Price Transparency

OVERVIEW 

In compliance with the Centers for Medicare and Medicaid Services (CMS), Culberson Hospital is making available to the public a copy of its standard charges known as a “Charge Master,” “Charge Description Master” or “CDM”.

Since payment rates for hospital care provided to insured patients are either negotiated with health plans, set by the federal government for Medicare, or set by state governments for Medicaid enrollees, the payments hospitals receive for patient care do not necessarily reflect the prices reflected in the Charge Master.  A patient’s responsibility may vary depending on the payment plans negotiated with insurance companies as well as the patient’s individual and/or family deductibles and co-payments with their insurance plan.  Additionally, uninsured patients are not generally expected to pay the hospital’s standard charges as reflected in the CDM and may be eligible for financial assistance.

The information provided is based on information we have gathered from contracts with managed care commercial insurance plans.  This is not a guarantee of what you will be charged. Your actual charges may differ from the estimated charges for many reasons, including the seriousness of your medical condition, actual time the procedure takes and the services and supplies that you receive.

The charges listed here are for services from the Hospital.  They do not reflect the charges for physicians (such as surgeon, anesthesiologist, radiologist, pathologist, etc.) who may be involved in providing particular services to a patient. These charges are billed separately from the individual physician/physicians group.

Culberson Hospital shall not be liable for any difference between charges listed in the price lists and the final bill for services.

AVAILABLE FILES 
There are two files regarding the hospital’s CDM for price transparency. 

The CSV file is a comprehensive, machine-readable file that makes public all standard charge information for all hospital items and services.  This can easily be imported into Microsoft Excel or similar software. This file contains the following information: 

  • Charge Code – specific charge code for each item or service
  • Description – description of each item or service
  • Department – department where item or service performed
  • Rev Code – corresponding department’s revenue code for item or service
  • CPT Code – corresponding CPT billing code for item or service (if applicable)
  • Gross Charge – corresponding gross charge for each individual item or service
  • Cash Price – corresponding discounted cash price that applies to each item or service
  • Payer-Specific Negotiated Charge – each column lists the negotiated charge with the name of each specific third-party payer as the column header
  • De-identified minimum negotiated charge that applies to each item or service
  • De-identified maximum negotiated charge that applies to each item or service

The PDF file is a searchable consumer-friendly format of payer-specific negotiated charge information of 300 “shoppable outpatient services” at the hospital.  The file contains the following information: 

  • Charge Code – specific charge code for each item or service
  • Description – description of each item or service
  • Department – department where item or service performed
  • Rev Code – corresponding department’s revenue code for item or service
  • CPT Code – corresponding CPT billing code for item or service (if applicable)
  • Gross Charge – corresponding gross charge for each individual item or service
  • Cash Price – corresponding discounted cash price that applies to each item or service
  • Payer-Specific Negotiated Charge – each column lists the negotiated charge with the name of each specific third-party payer as the column header
  • De-identified minimum negotiated charge that applies to each item or service
  • De-identified maximum negotiated charge that applies to each item or service

QUESTIONS?

If you have further questions about the Culberson Hospital CDM, please contact our hospital business office at (432) 283-2760 or come by and speak to one of our business office representatives.  Thank you for choosing Culberson Hospital for your health care needs! 

