,18.64,100% of CMS Medicare OPPS rate,18.64,100% of CMS Medicare OPPS rate,N/A,Not Applicable,196.2,90% of total billed charges,15.9,105% of GA Medicaid Rate,146.66,67.275% of total billed charges,174.4,80% of total billed charges,18.83,38.38% of total billed charges,174.4,80% of total billed charges,134.59,61.74% of total billed charges,15.44,102% of GA Medicaid Rate,18.64,100% of CMS Medicare OPPS rate,15.14,196.2,163.5
Outpatient Medical Services,LABORATORY,80305,URINE DRUG SCREEN (IN-HOUSE),301,91,70.98,78% of Total Billed charges,11.47,100% of GA Medicaid Rate,N/A,Not Applicable,12.6,100% of CMS Medicare OPPS rate,12.6,100% of CMS Medicare OPPS rate,N/A,Not Applicable,81.9,90% of total billed charges,12.04,105% of GA Medicaid Rate,61.22,67.275% of total billed charges,72.8,80% of total billed charges,12.73,38.38% of total billed charges,72.8,80% of total billed charges,56.18,61.74% of total billed charges,11.7,102% of GA Medicaid Rate,12.6,100% of CMS Medicare OPPS rate,11.47,81.9,68.25
Outpatient Medical Services,LABORATORY,80320,ALCOHOL-MEDICAL,300,70,54.6,78% of Total Billed charges,13.59,100% of GA Medicaid Rate,N/A,Not Applicable,26.6,38% of total billed charges,26.6,38% of total billed charges,N/A,Not Applicable,63,90% of total billed charges,14.27,105% of GA Medicaid Rate,47.09,67.275% of total billed charges,56,80% of total billed charges,26.87,38.38% of total billed charges,56,80% of total billed charges,43.22,61.74% of total billed charges,13.86,102% of GA Medicaid Rate,26.6,38% of total billed charges,13.59,63,52.5
Outpatient Medical Services,LABORATORY,80323,NICOTINE AND METABOLITE,301,155,120.9,78% of Total Billed charges,37.75,100% of GA Medicaid Rate,N/A,Not Applicable,58.9,38% of total billed charges,58.9,38% of total billed charges,N/A,Not Applicable,139.5,90% of total billed charges,39.64,105% of GA Medicaid Rate,104.28,67.275% of total billed charges,124,80% of total billed charges,59.49,38.38% of total billed charges,124,80% of total billed charges,95.7,61.74% of total billed charges,38.51,102% of GA Medicaid Rate,58.9,38% of total billed charges,37.75,139.5,116.25
Outpatient Medical Services,LABORATORY,80329,ACETAMINOPHEN,301,132,102.96,78% of Total Billed charges,25.45,100% of GA Medicaid Rate,N/A,Not Applicable,50.16,38% of total billed charges,50.16,38% of total billed charges,N/A,Not Applicable,118.8,90% of total billed charges,26.72,105% of GA Medicaid Rate,88.8,67.275% of total billed charges,105.6,80% of total billed charges,50.66,38.38% of total billed charges,105.6,80% of total billed charges,81.5,61.74% of total billed charges,25.96,102% of GA Medicaid Rate,50.16,38% of total billed charges,25.45,118.8,99
Outpatient Medical Services,LABORATORY,81000,Manual urinalysis test with examination using microscope,307,80,62.4,78% of Total Billed charges,3.99,100% of GA Medicaid Rate,N/A,Not Applicable,4.02,100% of CMS Medicare OPPS rate,4.02,100% of CMS Medicare OPPS rate,N/A,Not Applicable,72,90% of total billed charges,4.19,105% of GA Medicaid Rate,53.82,67.275% of total billed charges,64,80% of total billed charges,4.06,38.38% of total billed charges,64,80% of total billed charges,49.39,61.74% of total billed charges,4.07,102% of GA Medicaid Rate,4.02,100% of CMS Medicare OPPS rate,3.99,72,60
Outpatient Medical Services,LABORATORY,81001,Manual urinalysis test with examination with or without using microscope,307,46,35.88,78% of Total Billed charges,3.99,100% of GA Medicaid Rate,N/A,Not Applicable,3.17,100% of CMS Medicare OPPS rate,3.17,100% of CMS Medicare OPPS rate,N/A,Not Applicable,41.4,90% of total billed charges,4.19,105% of GA Medicaid Rate,30.95,67.275% of total billed charges,36.8,80% of total billed charges,3.2,38.38% of total billed charges,36.8,80% of total billed charges,28.4,61.74% of total billed charges,4.07,102% of GA Medicaid Rate,3.17,100% of CMS Medicare OPPS rate,3.17,41.4,34.5
Outpatient Medical Services,LABORATORY,81025,Urine pregnancy test,307,41,31.98,78% of Total Billed charges,7.96,100% of GA Medicaid Rate,N/A,Not Applicable,8.61,100% of CMS Medicare OPPS rate,8.61,100% of CMS Medicare OPPS rate,N/A,Not Applicable,36.9,90% of total billed charges,8.36,105% of GA Medicaid Rate,27.58,67.275% of total billed charges,32.8,80% of total billed charges,8.7,38.38% of total billed charges,32.8,80% of total billed charges,25.31,61.74% of total billed charges,8.12,102% of GA Medicaid Rate,8.61,100% of CMS Medicare OPPS rate,7.96,36.9,30.75
Outpatient Medical Services,LABORATORY,81050,VOLUME MEASUREMENT,301,45,35.1,78% of Total Billed charges,3.77,100% of GA Medicaid Rate,N/A,Not Applicable,3.64,100% of CMS Medicare OPPS rate,3.64,100% of CMS Medicare OPPS rate,N/A,Not Applicable,40.5,90% of total billed charges,3.96,105% of GA Medicaid Rate,30.27,67.275% of total billed charges,36,80% of total billed charges,3.68,38.38% of total billed charges,36,80% of total billed charges,27.78,61.74% of total billed charges,3.85,102% of GA Medicaid Rate,3.64,100% of CMS Medicare OPPS rate,3.64,40.5,33.75
Outpatient Medical Services,LABORATORY,82009,KETONES URINE,300,28,21.84,78% of Total Billed charges,4.13,100% of GA Medicaid Rate,N/A,Not Applicable,4.52,100% of CMS Medicare OPPS rate,4.52,100% of CMS Medicare OPPS rate,N/A,Not Applicable,25.2,90% of total billed charges,4.34,105% of GA Medicaid Rate,18.84,67.275% of total billed charges,22.4,80% of total billed charges,4.57,38.38% of total billed charges,22.4,80% of total billed charges,17.29,61.74% of total billed charges,4.21,102% of GA Medicaid Rate,4.52,100% of CMS Medicare OPPS rate,4.13,25.2,21
Outpatient Medical Services,LABORATORY,82024,ACTH,301,253,197.34,78% of Total Billed charges,48.57,100% of GA Medicaid Rate,N/A,Not Applicable,38.62,100% of CMS Medicare OPPS rate,38.62,100% of CMS Medicare OPPS rate,N/A,Not Applicable,227.7,90% of total billed charges,51,105% of GA Medicaid Rate,170.21,67.275% of total billed charges,202.4,80% of total billed charges,39.01,38.38% of total billed charges,202.4,80% of total billed charges,156.2,61.74% of total billed charges,49.54,102% of GA Medicaid Rate,38.62,100% of CMS Medicare OPPS rate,38.62,227.7,189.75
Outpatient Medical Services,LABORATORY,82040,ALBUMIN,301,31,24.18,78% of Total Billed charges,3.62,100% of GA Medicaid Rate,N/A,Not Applicable,4.95,100% of CMS Medicare OPPS rate,4.95,100% of CMS Medicare OPPS rate,N/A,Not Applicable,27.9,90% of total billed charges,3.8,105% of GA Medicaid Rate,20.86,67.275% of total billed charges,24.8,80% of total billed charges,5,38.38% of total billed charges,24.8,80% of total billed charges,19.14,61.74% of total billed charges,3.69,102% of GA Medicaid Rate,4.95,100% of CMS Medicare OPPS rate,3.62,27.9,23.25
Outpatient Medical Services,LABORATORY,82043,Urine test to measure albumin,301,56,43.68,78% of Total Billed charges,7.28,100% of GA Medicaid Rate,N/A,Not Applicable,5.78,100% of CMS Medicare OPPS rate,5.78,100% of CMS Medicare OPPS rate,N/A,Not Applicable,50.4,90% of total billed charges,7.64,105% of GA Medicaid Rate,37.67,67.275% of total billed charges,44.8,80% of total billed charges,5.84,38.38% of total billed charges,44.8,80% of total billed charges,34.57,61.74% of total billed charges,7.43,102% of GA Medicaid Rate,5.78,100% of CMS Medicare OPPS rate,5.78,50.4,42
Outpatient Medical Services,LABORATORY,82103,ALPHA-1 ANTITRYPSIN,301,88,68.64,78% of Total Billed charges,16.89,100% of GA Medicaid Rate,N/A,Not Applicable,13.44,100% of CMS Medicare OPPS rate,13.44,100% of CMS Medicare OPPS rate,N/A,Not Applicable,79.2,90% of total billed charges,17.73,105% of GA Medicaid Rate,59.2,67.275% of total billed charges,70.4,80% of total billed charges,13.57,38.38% of total billed charges,70.4,80% of total billed charges,54.33,61.74% of total billed charges,17.23,102% of GA Medicaid Rate,13.44,100% of CMS Medicare OPPS rate,13.44,79.2,66
Outpatient Medical Services,LABORATORY,82104,ALPHA-1-ANTITRYPSIN PHENOTYPE,301,111,86.58,78% of Total Billed charges,18.18,100% of GA Medicaid Rate,N/A,Not Applicable,14.46,100% of CMS Medicare OPPS rate,14.46,100% of CMS Medicare OPPS rate,N/A,Not Applicable,99.9,90% of total billed charges,19.09,105% of GA Medicaid Rate,74.68,67.275% of total billed charges,88.8,80% of total billed charges,14.6,38.38% of total billed charges,88.8,80% of total billed charges,68.53,61.74% of total billed charges,18.54,102% of GA Medicaid Rate,14.46,100% of CMS Medicare OPPS rate,14.46,99.9,83.25
Outpatient Medical Services,LABORATORY,82105,MATERNAL SCREEN 4,301,117,91.26,78% of Total Billed charges,21.1,100% of GA Medicaid Rate,N/A,Not Applicable,16.77,100% of CMS Medicare OPPS rate,16.77,100% of CMS Medicare OPPS rate,N/A,Not Applicable,105.3,90% of total billed charges,22.16,105% of GA Medicaid Rate,78.71,67.275% of total billed charges,93.6,80% of total billed charges,16.94,38.38% of total billed charges,93.6,80% of total billed charges,72.24,61.74% of total billed charges,21.52,102% of GA Medicaid Rate,16.77,100% of CMS Medicare OPPS rate,16.77,105.3,87.75
Outpatient Medical Services,LABORATORY,82140,AMMONIA,301,65,50.7,78% of Total Billed charges,12.44,100% of GA Medicaid Rate,N/A,Not Applicable,14.57,100% of CMS Medicare OPPS rate,14.57,100% of CMS Medicare OPPS rate,N/A,Not Applicable,58.5,90% of total billed charges,13.06,105% of GA Medicaid Rate,43.73,67.275% of total billed charges,52,80% of total billed charges,14.72,38.38% of total billed charges,52,80% of total billed charges,40.13,61.74% of total billed charges,12.69,102% of GA Medicaid Rate,14.57,100% of CMS Medicare OPPS rate,12.44,58.5,48.75
Outpatient Medical Services,LABORATORY,82150,AMYLASE,301,64,49.92,78% of Total Billed charges,8.15,100% of GA Medicaid Rate,N/A,Not Applicable,6.48,100% of CMS Medicare OPPS rate,6.48,100% of CMS Medicare OPPS rate,N/A,Not Applicable,57.6,90% of total billed charges,8.56,105% of GA Medicaid Rate,43.06,67.275% of total billed charges,51.2,80% of total billed charges,6.54,38.38% of total billed charges,51.2,80% of total billed charges,39.51,61.74% of total billed charges,8.31,102% of GA Medicaid Rate,6.48,100% of CMS Medicare OPPS rate,6.48,57.6,48
Outpatient Medical Services,LABORATORY,82247,BILIRUBIN TOTAL,301,90,70.2,78% of Total Billed charges,6.32,100% of GA Medicaid Rate,N/A,Not Applicable,5.02,100% of CMS Medicare OPPS rate,5.02,100% of CMS Medicare OPPS rate,N/A,Not Applicable,81,90% of total billed charges,6.64,105% of GA Medicaid Rate,60.55,67.275% of total billed charges,72,80% of total billed charges,5.07,38.38% of total billed charges,72,80% of total billed charges,55.57,61.74% of total billed charges,6.45,102% of GA Medicaid Rate,5.02,100% of CMS Medicare OPPS rate,5.02,81,67.5
Outpatient Medical Services,LABORATORY,82270,HEMOCCULT SC 1st SPECIMEN,301,56,43.68,78% of Total Billed charges,4.04,100% of GA Medicaid Rate,N/A,Not Applicable,4.38,100% of CMS Medicare OPPS rate,4.38,100% of CMS Medicare OPPS rate,N/A,Not Applicable,50.4,90% of total billed charges,4.24,105% of GA Medicaid Rate,37.67,67.275% of total billed charges,44.8,80% of total billed charges,4.42,38.38% of total billed charges,44.8,80% of total billed charges,34.57,61.74% of total billed charges,4.12,102% of GA Medicaid Rate,4.38,100% of CMS Medicare OPPS rate,4.04,50.4,42
Outpatient Medical Services,LABORATORY,82272,GASTROCULT,301,36,28.08,78% of Total Billed charges,4.04,100% of GA Medicaid Rate,N/A,Not Applicable,4.23,100% of CMS Medicare OPPS rate,4.23,100% of CMS Medicare OPPS rate,N/A,Not Applicable,32.4,90% of total billed charges,4.24,105% of GA Medicaid Rate,24.22,67.275% of total billed charges,28.8,80% of total billed charges,4.27,38.38% of total billed charges,28.8,80% of total billed charges,22.23,61.74% of total billed charges,4.12,102% of GA Medicaid Rate,4.23,100% of CMS Medicare OPPS rate,4.04,32.4,27
Outpatient Medical Services,LABORATORY,82306,Blood test to monitor vitamin D levels,301,336,262.08,78% of Total Billed charges,37.22,100% of GA Medicaid Rate,N/A,Not Applicable,29.6,100% of CMS Medicare OPPS rate,29.6,100% of CMS Medicare OPPS rate,N/A,Not Applicable,302.4,90% of total billed charges,39.08,105% of GA Medicaid Rate,226.04,67.275% of total billed charges,268.8,80% of total billed charges,29.9,38.38% of total billed charges,268.8,80% of total billed charges,207.45,61.74% of total billed charges,37.96,102% of GA Medicaid Rate,29.6,100% of CMS Medicare OPPS rate,29.6,302.4,252
Outpatient Medical Services,LABORATORY,82310,CALCIUM,301,38,29.64,78% of Total Billed charges,6.35,100% of GA Medicaid Rate,N/A,Not Applicable,5.16,100% of CMS Medicare OPPS rate,5.16,100% of CMS Medicare OPPS rate,N/A,Not Applicable,34.2,90% of total billed charges,6.67,105% of GA Medicaid Rate,25.56,67.275% of total billed charges,30.4,80% of total billed charges,5.21,38.38% of total billed charges,30.4,80% of total billed charges,23.46,61.74% of total billed charges,6.48,102% of GA Medicaid Rate,5.16,100% of CMS Medicare OPPS rate,5.16,34.2,28.5
Outpatient Medical Services,LABORATORY,82330,CALCIUM IONIZED,301,209,163.02,78% of Total Billed charges,17.18,100% of GA Medicaid Rate,N/A,Not Applicable,13.68,100% of CMS Medicare OPPS rate,13.68,100% of CMS Medicare OPPS rate,N/A,Not Applicable,188.1,90% of total billed charges,18.04,105% of GA Medicaid Rate,140.6,67.275% of total billed charges,167.2,80% of total billed charges,13.82,38.38% of total billed charges,167.2,80% of total billed charges,129.04,61.74% of total billed charges,17.52,102% of GA Medicaid Rate,13.68,100% of CMS Medicare OPPS rate,13.68,188.1,156.75
Outpatient Medical Services,LABORATORY,82360,KIDNEY STONE ANALYSIS,301,84,65.52,78% of Total Billed charges,16.19,100% of GA Medicaid Rate,N/A,Not Applicable,12.87,100% of CMS Medicare OPPS rate,12.87,100% of CMS Medicare OPPS rate,N/A,Not Applicable,75.6,90% of total billed charges,17,105% of GA Medicaid Rate,56.51,67.275% of total billed charges,67.2,80% of total billed charges,13,38.38% of total billed charges,67.2,80% of total billed charges,51.86,61.74% of total billed charges,16.51,102% of GA Medicaid Rate,12.87,100% of CMS Medicare OPPS rate,12.87,75.6,63
Outpatient Medical Services,LABORATORY,82390,CERULOPLASM,301,164,127.92,78% of Total Billed charges,13.51,100% of GA Medicaid Rate,N/A,Not Applicable,10.74,100% of CMS Medicare OPPS rate,10.74,100% of CMS Medicare OPPS rate,N/A,Not Applicable,147.6,90% of total billed charges,14.19,105% of GA Medicaid Rate,110.33,67.275% of total billed charges,131.2,80% of total billed charges,10.85,38.38% of total billed charges,131.2,80% of total billed charges,101.25,61.74% of total billed charges,13.78,102% of GA Medicaid Rate,10.74,100% of CMS Medicare OPPS rate,10.74,147.6,123
Outpatient Medical Services,LABORATORY,82530,CORTISOL FREE SERUM,301,255,198.9,78% of Total Billed charges,21.02,100% of GA Medicaid Rate,N/A,Not Applicable,16.71,100% of CMS Medicare OPPS rate,16.71,100% of CMS Medicare OPPS rate,N/A,Not Applicable,229.5,90% of total billed charges,22.07,105% of GA Medicaid Rate,171.55,67.275% of total billed charges,204,80% of total billed charges,16.88,38.38% of total billed charges,204,80% of total billed charges,157.44,61.74% of total billed charges,21.44,102% of GA Medicaid Rate,16.71,100% of CMS Medicare OPPS rate,16.71,229.5,191.25
Outpatient Medical Services,LABORATORY,82550,"CK, TOTAL",301,44,34.32,78% of Total Billed charges,6.35,100% of GA Medicaid Rate,N/A,Not Applicable,6.51,100% of CMS Medicare OPPS rate,6.51,100% of CMS Medicare OPPS rate,N/A,Not Applicable,39.6,90% of total billed charges,6.67,105% of GA Medicaid Rate,29.6,67.275% of total billed charges,35.2,80% of total billed charges,6.58,38.38% of total billed charges,35.2,80% of total billed charges,27.17,61.74% of total billed charges,6.48,102% of GA Medicaid Rate,6.51,100% of CMS Medicare OPPS rate,6.35,39.6,33
Outpatient Medical Services,LABORATORY,82552,CPK ISOENZYMES,301,88,68.64,78% of Total Billed charges,16.84,100% of GA Medicaid Rate,N/A,Not Applicable,13.39,100% of CMS Medicare OPPS rate,13.39,100% of CMS Medicare OPPS rate,N/A,Not Applicable,79.2,90% of total billed charges,17.68,105% of GA Medicaid Rate,59.2,67.275% of total billed charges,70.4,80% of total billed charges,13.52,38.38% of total billed charges,70.4,80% of total billed charges,54.33,61.74% of total billed charges,17.18,102% of GA Medicaid Rate,13.39,100% of CMS Medicare OPPS rate,13.39,79.2,66