Downloadable CDM and Shoppable Services

Charge Description Master

Shoppable Services

Searchable Shoppable Services

Culberson Hospital Shoppable Services as of 7/01/2024

descriptioncode|1code|1|typecode|2code|2|typecode|3code|3|typemodifierssettingdrug_unit_of_measurementdrug_type_of_measurementstandard_charge|grossstandard_charge|discounted_cashstandard_charge|Aetna Commercial|negotiated_dollarstandard_charge|Aetna Commercial|negotiated_percentagestandard_charge|Aetna Commercial|negotiated_algorithmestimated_amount|Aetna Commercialstandard_charge|Aetna Commercial|methodologyadditional_payer_notes|Aetna Commercialstandard_charge|BCBS|Advantage|negotiated_dollarstandard_charge|BCBS|Advantage|negotiated_percentagestandard_charge|BCBS|Advantage|negotiated_algorithmestimated_amount|BCBS|Advantagestandard_charge|BCBS|Advantage|methodologyadditional_payer_notes|BCBS|Advantagestandard_charge|BCBS|HMO|negotiated_dollarstandard_charge|BCBS|HMO|negotiated_percentagestandard_charge|BCBS|HMO|negotiated_algorithmestimated_amount|BCBS|HMOstandard_charge|BCBS|HMO|methodologyadditional_payer_notes|BCBS|HMOstandard_charge|BCBS|PPO|negotiated_dollarstandard_charge|BCBS|PPO|negotiated_percentagestandard_charge|BCBS|PPO|negotiated_algorithmestimated_amount|BCBS|PPOstandard_charge|BCBS|PPO|methodologyadditional_payer_notes|BCBS|PPOstandard_charge|BCBS|Traditional|negotiated_dollarstandard_charge|BCBS|Traditional|negotiated_percentagestandard_charge|BCBS|Traditional|negotiated_algorithmestimated_amount|BCBS|Traditionalstandard_charge|BCBS|Traditional|methodologyadditional_payer_notes|BCBS|Traditionalstandard_charge|CIGNA Commercial|negotiated_dollarstandard_charge|CIGNA Commercial|negotiated_percentagestandard_charge|CIGNA Commercial|negotiated_algorithmestimated_amount|CIGNA Commercialstandard_charge|CIGNA Commercial|methodologyadditional_payer_notes|CIGNA Commercialstandard_charge|Humana Commercial|negotiated_dollarstandard_charge|Humana Commercial|negotiated_percentagestandard_charge|Humana Commercial|negotiated_algorithmestimated_amount|Humana Commercialstandard_charge|Humana Commercial|methodologyadditional_payer_notes|Humana Commercialstandard_charge|Unicare Commercial|negotiated_dollarstandard_charge|Unicare Commercial|negotiated_percentagestandard_charge|Unicare Commercial|negotiated_algorithmestimated_amount|Unicare Commercialstandard_charge|Unicare Commercial|methodologyadditional_payer_notes|Unicare Commercialstandard_charge|United Commercial|negotiated_dollarstandard_charge|United Commercial|negotiated_percentagestandard_charge|United Commercial|negotiated_algorithmestimated_amount|United Commercialstandard_charge|United Commercial|methodologyadditional_payer_notes|United Commercialstandard_charge|minstandard_charge|maxadditional_generic_notes
SWINGBED ROOM & BOARD1200030CDM120RCboth350262.53080.88999999999Percent of total billed charges269.50.77999999999Percent of total billed charges269.50.77999999999Percent of total billed charges3150.9999999999Percent of total billed charges3150.9999999999Percent of total billed charges257.60.736999999999Percent of total billed charges2800.8999999999Percent of total billed charges2800.8999999999Percent of total billed charges2800.8999999999Percent of total billed charges257.6315
SEMI PRIVATE ROOM1200010CDM120RCboth4003003520.88999999999Percent of total billed charges3080.77999999999Percent of total billed charges3080.77999999999Percent of total billed charges3600.9999999999Percent of total billed charges3600.9999999999Percent of total billed charges294.40.736999999999Percent of total billed charges3200.8999999999Percent of total billed charges950999999999Per diem3200.8999999999Percent of total billed charges294.4950
TETANUS TOX 0.5ML INJ2509293CDM90714CPT250RCboth90.4467.8379.590.88999999999Percent of total billed charges69.640.77999999999Percent of total billed charges69.640.77999999999Percent of total billed charges81.40.9999999999Percent of total billed charges81.40.9999999999Percent of total billed charges66.560.736999999999Percent of total billed charges72.350.8999999999Percent of total billed charges72.350.8999999999Percent of total billed charges72.350.8999999999Percent of total billed charges66.5681.4
TDAP 0.5ml SDV#102506063CDM90715CPT250RCboth78.9659.2269.480.88999999999Percent of total billed charges60.80.77999999999Percent of total billed charges60.80.77999999999Percent of total billed charges71.060.9999999999Percent of total billed charges71.060.9999999999Percent of total billed charges58.110.736999999999Percent of total billed charges63.170.8999999999Percent of total billed charges63.170.8999999999Percent of total billed charges63.170.8999999999Percent of total billed charges58.1171.06
HEPATITIS B PER 1 ML25090740CDM90746CPT250RCboth11687102.080.88999999999Percent of total billed charges89.320.77999999999Percent of total billed charges89.320.77999999999Percent of total billed charges104.40.9999999999Percent of total billed charges104.40.9999999999Percent of total billed charges85.380.736999999999Percent of total billed charges92.80.8999999999Percent of total billed charges92.80.8999999999Percent of total billed charges92.80.8999999999Percent of total billed charges85.38104.4
COVID admin Pfizer 3rd dose2500003ACDM0003ACPT250RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
COVID Vaccine Admin 1st dose2500001ACDM0011ACPT250RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
COVID Vaccine Admin 2nd dose2500002ACDM0012ACPT250RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
COVID admin Moderna Booster2500013ACDM0013ACPT250RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
MMRV25090710CDM90710CPT250RCboth141105.75124.080.88999999999Percent of total billed charges108.570.77999999999Percent of total billed charges108.570.77999999999Percent of total billed charges126.90.9999999999Percent of total billed charges126.90.9999999999Percent of total billed charges103.780.736999999999Percent of total billed charges112.80.8999999999Percent of total billed charges112.80.8999999999Percent of total billed charges112.80.8999999999Percent of total billed charges103.78126.9
COVID Vaccine25091300CDM91301CPT250RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
PROTONIX 40MG IV2501118CDMC9113CPT250RCboth12910.560.88999999999Percent of total billed charges9.240.77999999999Percent of total billed charges9.240.77999999999Percent of total billed charges10.80.9999999999Percent of total billed charges10.80.9999999999Percent of total billed charges8.830.736999999999Percent of total billed charges9.60.8999999999Percent of total billed charges9.60.8999999999Percent of total billed charges9.60.8999999999Percent of total billed charges8.8310.8
Ofirmev Vial 1,000mg/100ml2500202CDMJ0131CPT250RCboth111.883.8598.380.88999999999Percent of total billed charges86.090.77999999999Percent of total billed charges86.090.77999999999Percent of total billed charges100.620.9999999999Percent of total billed charges100.620.9999999999Percent of total billed charges82.280.736999999999Percent of total billed charges89.440.8999999999Percent of total billed charges89.440.8999999999Percent of total billed charges89.440.8999999999Percent of total billed charges82.28100.62
ZITHROMAX 500MG IV2502976CDMJ0456CPT250RCboth14.410.812.670.88999999999Percent of total billed charges11.090.77999999999Percent of total billed charges11.090.77999999999Percent of total billed charges12.960.9999999999Percent of total billed charges12.960.9999999999Percent of total billed charges10.60.736999999999Percent of total billed charges11.520.8999999999Percent of total billed charges11.520.8999999999Percent of total billed charges11.520.8999999999Percent of total billed charges10.612.96
BICILLIN CR INJ - 1.2 MU2509038CDMJ0558CPT250RCboth225.8169.35198.70.88999999999Percent of total billed charges173.870.77999999999Percent of total billed charges173.870.77999999999Percent of total billed charges203.220.9999999999Percent of total billed charges203.220.9999999999Percent of total billed charges166.190.736999999999Percent of total billed charges180.640.8999999999Percent of total billed charges180.640.8999999999Percent of total billed charges180.640.8999999999Percent of total billed charges166.19203.22
BICILLIN L-A INJ - 1.2 MU2509040CDMJ0561CPT250RCboth283.26212.45249.270.88999999999Percent of total billed charges218.110.77999999999Percent of total billed charges218.110.77999999999Percent of total billed charges254.930.9999999999Percent of total billed charges254.930.9999999999Percent of total billed charges208.480.736999999999Percent of total billed charges226.610.8999999999Percent of total billed charges226.610.8999999999Percent of total billed charges226.610.8999999999Percent of total billed charges208.48254.93
Cefepime SDV 1gm/20 ml2502077CDMJ0692CPT250RCboth13.6810.2612.040.88999999999Percent of total billed charges10.530.77999999999Percent of total billed charges10.530.77999999999Percent of total billed charges12.310.9999999999Percent of total billed charges12.310.9999999999Percent of total billed charges10.070.736999999999Percent of total billed charges10.940.8999999999Percent of total billed charges10.940.8999999999Percent of total billed charges10.940.8999999999Percent of total billed charges10.0712.31
LISINOPRIL 40MG TAB2509463CDMJ0696CPT250RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
NYSTATIN CREAM 30G PER TUBE2509896CDMJ0696CPT250RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
ROCEPHIN 1GM2509686CDMJ0696CPT250RCboth7.25.46.340.88999999999Percent of total billed charges5.540.77999999999Percent of total billed charges5.540.77999999999Percent of total billed charges6.480.9999999999Percent of total billed charges6.480.9999999999Percent of total billed charges5.30.736999999999Percent of total billed charges5.760.8999999999Percent of total billed charges5.760.8999999999Percent of total billed charges5.760.8999999999Percent of total billed charges5.36.48