Outpatient Medical Services,LABORATORY,82553,Blood test to detect heart enzymes,301,106,82.68,78% of Total Billed charges,14.52,100% of GA Medicaid Rate,N/A,Not Applicable,11.55,100% of CMS Medicare OPPS rate,11.55,100% of CMS Medicare OPPS rate,N/A,Not Applicable,95.4,90% of total billed charges,15.25,105% of GA Medicaid Rate,71.31,67.275% of total billed charges,84.8,80% of total billed charges,11.67,38.38% of total billed charges,84.8,80% of total billed charges,65.44,61.74% of total billed charges,14.81,102% of GA Medicaid Rate,11.55,100% of CMS Medicare OPPS rate,11.55,95.4,79.5
Outpatient Medical Services,LABORATORY,82565,CREATININE BLOOD,301,77,60.06,78% of Total Billed charges,6.35,100% of GA Medicaid Rate,N/A,Not Applicable,5.12,100% of CMS Medicare OPPS rate,5.12,100% of CMS Medicare OPPS rate,N/A,Not Applicable,69.3,90% of total billed charges,6.67,105% of GA Medicaid Rate,51.8,67.275% of total billed charges,61.6,80% of total billed charges,5.17,38.38% of total billed charges,61.6,80% of total billed charges,47.54,61.74% of total billed charges,6.48,102% of GA Medicaid Rate,5.12,100% of CMS Medicare OPPS rate,5.12,69.3,57.75
Outpatient Medical Services,LABORATORY,82570,Test to measure creatinine in the urine,301,34,26.52,78% of Total Billed charges,6.51,100% of GA Medicaid Rate,N/A,Not Applicable,5.18,100% of CMS Medicare OPPS rate,5.18,100% of CMS Medicare OPPS rate,N/A,Not Applicable,30.6,90% of total billed charges,6.84,105% of GA Medicaid Rate,22.87,67.275% of total billed charges,27.2,80% of total billed charges,5.23,38.38% of total billed charges,27.2,80% of total billed charges,20.99,61.74% of total billed charges,6.64,102% of GA Medicaid Rate,5.18,100% of CMS Medicare OPPS rate,5.18,30.6,25.5
Outpatient Medical Services,LABORATORY,82607,Blood test to measure B-12,301,98,76.44,78% of Total Billed charges,18.95,100% of GA Medicaid Rate,N/A,Not Applicable,15.08,100% of CMS Medicare OPPS rate,15.08,100% of CMS Medicare OPPS rate,N/A,Not Applicable,88.2,90% of total billed charges,19.9,105% of GA Medicaid Rate,65.93,67.275% of total billed charges,78.4,80% of total billed charges,15.23,38.38% of total billed charges,78.4,80% of total billed charges,60.51,61.74% of total billed charges,19.33,102% of GA Medicaid Rate,15.08,100% of CMS Medicare OPPS rate,15.08,88.2,73.5
Outpatient Medical Services,LABORATORY,82656,PANCREATIC ELASTASE,301,134,104.52,78% of Total Billed charges,84.42,63% of total billed charges,N/A,Not Applicable,11.53,100% of CMS Medicare OPPS rate,11.53,100% of CMS Medicare OPPS rate,N/A,Not Applicable,120.6,90% of total billed charges,46.9,35% of total billed charges,90.15,67.275% of total billed charges,107.2,80% of total billed charges,11.65,38.38% of total billed charges,107.2,80% of total billed charges,82.73,61.74% of total billed charges,136.68,102% of percent of total billed charges,11.53,100% of CMS Medicare OPPS rate,11.53,136.68,100.5
Outpatient Medical Services,LABORATORY,82670,Blood test to measure a type of estrogen in the blood,301,426,332.28,78% of Total Billed charges,35.14,100% of GA Medicaid Rate,N/A,Not Applicable,27.94,100% of CMS Medicare OPPS rate,27.94,100% of CMS Medicare OPPS rate,N/A,Not Applicable,383.4,90% of total billed charges,36.9,105% of GA Medicaid Rate,286.59,67.275% of total billed charges,340.8,80% of total billed charges,28.22,38.38% of total billed charges,340.8,80% of total billed charges,263.01,61.74% of total billed charges,35.84,102% of GA Medicaid Rate,27.94,100% of CMS Medicare OPPS rate,27.94,383.4,319.5
Outpatient Medical Services,LABORATORY,82705,STOOL FOR FAT-QUAL,301,33,25.74,78% of Total Billed charges,6.4,100% of GA Medicaid Rate,N/A,Not Applicable,5.1,100% of CMS Medicare OPPS rate,5.1,100% of CMS Medicare OPPS rate,N/A,Not Applicable,29.7,90% of total billed charges,6.72,105% of GA Medicaid Rate,22.2,67.275% of total billed charges,26.4,80% of total billed charges,5.15,38.38% of total billed charges,26.4,80% of total billed charges,20.37,61.74% of total billed charges,6.53,102% of GA Medicaid Rate,5.1,100% of CMS Medicare OPPS rate,5.1,29.7,24.75
Outpatient Medical Services,LABORATORY,82728,Test to determine level of iron in the blood,301,69,53.82,78% of Total Billed charges,17.13,100% of GA Medicaid Rate,N/A,Not Applicable,13.63,100% of CMS Medicare OPPS rate,13.63,100% of CMS Medicare OPPS rate,N/A,Not Applicable,62.1,90% of total billed charges,17.99,105% of GA Medicaid Rate,46.42,67.275% of total billed charges,55.2,80% of total billed charges,13.77,38.38% of total billed charges,55.2,80% of total billed charges,42.6,61.74% of total billed charges,17.47,102% of GA Medicaid Rate,13.63,100% of CMS Medicare OPPS rate,13.63,62.1,51.75
Outpatient Medical Services,LABORATORY,82746,FOLATE,301,70,54.6,78% of Total Billed charges,18.49,100% of GA Medicaid Rate,N/A,Not Applicable,14.7,100% of CMS Medicare OPPS rate,14.7,100% of CMS Medicare OPPS rate,N/A,Not Applicable,63,90% of total billed charges,19.41,105% of GA Medicaid Rate,47.09,67.275% of total billed charges,56,80% of total billed charges,14.85,38.38% of total billed charges,56,80% of total billed charges,43.22,61.74% of total billed charges,18.86,102% of GA Medicaid Rate,14.7,100% of CMS Medicare OPPS rate,14.7,63,52.5
Outpatient Medical Services,LABORATORY,82784,Test to determine levels of immunoglobulins in the blood,301,141,109.98,78% of Total Billed charges,11.69,100% of GA Medicaid Rate,N/A,Not Applicable,9.3,100% of CMS Medicare OPPS rate,9.3,100% of CMS Medicare OPPS rate,N/A,Not Applicable,126.9,90% of total billed charges,12.27,105% of GA Medicaid Rate,94.86,67.275% of total billed charges,112.8,80% of total billed charges,9.39,38.38% of total billed charges,112.8,80% of total billed charges,87.05,61.74% of total billed charges,11.92,102% of GA Medicaid Rate,9.3,100% of CMS Medicare OPPS rate,9.3,126.9,105.75
Outpatient Medical Services,LABORATORY,82785,IGE QUANTITATIVE,301,251,195.78,78% of Total Billed charges,20.71,100% of GA Medicaid Rate,N/A,Not Applicable,16.46,100% of CMS Medicare OPPS rate,16.46,100% of CMS Medicare OPPS rate,N/A,Not Applicable,225.9,90% of total billed charges,21.75,105% of GA Medicaid Rate,168.86,67.275% of total billed charges,200.8,80% of total billed charges,16.62,38.38% of total billed charges,200.8,80% of total billed charges,154.97,61.74% of total billed charges,21.12,102% of GA Medicaid Rate,16.46,100% of CMS Medicare OPPS rate,16.46,225.9,188.25
Outpatient Medical Services,LABORATORY,82803,Test to measure arterial blood gases,301,127,99.06,78% of Total Billed charges,24.34,100% of GA Medicaid Rate,N/A,Not Applicable,26.07,100% of CMS Medicare OPPS rate,26.07,100% of CMS Medicare OPPS rate,N/A,Not Applicable,114.3,90% of total billed charges,25.56,105% of GA Medicaid Rate,85.44,67.275% of total billed charges,101.6,80% of total billed charges,26.33,38.38% of total billed charges,101.6,80% of total billed charges,78.41,61.74% of total billed charges,24.83,102% of GA Medicaid Rate,26.07,100% of CMS Medicare OPPS rate,24.34,114.3,95.25
Outpatient Medical Services,LABORATORY,82947,Quantitative measure of glucose build up in the blood over time,301,44,34.32,78% of Total Billed charges,4.93,100% of GA Medicaid Rate,N/A,Not Applicable,3.93,100% of CMS Medicare OPPS rate,3.93,100% of CMS Medicare OPPS rate,N/A,Not Applicable,39.6,90% of total billed charges,5.18,105% of GA Medicaid Rate,29.6,67.275% of total billed charges,35.2,80% of total billed charges,3.97,38.38% of total billed charges,35.2,80% of total billed charges,27.17,61.74% of total billed charges,5.03,102% of GA Medicaid Rate,3.93,100% of CMS Medicare OPPS rate,3.93,39.6,33
Outpatient Medical Services,LABORATORY,82950,Test of glucose level in the blood,301,31,24.18,78% of Total Billed charges,5.98,100% of GA Medicaid Rate,N/A,Not Applicable,4.75,100% of CMS Medicare OPPS rate,4.75,100% of CMS Medicare OPPS rate,N/A,Not Applicable,27.9,90% of total billed charges,6.28,105% of GA Medicaid Rate,20.86,67.275% of total billed charges,24.8,80% of total billed charges,4.8,38.38% of total billed charges,24.8,80% of total billed charges,19.14,61.74% of total billed charges,6.1,102% of GA Medicaid Rate,4.75,100% of CMS Medicare OPPS rate,4.75,27.9,23.25
Outpatient Medical Services,LABORATORY,82951,Test to predict likelihood of gestational diabetes,301,118,92.04,78% of Total Billed charges,16.19,100% of GA Medicaid Rate,N/A,Not Applicable,12.87,100% of CMS Medicare OPPS rate,12.87,100% of CMS Medicare OPPS rate,N/A,Not Applicable,106.2,90% of total billed charges,17,105% of GA Medicaid Rate,79.38,67.275% of total billed charges,94.4,80% of total billed charges,13,38.38% of total billed charges,94.4,80% of total billed charges,72.85,61.74% of total billed charges,16.51,102% of GA Medicaid Rate,12.87,100% of CMS Medicare OPPS rate,12.87,106.2,88.5
Outpatient Medical Services,LABORATORY,82952,GLUCOSE ADD'L HR,301,29,22.62,78% of Total Billed charges,4.93,100% of GA Medicaid Rate,N/A,Not Applicable,3.92,100% of CMS Medicare OPPS rate,3.92,100% of CMS Medicare OPPS rate,N/A,Not Applicable,26.1,90% of total billed charges,5.18,105% of GA Medicaid Rate,19.51,67.275% of total billed charges,23.2,80% of total billed charges,3.96,38.38% of total billed charges,23.2,80% of total billed charges,17.9,61.74% of total billed charges,5.03,102% of GA Medicaid Rate,3.92,100% of CMS Medicare OPPS rate,3.92,26.1,21.75
Outpatient Medical Services,LABORATORY,82977,GGT,301,47,36.66,78% of Total Billed charges,6.35,100% of GA Medicaid Rate,N/A,Not Applicable,7.2,100% of CMS Medicare OPPS rate,7.2,100% of CMS Medicare OPPS rate,N/A,Not Applicable,42.3,90% of total billed charges,6.67,105% of GA Medicaid Rate,31.62,67.275% of total billed charges,37.6,80% of total billed charges,7.27,38.38% of total billed charges,37.6,80% of total billed charges,29.02,61.74% of total billed charges,6.48,102% of GA Medicaid Rate,7.2,100% of CMS Medicare OPPS rate,6.35,42.3,35.25
Outpatient Medical Services,LABORATORY,83001,Test of hormone in the blood,301,121,94.38,78% of Total Billed charges,23.37,100% of GA Medicaid Rate,N/A,Not Applicable,18.58,100% of CMS Medicare OPPS rate,18.58,100% of CMS Medicare OPPS rate,N/A,Not Applicable,108.9,90% of total billed charges,24.54,105% of GA Medicaid Rate,81.4,67.275% of total billed charges,96.8,80% of total billed charges,18.77,38.38% of total billed charges,96.8,80% of total billed charges,74.71,61.74% of total billed charges,23.84,102% of GA Medicaid Rate,18.58,100% of CMS Medicare OPPS rate,18.58,108.9,90.75
Outpatient Medical Services,LABORATORY,83002,Test of hormone in the blood,301,121,94.38,78% of Total Billed charges,23.29,100% of GA Medicaid Rate,N/A,Not Applicable,18.52,100% of CMS Medicare OPPS rate,18.52,100% of CMS Medicare OPPS rate,N/A,Not Applicable,108.9,90% of total billed charges,24.45,105% of GA Medicaid Rate,81.4,67.275% of total billed charges,96.8,80% of total billed charges,18.71,38.38% of total billed charges,96.8,80% of total billed charges,74.71,61.74% of total billed charges,23.76,102% of GA Medicaid Rate,18.52,100% of CMS Medicare OPPS rate,18.52,108.9,90.75
Outpatient Medical Services,LABORATORY,83013,Test of breath for a stomach bacterium,300,208,162.24,78% of Total Billed charges,66.53,100% of GA Medicaid Rate,N/A,Not Applicable,67.36,100% of CMS Medicare OPPS rate,67.36,100% of CMS Medicare OPPS rate,N/A,Not Applicable,187.2,90% of total billed charges,69.86,105% of GA Medicaid Rate,139.93,67.275% of total billed charges,166.4,80% of total billed charges,68.03,38.38% of total billed charges,166.4,80% of total billed charges,128.42,61.74% of total billed charges,67.86,102% of GA Medicaid Rate,67.36,100% of CMS Medicare OPPS rate,66.53,187.2,156
Outpatient Medical Services,LABORATORY,83036,Blood test to measure average blood glucose levels for past 2-3 months,301,63,49.14,78% of Total Billed charges,12.2,100% of GA Medicaid Rate,N/A,Not Applicable,9.71,100% of CMS Medicare OPPS rate,9.71,100% of CMS Medicare OPPS rate,N/A,Not Applicable,56.7,90% of total billed charges,12.81,105% of GA Medicaid Rate,42.38,67.275% of total billed charges,50.4,80% of total billed charges,9.81,38.38% of total billed charges,50.4,80% of total billed charges,38.9,61.74% of total billed charges,12.44,102% of GA Medicaid Rate,9.71,100% of CMS Medicare OPPS rate,9.71,56.7,47.25
Outpatient Medical Services,LABORATORY,83516,Chemical test of the blood to measure presence or concentration of a substance in the blood,301,232,180.96,78% of Total Billed charges,13.45,100% of GA Medicaid Rate,N/A,Not Applicable,11.53,100% of CMS Medicare OPPS rate,11.53,100% of CMS Medicare OPPS rate,N/A,Not Applicable,208.8,90% of total billed charges,14.12,105% of GA Medicaid Rate,156.08,67.275% of total billed charges,185.6,80% of total billed charges,11.65,38.38% of total billed charges,185.6,80% of total billed charges,143.24,61.74% of total billed charges,13.72,102% of GA Medicaid Rate,11.53,100% of CMS Medicare OPPS rate,11.53,208.8,174
Outpatient Medical Services,LABORATORY,83520,INTERFERON-BETA AB IgG,301,85,66.3,78% of Total Billed charges,16.28,100% of GA Medicaid Rate,N/A,Not Applicable,17.27,100% of CMS Medicare OPPS rate,17.27,100% of CMS Medicare OPPS rate,N/A,Not Applicable,76.5,90% of total billed charges,17.09,105% of GA Medicaid Rate,57.18,67.275% of total billed charges,68,80% of total billed charges,17.44,38.38% of total billed charges,68,80% of total billed charges,52.48,61.74% of total billed charges,16.61,102% of GA Medicaid Rate,17.27,100% of CMS Medicare OPPS rate,16.28,76.5,63.75
Outpatient Medical Services,LABORATORY,83550,Blood test that measures the amount of iron carried in the blood,300,27,21.06,78% of Total Billed charges,10.99,100% of GA Medicaid Rate,N/A,Not Applicable,8.74,100% of CMS Medicare OPPS rate,8.74,100% of CMS Medicare OPPS rate,N/A,Not Applicable,24.3,90% of total billed charges,11.54,105% of GA Medicaid Rate,18.16,67.275% of total billed charges,21.6,80% of total billed charges,8.83,38.38% of total billed charges,21.6,80% of total billed charges,16.67,61.74% of total billed charges,11.21,102% of GA Medicaid Rate,8.74,100% of CMS Medicare OPPS rate,8.74,24.3,20.25
Outpatient Medical Services,LABORATORY,83605,LACTATE,301,167,130.26,78% of Total Billed charges,13.43,100% of GA Medicaid Rate,N/A,Not Applicable,11.57,100% of CMS Medicare OPPS rate,11.57,100% of CMS Medicare OPPS rate,N/A,Not Applicable,150.3,90% of total billed charges,14.1,105% of GA Medicaid Rate,112.35,67.275% of total billed charges,133.6,80% of total billed charges,11.69,38.38% of total billed charges,133.6,80% of total billed charges,103.11,61.74% of total billed charges,13.7,102% of GA Medicaid Rate,11.57,100% of CMS Medicare OPPS rate,11.57,150.3,125.25
Outpatient Medical Services,LABORATORY,83615,"LD, PLEURAL FLUID",301,40,31.2,78% of Total Billed charges,6.35,100% of GA Medicaid Rate,N/A,Not Applicable,6.04,100% of CMS Medicare OPPS rate,6.04,100% of CMS Medicare OPPS rate,N/A,Not Applicable,36,90% of total billed charges,6.67,105% of GA Medicaid Rate,26.91,67.275% of total billed charges,32,80% of total billed charges,6.1,38.38% of total billed charges,32,80% of total billed charges,24.7,61.74% of total billed charges,6.48,102% of GA Medicaid Rate,6.04,100% of CMS Medicare OPPS rate,6.04,36,30
Outpatient Medical Services,LABORATORY,83690,LIPASE,301,45,35.1,78% of Total Billed charges,8.66,100% of GA Medicaid Rate,N/A,Not Applicable,6.89,100% of CMS Medicare OPPS rate,6.89,100% of CMS Medicare OPPS rate,N/A,Not Applicable,40.5,90% of total billed charges,9.09,105% of GA Medicaid Rate,30.27,67.275% of total billed charges,36,80% of total billed charges,6.96,38.38% of total billed charges,36,80% of total billed charges,27.78,61.74% of total billed charges,8.83,102% of GA Medicaid Rate,6.89,100% of CMS Medicare OPPS rate,6.89,40.5,33.75
Outpatient Medical Services,LABORATORY,83735,MAGNESIUM,301,47,36.66,78% of Total Billed charges,8.42,100% of GA Medicaid Rate,N/A,Not Applicable,6.7,100% of CMS Medicare OPPS rate,6.7,100% of CMS Medicare OPPS rate,N/A,Not Applicable,42.3,90% of total billed charges,8.84,105% of GA Medicaid Rate,31.62,67.275% of total billed charges,37.6,80% of total billed charges,6.77,38.38% of total billed charges,37.6,80% of total billed charges,29.02,61.74% of total billed charges,8.59,102% of GA Medicaid Rate,6.7,100% of CMS Medicare OPPS rate,6.7,42.3,35.25
Outpatient Medical Services,LABORATORY,83880,Blood test used to diagnose heart failure,301,307,239.46,78% of Total Billed charges,42.69,100% of GA Medicaid Rate,N/A,Not Applicable,39.26,100% of CMS Medicare OPPS rate,39.26,100% of CMS Medicare OPPS rate,N/A,Not Applicable,276.3,90% of total billed charges,44.82,105% of GA Medicaid Rate,206.53,67.275% of total billed charges,245.6,80% of total billed charges,39.65,38.38% of total billed charges,245.6,80% of total billed charges,189.54,61.74% of total billed charges,43.54,102% of GA Medicaid Rate,39.26,100% of CMS Medicare OPPS rate,39.26,276.3,230.25
Outpatient Medical Services,LABORATORY,83930,OSMOLALITY SERUM,301,101,78.78,78% of Total Billed charges,8.32,100% of GA Medicaid Rate,N/A,Not Applicable,6.61,100% of CMS Medicare OPPS rate,6.61,100% of CMS Medicare OPPS rate,N/A,Not Applicable,90.9,90% of total billed charges,8.74,105% of GA Medicaid Rate,67.95,67.275% of total billed charges,80.8,80% of total billed charges,6.68,38.38% of total billed charges,80.8,80% of total billed charges,62.36,61.74% of total billed charges,8.49,102% of GA Medicaid Rate,6.61,100% of CMS Medicare OPPS rate,6.61,90.9,75.75
Outpatient Medical Services,LABORATORY,83935,OSMOLALITY URINE,301,44,34.32,78% of Total Billed charges,8.57,100% of GA Medicaid Rate,N/A,Not Applicable,6.82,100% of CMS Medicare OPPS rate,6.82,100% of CMS Medicare OPPS rate,N/A,Not Applicable,39.6,90% of total billed charges,9,105% of GA Medicaid Rate,29.6,67.275% of total billed charges,35.2,80% of total billed charges,6.89,38.38% of total billed charges,35.2,80% of total billed charges,27.17,61.74% of total billed charges,8.74,102% of GA Medicaid Rate,6.82,100% of CMS Medicare OPPS rate,6.82,39.6,33
Outpatient Medical Services,LABORATORY,83970,"PTH, INTACT",301,410,319.8,78% of Total Billed charges,51.9,100% of GA Medicaid Rate,N/A,Not Applicable,41.28,100% of CMS Medicare OPPS rate,41.28,100% of CMS Medicare OPPS rate,N/A,Not Applicable,369,90% of total billed charges,54.5,105% of GA Medicaid Rate,275.83,67.275% of total billed charges,328,80% of total billed charges,41.69,38.38% of total billed charges,328,80% of total billed charges,253.13,61.74% of total billed charges,52.94,102% of GA Medicaid Rate,41.28,100% of CMS Medicare OPPS rate,41.28,369,307.5
Outpatient Medical Services,LABORATORY,83993,"CALPROTECTIN, STOOL",301,300,234,78% of Total Billed charges,24.68,100% of GA Medicaid Rate,N/A,Not Applicable,19.63,100% of CMS Medicare OPPS rate,19.63,100% of CMS Medicare OPPS rate,N/A,Not Applicable,270,90% of total billed charges,25.91,105% of GA Medicaid Rate,201.83,67.275% of total billed charges,240,80% of total billed charges,19.83,38.38% of total billed charges,240,80% of total billed charges,185.22,61.74% of total billed charges,25.17,102% of GA Medicaid Rate,19.63,100% of CMS Medicare OPPS rate,19.63,270,225
Outpatient Medical Services,LABORATORY,84075,ALKALINE PHOSPHATASE,301,39,30.42,78% of Total Billed charges,6.35,100% of GA Medicaid Rate,N/A,Not Applicable,5.18,100% of CMS Medicare OPPS rate,5.18,100% of CMS Medicare OPPS rate,N/A,Not Applicable,35.1,90% of total billed charges,6.67,105% of GA Medicaid Rate,26.24,67.275% of total billed charges,31.2,80% of total billed charges,5.23,38.38% of total billed charges,31.2,80% of total billed charges,24.08,61.74% of total billed charges,6.48,102% of GA Medicaid Rate,5.18,100% of CMS Medicare OPPS rate,5.18,35.1,29.25
Outpatient Medical Services,LABORATORY,84080,ALK PHOSPHATASE ISOENZYMES,301,225,175.5,78% of Total Billed charges,18.59,100% of GA Medicaid Rate,N/A,Not Applicable,14.78,100% of CMS Medicare OPPS rate,14.78,100% of CMS Medicare OPPS rate,N/A,Not Applicable,202.5,90% of total billed charges,19.52,105% of GA Medicaid Rate,151.37,67.275% of total billed charges,180,80% of total billed charges,14.93,38.38% of total billed charges,180,80% of total billed charges,138.92,61.74% of total billed charges,18.96,102% of GA Medicaid Rate,14.78,100% of CMS Medicare OPPS rate,14.78,202.5,168.75
Outpatient Medical Services,LABORATORY,84100,PHOSPHORUS,301,88,68.64,78% of Total Billed charges,5.97,100% of GA Medicaid Rate,N/A,Not Applicable,4.74,100% of CMS Medicare OPPS rate,4.74,100% of CMS Medicare OPPS rate,N/A,Not Applicable,79.2,90% of total billed charges,6.27,105% of GA Medicaid Rate,59.2,67.275% of total billed charges,70.4,80% of total billed charges,4.79,38.38% of total billed charges,70.4,80% of total billed charges,54.33,61.74% of total billed charges,6.09,102% of GA Medicaid Rate,4.74,100% of CMS Medicare OPPS rate,4.74,79.2,66
Outpatient Medical Services,LABORATORY,84132,POTASSIUM,301,32,24.96,78% of Total Billed charges,5.78,100% of GA Medicaid Rate,N/A,Not Applicable,4.76,100% of CMS Medicare OPPS rate,4.76,100% of CMS Medicare OPPS rate,N/A,Not Applicable,28.8,90% of total billed charges,6.07,105% of GA Medicaid Rate,21.53,67.275% of total billed charges,25.6,80% of total billed charges,4.81,38.38% of total billed charges,25.6,80% of total billed charges,19.76,61.74% of total billed charges,5.9,102% of GA Medicaid Rate,4.76,100% of CMS Medicare OPPS rate,4.76,28.8,24
Outpatient Medical Services,LABORATORY,84146,PROLACTIN,301,127,99.06,78% of Total Billed charges,24.37,100% of GA Medicaid Rate,N/A,Not Applicable,19.38,100% of CMS Medicare OPPS rate,19.38,100% of CMS Medicare OPPS rate,N/A,Not Applicable,114.3,90% of total billed charges,25.59,105% of GA Medicaid Rate,85.44,67.275% of total billed charges,101.6,80% of total billed charges,19.57,38.38% of total billed charges,101.6,80% of total billed charges,78.41,61.74% of total billed charges,24.86,102% of GA Medicaid Rate,19.38,100% of CMS Medicare OPPS rate,19.38,114.3,95.25
Outpatient Medical Services,LABORATORY,84153,PSA (prostate specific antigen),301,112,87.36,78% of Total Billed charges,23.13,100% of GA Medicaid Rate,N/A,Not Applicable,18.39,100% of CMS Medicare OPPS rate,18.39,100% of CMS Medicare OPPS rate,N/A,Not Applicable,100.8,90% of total billed charges,24.29,105% of GA Medicaid Rate,75.35,67.275% of total billed charges,89.6,80% of total billed charges,18.57,38.38% of total billed charges,89.6,80% of total billed charges,69.15,61.74% of total billed charges,23.59,102% of GA Medicaid Rate,18.39,100% of CMS Medicare OPPS rate,18.39,100.8,84
Outpatient Medical Services,LABORATORY,84154,PSA (prostate specific antigen) measurement,301,280,218.4,78% of Total Billed charges,23.13,100% of GA Medicaid Rate,N/A,Not Applicable,18.39,100% of CMS Medicare OPPS rate,18.39,100% of CMS Medicare OPPS rate,N/A,Not Applicable,252,90% of total billed charges,24.29,105% of GA Medicaid Rate,188.37,67.275% of total billed charges,224,80% of total billed charges,18.57,38.38% of total billed charges,224,80% of total billed charges,172.87,61.74% of total billed charges,23.59,102% of GA Medicaid Rate,18.39,100% of CMS Medicare OPPS rate,18.39,252,210
Outpatient Medical Services,LABORATORY,84156,URINE PROTEIN RANDOM,301,78,60.84,78% of Total Billed charges,4.61,100% of GA Medicaid Rate,N/A,Not Applicable,3.67,100% of CMS Medicare OPPS rate,3.67,100% of CMS Medicare OPPS rate,N/A,Not Applicable,70.2,90% of total billed charges,4.84,105% of GA Medicaid Rate,52.47,67.275% of total billed charges,62.4,80% of total billed charges,3.71,38.38% of total billed charges,62.4,80% of total billed charges,48.16,61.74% of total billed charges,4.7,102% of GA Medicaid Rate,3.67,100% of CMS Medicare OPPS rate,3.67,70.2,58.5
Outpatient Medical Services,LABORATORY,84157,"PROTEIN TOTAL, PLEURAL FLUID",301,37,28.86,78% of Total Billed charges,4.61,100% of GA Medicaid Rate,N/A,Not Applicable,4,100% of CMS Medicare OPPS rate,4,100% of CMS Medicare OPPS rate,N/A,Not Applicable,33.3,90% of total billed charges,4.84,105% of GA Medicaid Rate,24.89,67.275% of total billed charges,29.6,80% of total billed charges,4.04,38.38% of total billed charges,29.6,80% of total billed charges,22.84,61.74% of total billed charges,4.7,102% of GA Medicaid Rate,4,100% of CMS Medicare OPPS rate,4,33.3,27.75
Outpatient Medical Services,LABORATORY,84166,PROTEIN ELECT (URINE 24 HR),301,116,90.48,78% of Total Billed charges,22.43,100% of GA Medicaid Rate,N/A,Not Applicable,17.83,100% of CMS Medicare OPPS rate,17.83,100% of CMS Medicare OPPS rate,N/A,Not Applicable,104.4,90% of total billed charges,23.55,105% of GA Medicaid Rate,78.04,67.275% of total billed charges,92.8,80% of total billed charges,18.01,38.38% of total billed charges,92.8,80% of total billed charges,71.62,61.74% of total billed charges,22.88,102% of GA Medicaid Rate,17.83,100% of CMS Medicare OPPS rate,17.83,104.4,87
Outpatient Medical Services,LABORATORY,84270,SEX HORMONE BINDING GLOBU,301,142,110.76,78% of Total Billed charges,27.32,100% of GA Medicaid Rate,N/A,Not Applicable,21.73,100% of CMS Medicare OPPS rate,21.73,100% of CMS Medicare OPPS rate,N/A,Not Applicable,127.8,90% of total billed charges,28.69,105% of GA Medicaid Rate,95.53,67.275% of total billed charges,113.6,80% of total billed charges,21.95,38.38% of total billed charges,113.6,80% of total billed charges,87.67,61.74% of total billed charges,27.87,102% of GA Medicaid Rate,21.73,100% of CMS Medicare OPPS rate,21.73,127.8,106.5
Outpatient Medical Services,LABORATORY,84295,SODIUM,301,73,56.94,78% of Total Billed charges,6.05,100% of GA Medicaid Rate,N/A,Not Applicable,4.81,100% of CMS Medicare OPPS rate,4.81,100% of CMS Medicare OPPS rate,N/A,Not Applicable,65.7,90% of total billed charges,6.35,105% of GA Medicaid Rate,49.11,67.275% of total billed charges,58.4,80% of total billed charges,4.86,38.38% of total billed charges,58.4,80% of total billed charges,45.07,61.74% of total billed charges,6.17,102% of GA Medicaid Rate,4.81,100% of CMS Medicare OPPS rate,4.81,65.7,54.75
Outpatient Medical Services,LABORATORY,84300,"SODIUM,URINE",300,34,26.52,78% of Total Billed charges,4.35,100% of GA Medicaid Rate,N/A,Not Applicable,5.06,100% of CMS Medicare OPPS rate,5.06,100% of CMS Medicare OPPS rate,N/A,Not Applicable,30.6,90% of total billed charges,4.57,105% of GA Medicaid Rate,22.87,67.275% of total billed charges,27.2,80% of total billed charges,5.11,38.38% of total billed charges,27.2,80% of total billed charges,20.99,61.74% of total billed charges,4.44,102% of GA Medicaid Rate,5.06,100% of CMS Medicare OPPS rate,4.35,30.6,25.5
Outpatient Medical Services,LABORATORY,84402,TESTOSTERONE FREE & TOTAL,301,166,129.48,78% of Total Billed charges,32.01,100% of GA Medicaid Rate,N/A,Not Applicable,25.47,100% of CMS Medicare OPPS rate,25.47,100% of CMS Medicare OPPS rate,N/A,Not Applicable,149.4,90% of total billed charges,33.61,105% of GA Medicaid Rate,111.68,67.275% of total billed charges,132.8,80% of total billed charges,25.72,38.38% of total billed charges,132.8,80% of total billed charges,102.49,61.74% of total billed charges,32.65,102% of GA Medicaid Rate,25.47,100% of CMS Medicare OPPS rate,25.47,149.4,124.5
Outpatient Medical Services,LABORATORY,84403,"TESTOSTERONE, TOTAL",300,393,306.54,78% of Total Billed charges,32.47,100% of GA Medicaid Rate,N/A,Not Applicable,25.81,100% of CMS Medicare OPPS rate,25.81,100% of CMS Medicare OPPS rate,N/A,Not Applicable,353.7,90% of total billed charges,34.09,105% of GA Medicaid Rate,264.39,67.275% of total billed charges,314.4,80% of total billed charges,26.07,38.38% of total billed charges,314.4,80% of total billed charges,242.64,61.74% of total billed charges,33.12,102% of GA Medicaid Rate,25.81,100% of CMS Medicare OPPS rate,25.81,353.7,294.75
Outpatient Medical Services,LABORATORY,84425,VITAMIN B-1,301,323,251.94,78% of Total Billed charges,26.7,100% of GA Medicaid Rate,N/A,Not Applicable,21.23,100% of CMS Medicare OPPS rate,21.23,100% of CMS Medicare OPPS rate,N/A,Not Applicable,290.7,90% of total billed charges,28.04,105% of GA Medicaid Rate,217.3,67.275% of total billed charges,258.4,80% of total billed charges,21.44,38.38% of total billed charges,258.4,80% of total billed charges,199.42,61.74% of total billed charges,27.23,102% of GA Medicaid Rate,21.23,100% of CMS Medicare OPPS rate,21.23,290.7,242.25
Outpatient Medical Services,LABORATORY,84436,Blood test to measure a type of thyroid hormone,301,104,81.12,78% of Total Billed charges,8.65,100% of GA Medicaid Rate,N/A,Not Applicable,6.87,100% of CMS Medicare OPPS rate,6.87,100% of CMS Medicare OPPS rate,N/A,Not Applicable,93.6,90% of total billed charges,9.08,105% of GA Medicaid Rate,69.97,67.275% of total billed charges,83.2,80% of total billed charges,6.94,38.38% of total billed charges,83.2,80% of total billed charges,64.21,61.74% of total billed charges,8.82,102% of GA Medicaid Rate,6.87,100% of CMS Medicare OPPS rate,6.87,93.6,78
Outpatient Medical Services,LABORATORY,84439,Blood test to evaluate thyroid function,301,137,106.86,78% of Total Billed charges,11.34,100% of GA Medicaid Rate,N/A,Not Applicable,9.02,100% of CMS Medicare OPPS rate,9.02,100% of CMS Medicare OPPS rate,N/A,Not Applicable,123.3,90% of total billed charges,11.91,105% of GA Medicaid Rate,92.17,67.275% of total billed charges,109.6,80% of total billed charges,9.11,38.38% of total billed charges,109.6,80% of total billed charges,84.58,61.74% of total billed charges,11.57,102% of GA Medicaid Rate,9.02,100% of CMS Medicare OPPS rate,9.02,123.3,102.75
Outpatient Medical Services,LABORATORY,84443,"Blood test, thyroid stimulating hormone (TSH)",300,68,53.04,78% of Total Billed charges,21.12,100% of GA Medicaid Rate,N/A,Not Applicable,16.8,100% of CMS Medicare OPPS rate,16.8,100% of CMS Medicare OPPS rate,N/A,Not Applicable,61.2,90% of total billed charges,22.18,105% of GA Medicaid Rate,45.75,67.275% of total billed charges,54.4,80% of total billed charges,16.97,38.38% of total billed charges,54.4,80% of total billed charges,41.98,61.74% of total billed charges,21.54,102% of GA Medicaid Rate,16.8,100% of CMS Medicare OPPS rate,16.8,61.2,51
Outpatient Medical Services,LABORATORY,84450,AST,301,34,26.52,78% of Total Billed charges,6.35,100% of GA Medicaid Rate,N/A,Not Applicable,5.18,100% of CMS Medicare OPPS rate,5.18,100% of CMS Medicare OPPS rate,N/A,Not Applicable,30.6,90% of total billed charges,6.67,105% of GA Medicaid Rate,22.87,67.275% of total billed charges,27.2,80% of total billed charges,5.23,38.38% of total billed charges,27.2,80% of total billed charges,20.99,61.74% of total billed charges,6.48,102% of GA Medicaid Rate,5.18,100% of CMS Medicare OPPS rate,5.18,30.6,25.5
Outpatient Medical Services,LABORATORY,84460,Blood test to evaluate liver function,301,45,35.1,78% of Total Billed charges,6.35,100% of GA Medicaid Rate,N/A,Not Applicable,5.3,100% of CMS Medicare OPPS rate,5.3,100% of CMS Medicare OPPS rate,N/A,Not Applicable,40.5,90% of total billed charges,6.67,105% of GA Medicaid Rate,30.27,67.275% of total billed charges,36,80% of total billed charges,5.35,38.38% of total billed charges,36,80% of total billed charges,27.78,61.74% of total billed charges,6.48,102% of GA Medicaid Rate,5.3,100% of CMS Medicare OPPS rate,5.3,40.5,33.75
Outpatient Medical Services,LABORATORY,84479,T3 UPTAKE,301,98,76.44,78% of Total Billed charges,8.14,100% of GA Medicaid Rate,N/A,Not Applicable,6.47,100% of CMS Medicare OPPS rate,6.47,100% of CMS Medicare OPPS rate,N/A,Not Applicable,88.2,90% of total billed charges,8.55,105% of GA Medicaid Rate,65.93,67.275% of total billed charges,78.4,80% of total billed charges,6.53,38.38% of total billed charges,78.4,80% of total billed charges,60.51,61.74% of total billed charges,8.3,102% of GA Medicaid Rate,6.47,100% of CMS Medicare OPPS rate,6.47,88.2,73.5
Outpatient Medical Services,LABORATORY,84480,Blood test to evaluate thyroid function,301,195,152.1,78% of Total Billed charges,16.03,100% of GA Medicaid Rate,N/A,Not Applicable,14.18,100% of CMS Medicare OPPS rate,14.18,100% of CMS Medicare OPPS rate,N/A,Not Applicable,175.5,90% of total billed charges,16.83,105% of GA Medicaid Rate,131.19,67.275% of total billed charges,156,80% of total billed charges,14.32,38.38% of total billed charges,156,80% of total billed charges,120.39,61.74% of total billed charges,16.35,102% of GA Medicaid Rate,14.18,100% of CMS Medicare OPPS rate,14.18,175.5,146.25
Outpatient Medical Services,LABORATORY,84481,T3 FREE,301,258,201.24,78% of Total Billed charges,21.3,100% of GA Medicaid Rate,N/A,Not Applicable,16.94,100% of CMS Medicare OPPS rate,16.94,100% of CMS Medicare OPPS rate,N/A,Not Applicable,232.2,90% of total billed charges,22.37,105% of GA Medicaid Rate,173.57,67.275% of total billed charges,206.4,80% of total billed charges,17.11,38.38% of total billed charges,206.4,80% of total billed charges,159.29,61.74% of total billed charges,21.73,102% of GA Medicaid Rate,16.94,100% of CMS Medicare OPPS rate,16.94,232.2,193.5