ROCEPHIN INJ - PER 250 MG2509688CDMJ0696CPT250RCboth523945.760.88999999999Percent of total billed charges40.040.77999999999Percent of total billed charges40.040.77999999999Percent of total billed charges46.80.9999999999Percent of total billed charges46.80.9999999999Percent of total billed charges38.270.736999999999Percent of total billed charges41.60.8999999999Percent of total billed charges41.60.8999999999Percent of total billed charges41.60.8999999999Percent of total billed charges38.2746.8
CELESTONE SOLUSPAN2501280CDMJ0702CPT250RCboth24.7218.5421.750.88999999999Percent of total billed charges19.030.77999999999Percent of total billed charges19.030.77999999999Percent of total billed charges22.250.9999999999Percent of total billed charges22.250.9999999999Percent of total billed charges18.190.736999999999Percent of total billed charges19.780.8999999999Percent of total billed charges19.780.8999999999Percent of total billed charges19.780.8999999999Percent of total billed charges18.1922.25
CIPRO 400 IV2501198CDMJ0744CPT250RCboth7.085.316.230.88999999999Percent of total billed charges5.450.77999999999Percent of total billed charges5.450.77999999999Percent of total billed charges6.370.9999999999Percent of total billed charges6.370.9999999999Percent of total billed charges5.210.736999999999Percent of total billed charges5.660.8999999999Percent of total billed charges5.660.8999999999Percent of total billed charges5.660.8999999999Percent of total billed charges5.216.37
DEPO ESTRADIOL 1CC2507099CDMJ1000CPT250RCboth50.5437.9144.480.88999999999Percent of total billed charges38.920.77999999999Percent of total billed charges38.920.77999999999Percent of total billed charges45.490.9999999999Percent of total billed charges45.490.9999999999Percent of total billed charges37.20.736999999999Percent of total billed charges40.430.8999999999Percent of total billed charges40.430.8999999999Percent of total billed charges40.430.8999999999Percent of total billed charges37.245.49
DEPO-MED 40MG/ML INJ2509078CDMJ1030CPT250RCboth25.3719.0322.330.88999999999Percent of total billed charges19.530.77999999999Percent of total billed charges19.530.77999999999Percent of total billed charges22.830.9999999999Percent of total billed charges22.830.9999999999Percent of total billed charges18.670.736999999999Percent of total billed charges20.30.8999999999Percent of total billed charges20.30.8999999999Percent of total billed charges20.30.8999999999Percent of total billed charges18.6722.83
DEPO-MED 80MG/ML INJ2509140CDMJ1040CPT250RCboth4130.7536.080.88999999999Percent of total billed charges31.570.77999999999Percent of total billed charges31.570.77999999999Percent of total billed charges36.90.9999999999Percent of total billed charges36.90.9999999999Percent of total billed charges30.180.736999999999Percent of total billed charges32.80.8999999999Percent of total billed charges32.80.8999999999Percent of total billed charges32.80.8999999999Percent of total billed charges30.1836.9
Medroxy Progesterone Acetate 10mg2506988CDMJ1050CPT250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
DEPO PROVERA 150MQ/ML2508965CDMJ1050CPT250RCboth359.61269.71316.460.88999999999Percent of total billed charges276.90.77999999999Percent of total billed charges276.90.77999999999Percent of total billed charges323.650.9999999999Percent of total billed charges323.650.9999999999Percent of total billed charges264.670.736999999999Percent of total billed charges287.690.8999999999Percent of total billed charges287.690.8999999999Percent of total billed charges287.690.8999999999Percent of total billed charges264.67323.65
DEXAMETH 4MG INJ2503330CDMJ1100CPT250RCboth5.764.325.070.88999999999Percent of total billed charges4.440.77999999999Percent of total billed charges4.440.77999999999Percent of total billed charges5.180.9999999999Percent of total billed charges5.180.9999999999Percent of total billed charges4.240.736999999999Percent of total billed charges4.610.8999999999Percent of total billed charges4.610.8999999999Percent of total billed charges4.610.8999999999Percent of total billed charges4.245.18
DILANTIN 250MG/5ML INJ25021211CDMJ1165CPT250RCboth4.343.263.820.88999999999Percent of total billed charges3.340.77999999999Percent of total billed charges3.340.77999999999Percent of total billed charges3.910.9999999999Percent of total billed charges3.910.9999999999Percent of total billed charges3.190.736999999999Percent of total billed charges3.470.8999999999Percent of total billed charges3.470.8999999999Percent of total billed charges3.470.8999999999Percent of total billed charges3.193.91
DILAUDID 1MG INJ2506545CDMJ1170CPT250RCboth8.646.487.60.88999999999Percent of total billed charges6.650.77999999999Percent of total billed charges6.650.77999999999Percent of total billed charges7.780.9999999999Percent of total billed charges7.780.9999999999Percent of total billed charges6.360.736999999999Percent of total billed charges6.910.8999999999Percent of total billed charges6.910.8999999999Percent of total billed charges6.910.8999999999Percent of total billed charges6.367.78
BENADRYL 50MG-1ML INJ2509034CDMJ1200CPT250RCboth2.561.922.250.88999999999Percent of total billed charges1.970.77999999999Percent of total billed charges1.970.77999999999Percent of total billed charges2.30.9999999999Percent of total billed charges2.30.9999999999Percent of total billed charges1.880.736999999999Percent of total billed charges2.050.8999999999Percent of total billed charges2.050.8999999999Percent of total billed charges2.050.8999999999Percent of total billed charges1.882.3
GENTAMICIN 80MG INJ2503310CDMJ1580CPT250RCboth7.755.816.820.88999999999Percent of total billed charges5.970.77999999999Percent of total billed charges5.970.77999999999Percent of total billed charges6.980.9999999999Percent of total billed charges6.980.9999999999Percent of total billed charges5.70.736999999999Percent of total billed charges6.20.8999999999Percent of total billed charges6.20.8999999999Percent of total billed charges6.20.8999999999Percent of total billed charges5.76.98
HALDOL 5MG/ML INJ2509115CDMJ1630CPT250RCboth14.7411.0612.970.88999999999Percent of total billed charges11.350.77999999999Percent of total billed charges11.350.77999999999Percent of total billed charges13.270.9999999999Percent of total billed charges13.270.9999999999Percent of total billed charges10.850.736999999999Percent of total billed charges11.790.8999999999Percent of total billed charges11.790.8999999999Percent of total billed charges11.790.8999999999Percent of total billed charges10.8513.27
HEPARIN 10,000 UNITS2501327CDMJ1644CPT250RCboth107.58.80.88999999999Percent of total billed charges7.70.77999999999Percent of total billed charges7.70.77999999999Percent of total billed charges90.9999999999Percent of total billed charges90.9999999999Percent of total billed charges7.360.736999999999Percent of total billed charges80.8999999999Percent of total billed charges80.8999999999Percent of total billed charges80.8999999999Percent of total billed charges7.369
SOLU-CORTEF 100MG 2ML VIAL2508226CDMJ1720CPT250RCboth32.2424.1828.370.88999999999Percent of total billed charges24.820.77999999999Percent of total billed charges24.820.77999999999Percent of total billed charges29.020.9999999999Percent of total billed charges29.020.9999999999Percent of total billed charges23.730.736999999999Percent of total billed charges25.790.8999999999Percent of total billed charges25.790.8999999999Percent of total billed charges25.790.8999999999Percent of total billed charges23.7329.02
Infed vials 50mg/ml 2ml #102502655CDMJ1750CPT250RCboth66.7750.0858.760.88999999999Percent of total billed charges51.410.77999999999Percent of total billed charges51.410.77999999999Percent of total billed charges60.090.9999999999Percent of total billed charges60.090.9999999999Percent of total billed charges49.140.736999999999Percent of total billed charges53.420.8999999999Percent of total billed charges53.420.8999999999Percent of total billed charges53.420.8999999999Percent of total billed charges49.1460.09
TORADOL INJ - PER 60 MG2506202CDMJ1885CPT250RCboth6.925.196.090.88999999999Percent of total billed charges5.330.77999999999Percent of total billed charges5.330.77999999999Percent of total billed charges6.230.9999999999Percent of total billed charges6.230.9999999999Percent of total billed charges5.090.736999999999Percent of total billed charges5.540.8999999999Percent of total billed charges5.540.8999999999Percent of total billed charges5.540.8999999999Percent of total billed charges5.096.23
TORADOL INJ - PER 30 MG2509330CDMJ1885CPT250RCboth867.040.88999999999Percent of total billed charges6.160.77999999999Percent of total billed charges6.160.77999999999Percent of total billed charges7.20.9999999999Percent of total billed charges7.20.9999999999Percent of total billed charges5.890.736999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges5.897.2
TORADOL INJ - 15 MG90788CDMJ1885CPT250RCboth2115.7518.480.88999999999Percent of total billed charges16.170.77999999999Percent of total billed charges16.170.77999999999Percent of total billed charges18.90.9999999999Percent of total billed charges18.90.9999999999Percent of total billed charges15.460.736999999999Percent of total billed charges16.80.8999999999Percent of total billed charges16.80.8999999999Percent of total billed charges16.80.8999999999Percent of total billed charges15.4618.9
LEVAQUIN 500 MG2503067CDMJ1956CPT250RCboth137102.75120.560.88999999999Percent of total billed charges105.490.77999999999Percent of total billed charges105.490.77999999999Percent of total billed charges123.30.9999999999Percent of total billed charges123.30.9999999999Percent of total billed charges100.830.736999999999Percent of total billed charges109.60.8999999999Percent of total billed charges109.60.8999999999Percent of total billed charges109.60.8999999999Percent of total billed charges100.83123.3
INJ-ATIVAN, 2MG2501052CDMJ2060CPT250RCboth1410.512.320.88999999999Percent of total billed charges10.780.77999999999Percent of total billed charges10.780.77999999999Percent of total billed charges12.60.9999999999Percent of total billed charges12.60.9999999999Percent of total billed charges10.30.736999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges10.312.6
DEMEROL 25MG INJ2501267CDMJ2175CPT250RCboth118.259.680.88999999999Percent of total billed charges8.470.77999999999Percent of total billed charges8.470.77999999999Percent of total billed charges9.90.9999999999Percent of total billed charges9.90.9999999999Percent of total billed charges8.10.736999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.19.9
VERSED 5MG/ML INJ2509725CDMJ2250CPT250RCboth2.922.192.570.88999999999Percent of total billed charges2.250.77999999999Percent of total billed charges2.250.77999999999Percent of total billed charges2.630.9999999999Percent of total billed charges2.630.9999999999Percent of total billed charges2.150.736999999999Percent of total billed charges2.340.8999999999Percent of total billed charges2.340.8999999999Percent of total billed charges2.340.8999999999Percent of total billed charges2.152.63
NARCAN 0.4MG-1ML INJ2509188CDMJ2310CPT250RCboth241821.120.88999999999Percent of total billed charges18.480.77999999999Percent of total billed charges18.480.77999999999Percent of total billed charges21.60.9999999999Percent of total billed charges21.60.9999999999Percent of total billed charges17.660.736999999999Percent of total billed charges19.20.8999999999Percent of total billed charges19.20.8999999999Percent of total billed charges19.20.8999999999Percent of total billed charges17.6621.6
NARCAN 2MG INJ2509187CDMJ2310CPT250RCboth79.259.469.70.88999999999Percent of total billed charges60.980.77999999999Percent of total billed charges60.980.77999999999Percent of total billed charges71.280.9999999999Percent of total billed charges71.280.9999999999Percent of total billed charges58.290.736999999999Percent of total billed charges63.360.8999999999Percent of total billed charges63.360.8999999999Percent of total billed charges63.360.8999999999Percent of total billed charges58.2971.28
ZOFRAN 4MG IV/INJ2501400CDMJ2405CPT250RCboth2.762.072.430.88999999999Percent of total billed charges2.130.77999999999Percent of total billed charges2.130.77999999999Percent of total billed charges2.480.9999999999Percent of total billed charges2.480.9999999999Percent of total billed charges2.030.736999999999Percent of total billed charges2.210.8999999999Percent of total billed charges2.210.8999999999Percent of total billed charges2.210.8999999999Percent of total billed charges2.032.48
ZOSYN 3.375 GM INJ2504560CDMJ2543CPT250RCboth43.5132.6338.290.88999999999Percent of total billed charges33.50.77999999999Percent of total billed charges33.50.77999999999Percent of total billed charges39.160.9999999999Percent of total billed charges39.160.9999999999Percent of total billed charges32.020.736999999999Percent of total billed charges34.810.8999999999Percent of total billed charges34.810.8999999999Percent of total billed charges34.810.8999999999Percent of total billed charges32.0239.16
PHENERGAN INJ 25MG (UP TO 50)2507031CDMJ2550CPT250RCboth8.086.067.110.88999999999Percent of total billed charges6.220.77999999999Percent of total billed charges6.220.77999999999Percent of total billed charges7.270.9999999999Percent of total billed charges7.270.9999999999Percent of total billed charges5.950.736999999999Percent of total billed charges6.460.8999999999Percent of total billed charges6.460.8999999999Percent of total billed charges6.460.8999999999Percent of total billed charges5.957.27
PHENERGAN INJ 12.5MG-UPTO 50MG2507032CDMJ2550CPT250RCboth96.757.920.88999999999Percent of total billed charges6.930.77999999999Percent of total billed charges6.930.77999999999Percent of total billed charges8.10.9999999999Percent of total billed charges8.10.9999999999Percent of total billed charges6.620.736999999999Percent of total billed charges7.20.8999999999Percent of total billed charges7.20.8999999999Percent of total billed charges7.20.8999999999Percent of total billed charges6.628.1
PITOCIN 10U-1ML INJ2509221CDMJ2590CPT250RCboth3.582.693.150.88999999999Percent of total billed charges2.760.77999999999Percent of total billed charges2.760.77999999999Percent of total billed charges3.220.9999999999Percent of total billed charges3.220.9999999999Percent of total billed charges2.630.736999999999Percent of total billed charges2.860.8999999999Percent of total billed charges2.860.8999999999Percent of total billed charges2.860.8999999999Percent of total billed charges2.633.22
REGLAN 10MG/2ML INJ2504017CDMJ2765CPT250RCboth1.3311.170.88999999999Percent of total billed charges1.020.77999999999Percent of total billed charges1.020.77999999999Percent of total billed charges1.20.9999999999Percent of total billed charges1.20.9999999999Percent of total billed charges0.980.736999999999Percent of total billed charges1.060.8999999999Percent of total billed charges1.060.8999999999Percent of total billed charges1.060.8999999999Percent of total billed charges0.981.2
SOLU-MDROL 40MG INJ2509266CDMJ2920CPT250RCboth14.4410.8312.710.88999999999Percent of total billed charges11.120.77999999999Percent of total billed charges11.120.77999999999Percent of total billed charges130.9999999999Percent of total billed charges130.9999999999Percent of total billed charges10.630.736999999999Percent of total billed charges11.550.8999999999Percent of total billed charges11.550.8999999999Percent of total billed charges11.550.8999999999Percent of total billed charges10.6313
SOLU-MEDROL 125MG INJ2509267CDMJ2930CPT250RCboth23.2617.4520.470.88999999999Percent of total billed charges17.910.77999999999Percent of total billed charges17.910.77999999999Percent of total billed charges20.930.9999999999Percent of total billed charges20.930.9999999999Percent of total billed charges17.120.736999999999Percent of total billed charges18.610.8999999999Percent of total billed charges18.610.8999999999Percent of total billed charges18.610.8999999999Percent of total billed charges17.1220.93
ACTIVASE 100MG2501300CDMJ2997CPT250RCboth87796584.257725.520.88999999999Percent of total billed charges6759.830.77999999999Percent of total billed charges6759.830.77999999999Percent of total billed charges7901.10.9999999999Percent of total billed charges7901.10.9999999999Percent of total billed charges6461.340.736999999999Percent of total billed charges7023.20.8999999999Percent of total billed charges7023.20.8999999999Percent of total billed charges7023.20.8999999999Percent of total billed charges6461.347901.1
Fentanyl FTV 0.05mg/ml2509968CDMJ3010CPT250RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
KENALOG INJ-PER 10 MG2509166CDMJ3301CPT250RCboth5.84.355.10.88999999999Percent of total billed charges4.470.77999999999Percent of total billed charges4.470.77999999999Percent of total billed charges5.220.9999999999Percent of total billed charges5.220.9999999999Percent of total billed charges4.270.736999999999Percent of total billed charges4.640.8999999999Percent of total billed charges4.640.8999999999Percent of total billed charges4.640.8999999999Percent of total billed charges4.275.22
CYANOCOBALAMIN 1MG INJ2501076CDMJ3420CPT250RCboth53.754.40.88999999999Percent of total billed charges3.850.77999999999Percent of total billed charges3.850.77999999999Percent of total billed charges4.50.9999999999Percent of total billed charges4.50.9999999999Percent of total billed charges3.680.736999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges3.684.5
Geodon SDV 20mg IM250295CDMJ3486CPT250RCboth89.4367.0778.70.88999999999Percent of total billed charges68.860.77999999999Percent of total billed charges68.860.77999999999Percent of total billed charges80.490.9999999999Percent of total billed charges80.490.9999999999Percent of total billed charges65.820.736999999999Percent of total billed charges71.540.8999999999Percent of total billed charges71.540.8999999999Percent of total billed charges71.540.8999999999Percent of total billed charges65.8280.49
SUPARTZ PFS 25MQ/2.5 ML SINGLE2508694CDMJ7321CPT250RCboth467350.25410.960.88999999999Percent of total billed charges359.590.77999999999Percent of total billed charges359.590.77999999999Percent of total billed charges420.30.9999999999Percent of total billed charges420.30.9999999999Percent of total billed charges343.710.736999999999Percent of total billed charges373.60.8999999999Percent of total billed charges373.60.8999999999Percent of total billed charges373.60.8999999999Percent of total billed charges343.71420.3
SYNVISCONE INJ2508693CDMJ7325CPT250RCboth389.84292.38343.060.88999999999Percent of total billed charges300.180.77999999999Percent of total billed charges300.180.77999999999Percent of total billed charges350.860.9999999999Percent of total billed charges350.860.9999999999Percent of total billed charges286.920.736999999999Percent of total billed charges311.870.8999999999Percent of total billed charges311.870.8999999999Percent of total billed charges311.870.8999999999Percent of total billed charges286.92350.86
ALBUTEROL UNIT DOSE2504725CDMJ7614CPT250RCboth2.461.852.160.88999999999Percent of total billed charges1.890.77999999999Percent of total billed charges1.890.77999999999Percent of total billed charges2.210.9999999999Percent of total billed charges2.210.9999999999Percent of total billed charges1.810.736999999999Percent of total billed charges1.970.8999999999Percent of total billed charges1.970.8999999999Percent of total billed charges1.970.8999999999Percent of total billed charges1.812.21
PULMICORT 0.5 MG2508041CDMJ7626CPT250RCboth22.1616.6219.50.88999999999Percent of total billed charges17.060.77999999999Percent of total billed charges17.060.77999999999Percent of total billed charges19.940.9999999999Percent of total billed charges19.940.9999999999Percent of total billed charges16.310.736999999999Percent of total billed charges17.730.8999999999Percent of total billed charges17.730.8999999999Percent of total billed charges17.730.8999999999Percent of total billed charges16.3119.94
Atrovent .5/2.5ml2500087CDMJ7644CPT250RCboth2.641.982.320.88999999999Percent of total billed charges2.030.77999999999Percent of total billed charges2.030.77999999999Percent of total billed charges2.380.9999999999Percent of total billed charges2.380.9999999999Percent of total billed charges1.940.736999999999Percent of total billed charges2.110.8999999999Percent of total billed charges2.110.8999999999Percent of total billed charges2.110.8999999999Percent of total billed charges1.942.38