Outpatient Medical Services,LABORATORY,84484,Blood test to measure a certain protein in the blood to determine heart muscle damage,300,100,78,78% of Total Billed charges,12.38,100% of GA Medicaid Rate,N/A,Not Applicable,12.47,100% of CMS Medicare OPPS rate,12.47,100% of CMS Medicare OPPS rate,N/A,Not Applicable,90,90% of total billed charges,13,105% of GA Medicaid Rate,67.28,67.275% of total billed charges,80,80% of total billed charges,12.59,38.38% of total billed charges,80,80% of total billed charges,61.74,61.74% of total billed charges,12.63,102% of GA Medicaid Rate,12.47,100% of CMS Medicare OPPS rate,12.38,90,75
Outpatient Medical Services,LABORATORY,84520,BUN,301,74,57.72,78% of Total Billed charges,4.96,100% of GA Medicaid Rate,N/A,Not Applicable,3.95,100% of CMS Medicare OPPS rate,3.95,100% of CMS Medicare OPPS rate,N/A,Not Applicable,66.6,90% of total billed charges,5.21,105% of GA Medicaid Rate,49.78,67.275% of total billed charges,59.2,80% of total billed charges,3.99,38.38% of total billed charges,59.2,80% of total billed charges,45.69,61.74% of total billed charges,5.06,102% of GA Medicaid Rate,3.95,100% of CMS Medicare OPPS rate,3.95,66.6,55.5
Outpatient Medical Services,LABORATORY,84550,URIC ACID,301,113,88.14,78% of Total Billed charges,5.68,100% of GA Medicaid Rate,N/A,Not Applicable,4.52,100% of CMS Medicare OPPS rate,4.52,100% of CMS Medicare OPPS rate,N/A,Not Applicable,101.7,90% of total billed charges,5.96,105% of GA Medicaid Rate,76.02,67.275% of total billed charges,90.4,80% of total billed charges,4.57,38.38% of total billed charges,90.4,80% of total billed charges,69.77,61.74% of total billed charges,5.79,102% of GA Medicaid Rate,4.52,100% of CMS Medicare OPPS rate,4.52,101.7,84.75
Outpatient Medical Services,LABORATORY,84702,BETA-HCG QUANT,301,251,195.78,78% of Total Billed charges,8.07,100% of GA Medicaid Rate,N/A,Not Applicable,15.05,100% of CMS Medicare OPPS rate,15.05,100% of CMS Medicare OPPS rate,N/A,Not Applicable,225.9,90% of total billed charges,8.47,105% of GA Medicaid Rate,168.86,67.275% of total billed charges,200.8,80% of total billed charges,15.2,38.38% of total billed charges,200.8,80% of total billed charges,154.97,61.74% of total billed charges,8.23,102% of GA Medicaid Rate,15.05,100% of CMS Medicare OPPS rate,8.07,225.9,188.25
Outpatient Medical Services,LABORATORY,84703,Blood test to assess for pregnancy,300,106,82.68,78% of Total Billed charges,8.07,100% of GA Medicaid Rate,N/A,Not Applicable,7.52,100% of CMS Medicare OPPS rate,7.52,100% of CMS Medicare OPPS rate,N/A,Not Applicable,95.4,90% of total billed charges,8.47,105% of GA Medicaid Rate,71.31,67.275% of total billed charges,84.8,80% of total billed charges,7.6,38.38% of total billed charges,84.8,80% of total billed charges,65.44,61.74% of total billed charges,8.23,102% of GA Medicaid Rate,7.52,100% of CMS Medicare OPPS rate,7.52,95.4,79.5
Outpatient Medical Services,LABORATORY,85007,Blood test to assess for infection,305,31,24.18,78% of Total Billed charges,4.33,100% of GA Medicaid Rate,N/A,Not Applicable,3.8,100% of CMS Medicare OPPS rate,3.8,100% of CMS Medicare OPPS rate,N/A,Not Applicable,27.9,90% of total billed charges,4.55,105% of GA Medicaid Rate,20.86,67.275% of total billed charges,24.8,80% of total billed charges,3.84,38.38% of total billed charges,24.8,80% of total billed charges,19.14,61.74% of total billed charges,4.42,102% of GA Medicaid Rate,3.8,100% of CMS Medicare OPPS rate,3.8,27.9,23.25
Outpatient Medical Services,LABORATORY,85014,HEMATOCRIT,305,23,17.94,78% of Total Billed charges,2.98,100% of GA Medicaid Rate,N/A,Not Applicable,2.37,100% of CMS Medicare OPPS rate,2.37,100% of CMS Medicare OPPS rate,N/A,Not Applicable,20.7,90% of total billed charges,3.13,105% of GA Medicaid Rate,15.47,67.275% of total billed charges,18.4,80% of total billed charges,2.39,38.38% of total billed charges,18.4,80% of total billed charges,14.2,61.74% of total billed charges,3.04,102% of GA Medicaid Rate,2.37,100% of CMS Medicare OPPS rate,2.37,20.7,17.25
Outpatient Medical Services,LABORATORY,85018,Blood test to measure levels of hemoglobin,305,21,16.38,78% of Total Billed charges,2.98,100% of GA Medicaid Rate,N/A,Not Applicable,2.37,100% of CMS Medicare OPPS rate,2.37,100% of CMS Medicare OPPS rate,N/A,Not Applicable,18.9,90% of total billed charges,3.13,105% of GA Medicaid Rate,14.13,67.275% of total billed charges,16.8,80% of total billed charges,2.39,38.38% of total billed charges,16.8,80% of total billed charges,12.97,61.74% of total billed charges,3.04,102% of GA Medicaid Rate,2.37,100% of CMS Medicare OPPS rate,2.37,18.9,15.75
Outpatient Medical Services,LABORATORY,85025,"Complete blood cell count, with differential white blood cells, automated",305,N/A,N/A,Not Applicable,9.77,100% of GA Medicaid Rate,N/A,Not Applicable,7.77,100% of CMS Medicare OPPS rate,7.77,100% of CMS Medicare OPPS rate,N/A,Not Applicable,N/A,Not Applicable,10.26,105% of GA Medicaid Rate,N/A,Not Applicable,N/A,Not Applicable,7.85,38.38% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,9.97,102% of GA Medicaid Rate,7.77,100% of CMS Medicare OPPS rate,7.77,10.26,0
Outpatient Medical Services,LABORATORY,85027,"Complete blood count, automated",305,70,54.6,78% of Total Billed charges,8.14,100% of GA Medicaid Rate,N/A,Not Applicable,6.47,100% of CMS Medicare OPPS rate,6.47,100% of CMS Medicare OPPS rate,N/A,Not Applicable,63,90% of total billed charges,8.55,105% of GA Medicaid Rate,47.09,67.275% of total billed charges,56,Not Applicable,6.53,38.38% of total billed charges,56,Not Applicable,43.22,61.74% of total billed charges,8.3,102% of GA Medicaid Rate,6.47,100% of CMS Medicare OPPS rate,6.47,63,52.5
Outpatient Medical Services,LABORATORY,85045,RETICULOCYTE COUNT,305,28,21.84,78% of Total Billed charges,5.03,100% of GA Medicaid Rate,N/A,Not Applicable,3.99,100% of CMS Medicare OPPS rate,3.99,100% of CMS Medicare OPPS rate,N/A,Not Applicable,25.2,90% of total billed charges,5.28,105% of GA Medicaid Rate,18.84,67.275% of total billed charges,22.4,80% of total billed charges,4.03,38.38% of total billed charges,22.4,80% of total billed charges,17.29,61.74% of total billed charges,5.13,102% of GA Medicaid Rate,3.99,100% of CMS Medicare OPPS rate,3.99,25.2,21
Outpatient Medical Services,LABORATORY,85246,VON WILLEBRAND FACTOR AG,305,158,123.24,78% of Total Billed charges,28.85,100% of GA Medicaid Rate,N/A,Not Applicable,22.94,100% of CMS Medicare OPPS rate,22.94,100% of CMS Medicare OPPS rate,N/A,Not Applicable,142.2,90% of total billed charges,30.29,105% of GA Medicaid Rate,106.29,67.275% of total billed charges,126.4,80% of total billed charges,23.17,38.38% of total billed charges,126.4,80% of total billed charges,97.55,61.74% of total billed charges,29.43,102% of GA Medicaid Rate,22.94,100% of CMS Medicare OPPS rate,22.94,142.2,118.5
Outpatient Medical Services,LABORATORY,85379,D-DIMER,305,280,218.4,78% of Total Billed charges,12.8,100% of GA Medicaid Rate,N/A,Not Applicable,10.18,100% of CMS Medicare OPPS rate,10.18,100% of CMS Medicare OPPS rate,N/A,Not Applicable,252,90% of total billed charges,13.44,105% of GA Medicaid Rate,188.37,67.275% of total billed charges,224,80% of total billed charges,10.28,38.38% of total billed charges,224,80% of total billed charges,172.87,61.74% of total billed charges,13.06,102% of GA Medicaid Rate,10.18,100% of CMS Medicare OPPS rate,10.18,252,210
Outpatient Medical Services,LABORATORY,85610,"Blood test, clotting time",305,40,31.2,78% of Total Billed charges,4.94,100% of GA Medicaid Rate,N/A,Not Applicable,4.29,100% of CMS Medicare OPPS rate,4.29,100% of CMS Medicare OPPS rate,N/A,Not Applicable,36,90% of total billed charges,5.19,105% of GA Medicaid Rate,26.91,67.275% of total billed charges,32,80% of total billed charges,4.33,38.38% of total billed charges,32,80% of total billed charges,24.7,61.74% of total billed charges,5.04,102% of GA Medicaid Rate,4.29,100% of CMS Medicare OPPS rate,4.29,36,30
Outpatient Medical Services,LABORATORY,85651,SED RATE,305,36,28.08,78% of Total Billed charges,4.46,100% of GA Medicaid Rate,N/A,Not Applicable,4.27,100% of CMS Medicare OPPS rate,4.27,100% of CMS Medicare OPPS rate,N/A,Not Applicable,32.4,90% of total billed charges,4.68,105% of GA Medicaid Rate,24.22,67.275% of total billed charges,28.8,80% of total billed charges,4.31,38.38% of total billed charges,28.8,80% of total billed charges,22.23,61.74% of total billed charges,4.55,102% of GA Medicaid Rate,4.27,100% of CMS Medicare OPPS rate,4.27,32.4,27
Outpatient Medical Services,LABORATORY,85730,Coagulation assessment blood test,305,56,43.68,78% of Total Billed charges,7.54,100% of GA Medicaid Rate,N/A,Not Applicable,6.01,100% of CMS Medicare OPPS rate,6.01,100% of CMS Medicare OPPS rate,N/A,Not Applicable,50.4,90% of total billed charges,7.92,105% of GA Medicaid Rate,37.67,67.275% of total billed charges,44.8,80% of total billed charges,6.07,38.38% of total billed charges,44.8,80% of total billed charges,34.57,61.74% of total billed charges,7.69,102% of GA Medicaid Rate,6.01,100% of CMS Medicare OPPS rate,6.01,50.4,42
Outpatient Medical Services,LABORATORY,86003,ALLG SPEC IGE EA,302,34,26.52,78% of Total Billed charges,6.57,100% of GA Medicaid Rate,N/A,Not Applicable,5.22,100% of CMS Medicare OPPS rate,5.22,100% of CMS Medicare OPPS rate,N/A,Not Applicable,30.6,90% of total billed charges,6.9,105% of GA Medicaid Rate,22.87,67.275% of total billed charges,27.2,80% of total billed charges,5.27,38.38% of total billed charges,27.2,80% of total billed charges,20.99,61.74% of total billed charges,6.7,102% of GA Medicaid Rate,5.22,100% of CMS Medicare OPPS rate,5.22,30.6,25.5
Outpatient Medical Services,LABORATORY,86038,CENTROMERE B ANTIBODY,302,79,61.62,78% of Total Billed charges,15.2,100% of GA Medicaid Rate,N/A,Not Applicable,12.09,100% of CMS Medicare OPPS rate,12.09,100% of CMS Medicare OPPS rate,N/A,Not Applicable,71.1,90% of total billed charges,15.96,105% of GA Medicaid Rate,53.15,67.275% of total billed charges,63.2,80% of total billed charges,12.21,38.38% of total billed charges,63.2,80% of total billed charges,48.77,61.74% of total billed charges,15.5,102% of GA Medicaid Rate,12.09,100% of CMS Medicare OPPS rate,12.09,71.1,59.25
Outpatient Medical Services,LABORATORY,86140,C-REACTIVE PROTEIN,302,34,26.52,78% of Total Billed charges,6.51,100% of GA Medicaid Rate,N/A,Not Applicable,5.18,100% of CMS Medicare OPPS rate,5.18,100% of CMS Medicare OPPS rate,N/A,Not Applicable,30.6,90% of total billed charges,6.84,105% of GA Medicaid Rate,22.87,67.275% of total billed charges,27.2,80% of total billed charges,5.23,38.38% of total billed charges,27.2,80% of total billed charges,20.99,61.74% of total billed charges,6.64,102% of GA Medicaid Rate,5.18,100% of CMS Medicare OPPS rate,5.18,30.6,25.5
Outpatient Medical Services,LABORATORY,86160,C-2 COMPLEMENT,302,87,67.86,78% of Total Billed charges,15.1,100% of GA Medicaid Rate,N/A,Not Applicable,12,100% of CMS Medicare OPPS rate,12,100% of CMS Medicare OPPS rate,N/A,Not Applicable,78.3,90% of total billed charges,15.86,105% of GA Medicaid Rate,58.53,67.275% of total billed charges,69.6,80% of total billed charges,12.12,38.38% of total billed charges,69.6,80% of total billed charges,53.71,61.74% of total billed charges,15.4,102% of GA Medicaid Rate,12,100% of CMS Medicare OPPS rate,12,78.3,65.25
Outpatient Medical Services,LABORATORY,86255,NEUTROPHIL CYTOPLASM ABC,302,79,61.62,78% of Total Billed charges,15.16,100% of GA Medicaid Rate,N/A,Not Applicable,12.05,100% of CMS Medicare OPPS rate,12.05,100% of CMS Medicare OPPS rate,N/A,Not Applicable,71.1,90% of total billed charges,15.92,105% of GA Medicaid Rate,53.15,67.275% of total billed charges,63.2,80% of total billed charges,12.17,38.38% of total billed charges,63.2,80% of total billed charges,48.77,61.74% of total billed charges,15.46,102% of GA Medicaid Rate,12.05,100% of CMS Medicare OPPS rate,12.05,71.1,59.25
Outpatient Medical Services,LABORATORY,86308,MONO TEST,302,85,66.3,78% of Total Billed charges,6.51,100% of GA Medicaid Rate,N/A,Not Applicable,5.18,100% of CMS Medicare OPPS rate,5.18,100% of CMS Medicare OPPS rate,N/A,Not Applicable,76.5,90% of total billed charges,6.84,105% of GA Medicaid Rate,57.18,67.275% of total billed charges,68,80% of total billed charges,5.23,38.38% of total billed charges,68,80% of total billed charges,52.48,61.74% of total billed charges,6.64,102% of GA Medicaid Rate,5.18,100% of CMS Medicare OPPS rate,5.18,76.5,63.75
Outpatient Medical Services,LABORATORY,86317,STREP SCREEN RAPID,300,46,35.88,78% of Total Billed charges,15.09,100% of GA Medicaid Rate,N/A,Not Applicable,14.99,100% of CMS Medicare OPPS rate,14.99,100% of CMS Medicare OPPS rate,N/A,Not Applicable,41.4,90% of total billed charges,15.84,105% of GA Medicaid Rate,30.95,67.275% of total billed charges,36.8,80% of total billed charges,15.14,38.38% of total billed charges,36.8,80% of total billed charges,28.4,61.74% of total billed charges,15.39,102% of GA Medicaid Rate,14.99,100% of CMS Medicare OPPS rate,14.99,41.4,34.5
Outpatient Medical Services,LABORATORY,86376,THYROID PEROXIDASE,300,221,172.38,78% of Total Billed charges,18.3,100% of GA Medicaid Rate,N/A,Not Applicable,14.55,100% of CMS Medicare OPPS rate,14.55,100% of CMS Medicare OPPS rate,N/A,Not Applicable,198.9,90% of total billed charges,19.22,105% of GA Medicaid Rate,148.68,67.275% of total billed charges,176.8,80% of total billed charges,14.7,38.38% of total billed charges,176.8,80% of total billed charges,136.45,61.74% of total billed charges,18.67,102% of GA Medicaid Rate,14.55,100% of CMS Medicare OPPS rate,14.55,198.9,165.75
Outpatient Medical Services,LABORATORY,86592,Blood test to screen for syphilis,302,28,21.84,78% of Total Billed charges,4.65,100% of GA Medicaid Rate,N/A,Not Applicable,4.27,100% of CMS Medicare OPPS rate,4.27,100% of CMS Medicare OPPS rate,N/A,Not Applicable,25.2,90% of total billed charges,4.88,105% of GA Medicaid Rate,18.84,67.275% of total billed charges,22.4,80% of total billed charges,4.31,38.38% of total billed charges,22.4,80% of total billed charges,17.29,61.74% of total billed charges,4.74,102% of GA Medicaid Rate,4.27,100% of CMS Medicare OPPS rate,4.27,25.2,21
Outpatient Medical Services,LABORATORY,86618,"LYME AB IGG,IGM W/REFL",302,111,86.58,78% of Total Billed charges,21.42,100% of GA Medicaid Rate,N/A,Not Applicable,17.03,100% of CMS Medicare OPPS rate,17.03,100% of CMS Medicare OPPS rate,N/A,Not Applicable,99.9,90% of total billed charges,22.49,105% of GA Medicaid Rate,74.68,67.275% of total billed charges,88.8,80% of total billed charges,17.2,38.38% of total billed charges,88.8,80% of total billed charges,68.53,61.74% of total billed charges,21.85,102% of GA Medicaid Rate,17.03,100% of CMS Medicare OPPS rate,17.03,99.9,83.25
Outpatient Medical Services,LABORATORY,86666,EHRLICHIA ANTIBODY,302,157,122.46,78% of Total Billed charges,12.8,100% of GA Medicaid Rate,N/A,Not Applicable,10.18,100% of CMS Medicare OPPS rate,10.18,100% of CMS Medicare OPPS rate,N/A,Not Applicable,141.3,90% of total billed charges,13.44,105% of GA Medicaid Rate,105.62,67.275% of total billed charges,125.6,80% of total billed charges,10.28,38.38% of total billed charges,125.6,80% of total billed charges,96.93,61.74% of total billed charges,13.06,102% of GA Medicaid Rate,10.18,100% of CMS Medicare OPPS rate,10.18,141.3,117.75
Outpatient Medical Services,LABORATORY,86704,Blood test indicating infection with Hepatitis B,300,183,142.74,78% of Total Billed charges,15.16,100% of GA Medicaid Rate,N/A,Not Applicable,12.05,100% of CMS Medicare OPPS rate,12.05,100% of CMS Medicare OPPS rate,N/A,Not Applicable,164.7,90% of total billed charges,15.92,105% of GA Medicaid Rate,123.11,67.275% of total billed charges,146.4,80% of total billed charges,12.17,38.38% of total billed charges,146.4,80% of total billed charges,112.98,61.74% of total billed charges,15.46,102% of GA Medicaid Rate,12.05,100% of CMS Medicare OPPS rate,12.05,164.7,137.25
Outpatient Medical Services,LABORATORY,86706,HEPATITIS B SURF AB,302,71,55.38,78% of Total Billed charges,13.51,100% of GA Medicaid Rate,N/A,Not Applicable,10.74,100% of CMS Medicare OPPS rate,10.74,100% of CMS Medicare OPPS rate,N/A,Not Applicable,63.9,90% of total billed charges,14.19,105% of GA Medicaid Rate,47.77,67.275% of total billed charges,56.8,80% of total billed charges,10.85,38.38% of total billed charges,56.8,80% of total billed charges,43.84,61.74% of total billed charges,13.78,102% of GA Medicaid Rate,10.74,100% of CMS Medicare OPPS rate,10.74,63.9,53.25