ATROVENT INH U/D2501195CDMJ7644CPT250RCboth12910.560.88999999999Percent of total billed charges9.240.77999999999Percent of total billed charges9.240.77999999999Percent of total billed charges10.80.9999999999Percent of total billed charges10.80.9999999999Percent of total billed charges8.830.736999999999Percent of total billed charges9.60.8999999999Percent of total billed charges9.60.8999999999Percent of total billed charges9.60.8999999999Percent of total billed charges8.8310.8
ATROVENT INHALER2501291CDMJ7644CPT250RCboth11687102.080.88999999999Percent of total billed charges89.320.77999999999Percent of total billed charges89.320.77999999999Percent of total billed charges104.40.9999999999Percent of total billed charges104.40.9999999999Percent of total billed charges85.380.736999999999Percent of total billed charges92.80.8999999999Percent of total billed charges92.80.8999999999Percent of total billed charges92.80.8999999999Percent of total billed charges85.38104.4
ZITHROMAX 250MG TAB2509632CDMQ0144CPT250RCboth118.259.680.88999999999Percent of total billed charges8.470.77999999999Percent of total billed charges8.470.77999999999Percent of total billed charges9.90.9999999999Percent of total billed charges9.90.9999999999Percent of total billed charges8.10.736999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.19.9
ZOFRAN 4MG PO2500004CDMS0119CPT250RCboth46.2334.6740.680.88999999999Percent of total billed charges35.60.77999999999Percent of total billed charges35.60.77999999999Percent of total billed charges41.610.9999999999Percent of total billed charges41.610.9999999999Percent of total billed charges34.030.736999999999Percent of total billed charges36.980.8999999999Percent of total billed charges36.980.8999999999Percent of total billed charges36.980.8999999999Percent of total billed charges34.0341.61
ACETAMINOPHEN 325MG TAB2504001CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
ALMACONE2500006CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
AMOXICILLIN 250MG2501276CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
ASPIRIN 325MG2500010CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
ASPIRIN 81MG CHEWABLE25012912CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
ASPIRIN 81MG EC PO25012915CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
BACTRIM DS2501227CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
BENADRYL 25MG PO25080911CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
BENADRYL ORAL LIQUID2500011CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
BENEFIBER POWDER 4GM2500013CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
BISACODYL 5MG TAB2503141CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
BUPROPION 100MG TABS25080912CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
CALCIUM TAB 600MG2500016CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
D5 NS 1000ML2500025CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
DEXAMETHASONE TAB 0.5MG2500028CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
FLOMAX .04 MG CAP2501328CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
FOLIC ACID 1MG TAB2503175CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
GLIPIZIDE 5MG2501205CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
GLUCOPHAGE 500MG TAB2509321CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
hydralazine 10mg2504070CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
HYDROCHLORATHIAZIDE 12.5MG2500045CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
HYDROXYZINE PAMOATE 25MG TAB2500046CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
LABETOLOL 20ML2501241CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
Metoprolol Tartrate 25mg UD #1002503224CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
METRONIDAZOLE INJ 500 MG/100 ML2500067CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
MOM 30 ML2500068CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
MOTRIN 5CC2503137CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
MULTIVITAMIN TAB2500069CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
NoHist DM 473 ml2507896CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
NYSTATIN SUSP 100,000 UNITS2500076CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
NYSTATION 500,000 UNITS/5 ML2500136CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
POTASSIUM CHLORIDE 10% 20MEQ/2509874CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
PREDNISONE 5MG TAB2501221CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
PROPRANOLOL 10 MG2506841CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
Reglan, 10mg tab2504625CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
ROBAFEN DM ORAL SYRUP2500088CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
SIMETHICONE 80MG2509268CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
SODIUM CHLORIDE 10 ML2500127CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
SPIRONOLACTONE 25MG TAB2502029CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
SYNTHROID 50MCG TAB2509634CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
TRAZADONE 50MG2509296CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
Vitamin B1 tab 100mg2504456CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
VITAMIN B-12 TAB 500 MCG2500114CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
VITAMIN C 500MG2501364CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
XANAX .252509595CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
XYLOCAINE 1% EPI INJ2503360CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
XYLOCAINE 1%W/EPI2500137CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
ZANTAC 150MG TAB2508157CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
ZINC 50MG2501365CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
ZOLOFT 50MG TAB2502028CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
Cetirizine 10mg2500150CDM250RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
MUCINEX 600MG TAB2509349CDM250RCboth1.040.780.920.88999999999Percent of total billed charges0.80.77999999999Percent of total billed charges0.80.77999999999Percent of total billed charges0.940.9999999999Percent of total billed charges0.940.9999999999Percent of total billed charges0.770.736999999999Percent of total billed charges0.830.8999999999Percent of total billed charges0.830.8999999999Percent of total billed charges0.830.8999999999Percent of total billed charges0.770.94
GABAPENTIN CAPSULE 100MG2502596CDM250RCboth1.060.80.930.88999999999Percent of total billed charges0.820.77999999999Percent of total billed charges0.820.77999999999Percent of total billed charges0.950.9999999999Percent of total billed charges0.950.9999999999Percent of total billed charges0.780.736999999999Percent of total billed charges0.850.8999999999Percent of total billed charges0.850.8999999999Percent of total billed charges0.850.8999999999Percent of total billed charges0.780.95
HYDRALAZINE TAB 10MG2500044CDM250RCboth1.060.80.930.88999999999Percent of total billed charges0.820.77999999999Percent of total billed charges0.820.77999999999Percent of total billed charges0.950.9999999999Percent of total billed charges0.950.9999999999Percent of total billed charges0.780.736999999999Percent of total billed charges0.850.8999999999Percent of total billed charges0.850.8999999999Percent of total billed charges0.850.8999999999Percent of total billed charges0.780.95
ISOSORBIDE MONO ER TAB 60MG2500048CDM250RCboth1.090.820.960.88999999999Percent of total billed charges0.840.77999999999Percent of total billed charges0.840.77999999999Percent of total billed charges0.980.9999999999Percent of total billed charges0.980.9999999999Percent of total billed charges0.80.736999999999Percent of total billed charges0.870.8999999999Percent of total billed charges0.870.8999999999Percent of total billed charges0.870.8999999999Percent of total billed charges0.80.98
VERAPAMIL 80MG TAB2508188CDM250RCboth1.140.8610.88999999999Percent of total billed charges0.880.77999999999Percent of total billed charges0.880.77999999999Percent of total billed charges1.030.9999999999Percent of total billed charges1.030.9999999999Percent of total billed charges0.840.736999999999Percent of total billed charges0.910.8999999999Percent of total billed charges0.910.8999999999Percent of total billed charges0.910.8999999999Percent of total billed charges0.841.03
COUMADIN 1MG TAB2501323CDM250RCboth1.170.881.030.88999999999Percent of total billed charges0.90.77999999999Percent of total billed charges0.90.77999999999Percent of total billed charges1.050.9999999999Percent of total billed charges1.050.9999999999Percent of total billed charges0.860.736999999999Percent of total billed charges0.940.8999999999Percent of total billed charges0.940.8999999999Percent of total billed charges0.940.8999999999Percent of total billed charges0.861.05
ACETAMINOPHEN 120 MG SUPP2501329CDM250RCboth1.180.891.040.88999999999Percent of total billed charges0.910.77999999999Percent of total billed charges0.910.77999999999Percent of total billed charges1.060.9999999999Percent of total billed charges1.060.9999999999Percent of total billed charges0.870.736999999999Percent of total billed charges0.940.8999999999Percent of total billed charges0.940.8999999999Percent of total billed charges0.940.8999999999Percent of total billed charges0.871.06
AMIODARONE 200MG CAP2502008CDM250RCboth1.180.891.040.88999999999Percent of total billed charges0.910.77999999999Percent of total billed charges0.910.77999999999Percent of total billed charges1.060.9999999999Percent of total billed charges1.060.9999999999Percent of total billed charges0.870.736999999999Percent of total billed charges0.940.8999999999Percent of total billed charges0.940.8999999999Percent of total billed charges0.940.8999999999Percent of total billed charges0.871.06
BENTYL CAP 10MG2500030CDM250RCboth1.190.891.050.88999999999Percent of total billed charges0.920.77999999999Percent of total billed charges0.920.77999999999Percent of total billed charges1.070.9999999999Percent of total billed charges1.070.9999999999Percent of total billed charges0.880.736999999999Percent of total billed charges0.950.8999999999Percent of total billed charges0.950.8999999999Percent of total billed charges0.950.8999999999Percent of total billed charges0.881.07
LIBRIUM CAP 10MG2500053CDM250RCboth1.240.931.090.88999999999Percent of total billed charges0.950.77999999999Percent of total billed charges0.950.77999999999Percent of total billed charges1.120.9999999999Percent of total billed charges1.120.9999999999Percent of total billed charges0.910.736999999999Percent of total billed charges0.990.8999999999Percent of total billed charges0.990.8999999999Percent of total billed charges0.990.8999999999Percent of total billed charges0.911.12
DILANTIN 100MG CAP2501042CDM250RCboth1.280.961.130.88999999999Percent of total billed charges0.990.77999999999Percent of total billed charges0.990.77999999999Percent of total billed charges1.150.9999999999Percent of total billed charges1.150.9999999999Percent of total billed charges0.940.736999999999Percent of total billed charges1.020.8999999999Percent of total billed charges1.020.8999999999Percent of total billed charges1.020.8999999999Percent of total billed charges0.941.15
NORMAL SALINE FLUSH 10 ML2500073CDM250RCboth1.341.011.180.88999999999Percent of total billed charges1.030.77999999999Percent of total billed charges1.030.77999999999Percent of total billed charges1.210.9999999999Percent of total billed charges1.210.9999999999Percent of total billed charges0.990.736999999999Percent of total billed charges1.070.8999999999Percent of total billed charges1.070.8999999999Percent of total billed charges1.070.8999999999Percent of total billed charges0.991.21
CLINDAMYCIN 150MG PO25080910CDM250RCboth1.371.031.210.88999999999Percent of total billed charges1.050.77999999999Percent of total billed charges1.050.77999999999Percent of total billed charges1.230.9999999999Percent of total billed charges1.230.9999999999Percent of total billed charges1.010.736999999999Percent of total billed charges1.10.8999999999Percent of total billed charges1.10.8999999999Percent of total billed charges1.10.8999999999Percent of total billed charges1.011.23
Norco 5/325mg2502645CDM250RCboth1.381.041.210.88999999999Percent of total billed charges1.060.77999999999Percent of total billed charges1.060.77999999999Percent of total billed charges1.240.9999999999Percent of total billed charges1.240.9999999999Percent of total billed charges1.020.736999999999Percent of total billed charges1.10.8999999999Percent of total billed charges1.10.8999999999Percent of total billed charges1.10.8999999999Percent of total billed charges1.021.24
LOMOTIL 2.5MG TAB2503518CDM250RCboth1.41.051.230.88999999999Percent of total billed charges1.080.77999999999Percent of total billed charges1.080.77999999999Percent of total billed charges1.260.9999999999Percent of total billed charges1.260.9999999999Percent of total billed charges1.030.736999999999Percent of total billed charges1.120.8999999999Percent of total billed charges1.120.8999999999Percent of total billed charges1.120.8999999999Percent of total billed charges1.031.26
CEPHALEXIN 250MG2501060CDM250RCboth1.421.071.250.88999999999Percent of total billed charges1.090.77999999999Percent of total billed charges1.090.77999999999Percent of total billed charges1.280.9999999999Percent of total billed charges1.280.9999999999Percent of total billed charges1.050.736999999999Percent of total billed charges1.140.8999999999Percent of total billed charges1.140.8999999999Percent of total billed charges1.140.8999999999Percent of total billed charges1.051.28
Levetiracetam 500mg tabs #1002500203CDM250RCboth1.441.081.270.88999999999Percent of total billed charges1.110.77999999999Percent of total billed charges1.110.77999999999Percent of total billed charges1.30.9999999999Percent of total billed charges1.30.9999999999Percent of total billed charges1.060.736999999999Percent of total billed charges1.150.8999999999Percent of total billed charges1.150.8999999999Percent of total billed charges1.150.8999999999Percent of total billed charges1.061.3
Benzonatate 100mg2504687CDM250RCboth1.461.11.280.88999999999Percent of total billed charges1.120.77999999999Percent of total billed charges1.120.77999999999Percent of total billed charges1.310.9999999999Percent of total billed charges1.310.9999999999Percent of total billed charges1.070.736999999999Percent of total billed charges1.170.8999999999Percent of total billed charges1.170.8999999999Percent of total billed charges1.170.8999999999Percent of total billed charges1.071.31
PEPTO BISMOL 30ML2501896CDM250RCboth1.51.131.320.88999999999Percent of total billed charges1.160.77999999999Percent of total billed charges1.160.77999999999Percent of total billed charges1.350.9999999999Percent of total billed charges1.350.9999999999Percent of total billed charges1.10.736999999999Percent of total billed charges1.20.8999999999Percent of total billed charges1.20.8999999999Percent of total billed charges1.20.8999999999Percent of total billed charges1.11.35
NAPROXEN TAB 250 MG2500071CDM250RCboth1.561.171.370.88999999999Percent of total billed charges1.20.77999999999Percent of total billed charges1.20.77999999999Percent of total billed charges1.40.9999999999Percent of total billed charges1.40.9999999999Percent of total billed charges1.150.736999999999Percent of total billed charges1.250.8999999999Percent of total billed charges1.250.8999999999Percent of total billed charges1.250.8999999999Percent of total billed charges1.151.4
TORSEMIDE TAB 20 MG2500099CDM250RCboth1.641.231.440.88999999999Percent of total billed charges1.260.77999999999Percent of total billed charges1.260.77999999999Percent of total billed charges1.480.9999999999Percent of total billed charges1.480.9999999999Percent of total billed charges1.210.736999999999Percent of total billed charges1.310.8999999999Percent of total billed charges1.310.8999999999Percent of total billed charges1.310.8999999999Percent of total billed charges1.211.48
NOVOLIN INSULIN 70/302500074CDM250RCboth1.651.241.450.88999999999Percent of total billed charges1.270.77999999999Percent of total billed charges1.270.77999999999Percent of total billed charges1.490.9999999999Percent of total billed charges1.490.9999999999Percent of total billed charges1.210.736999999999Percent of total billed charges1.320.8999999999Percent of total billed charges1.320.8999999999Percent of total billed charges1.320.8999999999Percent of total billed charges1.211.49
NOVOLIN R INSULIN2500075CDM250RCboth1.651.241.450.88999999999Percent of total billed charges1.270.77999999999Percent of total billed charges1.270.77999999999Percent of total billed charges1.490.9999999999Percent of total billed charges1.490.9999999999Percent of total billed charges1.210.736999999999Percent of total billed charges1.320.8999999999Percent of total billed charges1.320.8999999999Percent of total billed charges1.320.8999999999Percent of total billed charges1.211.49
DEPAKOTE2502566CDM250RCboth1.771.331.560.88999999999Percent of total billed charges1.360.77999999999Percent of total billed charges1.360.77999999999Percent of total billed charges1.590.9999999999Percent of total billed charges1.590.9999999999Percent of total billed charges1.30.736999999999Percent of total billed charges1.420.8999999999Percent of total billed charges1.420.8999999999Percent of total billed charges1.420.8999999999Percent of total billed charges1.31.59
HUMULIN N PER UNIT2502257CDM250RCboth1.781.341.570.88999999999Percent of total billed charges1.370.77999999999Percent of total billed charges1.370.77999999999Percent of total billed charges1.60.9999999999Percent of total billed charges1.60.9999999999Percent of total billed charges1.310.736999999999Percent of total billed charges1.420.8999999999Percent of total billed charges1.420.8999999999Percent of total billed charges1.420.8999999999Percent of total billed charges1.311.6
METRONIDAZOLE TAB 500 MG2500066CDM250RCboth1.841.381.620.88999999999Percent of total billed charges1.420.77999999999Percent of total billed charges1.420.77999999999Percent of total billed charges1.660.9999999999Percent of total billed charges1.660.9999999999Percent of total billed charges1.350.736999999999Percent of total billed charges1.470.8999999999Percent of total billed charges1.470.8999999999Percent of total billed charges1.470.8999999999Percent of total billed charges1.351.66
POTASSIUM CHLORIDE 20MG TAB2509496CDM250RCboth1.861.41.640.88999999999Percent of total billed charges1.430.77999999999Percent of total billed charges1.430.77999999999Percent of total billed charges1.670.9999999999Percent of total billed charges1.670.9999999999Percent of total billed charges1.370.736999999999Percent of total billed charges1.490.8999999999Percent of total billed charges1.490.8999999999Percent of total billed charges1.490.8999999999Percent of total billed charges1.371.67
XYLOCAINE W/EPI 2% 20 ML2500116CDM250RCboth1.891.421.660.88999999999Percent of total billed charges1.460.77999999999Percent of total billed charges1.460.77999999999Percent of total billed charges1.70.9999999999Percent of total billed charges1.70.9999999999Percent of total billed charges1.390.736999999999Percent of total billed charges1.510.8999999999Percent of total billed charges1.510.8999999999Percent of total billed charges1.510.8999999999Percent of total billed charges1.391.7
BENAZEPRIL 20MG TAB2500012CDM250RCboth1.91.431.670.88999999999Percent of total billed charges1.460.77999999999Percent of total billed charges1.460.77999999999Percent of total billed charges1.710.9999999999Percent of total billed charges1.710.9999999999Percent of total billed charges1.40.736999999999Percent of total billed charges1.520.8999999999Percent of total billed charges1.520.8999999999Percent of total billed charges1.520.8999999999Percent of total billed charges1.41.71