Outpatient Medical Services,LABORATORY,86708,Blood test indicating infection with Hepatitis A,302,81,63.18,78% of Total Billed charges,15.58,100% of GA Medicaid Rate,N/A,Not Applicable,12.39,100% of CMS Medicare OPPS rate,12.39,100% of CMS Medicare OPPS rate,N/A,Not Applicable,72.9,90% of total billed charges,16.36,105% of GA Medicaid Rate,54.49,67.275% of total billed charges,64.8,80% of total billed charges,12.51,38.38% of total billed charges,64.8,80% of total billed charges,50.01,61.74% of total billed charges,15.89,102% of GA Medicaid Rate,12.39,100% of CMS Medicare OPPS rate,12.39,72.9,60.75
Outpatient Medical Services,LABORATORY,86709,HEPATITIS A IGM ANTIBODY,300,73,56.94,78% of Total Billed charges,14.16,100% of GA Medicaid Rate,N/A,Not Applicable,11.26,100% of CMS Medicare OPPS rate,11.26,100% of CMS Medicare OPPS rate,N/A,Not Applicable,65.7,90% of total billed charges,14.87,105% of GA Medicaid Rate,49.11,67.275% of total billed charges,58.4,80% of total billed charges,11.37,38.38% of total billed charges,58.4,80% of total billed charges,45.07,61.74% of total billed charges,14.44,102% of GA Medicaid Rate,11.26,100% of CMS Medicare OPPS rate,11.26,65.7,54.75
Outpatient Medical Services,LABORATORY,86757,RICKETTSIAL AB-RMSF,302,127,99.06,78% of Total Billed charges,24.35,100% of GA Medicaid Rate,N/A,Not Applicable,19.35,100% of CMS Medicare OPPS rate,19.35,100% of CMS Medicare OPPS rate,N/A,Not Applicable,114.3,90% of total billed charges,25.57,105% of GA Medicaid Rate,85.44,67.275% of total billed charges,101.6,80% of total billed charges,19.54,38.38% of total billed charges,101.6,80% of total billed charges,78.41,61.74% of total billed charges,24.84,102% of GA Medicaid Rate,19.35,100% of CMS Medicare OPPS rate,19.35,114.3,95.25
Outpatient Medical Services,LABORATORY,86788,WEST NILE IGM-SERUM,302,110,85.8,78% of Total Billed charges,21.19,100% of GA Medicaid Rate,N/A,Not Applicable,16.85,100% of CMS Medicare OPPS rate,16.85,100% of CMS Medicare OPPS rate,N/A,Not Applicable,99,90% of total billed charges,22.25,105% of GA Medicaid Rate,74,67.275% of total billed charges,88,80% of total billed charges,17.02,38.38% of total billed charges,88,80% of total billed charges,67.91,61.74% of total billed charges,21.61,102% of GA Medicaid Rate,16.85,100% of CMS Medicare OPPS rate,16.85,99,82.5
Outpatient Medical Services,LABORATORY,86789,WEST NILE IGG-SERUM,302,76,59.28,78% of Total Billed charges,14.63,100% of GA Medicaid Rate,N/A,Not Applicable,14.39,100% of CMS Medicare OPPS rate,14.39,100% of CMS Medicare OPPS rate,N/A,Not Applicable,68.4,90% of total billed charges,15.36,105% of GA Medicaid Rate,51.13,67.275% of total billed charges,60.8,80% of total billed charges,14.53,38.38% of total billed charges,60.8,80% of total billed charges,46.92,61.74% of total billed charges,14.92,102% of GA Medicaid Rate,14.39,100% of CMS Medicare OPPS rate,14.39,68.4,57
Outpatient Medical Services,LABORATORY,86803,Blood test to determine infection with Hepatitis C,300,93,72.54,78% of Total Billed charges,10,100% of GA Medicaid Rate,N/A,Not Applicable,14.27,100% of CMS Medicare OPPS rate,14.27,100% of CMS Medicare OPPS rate,N/A,Not Applicable,83.7,90% of total billed charges,10.5,105% of GA Medicaid Rate,62.57,67.275% of total billed charges,74.4,80% of total billed charges,14.41,38.38% of total billed charges,74.4,80% of total billed charges,57.42,61.74% of total billed charges,10.2,102% of GA Medicaid Rate,14.27,100% of CMS Medicare OPPS rate,10,83.7,69.75
Outpatient Medical Services,LABORATORY,86850,Blood test to screen for antibodies that could harm red blood cells,300,N/A,N/A,Not Applicable,15.23,100% of GA Medicaid Rate,N/A,Not Applicable,9.77,100% of CMS Medicare OPPS rate,9.77,100% of CMS Medicare OPPS rate,N/A,Not Applicable,N/A,Not Applicable,15.99,105% of GA Medicaid Rate,N/A,Not Applicable,N/A,Not Applicable,9.87,38.38% of total billed charges,N/A,Not Applicable,N/A,Not Applicable,15.53,102% of GA Medicaid Rate,9.77,100% of CMS Medicare OPPS rate,9.77,15.99,0
Outpatient Medical Services,LABORATORY,86900,BB ABO GROUP,300,221,172.38,78% of Total Billed charges,3.75,100% of GA Medicaid Rate,N/A,Not Applicable,2.99,100% of CMS Medicare OPPS rate,2.99,100% of CMS Medicare OPPS rate,N/A,Not Applicable,198.9,90% of total billed charges,3.94,105% of GA Medicaid Rate,148.68,67.275% of total billed charges,176.8,80% of total billed charges,3.02,38.38% of total billed charges,176.8,80% of total billed charges,136.45,61.74% of total billed charges,3.83,102% of GA Medicaid Rate,2.99,100% of CMS Medicare OPPS rate,2.99,198.9,165.75
Outpatient Medical Services,LABORATORY,86901,BB RH TYPE,300,67,52.26,78% of Total Billed charges,14.51,100% of GA Medicaid Rate,N/A,Not Applicable,2.99,100% of CMS Medicare OPPS rate,2.99,100% of CMS Medicare OPPS rate,N/A,Not Applicable,60.3,90% of total billed charges,15.24,105% of GA Medicaid Rate,45.07,67.275% of total billed charges,53.6,80% of total billed charges,3.02,38.38% of total billed charges,53.6,80% of total billed charges,41.37,61.74% of total billed charges,14.8,102% of GA Medicaid Rate,2.99,100% of CMS Medicare OPPS rate,2.99,60.3,50.25
Outpatient Medical Services,LABORATORY,86923,BB CROSSMATCH,300,272,212.16,78% of Total Billed charges,171.36,63% of total billed charges,N/A,Not Applicable,103.36,38% of total billed charges,103.36,38% of total billed charges,N/A,Not Applicable,244.8,90% of total billed charges,95.2,35% of total billed charges,182.99,67.275% of total billed charges,217.6,80% of total billed charges,104.39,38.38% of total billed charges,217.6,80% of total billed charges,167.93,61.74% of total billed charges,277.44,102% of percent of total billed charges,103.36,38% of total billed charges,95.2,277.44,204
Outpatient Medical Services,LABORATORY,87040,Blood test to screen for bacteria in the blood,306,51,39.78,78% of Total Billed charges,12.98,100% of GA Medicaid Rate,N/A,Not Applicable,10.32,100% of CMS Medicare OPPS rate,10.32,100% of CMS Medicare OPPS rate,N/A,Not Applicable,45.9,90% of total billed charges,13.63,105% of GA Medicaid Rate,34.31,67.275% of total billed charges,40.8,80% of total billed charges,10.42,38.38% of total billed charges,40.8,80% of total billed charges,31.49,61.74% of total billed charges,13.24,102% of GA Medicaid Rate,10.32,100% of CMS Medicare OPPS rate,10.32,45.9,38.25
Outpatient Medical Services,LABORATORY,87045,CULTURE STOOL SAL SHIG,306,62,48.36,78% of Total Billed charges,39.06,63% of total billed charges,N/A,Not Applicable,9.44,100% of CMS Medicare OPPS rate,9.44,100% of CMS Medicare OPPS rate,N/A,Not Applicable,55.8,90% of total billed charges,21.7,35% of total billed charges,41.71,67.275% of total billed charges,49.6,80% of total billed charges,9.53,38.38% of total billed charges,49.6,80% of total billed charges,38.28,61.74% of total billed charges,63.24,102% of percent of total billed charges,9.44,100% of CMS Medicare OPPS rate,9.44,63.24,46.5
Outpatient Medical Services,LABORATORY,87046,Blood test to identify bacteria that may be contributing to symptoms in the gastrointestinal tract,306,62,48.36,78% of Total Billed charges,2.97,100% of GA Medicaid Rate,N/A,Not Applicable,9.44,100% of CMS Medicare OPPS rate,9.44,100% of CMS Medicare OPPS rate,N/A,Not Applicable,55.8,90% of total billed charges,3.12,105% of GA Medicaid Rate,41.71,67.275% of total billed charges,49.6,80% of total billed charges,9.53,38.38% of total billed charges,49.6,80% of total billed charges,38.28,61.74% of total billed charges,3.03,102% of GA Medicaid Rate,9.44,100% of CMS Medicare OPPS rate,2.97,55.8,46.5
Outpatient Medical Services,LABORATORY,87070,Test of body fluid other than blood to assess for bacteria,306,56,43.68,78% of Total Billed charges,10.83,100% of GA Medicaid Rate,N/A,Not Applicable,8.62,100% of CMS Medicare OPPS rate,8.62,100% of CMS Medicare OPPS rate,N/A,Not Applicable,50.4,90% of total billed charges,11.37,105% of GA Medicaid Rate,37.67,67.275% of total billed charges,44.8,80% of total billed charges,8.71,38.38% of total billed charges,44.8,80% of total billed charges,34.57,61.74% of total billed charges,11.05,102% of GA Medicaid Rate,8.62,100% of CMS Medicare OPPS rate,8.62,50.4,42
Outpatient Medical Services,LABORATORY,87077,Test of a wound for type of bacterial infection,306,53,41.34,78% of Total Billed charges,10.16,100% of GA Medicaid Rate,N/A,Not Applicable,8.08,100% of CMS Medicare OPPS rate,8.08,100% of CMS Medicare OPPS rate,N/A,Not Applicable,47.7,90% of total billed charges,10.67,105% of GA Medicaid Rate,35.66,67.275% of total billed charges,42.4,80% of total billed charges,8.16,38.38% of total billed charges,42.4,80% of total billed charges,32.72,61.74% of total billed charges,10.36,102% of GA Medicaid Rate,8.08,100% of CMS Medicare OPPS rate,8.08,47.7,39.75
Outpatient Medical Services,LABORATORY,87081,Medical test to find an infection,306,20,15.6,78% of Total Billed charges,8.33,100% of GA Medicaid Rate,N/A,Not Applicable,6.63,100% of CMS Medicare OPPS rate,6.63,100% of CMS Medicare OPPS rate,N/A,Not Applicable,18,90% of total billed charges,8.75,105% of GA Medicaid Rate,13.46,67.275% of total billed charges,16,80% of total billed charges,6.7,38.38% of total billed charges,16,80% of total billed charges,12.35,61.74% of total billed charges,8.5,102% of GA Medicaid Rate,6.63,100% of CMS Medicare OPPS rate,6.63,18,15
Outpatient Medical Services,LABORATORY,87088,Culture of the urine to determine bacterial infection,306,123,95.94,78% of Total Billed charges,10.18,100% of GA Medicaid Rate,N/A,Not Applicable,8.09,100% of CMS Medicare OPPS rate,8.09,100% of CMS Medicare OPPS rate,N/A,Not Applicable,110.7,90% of total billed charges,10.69,105% of GA Medicaid Rate,82.75,67.275% of total billed charges,98.4,80% of total billed charges,8.17,38.38% of total billed charges,98.4,80% of total billed charges,75.94,61.74% of total billed charges,10.38,102% of GA Medicaid Rate,8.09,100% of CMS Medicare OPPS rate,8.09,110.7,92.25
Outpatient Medical Services,LABORATORY,87177,OVA & PARASITE,306,136,106.08,78% of Total Billed charges,11.19,100% of GA Medicaid Rate,N/A,Not Applicable,8.9,100% of CMS Medicare OPPS rate,8.9,100% of CMS Medicare OPPS rate,N/A,Not Applicable,122.4,90% of total billed charges,11.75,105% of GA Medicaid Rate,91.49,67.275% of total billed charges,108.8,80% of total billed charges,8.99,38.38% of total billed charges,108.8,80% of total billed charges,83.97,61.74% of total billed charges,11.41,102% of GA Medicaid Rate,8.9,100% of CMS Medicare OPPS rate,8.9,122.4,102
Outpatient Medical Services,LABORATORY,87186,A test used to determine which medications work on bacteria for fungi,306,56,43.68,78% of Total Billed charges,10.87,100% of GA Medicaid Rate,N/A,Not Applicable,8.65,100% of CMS Medicare OPPS rate,8.65,100% of CMS Medicare OPPS rate,N/A,Not Applicable,50.4,90% of total billed charges,11.41,105% of GA Medicaid Rate,37.67,67.275% of total billed charges,44.8,80% of total billed charges,8.74,38.38% of total billed charges,44.8,80% of total billed charges,34.57,61.74% of total billed charges,11.09,102% of GA Medicaid Rate,8.65,100% of CMS Medicare OPPS rate,8.65,50.4,42
Outpatient Medical Services,LABORATORY,87187,SENSITIVITY EACH ADDITION,306,100,78,78% of Total Billed charges,13.03,100% of GA Medicaid Rate,N/A,Not Applicable,40.17,100% of CMS Medicare OPPS rate,40.17,100% of CMS Medicare OPPS rate,N/A,Not Applicable,90,90% of total billed charges,13.68,105% of GA Medicaid Rate,67.28,67.275% of total billed charges,80,80% of total billed charges,40.57,38.38% of total billed charges,80,80% of total billed charges,61.74,61.74% of total billed charges,13.29,102% of GA Medicaid Rate,40.17,100% of CMS Medicare OPPS rate,13.03,90,75
Outpatient Medical Services,LABORATORY,87205,A lab test used to detect bacteria or fungi in a sample taken from the site of a suspected infection,306,56,43.68,78% of Total Billed charges,2.95,100% of GA Medicaid Rate,N/A,Not Applicable,4.27,100% of CMS Medicare OPPS rate,4.27,100% of CMS Medicare OPPS rate,N/A,Not Applicable,50.4,90% of total billed charges,3.1,105% of GA Medicaid Rate,37.67,67.275% of total billed charges,44.8,80% of total billed charges,4.31,38.38% of total billed charges,44.8,80% of total billed charges,34.57,61.74% of total billed charges,3.01,102% of GA Medicaid Rate,4.27,100% of CMS Medicare OPPS rate,2.95,50.4,42
Outpatient Medical Services,LABORATORY,87324,A test of the stool to diagnose Clostridium difficile (C. diff) infection,306,37,28.86,78% of Total Billed charges,15.08,100% of GA Medicaid Rate,N/A,Not Applicable,11.98,100% of CMS Medicare OPPS rate,11.98,100% of CMS Medicare OPPS rate,N/A,Not Applicable,33.3,90% of total billed charges,15.83,105% of GA Medicaid Rate,24.89,67.275% of total billed charges,29.6,80% of total billed charges,12.1,38.38% of total billed charges,29.6,80% of total billed charges,22.84,61.74% of total billed charges,15.38,102% of GA Medicaid Rate,11.98,100% of CMS Medicare OPPS rate,11.98,33.3,27.75
Outpatient Medical Services,LABORATORY,87338,H PYLORI ANTIGEN STOOL,300,218,170.04,78% of Total Billed charges,18.09,100% of GA Medicaid Rate,N/A,Not Applicable,14.38,100% of CMS Medicare OPPS rate,14.38,100% of CMS Medicare OPPS rate,N/A,Not Applicable,196.2,90% of total billed charges,18.99,105% of GA Medicaid Rate,146.66,67.275% of total billed charges,174.4,80% of total billed charges,14.52,38.38% of total billed charges,174.4,80% of total billed charges,134.59,61.74% of total billed charges,18.45,102% of GA Medicaid Rate,14.38,100% of CMS Medicare OPPS rate,14.38,196.2,163.5
Outpatient Medical Services,LABORATORY,87340,HEPATITIS B SURF AG,306,112,87.36,78% of Total Billed charges,12.99,100% of GA Medicaid Rate,N/A,Not Applicable,10.33,100% of CMS Medicare OPPS rate,10.33,100% of CMS Medicare OPPS rate,N/A,Not Applicable,100.8,90% of total billed charges,13.64,105% of GA Medicaid Rate,75.35,67.275% of total billed charges,89.6,80% of total billed charges,10.43,38.38% of total billed charges,89.6,80% of total billed charges,69.15,61.74% of total billed charges,13.25,102% of GA Medicaid Rate,10.33,100% of CMS Medicare OPPS rate,10.33,100.8,84
Outpatient Medical Services,LABORATORY,87426,COVID-19 ANTIGEN (IN-HOUSE),306,200,156,78% of Total Billed charges,36.18,100% of GA Medicaid Rate,N/A,Not Applicable,35.33,100% of CMS Medicare OPPS rate,35.33,100% of CMS Medicare OPPS rate,N/A,Not Applicable,180,90% of total billed charges,37.99,105% of GA Medicaid Rate,134.55,67.275% of total billed charges,160,80% of total billed charges,35.68,38.38% of total billed charges,160,80% of total billed charges,123.48,61.74% of total billed charges,36.9,102% of GA Medicaid Rate,35.33,100% of CMS Medicare OPPS rate,35.33,180,150
Outpatient Medical Services,LABORATORY,87449,FLU SCREEN A & B,306,83,64.74,78% of Total Billed charges,15.08,100% of GA Medicaid Rate,N/A,Not Applicable,11.98,100% of CMS Medicare OPPS rate,11.98,100% of CMS Medicare OPPS rate,N/A,Not Applicable,74.7,90% of total billed charges,15.83,105% of GA Medicaid Rate,55.84,67.275% of total billed charges,66.4,80% of total billed charges,12.1,38.38% of total billed charges,66.4,80% of total billed charges,51.24,61.74% of total billed charges,15.38,102% of GA Medicaid Rate,11.98,100% of CMS Medicare OPPS rate,11.98,74.7,62.25
Outpatient Medical Services,LABORATORY,87486,CHLAM PNEUMONIA,306,100,78,78% of Total Billed charges,24.67,100% of GA Medicaid Rate,N/A,Not Applicable,35.09,100% of CMS Medicare OPPS rate,35.09,100% of CMS Medicare OPPS rate,N/A,Not Applicable,90,90% of total billed charges,25.9,105% of GA Medicaid Rate,67.28,67.275% of total billed charges,80,80% of total billed charges,35.44,38.38% of total billed charges,80,80% of total billed charges,61.74,61.74% of total billed charges,25.16,102% of GA Medicaid Rate,35.09,100% of CMS Medicare OPPS rate,24.67,90,75
Outpatient Medical Services,LABORATORY,87491,Test that detects Chlamydia,306,84,65.52,78% of Total Billed charges,24.67,100% of GA Medicaid Rate,N/A,Not Applicable,35.09,100% of CMS Medicare OPPS rate,35.09,100% of CMS Medicare OPPS rate,N/A,Not Applicable,75.6,90% of total billed charges,25.9,105% of GA Medicaid Rate,56.51,67.275% of total billed charges,67.2,80% of total billed charges,35.44,38.38% of total billed charges,67.2,80% of total billed charges,51.86,61.74% of total billed charges,25.16,102% of GA Medicaid Rate,35.09,100% of CMS Medicare OPPS rate,24.67,75.6,63
Outpatient Medical Services,LABORATORY,87581,MYCOPLASMA PNEUMONIA,306,100,78,78% of Total Billed charges,24.67,100% of GA Medicaid Rate,N/A,Not Applicable,35.09,100% of CMS Medicare OPPS rate,35.09,100% of CMS Medicare OPPS rate,N/A,Not Applicable,90,90% of total billed charges,25.9,105% of GA Medicaid Rate,67.28,67.275% of total billed charges,80,80% of total billed charges,35.44,38.38% of total billed charges,80,80% of total billed charges,61.74,61.74% of total billed charges,25.16,102% of GA Medicaid Rate,35.09,100% of CMS Medicare OPPS rate,24.67,90,75
Outpatient Medical Services,LABORATORY,87591,Blood test for an STD,306,84,65.52,78% of Total Billed charges,21.42,100% of GA Medicaid Rate,N/A,Not Applicable,35.09,100% of CMS Medicare OPPS rate,35.09,100% of CMS Medicare OPPS rate,N/A,Not Applicable,75.6,90% of total billed charges,22.49,105% of GA Medicaid Rate,56.51,67.275% of total billed charges,67.2,80% of total billed charges,35.44,38.38% of total billed charges,67.2,80% of total billed charges,51.86,61.74% of total billed charges,21.85,102% of GA Medicaid Rate,35.09,100% of CMS Medicare OPPS rate,21.42,75.6,63
Outpatient Medical Services,LABORATORY,87633,RESP VIRUS MULTIBE TYPES 12-25,306,1200,936,78% of Total Billed charges,193.9,100% of GA Medicaid Rate,N/A,Not Applicable,416.78,100% of CMS Medicare OPPS rate,416.78,100% of CMS Medicare OPPS rate,N/A,Not Applicable,1080,90% of total billed charges,203.6,105% of GA Medicaid Rate,807.3,67.275% of total billed charges,960,80% of total billed charges,420.95,38.38% of total billed charges,960,80% of total billed charges,740.88,61.74% of total billed charges,197.78,102% of GA Medicaid Rate,416.78,100% of CMS Medicare OPPS rate,193.9,1080,900
Outpatient Medical Services,LABORATORY,87635,COVID-19 PCR (SEND OUT),306,200,156,78% of Total Billed charges,51.31,100% of GA Medicaid Rate,N/A,Not Applicable,51.31,100% of CMS Medicare OPPS rate,51.31,100% of CMS Medicare OPPS rate,N/A,Not Applicable,180,90% of total billed charges,53.88,105% of GA Medicaid Rate,134.55,67.275% of total billed charges,160,80% of total billed charges,51.82,38.38% of total billed charges,160,80% of total billed charges,123.48,61.74% of total billed charges,52.34,102% of GA Medicaid Rate,51.31,100% of CMS Medicare OPPS rate,51.31,180,150
Outpatient Medical Services,LABORATORY,87798,"B PERTUSSIS/PARA,DNA,QL",302,214,166.92,78% of Total Billed charges,24.67,100% of GA Medicaid Rate,N/A,Not Applicable,35.09,100% of CMS Medicare OPPS rate,35.09,100% of CMS Medicare OPPS rate,N/A,Not Applicable,192.6,90% of total billed charges,25.9,105% of GA Medicaid Rate,143.97,67.275% of total billed charges,171.2,80% of total billed charges,35.44,38.38% of total billed charges,171.2,80% of total billed charges,132.12,61.74% of total billed charges,25.16,102% of GA Medicaid Rate,35.09,100% of CMS Medicare OPPS rate,24.67,192.6,160.5
Outpatient Medical Services,LABORATORY,87807,Test for RSV,306,130,101.4,78% of Total Billed charges,15.08,100% of GA Medicaid Rate,N/A,Not Applicable,13.1,100% of CMS Medicare OPPS rate,13.1,100% of CMS Medicare OPPS rate,N/A,Not Applicable,117,90% of total billed charges,15.83,105% of GA Medicaid Rate,87.46,67.275% of total billed charges,104,80% of total billed charges,13.23,38.38% of total billed charges,104,80% of total billed charges,80.26,61.74% of total billed charges,15.38,102% of GA Medicaid Rate,13.1,100% of CMS Medicare OPPS rate,13.1,117,97.5
Outpatient Medical Services,LABORATORY,89051,"CELL COUNT,FLUID",309,41,31.98,78% of Total Billed charges,2.21,100% of GA Medicaid Rate,N/A,Not Applicable,5.6,100% of CMS Medicare OPPS rate,5.6,100% of CMS Medicare OPPS rate,N/A,Not Applicable,36.9,90% of total billed charges,2.32,105% of GA Medicaid Rate,27.58,67.275% of total billed charges,32.8,80% of total billed charges,5.66,38.38% of total billed charges,32.8,80% of total billed charges,25.31,61.74% of total billed charges,2.25,102% of GA Medicaid Rate,5.6,100% of CMS Medicare OPPS rate,2.21,36.9,30.75
Outpatient Medical Services,LABORATORY,89060,CRYSTAL ID FLUID,309,111,86.58,78% of Total Billed charges,8.99,100% of GA Medicaid Rate,N/A,Not Applicable,7.33,100% of CMS Medicare OPPS rate,7.33,100% of CMS Medicare OPPS rate,N/A,Not Applicable,99.9,90% of total billed charges,9.44,105% of GA Medicaid Rate,74.68,67.275% of total billed charges,88.8,80% of total billed charges,7.4,38.38% of total billed charges,88.8,80% of total billed charges,68.53,61.74% of total billed charges,9.17,102% of GA Medicaid Rate,7.33,100% of CMS Medicare OPPS rate,7.33,99.9,83.25
Outpatient Medical Services,LABORATORY,90460,Immunization administration in children <18,450,48,37.44,78% of Total Billed charges,30.24,63% of total billed charges,N/A,Not Applicable,18.24,38% of total billed charges,18.24,38% of total billed charges,N/A,Not Applicable,43.2,90% of total billed charges,16.8,35% of total billed charges,32.29,67.275% of total billed charges,38.4,80% of total billed charges,18.42,38.38% of total billed charges,38.4,80% of total billed charges,29.64,61.74% of total billed charges,48.96,102% of percent of total billed charges,18.24,38% of total billed charges,16.8,48.96,36
Outpatient Medical Services,LABORATORY,G0103,Prostate cancer screening; prostate specific antigen test (psa),301,57,44.46,78% of Total Billed charges,25.7,100% of GA Medicaid Rate,N/A,Not Applicable,19.31,100% of CMS Medicare OPPS rate,19.31,100% of CMS Medicare OPPS rate,N/A,Not Applicable,51.3,90% of total billed charges,26.99,105% of GA Medicaid Rate,38.35,67.275% of total billed charges,45.6,80% of total billed charges,19.5,38.38% of total billed charges,45.6,80% of total billed charges,35.19,61.74% of total billed charges,26.21,102% of GA Medicaid Rate,19.31,100% of CMS Medicare OPPS rate,19.31,51.3,42.75
Outpatient Medical Services,LABORATORY,P9016,BB RBC LEUK REDU,390,387,301.86,78% of Total Billed charges,243.81,63% of total billed charges,N/A,Not Applicable,147.06,38% of total billed charges,147.06,38% of total billed charges,N/A,Not Applicable,348.3,90% of total billed charges,135.45,35% of total billed charges,260.35,67.275% of total billed charges,309.6,80% of total billed charges,148.53,38.38% of total billed charges,309.6,80% of total billed charges,238.93,61.74% of total billed charges,394.74,102% of percent of total billed charges,147.06,38% of total billed charges,135.45,394.74,290.25
Outpatient Medical Services,LABORATORY,P9017,BB FFP EA UNIT,390,380,296.4,78% of Total Billed charges,239.4,63% of total billed charges,N/A,Not Applicable,144.4,38% of total billed charges,144.4,38% of total billed charges,N/A,Not Applicable,342,90% of total billed charges,133,35% of total billed charges,255.65,67.275% of total billed charges,304,80% of total billed charges,145.84,38.38% of total billed charges,304,80% of total billed charges,234.61,61.74% of total billed charges,387.6,102% of percent of total billed charges,144.4,38% of total billed charges,133,387.6,285
Outpatient Medical Services,OUTPATIENT PROCEDURES,10060,Incision and drainage of abscess; simple or single and complex or multiple,360,1129.97,881.38,78% of Total Billed charges,711.88,63% of total billed charges,N/A,Not Applicable,429.39,38% of total billed charges,429.39,38% of total billed charges,N/A,Not Applicable,1016.97,90% of total billed charges,395.49,35% of total billed charges,760.19,67.275% of total billed charges,903.98,80% of total billed charges,433.68,38.38% of total billed charges,903.98,80% of total billed charges,697.64,61.74% of total billed charges,1152.57,102% of percent of total billed charges,429.39,38% of total billed charges,395.49,1152.57,847.4775
Outpatient Medical Services,OUTPATIENT PROCEDURES,10120,Needle Aspiration,360,2162.67,1686.88,78% of Total Billed charges,1362.48,63% of total billed charges,N/A,Not Applicable,821.81,38% of total billed charges,821.81,38% of total billed charges,N/A,Not Applicable,1946.4,90% of total billed charges,756.93,35% of total billed charges,1454.94,67.275% of total billed charges,1730.14,80% of total billed charges,830.03,38.38% of total billed charges,1730.14,80% of total billed charges,1335.23,61.74% of total billed charges,2205.92,102% of percent of total billed charges,821.81,38% of total billed charges,756.93,2205.92,1622.0025
Outpatient Medical Services,OUTPATIENT PROCEDURES,11730,Separation and removal of the entire nail plate or a portion of nail plate,360,877.88,684.75,78% of Total Billed charges,553.06,63% of total billed charges,N/A,Not Applicable,333.59,38% of total billed charges,333.59,38% of total billed charges,N/A,Not Applicable,790.09,90% of total billed charges,307.26,35% of total billed charges,590.59,67.275% of total billed charges,702.3,80% of total billed charges,336.93,38.38% of total billed charges,702.3,80% of total billed charges,542,61.74% of total billed charges,895.44,102% of percent of total billed charges,333.59,38% of total billed charges,307.26,895.44,658.41
Outpatient Medical Services,OUTPATIENT PROCEDURES,12001,"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities",360,1415.31,1103.94,78% of Total Billed charges,891.65,63% of total billed charges,N/A,Not Applicable,537.82,38% of total billed charges,537.82,38% of total billed charges,N/A,Not Applicable,1273.78,90% of total billed charges,495.36,35% of total billed charges,952.15,67.275% of total billed charges,1132.25,80% of total billed charges,543.2,38.38% of total billed charges,1132.25,80% of total billed charges,873.81,61.74% of total billed charges,1443.62,102% of percent of total billed charges,537.82,38% of total billed charges,495.36,1443.62,1061.4825
Outpatient Medical Services,OUTPATIENT PROCEDURES,12002,Simple repair of wound 2.6 cm - 7.5 cm,360,1578.6,1231.31,78% of Total Billed charges,994.52,63% of total billed charges,N/A,Not Applicable,599.87,38% of total billed charges,599.87,38% of total billed charges,N/A,Not Applicable,1420.74,90% of total billed charges,552.51,35% of total billed charges,1062,67.275% of total billed charges,1262.88,80% of total billed charges,605.87,38.38% of total billed charges,1262.88,80% of total billed charges,974.63,61.74% of total billed charges,1610.17,102% of percent of total billed charges,599.87,38% of total billed charges,552.51,1610.17,1183.95
Outpatient Medical Services,OUTPATIENT PROCEDURES,12004,Simple repair of wound 7.6 cm - 12.5 cm,360,1764.47,1376.29,78% of Total Billed charges,1111.62,63% of total billed charges,N/A,Not Applicable,670.5,38% of total billed charges,670.5,38% of total billed charges,N/A,Not Applicable,1588.02,90% of total billed charges,617.56,35% of total billed charges,1187.05,67.275% of total billed charges,1411.58,80% of total billed charges,677.2,38.38% of total billed charges,1411.58,80% of total billed charges,1089.38,61.74% of total billed charges,1799.76,102% of percent of total billed charges,670.5,38% of total billed charges,617.56,1799.76,1323.3525
Outpatient Medical Services,OUTPATIENT PROCEDURES,12011,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes",360,1808.74,1410.82,78% of Total Billed charges,1139.51,63% of total billed charges,N/A,Not Applicable,687.32,38% of total billed charges,687.32,38% of total billed charges,N/A,Not Applicable,1627.87,90% of total billed charges,633.06,35% of total billed charges,1216.83,67.275% of total billed charges,1446.99,80% of total billed charges,694.19,38.38% of total billed charges,1446.99,80% of total billed charges,1116.72,61.74% of total billed charges,1844.91,102% of percent of total billed charges,687.32,38% of total billed charges,633.06,1844.91,1356.555
Outpatient Medical Services,OUTPATIENT PROCEDURES,12013,Laceration repaiir,360,1451.89,1132.47,78% of Total Billed charges,914.69,63% of total billed charges,N/A,Not Applicable,551.72,38% of total billed charges,551.72,38% of total billed charges,N/A,Not Applicable,1306.7,90% of total billed charges,508.16,35% of total billed charges,976.76,67.275% of total billed charges,1161.51,80% of total billed charges,557.24,38.38% of total billed charges,1161.51,80% of total billed charges,896.4,61.74% of total billed charges,1480.93,102% of percent of total billed charges,551.72,38% of total billed charges,508.16,1480.93,1088.9175
Outpatient Medical Services,OUTPATIENT PROCEDURES,23650,Treatment of fracture or dislocation Ulnar,360,5025.59,3919.96,78% of Total Billed charges,3166.12,63% of total billed charges,N/A,Not Applicable,1909.72,38% of total billed charges,1909.72,38% of total billed charges,N/A,Not Applicable,4523.03,90% of total billed charges,1758.96,35% of total billed charges,3380.97,67.275% of total billed charges,4020.47,80% of total billed charges,1928.82,38.38% of total billed charges,4020.47,80% of total billed charges,3102.8,61.74% of total billed charges,5126.1,102% of percent of total billed charges,1909.72,38% of total billed charges,1758.96,5126.1,3769.1925
Outpatient Medical Services,OUTPATIENT PROCEDURES,24300,Surgical procedure of upper arm,360,1041,811.98,78% of Total Billed charges,655.83,63% of total billed charges,N/A,Not Applicable,395.58,38% of total billed charges,395.58,38% of total billed charges,N/A,Not Applicable,936.9,90% of total billed charges,364.35,35% of total billed charges,700.33,67.275% of total billed charges,832.8,80% of total billed charges,399.54,38.38% of total billed charges,832.8,80% of total billed charges,642.71,61.74% of total billed charges,1061.82,102% of percent of total billed charges,395.58,38% of total billed charges,364.35,1061.82,780.75
Outpatient Medical Services,OUTPATIENT PROCEDURES,25605,Treatment of distal radial fracture,360,3499.55,2729.65,78% of Total Billed charges,2204.72,63% of total billed charges,N/A,Not Applicable,1329.83,38% of total billed charges,1329.83,38% of total billed charges,N/A,Not Applicable,3149.6,90% of total billed charges,1224.84,35% of total billed charges,2354.32,67.275% of total billed charges,2799.64,80% of total billed charges,1343.13,38.38% of total billed charges,2799.64,80% of total billed charges,2160.62,61.74% of total billed charges,3569.54,102% of percent of total billed charges,1329.83,38% of total billed charges,1224.84,3569.54,2624.6625
Outpatient Medical Services,OUTPATIENT PROCEDURES,26770,Treatment of hand or finger(s) fracture,360,5547.57,4327.1,78% of Total Billed charges,3494.97,63% of total billed charges,N/A,Not Applicable,2108.08,38% of total billed charges,2108.08,38% of total billed charges,N/A,Not Applicable,4992.81,90% of total billed charges,1941.65,35% of total billed charges,3732.13,67.275% of total billed charges,4438.06,80% of total billed charges,2129.16,38.38% of total billed charges,4438.06,80% of total billed charges,3425.07,61.74% of total billed charges,5658.52,102% of percent of total billed charges,2108.08,38% of total billed charges,1941.65,5658.52,4160.6775
Outpatient Medical Services,OUTPATIENT PROCEDURES,31720,Nasopharyngeal Aspiration,360,5325.82,4154.14,78% of Total Billed charges,3355.27,63% of total billed charges,N/A,Not Applicable,2023.81,38% of total billed charges,2023.81,38% of total billed charges,N/A,Not Applicable,4793.24,90% of total billed charges,1864.04,35% of total billed charges,3582.95,67.275% of total billed charges,4260.66,80% of total billed charges,2044.05,38.38% of total billed charges,4260.66,80% of total billed charges,3288.16,61.74% of total billed charges,5432.34,102% of percent of total billed charges,2023.81,38% of total billed charges,1864.04,5432.34,3994.365
Outpatient Medical Services,OUTPATIENT PROCEDURES,36430,Blood or blood component transfusion,360,17053.64,13301.84,78% of Total Billed charges,10743.79,63% of total billed charges,N/A,Not Applicable,6480.38,38% of total billed charges,6480.38,38% of total billed charges,N/A,Not Applicable,15348.28,90% of total billed charges,5968.77,35% of total billed charges,11472.84,67.275% of total billed charges,13642.91,80% of total billed charges,6545.19,38.38% of total billed charges,13642.91,80% of total billed charges,10528.92,61.74% of total billed charges,17394.71,102% of percent of total billed charges,6480.38,38% of total billed charges,5968.77,17394.71,12790.23
Outpatient Medical Services,OUTPATIENT PROCEDURES,36556,Catheter central venous insertion,360,5414.07,4222.97,78% of Total Billed charges,3410.86,63% of total billed charges,N/A,Not Applicable,2057.35,38% of total billed charges,2057.35,38% of total billed charges,N/A,Not Applicable,4872.66,90% of total billed charges,1894.92,35% of total billed charges,3642.32,67.275% of total billed charges,4331.26,80% of total billed charges,2077.92,38.38% of total billed charges,4331.26,80% of total billed charges,3342.65,61.74% of total billed charges,5522.35,102% of percent of total billed charges,2057.35,38% of total billed charges,1894.92,5522.35,4060.5525