LISINOPRIL 5MG TAB2501456CDM250RCboth1.921.441.690.88999999999Percent of total billed charges1.480.77999999999Percent of total billed charges1.480.77999999999Percent of total billed charges1.730.9999999999Percent of total billed charges1.730.9999999999Percent of total billed charges1.410.736999999999Percent of total billed charges1.540.8999999999Percent of total billed charges1.540.8999999999Percent of total billed charges1.540.8999999999Percent of total billed charges1.411.73
AMOXIL 125MG/5ML 5ML2501245CDM250RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
ANASPAZ 0.125MG2501040CDM250RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
BENADRYL ADULT SUSP2507168CDM250RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
BENADRYL CHILD SUSP2501039CDM250RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
CARDIZEM 30MG TAB2508131CDM250RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
CATAPRES 0.1MG TAB2504055CDM250RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
Dexamethasone 2mg tab2501491CDM250RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
DIPHENHYDRAMINE 12.5MG/5ML U/D2501087CDM250RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
Famotidine 20mg inj2509232CDM250RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
FLUOR-I-STRIP A.T.2503221CDM250RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
GLYCERINE SUPP INF2507023CDM250RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
HUMULIN R INSULIN PER UNIT (1)2501258CDM250RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
IBUPROFEN 200MG TAB2503405CDM250RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
IBUPROFEN 800MG TAB2502010CDM250RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
IMMODIUM 1 DOSE (5CC)2501255CDM250RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
LABATELOL 100MG TAB2501243CDM250RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
LIBRIUM 25MG CAP2501244CDM250RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
LIBRIUM 5 MG CAPSULE2509182CDM250RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
MAALOX SUSP. 30ML U/D2508187CDM250RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
METAMUCIL PKT.2505092CDM250RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
MULTIVITAMIN THERA M2501214CDM250RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
MYLANTA SUSP 30ML2509133CDM250RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
NEOSPORIN OINT PKT2501148CDM250RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
PREDNISONE 20MG2501222CDM250RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
PYRIDIUM 200MG2501247CDM250RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
Losartan 50mg2500151CDM250RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
Hyoscyamine 0.125mg #1002509090CDM250RCboth2.031.521.790.88999999999Percent of total billed charges1.560.77999999999Percent of total billed charges1.560.77999999999Percent of total billed charges1.830.9999999999Percent of total billed charges1.830.9999999999Percent of total billed charges1.490.736999999999Percent of total billed charges1.620.8999999999Percent of total billed charges1.620.8999999999Percent of total billed charges1.620.8999999999Percent of total billed charges1.491.83
FLEETS ENEMA2501203CDM250RCboth2.041.531.80.88999999999Percent of total billed charges1.570.77999999999Percent of total billed charges1.570.77999999999Percent of total billed charges1.840.9999999999Percent of total billed charges1.840.9999999999Percent of total billed charges1.50.736999999999Percent of total billed charges1.630.8999999999Percent of total billed charges1.630.8999999999Percent of total billed charges1.630.8999999999Percent of total billed charges1.51.84
HALOPERIDOL 5MG TAB2503509CDM250RCboth2.051.541.80.88999999999Percent of total billed charges1.580.77999999999Percent of total billed charges1.580.77999999999Percent of total billed charges1.850.9999999999Percent of total billed charges1.850.9999999999Percent of total billed charges1.510.736999999999Percent of total billed charges1.640.8999999999Percent of total billed charges1.640.8999999999Percent of total billed charges1.640.8999999999Percent of total billed charges1.511.85
BUMEX TAB 0.5MG2500015CDM250RCboth2.161.621.90.88999999999Percent of total billed charges1.660.77999999999Percent of total billed charges1.660.77999999999Percent of total billed charges1.940.9999999999Percent of total billed charges1.940.9999999999Percent of total billed charges1.590.736999999999Percent of total billed charges1.730.8999999999Percent of total billed charges1.730.8999999999Percent of total billed charges1.730.8999999999Percent of total billed charges1.591.94
ISORDIL 10 MG2501120CDM250RCboth2.171.631.910.88999999999Percent of total billed charges1.670.77999999999Percent of total billed charges1.670.77999999999Percent of total billed charges1.950.9999999999Percent of total billed charges1.950.9999999999Percent of total billed charges1.60.736999999999Percent of total billed charges1.740.8999999999Percent of total billed charges1.740.8999999999Percent of total billed charges1.740.8999999999Percent of total billed charges1.61.95
DULCOLAX 10MG2507021CDM250RCboth2.191.641.930.88999999999Percent of total billed charges1.690.77999999999Percent of total billed charges1.690.77999999999Percent of total billed charges1.970.9999999999Percent of total billed charges1.970.9999999999Percent of total billed charges1.610.736999999999Percent of total billed charges1.750.8999999999Percent of total billed charges1.750.8999999999Percent of total billed charges1.750.8999999999Percent of total billed charges1.611.97
CEFTRIAXONE 500 MG IV2500124CDM250RCboth2.281.712.010.88999999999Percent of total billed charges1.760.77999999999Percent of total billed charges1.760.77999999999Percent of total billed charges2.050.9999999999Percent of total billed charges2.050.9999999999Percent of total billed charges1.680.736999999999Percent of total billed charges1.820.8999999999Percent of total billed charges1.820.8999999999Percent of total billed charges1.820.8999999999Percent of total billed charges1.682.05
ROBITUSSIN AC 5CC2508099CDM250RCboth2.31.732.020.88999999999Percent of total billed charges1.770.77999999999Percent of total billed charges1.770.77999999999Percent of total billed charges2.070.9999999999Percent of total billed charges2.070.9999999999Percent of total billed charges1.690.736999999999Percent of total billed charges1.840.8999999999Percent of total billed charges1.840.8999999999Percent of total billed charges1.840.8999999999Percent of total billed charges1.692.07
LACTULOSE SYRUP 30ML2509433CDM250RCboth2.321.742.040.88999999999Percent of total billed charges1.790.77999999999Percent of total billed charges1.790.77999999999Percent of total billed charges2.090.9999999999Percent of total billed charges2.090.9999999999Percent of total billed charges1.710.736999999999Percent of total billed charges1.860.8999999999Percent of total billed charges1.860.8999999999Percent of total billed charges1.860.8999999999Percent of total billed charges1.712.09
Midodrine 2.5 mg2504696CDM250RCboth2.421.822.130.88999999999Percent of total billed charges1.860.77999999999Percent of total billed charges1.860.77999999999Percent of total billed charges2.180.9999999999Percent of total billed charges2.180.9999999999Percent of total billed charges1.780.736999999999Percent of total billed charges1.940.8999999999Percent of total billed charges1.940.8999999999Percent of total billed charges1.940.8999999999Percent of total billed charges1.782.18
NORCO 10/325MG EA TAB2506665CDM250RCboth2.421.822.130.88999999999Percent of total billed charges1.860.77999999999Percent of total billed charges1.860.77999999999Percent of total billed charges2.180.9999999999Percent of total billed charges2.180.9999999999Percent of total billed charges1.780.736999999999Percent of total billed charges1.940.8999999999Percent of total billed charges1.940.8999999999Percent of total billed charges1.940.8999999999Percent of total billed charges1.782.18
LISINOPRIL 10MG25021213CDM250RCboth2.471.852.170.88999999999Percent of total billed charges1.90.77999999999Percent of total billed charges1.90.77999999999Percent of total billed charges2.220.9999999999Percent of total billed charges2.220.9999999999Percent of total billed charges1.820.736999999999Percent of total billed charges1.980.8999999999Percent of total billed charges1.980.8999999999Percent of total billed charges1.980.8999999999Percent of total billed charges1.822.22
LISINOPRIL TAB 20 MG2500059CDM250RCboth2.651.992.330.88999999999Percent of total billed charges2.040.77999999999Percent of total billed charges2.040.77999999999Percent of total billed charges2.390.9999999999Percent of total billed charges2.390.9999999999Percent of total billed charges1.950.736999999999Percent of total billed charges2.120.8999999999Percent of total billed charges2.120.8999999999Percent of total billed charges2.120.8999999999Percent of total billed charges1.952.39
ZEMURON 10MG/ML-5ML INJ2503193CDM250RCboth2.882.162.530.88999999999Percent of total billed charges2.220.77999999999Percent of total billed charges2.220.77999999999Percent of total billed charges2.590.9999999999Percent of total billed charges2.590.9999999999Percent of total billed charges2.120.736999999999Percent of total billed charges2.30.8999999999Percent of total billed charges2.30.8999999999Percent of total billed charges2.30.8999999999Percent of total billed charges2.122.59
NITROQUICK 0.4MG2501041CDM250RCboth2.992.242.630.88999999999Percent of total billed charges2.30.77999999999Percent of total billed charges2.30.77999999999Percent of total billed charges2.690.9999999999Percent of total billed charges2.690.9999999999Percent of total billed charges2.20.736999999999Percent of total billed charges2.390.8999999999Percent of total billed charges2.390.8999999999Percent of total billed charges2.390.8999999999Percent of total billed charges2.22.69
AMOXICILLIN 500MG CAPS2501254CDM250RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
BENADRYL 25MG-INJ2509035CDM250RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
COLACE 100MG2502693CDM250RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
Fleet Pedia-Lax Enema 2.25 oz2509969CDM250RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