Outpatient Medical Services,OUTPATIENT PROCEDURES,36600,Arterial procedure,360,4300.45,3354.35,78% of Total Billed charges,2709.28,63% of total billed charges,N/A,Not Applicable,1634.17,38% of total billed charges,1634.17,38% of total billed charges,N/A,Not Applicable,3870.41,90% of total billed charges,1505.16,35% of total billed charges,2893.13,67.275% of total billed charges,3440.36,80% of total billed charges,1650.51,38.38% of total billed charges,3440.36,80% of total billed charges,2655.1,61.74% of total billed charges,4386.46,102% of percent of total billed charges,1634.17,38% of total billed charges,1505.16,4386.46,3225.3375
Outpatient Medical Services,OUTPATIENT PROCEDURES,51702,"Bladder cathether, temporary",360,6077.45,4740.41,78% of Total Billed charges,3828.79,63% of total billed charges,N/A,Not Applicable,2309.43,38% of total billed charges,2309.43,38% of total billed charges,N/A,Not Applicable,5469.71,90% of total billed charges,2127.11,35% of total billed charges,4088.6,67.275% of total billed charges,4861.96,80% of total billed charges,2332.53,38.38% of total billed charges,4861.96,80% of total billed charges,3752.22,61.74% of total billed charges,6199,102% of percent of total billed charges,2309.43,38% of total billed charges,2127.11,6199,4558.0875
Outpatient Medical Services,OUTPATIENT PROCEDURES,51798,Ultrasound of bladder to measure urine capacity,360,1414,1102.92,78% of Total Billed charges,890.82,63% of total billed charges,N/A,Not Applicable,537.32,38% of total billed charges,537.32,38% of total billed charges,N/A,Not Applicable,1272.6,90% of total billed charges,494.9,35% of total billed charges,951.27,67.275% of total billed charges,1131.2,80% of total billed charges,542.69,38.38% of total billed charges,1131.2,80% of total billed charges,873,61.74% of total billed charges,1442.28,102% of percent of total billed charges,537.32,38% of total billed charges,494.9,1442.28,1060.5
Outpatient Medical Services,OUTPATIENT PROCEDURES,62270,Lumbar puncture,360,8094.05,6313.36,78% of Total Billed charges,5099.25,63% of total billed charges,N/A,Not Applicable,3075.74,38% of total billed charges,3075.74,38% of total billed charges,N/A,Not Applicable,7284.65,90% of total billed charges,2832.92,35% of total billed charges,5445.27,67.275% of total billed charges,6475.24,80% of total billed charges,3106.5,38.38% of total billed charges,6475.24,80% of total billed charges,4997.27,61.74% of total billed charges,8255.93,102% of percent of total billed charges,3075.74,38% of total billed charges,2832.92,8255.93,6070.5375
Outpatient Medical Services,OUTPATIENT PROCEDURES,69200,Removal foreign body of the ear,360,1019,794.82,78% of Total Billed charges,641.97,63% of total billed charges,N/A,Not Applicable,387.22,38% of total billed charges,387.22,38% of total billed charges,N/A,Not Applicable,917.1,90% of total billed charges,356.65,35% of total billed charges,685.53,67.275% of total billed charges,815.2,80% of total billed charges,391.09,38.38% of total billed charges,815.2,80% of total billed charges,629.13,61.74% of total billed charges,1039.38,102% of percent of total billed charges,387.22,38% of total billed charges,356.65,1039.38,764.25
Outpatient Medical Services,EVALUATION AND MANAGEMENT,90471,Immunization administration by a medical assistant or nurse,450,122,95.16,78% of Total Billed charges,76.86,63% of total billed charges,N/A,Not Applicable,46.36,38% of total billed charges,46.36,38% of total billed charges,N/A,Not Applicable,109.8,90% of total billed charges,42.7,35% of total billed charges,82.08,67.275% of total billed charges,97.6,80% of total billed charges,46.82,38.38% of total billed charges,97.6,80% of total billed charges,75.32,61.74% of total billed charges,124.44,102% of percent of total billed charges,46.36,38% of total billed charges,42.7,124.44,91.5
Outpatient Medical Services,EVALUATION AND MANAGEMENT,90675,INJECTION RABIES VACCINE IM,450,599,467.22,78% of Total Billed charges,328.55,100% of GA Medicaid Rate,N/A,Not Applicable,227.62,38% of total billed charges,227.62,38% of total billed charges,N/A,Not Applicable,539.1,90% of total billed charges,344.98,105% of GA Medicaid Rate,402.98,67.275% of total billed charges,479.2,80% of total billed charges,229.9,38.38% of total billed charges,479.2,80% of total billed charges,369.82,61.74% of total billed charges,335.12,102% of GA Medicaid Rate,227.62,38% of total billed charges,227.62,539.1,449.25
Outpatient Medical Services,EVALUATION AND MANAGEMENT,93005,EKG,730,118,92.04,78% of Total Billed charges,74.34,63% of total billed charges,N/A,Not Applicable,44.84,38% of total billed charges,44.84,38% of total billed charges,N/A,Not Applicable,106.2,90% of total billed charges,41.3,35% of total billed charges,79.38,67.275% of total billed charges,94.4,80% of total billed charges,45.29,38.38% of total billed charges,94.4,80% of total billed charges,72.85,61.74% of total billed charges,120.36,102% of percent of total billed charges,44.84,38% of total billed charges,41.3,120.36,88.5
Outpatient Medical Services,EVALUATION AND MANAGEMENT,93226,TELEMETRY,731,249,194.22,78% of Total Billed charges,156.87,63% of total billed charges,N/A,Not Applicable,94.62,38% of total billed charges,94.62,38% of total billed charges,N/A,Not Applicable,224.1,90% of total billed charges,87.15,35% of total billed charges,167.51,67.275% of total billed charges,199.2,80% of total billed charges,95.57,38.38% of total billed charges,199.2,80% of total billed charges,153.73,61.74% of total billed charges,253.98,102% of percent of total billed charges,94.62,38% of total billed charges,87.15,253.98,186.75
Outpatient Medical Services,EVALUATION AND MANAGEMENT,93306,"Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function",483,1341,1045.98,78% of Total Billed charges,844.83,63% of total billed charges,N/A,Not Applicable,509.58,38% of total billed charges,509.58,38% of total billed charges,N/A,Not Applicable,1206.9,90% of total billed charges,469.35,35% of total billed charges,902.16,67.275% of total billed charges,1072.8,80% of total billed charges,514.68,38.38% of total billed charges,1072.8,80% of total billed charges,827.93,61.74% of total billed charges,1367.82,102% of percent of total billed charges,509.58,38% of total billed charges,469.35,1367.82,1005.75
Outpatient Medical Services,EVALUATION AND MANAGEMENT,93880,Study of vessels on both sides of the head and neck,921,751,585.78,78% of Total Billed charges,473.13,63% of total billed charges,N/A,Not Applicable,285.38,38% of total billed charges,285.38,38% of total billed charges,N/A,Not Applicable,675.9,90% of total billed charges,262.85,35% of total billed charges,505.24,67.275% of total billed charges,600.8,80% of total billed charges,288.23,38.38% of total billed charges,600.8,80% of total billed charges,463.67,61.74% of total billed charges,766.02,102% of percent of total billed charges,285.38,38% of total billed charges,262.85,766.02,563.25
Outpatient Medical Services,EVALUATION AND MANAGEMENT,93970,Complete bilateral study of the extremities,921,600,468,78% of Total Billed charges,378,63% of total billed charges,N/A,Not Applicable,228,38% of total billed charges,228,38% of total billed charges,N/A,Not Applicable,540,90% of total billed charges,210,35% of total billed charges,403.65,67.275% of total billed charges,480,80% of total billed charges,230.28,38.38% of total billed charges,480,80% of total billed charges,370.44,61.74% of total billed charges,612,102% of percent of total billed charges,228,38% of total billed charges,210,612,450
Outpatient Medical Services,EVALUATION AND MANAGEMENT,93971,One sided or limited bilateral study,921,500,390,78% of Total Billed charges,315,63% of total billed charges,N/A,Not Applicable,190,38% of total billed charges,190,38% of total billed charges,N/A,Not Applicable,450,90% of total billed charges,175,35% of total billed charges,336.38,67.275% of total billed charges,400,80% of total billed charges,191.9,38.38% of total billed charges,400,80% of total billed charges,308.7,61.74% of total billed charges,510,102% of percent of total billed charges,190,38% of total billed charges,175,510,375
Outpatient Medical Services,EVALUATION AND MANAGEMENT,93975,US TESTICU DUPLEX ART/VEN ABD PELV RETRO,921,1520,1185.6,78% of Total Billed charges,957.6,63% of total billed charges,N/A,Not Applicable,577.6,38% of total billed charges,577.6,38% of total billed charges,N/A,Not Applicable,1368,90% of total billed charges,532,35% of total billed charges,1022.58,67.275% of total billed charges,1216,80% of total billed charges,583.38,38.38% of total billed charges,1216,80% of total billed charges,938.45,61.74% of total billed charges,1550.4,102% of percent of total billed charges,577.6,38% of total billed charges,532,1550.4,1140
Outpatient Medical Services,EVALUATION AND MANAGEMENT,94002,"VENTILATOR MGT,INITIAL DAY,INPATIENT",410,969,755.82,78% of Total Billed charges,610.47,63% of total billed charges,N/A,Not Applicable,368.22,38% of total billed charges,368.22,38% of total billed charges,N/A,Not Applicable,872.1,90% of total billed charges,339.15,35% of total billed charges,145.93,Case rate,775.2,80% of total billed charges,371.9,38.38% of total billed charges,775.2,80% of total billed charges,598.26,61.74% of total billed charges,988.38,102% of percent of total billed charges,368.22,38% of total billed charges,145.93,988.38,726.75
Outpatient Medical Services,EVALUATION AND MANAGEMENT,94003,"VENTILATOR MGT, SUBSEQ DAY, INPATIENT",410,969,755.82,78% of Total Billed charges,610.47,63% of total billed charges,N/A,Not Applicable,368.22,38% of total billed charges,368.22,38% of total billed charges,N/A,Not Applicable,872.1,90% of total billed charges,339.15,35% of total billed charges,145.93,Case rate,775.2,80% of total billed charges,371.9,38.38% of total billed charges,775.2,80% of total billed charges,598.26,61.74% of total billed charges,988.38,102% of percent of total billed charges,368.22,38% of total billed charges,145.93,988.38,726.75
Outpatient Medical Services,EVALUATION AND MANAGEMENT,94060,Test to determine if wheezing is present,460,338,263.64,78% of Total Billed charges,212.94,63% of total billed charges,N/A,Not Applicable,128.44,38% of total billed charges,128.44,38% of total billed charges,N/A,Not Applicable,304.2,90% of total billed charges,118.3,35% of total billed charges,227.39,67.275% of total billed charges,270.4,80% of total billed charges,129.72,38.38% of total billed charges,270.4,80% of total billed charges,208.68,61.74% of total billed charges,344.76,102% of percent of total billed charges,128.44,38% of total billed charges,118.3,344.76,253.5
Outpatient Medical Services,EVALUATION AND MANAGEMENT,94640,"UPDRAFT INITIAL, RESP THERAPIST",410,392,305.76,78% of Total Billed charges,246.96,63% of total billed charges,N/A,Not Applicable,148.96,38% of total billed charges,148.96,38% of total billed charges,N/A,Not Applicable,352.8,90% of total billed charges,137.2,35% of total billed charges,145.93,Case rate,313.6,80% of total billed charges,150.45,38.38% of total billed charges,313.6,80% of total billed charges,242.02,61.74% of total billed charges,399.84,102% of percent of total billed charges,148.96,38% of total billed charges,137.2,399.84,294
Outpatient Medical Services,EVALUATION AND MANAGEMENT,94644,"CONTINUOUS INHALAT W/ AERO,MED,FIRST HR",410,245,191.1,78% of Total Billed charges,154.35,63% of total billed charges,N/A,Not Applicable,93.1,38% of total billed charges,93.1,38% of total billed charges,N/A,Not Applicable,220.5,90% of total billed charges,85.75,35% of total billed charges,145.93,Case rate,196,80% of total billed charges,94.03,38.38% of total billed charges,196,80% of total billed charges,151.26,61.74% of total billed charges,249.9,102% of percent of total billed charges,93.1,38% of total billed charges,85.75,249.9,183.75
Outpatient Medical Services,EVALUATION AND MANAGEMENT,94660,BIPAP VENTILATION DAY 2+,410,1678,1308.84,78% of Total Billed charges,1057.14,63% of total billed charges,N/A,Not Applicable,637.64,38% of total billed charges,637.64,38% of total billed charges,N/A,Not Applicable,1510.2,90% of total billed charges,587.3,35% of total billed charges,145.93,Case rate,1342.4,80% of total billed charges,644.02,38.38% of total billed charges,1342.4,80% of total billed charges,1036,61.74% of total billed charges,1711.56,102% of percent of total billed charges,637.64,38% of total billed charges,145.93,1711.56,1258.5
Outpatient Medical Services,EVALUATION AND MANAGEMENT,94760,"PULSE OXIMETRY, SINGLE 02 SAT (OR EAR)",410,7,5.46,78% of Total Billed charges,4.41,63% of total billed charges,N/A,Not Applicable,2.66,38% of total billed charges,2.66,38% of total billed charges,N/A,Not Applicable,6.3,90% of total billed charges,2.45,35% of total billed charges,145.93,Case rate,5.6,80% of total billed charges,2.69,38.38% of total billed charges,5.6,80% of total billed charges,4.32,61.74% of total billed charges,7.14,102% of percent of total billed charges,2.66,38% of total billed charges,2.45,145.93,5.25
Outpatient Medical Services,EVALUATION AND MANAGEMENT,96360,"INFUSION HYDRATION, 31 MIN TO 1 HR",450,402,313.56,78% of Total Billed charges,253.26,63% of total billed charges,N/A,Not Applicable,152.76,38% of total billed charges,152.76,38% of total billed charges,N/A,Not Applicable,361.8,90% of total billed charges,140.7,35% of total billed charges,270.45,67.275% of total billed charges,321.6,80% of total billed charges,154.29,38.38% of total billed charges,321.6,80% of total billed charges,248.19,61.74% of total billed charges,410.04,102% of percent of total billed charges,152.76,38% of total billed charges,140.7,410.04,301.5
Outpatient Medical Services,EVALUATION AND MANAGEMENT,96361,INFUSION HYDRATION EA ADD'L 31 M TO 1 HR,450,102,79.56,78% of Total Billed charges,64.26,63% of total billed charges,N/A,Not Applicable,38.76,38% of total billed charges,38.76,38% of total billed charges,N/A,Not Applicable,91.8,90% of total billed charges,35.7,35% of total billed charges,68.62,67.275% of total billed charges,81.6,80% of total billed charges,39.15,38.38% of total billed charges,81.6,80% of total billed charges,62.97,61.74% of total billed charges,104.04,102% of percent of total billed charges,38.76,38% of total billed charges,35.7,104.04,76.5
Outpatient Medical Services,EVALUATION AND MANAGEMENT,96365,"Intravenous infusion, for therapy, prophylaxis, or diagnosis-initial infusion",450,409,319.02,78% of Total Billed charges,257.67,63% of total billed charges,N/A,Not Applicable,155.42,38% of total billed charges,155.42,38% of total billed charges,N/A,Not Applicable,368.1,90% of total billed charges,143.15,35% of total billed charges,275.15,67.275% of total billed charges,327.2,80% of total billed charges,156.97,38.38% of total billed charges,327.2,80% of total billed charges,252.52,61.74% of total billed charges,417.18,102% of percent of total billed charges,155.42,38% of total billed charges,143.15,417.18,306.75
Outpatient Medical Services,EVALUATION AND MANAGEMENT,96366,"Intravenous infusion, for therapy, prophylaxis, or diagnosis-additional infusions",450,102,79.56,78% of Total Billed charges,64.26,63% of total billed charges,N/A,Not Applicable,38.76,38% of total billed charges,38.76,38% of total billed charges,N/A,Not Applicable,91.8,90% of total billed charges,35.7,35% of total billed charges,68.62,67.275% of total billed charges,81.6,80% of total billed charges,39.15,38.38% of total billed charges,81.6,80% of total billed charges,62.97,61.74% of total billed charges,104.04,102% of percent of total billed charges,38.76,38% of total billed charges,35.7,104.04,76.5
Outpatient Medical Services,EVALUATION AND MANAGEMENT,96367,INFUSION DX SEQUENTIAL TO 1 HR,450,122,95.16,78% of Total Billed charges,76.86,63% of total billed charges,N/A,Not Applicable,46.36,38% of total billed charges,46.36,38% of total billed charges,N/A,Not Applicable,109.8,90% of total billed charges,42.7,35% of total billed charges,82.08,67.275% of total billed charges,97.6,80% of total billed charges,46.82,38.38% of total billed charges,97.6,80% of total billed charges,75.32,61.74% of total billed charges,124.44,102% of percent of total billed charges,46.36,38% of total billed charges,42.7,124.44,91.5
Outpatient Medical Services,EVALUATION AND MANAGEMENT,96368,INFUSION CONCURRENT,450,49,38.22,78% of Total Billed charges,30.87,63% of total billed charges,N/A,Not Applicable,18.62,38% of total billed charges,18.62,38% of total billed charges,N/A,Not Applicable,44.1,90% of total billed charges,17.15,35% of total billed charges,32.96,67.275% of total billed charges,39.2,80% of total billed charges,18.81,38.38% of total billed charges,39.2,80% of total billed charges,30.25,61.74% of total billed charges,49.98,102% of percent of total billed charges,18.62,38% of total billed charges,17.15,49.98,36.75
Outpatient Medical Services,EVALUATION AND MANAGEMENT,96372,INJECTION SC/IM,450,122,95.16,78% of Total Billed charges,76.86,63% of total billed charges,N/A,Not Applicable,46.36,38% of total billed charges,46.36,38% of total billed charges,N/A,Not Applicable,109.8,90% of total billed charges,42.7,35% of total billed charges,82.08,67.275% of total billed charges,97.6,80% of total billed charges,46.82,38.38% of total billed charges,97.6,80% of total billed charges,75.32,61.74% of total billed charges,124.44,102% of percent of total billed charges,46.36,38% of total billed charges,42.7,124.44,91.5
Outpatient Medical Services,EVALUATION AND MANAGEMENT,96374,"Intravenous infusion, for therapy, prophylaxis, or diagnosis-IV push",450,118,92.04,78% of Total Billed charges,74.34,63% of total billed charges,N/A,Not Applicable,44.84,38% of total billed charges,44.84,38% of total billed charges,N/A,Not Applicable,106.2,90% of total billed charges,41.3,35% of total billed charges,79.38,67.275% of total billed charges,94.4,80% of total billed charges,45.29,38.38% of total billed charges,94.4,80% of total billed charges,72.85,61.74% of total billed charges,120.36,102% of percent of total billed charges,44.84,38% of total billed charges,41.3,120.36,88.5
Outpatient Medical Services,EVALUATION AND MANAGEMENT,96375,"Intravenous infusion, for treatment, prophylaxis, or diagnosis-new drug add on",450,153,119.34,78% of Total Billed charges,96.39,63% of total billed charges,N/A,Not Applicable,58.14,38% of total billed charges,58.14,38% of total billed charges,N/A,Not Applicable,137.7,90% of total billed charges,53.55,35% of total billed charges,102.93,67.275% of total billed charges,122.4,80% of total billed charges,58.72,38.38% of total billed charges,122.4,80% of total billed charges,94.46,61.74% of total billed charges,156.06,102% of percent of total billed charges,58.14,38% of total billed charges,53.55,156.06,114.75
Outpatient Medical Services,EVALUATION AND MANAGEMENT,96376,"Intravenous infusion, for treatment, prophylaxis, or diagnosis-same drug add on",450,8,6.24,78% of Total Billed charges,5.04,63% of total billed charges,N/A,Not Applicable,3.04,38% of total billed charges,3.04,38% of total billed charges,N/A,Not Applicable,7.2,90% of total billed charges,2.8,35% of total billed charges,5.38,67.275% of total billed charges,6.4,80% of total billed charges,3.07,38.38% of total billed charges,6.4,80% of total billed charges,4.94,61.74% of total billed charges,8.16,102% of percent of total billed charges,3.04,38% of total billed charges,2.8,8.16,6
Outpatient Medical Services,EVALUATION AND MANAGEMENT,97110,"Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes",420,74,57.72,78% of Total Billed charges,46.62,63% of total billed charges,N/A,Not Applicable,28.12,38% of total billed charges,28.12,38% of total billed charges,N/A,Not Applicable,66.6,90% of total billed charges,25.9,35% of total billed charges,145.93,Case rate,59.2,80% of total billed charges,28.4,38.38% of total billed charges,59.2,80% of total billed charges,45.69,61.74% of total billed charges,75.48,102% of percent of total billed charges,28.12,38% of total billed charges,25.9,145.93,55.5
Outpatient Medical Services,EVALUATION AND MANAGEMENT,97530,"Incorporates the use of multiple parameters, such as balance, strength, and range of motion, for a functional activity",420,97,75.66,78% of Total Billed charges,61.11,63% of total billed charges,N/A,Not Applicable,36.86,38% of total billed charges,36.86,38% of total billed charges,N/A,Not Applicable,87.3,90% of total billed charges,33.95,35% of total billed charges,145.93,Case rate,77.6,80% of total billed charges,37.23,38.38% of total billed charges,77.6,80% of total billed charges,59.89,61.74% of total billed charges,98.94,102% of percent of total billed charges,36.86,38% of total billed charges,33.95,145.93,72.75
Outpatient Medical Services,EVALUATION AND MANAGEMENT,99201,OUTPATIENT VISIT LEVEL 1,510,119,92.82,78% of Total Billed charges,74.97,63% of total billed charges,N/A,Not Applicable,45.22,38% of total billed charges,45.22,38% of total billed charges,N/A,Not Applicable,107.1,90% of total billed charges,41.65,35% of total billed charges,133.52,Case rate,95.2,80% of total billed charges,45.67,38.38% of total billed charges,95.2,80% of total billed charges,73.47,61.74% of total billed charges,121.38,102% of percent of total billed charges,45.22,38% of total billed charges,41.65,133.52,89.25
Outpatient Medical Services,EVALUATION AND MANAGEMENT,99202,"New patient office or other outpatient visit, typically 10 minutes",510,178,138.84,78% of Total Billed charges,112.14,63% of total billed charges,N/A,Not Applicable,67.64,38% of total billed charges,67.64,38% of total billed charges,N/A,Not Applicable,160.2,90% of total billed charges,62.3,35% of total billed charges,133.52,Case rate,142.4,80% of total billed charges,68.32,38.38% of total billed charges,142.4,80% of total billed charges,109.9,61.74% of total billed charges,181.56,102% of percent of total billed charges,67.64,38% of total billed charges,62.3,181.56,133.5
Outpatient Medical Services,EVALUATION AND MANAGEMENT,99203,"New patient office or other outpatient visit, typically 30 min",510,188,146.64,78% of Total Billed charges,118.44,63% of total billed charges,N/A,Not Applicable,71.44,38% of total billed charges,71.44,38% of total billed charges,N/A,Not Applicable,169.2,90% of total billed charges,65.8,35% of total billed charges,133.52,Case rate,150.4,80% of total billed charges,72.15,38.38% of total billed charges,150.4,80% of total billed charges,116.07,61.74% of total billed charges,191.76,102% of percent of total billed charges,71.44,38% of total billed charges,65.8,191.76,141
Outpatient Medical Services,EVALUATION AND MANAGEMENT,99204,"New patient office of other outpatient visit, typically 45 min",510,317,247.26,78% of Total Billed charges,199.71,63% of total billed charges,N/A,Not Applicable,120.46,38% of total billed charges,120.46,38% of total billed charges,N/A,Not Applicable,285.3,90% of total billed charges,110.95,35% of total billed charges,133.52,Case rate,253.6,80% of total billed charges,121.66,38.38% of total billed charges,253.6,80% of total billed charges,195.72,61.74% of total billed charges,323.34,102% of percent of total billed charges,120.46,38% of total billed charges,110.95,323.34,237.75
Outpatient Medical Services,EVALUATION AND MANAGEMENT,99205,"New patient office of other outpatient visit, typically 60 min",510,414,322.92,78% of Total Billed charges,260.82,63% of total billed charges,N/A,Not Applicable,157.32,38% of total billed charges,157.32,38% of total billed charges,N/A,Not Applicable,372.6,90% of total billed charges,144.9,35% of total billed charges,133.52,Case rate,331.2,80% of total billed charges,158.89,38.38% of total billed charges,331.2,80% of total billed charges,255.6,61.74% of total billed charges,422.28,102% of percent of total billed charges,157.32,38% of total billed charges,133.52,422.28,310.5
Outpatient Medical Services,EVALUATION AND MANAGEMENT,99281,ER VISIT LEVEL 1,450,450,351,78% of Total Billed charges,50,Case rate,131,Case rate,171,38% of total billed charges,171,38% of total billed charges,141,Case rate,405,90% of total billed charges,157.5,35% of total billed charges,796.95,Case rate,360,80% of total billed charges,172.71,38.38% of total billed charges,360,80% of total billed charges,277.83,61.74% of total billed charges,459,102% of percent of total billed charges,171,38% of total billed charges,50,796.95,337.5
Outpatient Medical Services,EVALUATION AND MANAGEMENT,99282,ER VISIT LEVEL 2,450,550,429,78% of Total Billed charges,346.5,63% of total billed charges,131,Case rate,209,38% of total billed charges,209,38% of total billed charges,141,Case rate,495,90% of total billed charges,192.5,35% of total billed charges,796.95,Case rate,440,80% of total billed charges,211.09,38.38% of total billed charges,440,80% of total billed charges,339.57,61.74% of total billed charges,561,102% of percent of total billed charges,209,38% of total billed charges,131,796.95,412.5
Outpatient Medical Services,EVALUATION AND MANAGEMENT,99283,"Emergency department visit, moderately severe problem",450,700,546,78% of Total Billed charges,441,63% of total billed charges,375,Case rate,266,38% of total billed charges,266,38% of total billed charges,385,Case rate,630,90% of total billed charges,245,35% of total billed charges,796.95,Case rate,560,80% of total billed charges,268.66,38.38% of total billed charges,560,80% of total billed charges,432.18,61.74% of total billed charges,714,102% of percent of total billed charges,266,38% of total billed charges,245,796.95,525
Outpatient Medical Services,EVALUATION AND MANAGEMENT,99284,"Emergency department visit, problem of high severity",450,850,663,78% of Total Billed charges,535.5,63% of total billed charges,375,Case rate,323,38% of total billed charges,323,38% of total billed charges,385,Case rate,765,90% of total billed charges,297.5,35% of total billed charges,796.95,Case rate,680,80% of total billed charges,326.23,38.38% of total billed charges,680,80% of total billed charges,524.79,61.74% of total billed charges,867,102% of percent of total billed charges,323,38% of total billed charges,297.5,867,637.5
Outpatient Medical Services,EVALUATION AND MANAGEMENT,99285,"Emergency department visit, problem with significant threat to life or function",450,1000,780,78% of Total Billed charges,630,63% of total billed charges,1071.64,Case rate,380,38% of total billed charges,380,38% of total billed charges,1071.2,Case rate,900,90% of total billed charges,350,35% of total billed charges,796.95,Case rate,800,80% of total billed charges,383.8,38.38% of total billed charges,800,80% of total billed charges,617.4,61.74% of total billed charges,1020,102% of percent of total billed charges,380,38% of total billed charges,350,1071.64,750
Outpatient Medical Services,EVALUATION AND MANAGEMENT,99291,ER VISIT CRITICAL CARE,450,1543,1203.54,78% of Total Billed charges,972.09,63% of total billed charges,1071.64,Case rate,586.34,38% of total billed charges,586.34,38% of total billed charges,1071.2,Case rate,1388.7,90% of total billed charges,540.05,35% of total billed charges,796.95,Case rate,1234.4,80% of total billed charges,592.2,38.38% of total billed charges,1234.4,80% of total billed charges,952.65,61.74% of total billed charges,1573.86,102% of percent of total billed charges,586.34,38% of total billed charges,540.05,1573.86,1157.25
Outpatient Medical Services,BEHAVIORAL,90832,"Psychotherapy, 30 minute",900,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,BEHAVIORAL,90834,"Psychotherapy, 45 minutes",900,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,BEHAVIORAL,90837,"Psychotherapy, 60 minutes",900,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,BEHAVIORAL,90846,"Family psychotherapy, not including patient, 50 minutes",900,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,BEHAVIORAL,90847,"Family psychotherapy, including patient, 50 min",900,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,BEHAVIORAL,90853,Group psychotherapy,900,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OFFICE VISIT,99243,"Patient office consultation, typically 40 min",761,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OFFICE VISIT,99244,"Patient office consultation, typically 60 min",761,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OFFICE VISIT,99385,"Initial new patient preventive medicine evaluation, for those ages 18 to 39",761,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OFFICE VISIT,99386,"Initial new patient preventive medicine evaluation, for those ages 40 to 64",761,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,LABORATORY,81002,Automated urinalysis test,300,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,LABORATORY,81003,Prostate specific antigen,300,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,RADIOLOGY,19120,"Removal of 1 or more breast growth, open procedure",360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT PROCEDURES,29826,Shaving of shoulder bone using an endoscope,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT PROCEDURES,29881,Removal of one knee cartilage using an endoscope,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT PROCEDURES,42820,Removal of tonsils and adenoid glands patient younger than age 12,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT PROCEDURES,43235,"Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscop",360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT PROCEDURES,43239,"Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope",360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT PROCEDURES,45378,Diagnostic examination of large bowel using an endoscope,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT PROCEDURES,45380,Biopsy of large bowel using an endoscope,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT PROCEDURES,45385,Removal of polyps or growths of large bowel using an endoscope,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT PROCEDURES,45391,Ultrasound examination of lower large bowel using an endoscope,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT PROCEDURES,47562,Removal of gallbladder using an endoscope,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT PROCEDURES,49505,Repair of groin hernia patient age 5 or older,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT PROCEDURES,55700,Biopsy of prostate gland,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT PROCEDURES,55866,Surgical removal of prostate and surrounding lymph nodes using an endoscope,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT PROCEDURES,59400,"Routine obstetric care for vaginal delivery, including pre-and post-delivery care",720,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT PROCEDURES,59510,"Routine obstetric care for cesarean delivery, including pre-and post-delivery care",720,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT PROCEDURES,59610,Routine obstetric care for vaginal delivery after prior cesarean delivery including pre-and post-delivery care,720,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT PROCEDURES,62323,Injection of substance into spinal canal of lower back or sacrum using imaging guidanc,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT PROCEDURES,62322,Injection of substance into spinal canal of lower back or sacrum using imaging guidanc,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT PROCEDURES,64483,Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT PROCEDURES,66821,Removal of recurring cataract in lens capsule using laser,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT PROCEDURES,66984,Removal of cataract with insertion of lens,360,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,ECCG,93000,"Electrocardiogram, routine, with interpretation and report",730,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,CARDIOLOGY,93452,Insertion of catheter into left heart for diagnosis,480,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Outpatient Medical Services,SLEEP STUDY,95810,Sleep study,920,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Inpatient Medical Services,INPATIENT PROCEDURES,216,Cardiac valve and other major cardiothoracic procedures with cardiac catheterization with major complications or comorbidities,100,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Inpatient Medical Services,INPATIENT PROCEDURES,460,Spinal fusion except cervical without major comorbid conditions or complications,100,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Inpatient Medical Services,INPATIENT PROCEDURES,470,Major joint replacement or reattachment of lower extremity without major comorbid conditions or complications,100,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Inpatient Medical Services,INPATIENT PROCEDURES,473,Cervical spinal fusion without comorbid conditions or major comorbid conditions or complications,100,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A
Inpatient Medical Services,INPATIENT PROCEDURES,743,Uterine and adnexa procedures for non-malignancy without comorbid conditions or major comorbid conditions or complications,100,SERVICE NOT OFFERED,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,Service not offered,N/A,N/A,N/A