FLOMAX 0.4MG PO2509466CDM250RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
HYDRALAZINE TAB 25mg2504009CDM250RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
HYDROXYZINE 50MG TAB2501152CDM250RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
Levofloxacin 750mg tab2500146CDM250RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
NS 1000 Flush w/ swabcap2502587CDM250RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
NS 10CC FLUSH5402566CDM250RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
PEDIALYTE 4OZ BOTTLE2505080CDM250RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
Sodium Chloride 2.5ml flushes2500142CDM250RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
TESSALON PEARL 200MG2504002CDM250RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
Heparin 1000 units/ml2509987CDM250RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
FENTANYL INJ 100MCG/2ML2500039CDM250RCboth3.022.272.660.88999999999Percent of total billed charges2.330.77999999999Percent of total billed charges2.330.77999999999Percent of total billed charges2.720.9999999999Percent of total billed charges2.720.9999999999Percent of total billed charges2.220.736999999999Percent of total billed charges2.420.8999999999Percent of total billed charges2.420.8999999999Percent of total billed charges2.420.8999999999Percent of total billed charges2.222.72
PEPCID 20MG TAB2509230CDM250RCboth3.032.272.670.88999999999Percent of total billed charges2.330.77999999999Percent of total billed charges2.330.77999999999Percent of total billed charges2.730.9999999999Percent of total billed charges2.730.9999999999Percent of total billed charges2.230.736999999999Percent of total billed charges2.420.8999999999Percent of total billed charges2.420.8999999999Percent of total billed charges2.420.8999999999Percent of total billed charges2.232.73
XYLOCAINE 2% INJ 40M MG/2 ML2500133CDM250RCboth3.062.32.690.88999999999Percent of total billed charges2.360.77999999999Percent of total billed charges2.360.77999999999Percent of total billed charges2.750.9999999999Percent of total billed charges2.750.9999999999Percent of total billed charges2.250.736999999999Percent of total billed charges2.450.8999999999Percent of total billed charges2.450.8999999999Percent of total billed charges2.450.8999999999Percent of total billed charges2.252.75
HYTRIN 1MG (TERAZOSIN)2509233CDM250RCboth3.212.412.820.88999999999Percent of total billed charges2.470.77999999999Percent of total billed charges2.470.77999999999Percent of total billed charges2.890.9999999999Percent of total billed charges2.890.9999999999Percent of total billed charges2.360.736999999999Percent of total billed charges2.570.8999999999Percent of total billed charges2.570.8999999999Percent of total billed charges2.570.8999999999Percent of total billed charges2.362.89
CARBAMAZEPINE TAB 200MG2500018CDM250RCboth3.292.472.90.88999999999Percent of total billed charges2.530.77999999999Percent of total billed charges2.530.77999999999Percent of total billed charges2.960.9999999999Percent of total billed charges2.960.9999999999Percent of total billed charges2.420.736999999999Percent of total billed charges2.630.8999999999Percent of total billed charges2.630.8999999999Percent of total billed charges2.630.8999999999Percent of total billed charges2.422.96
HUMALOG PER UNIT2500063CDM250RCboth3.32.482.90.88999999999Percent of total billed charges2.540.77999999999Percent of total billed charges2.540.77999999999Percent of total billed charges2.970.9999999999Percent of total billed charges2.970.9999999999Percent of total billed charges2.430.736999999999Percent of total billed charges2.640.8999999999Percent of total billed charges2.640.8999999999Percent of total billed charges2.640.8999999999Percent of total billed charges2.432.97
AMIODARONE 150MG2502070CDM250RCboth3.382.542.970.88999999999Percent of total billed charges2.60.77999999999Percent of total billed charges2.60.77999999999Percent of total billed charges3.040.9999999999Percent of total billed charges3.040.9999999999Percent of total billed charges2.490.736999999999Percent of total billed charges2.70.8999999999Percent of total billed charges2.70.8999999999Percent of total billed charges2.70.8999999999Percent of total billed charges2.493.04
NORVASC 5MG2506843CDM250RCboth3.462.63.040.88999999999Percent of total billed charges2.660.77999999999Percent of total billed charges2.660.77999999999Percent of total billed charges3.110.9999999999Percent of total billed charges3.110.9999999999Percent of total billed charges2.550.736999999999Percent of total billed charges2.770.8999999999Percent of total billed charges2.770.8999999999Percent of total billed charges2.770.8999999999Percent of total billed charges2.553.11
NASOPEN PE ORAL LIQUID 15 ML2500072CDM250RCboth3.52.633.080.88999999999Percent of total billed charges2.70.77999999999Percent of total billed charges2.70.77999999999Percent of total billed charges3.150.9999999999Percent of total billed charges3.150.9999999999Percent of total billed charges2.580.736999999999Percent of total billed charges2.80.8999999999Percent of total billed charges2.80.8999999999Percent of total billed charges2.80.8999999999Percent of total billed charges2.583.15
PROCARDIA XL 30MG TAB2506058CDM250RCboth3.582.693.150.88999999999Percent of total billed charges2.760.77999999999Percent of total billed charges2.760.77999999999Percent of total billed charges3.220.9999999999Percent of total billed charges3.220.9999999999Percent of total billed charges2.630.736999999999Percent of total billed charges2.860.8999999999Percent of total billed charges2.860.8999999999Percent of total billed charges2.860.8999999999Percent of total billed charges2.633.22
RACEPINEPHRINE SOL 2.25%2503404CDM250RCboth3.62.73.170.88999999999Percent of total billed charges2.770.77999999999Percent of total billed charges2.770.77999999999Percent of total billed charges3.240.9999999999Percent of total billed charges3.240.9999999999Percent of total billed charges2.650.736999999999Percent of total billed charges2.880.8999999999Percent of total billed charges2.880.8999999999Percent of total billed charges2.880.8999999999Percent of total billed charges2.653.24
CAPTOPRIL TAB 25MG2500017CDM250RCboth3.692.773.250.88999999999Percent of total billed charges2.840.77999999999Percent of total billed charges2.840.77999999999Percent of total billed charges3.320.9999999999Percent of total billed charges3.320.9999999999Percent of total billed charges2.720.736999999999Percent of total billed charges2.950.8999999999Percent of total billed charges2.950.8999999999Percent of total billed charges2.950.8999999999Percent of total billed charges2.723.32
LOPRESSOR 5MG/5ML2501210CDM250RCboth3.92.933.430.88999999999Percent of total billed charges30.77999999999Percent of total billed charges30.77999999999Percent of total billed charges3.510.9999999999Percent of total billed charges3.510.9999999999Percent of total billed charges2.870.736999999999Percent of total billed charges3.120.8999999999Percent of total billed charges3.120.8999999999Percent of total billed charges3.120.8999999999Percent of total billed charges2.873.51
Magnesium Sulfate 50% (1gm/2ml)5402638CDM250RCboth433.520.88999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.60.9999999999Percent of total billed charges3.60.9999999999Percent of total billed charges2.940.736999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges2.943.6
Jevity 1.2 calories2500207CDM250RCboth433.520.88999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.60.9999999999Percent of total billed charges3.60.9999999999Percent of total billed charges2.940.736999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges2.943.6
MUCOMYST 10% 4ML2501131CDM250RCboth433.520.88999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.60.9999999999Percent of total billed charges3.60.9999999999Percent of total billed charges2.940.736999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges2.943.6
ZIDOVUDINE CAP 100 MG2500118CDM250RCboth4.043.033.560.88999999999Percent of total billed charges3.110.77999999999Percent of total billed charges3.110.77999999999Percent of total billed charges3.640.9999999999Percent of total billed charges3.640.9999999999Percent of total billed charges2.970.736999999999Percent of total billed charges3.230.8999999999Percent of total billed charges3.230.8999999999Percent of total billed charges3.230.8999999999Percent of total billed charges2.973.64
HEPARIN INJ 5000 UNIT/ML2500043CDM250RCboth4.153.113.650.88999999999Percent of total billed charges3.20.77999999999Percent of total billed charges3.20.77999999999Percent of total billed charges3.740.9999999999Percent of total billed charges3.740.9999999999Percent of total billed charges3.050.736999999999Percent of total billed charges3.320.8999999999Percent of total billed charges3.320.8999999999Percent of total billed charges3.320.8999999999Percent of total billed charges3.053.74
COREG 12.5MG PO25012913CDM250RCboth4.23.153.70.88999999999Percent of total billed charges3.230.77999999999Percent of total billed charges3.230.77999999999Percent of total billed charges3.780.9999999999Percent of total billed charges3.780.9999999999Percent of total billed charges3.090.736999999999Percent of total billed charges3.360.8999999999Percent of total billed charges3.360.8999999999Percent of total billed charges3.360.8999999999Percent of total billed charges3.093.78
COREG 3.12MG2503183CDM250RCboth4.23.153.70.88999999999Percent of total billed charges3.230.77999999999Percent of total billed charges3.230.77999999999Percent of total billed charges3.780.9999999999Percent of total billed charges3.780.9999999999Percent of total billed charges3.090.736999999999Percent of total billed charges3.360.8999999999Percent of total billed charges3.360.8999999999Percent of total billed charges3.360.8999999999Percent of total billed charges3.093.78
MAG CITRATAE2501912CDM250RCboth4.23.153.70.88999999999Percent of total billed charges3.230.77999999999Percent of total billed charges3.230.77999999999Percent of total billed charges3.780.9999999999Percent of total billed charges3.780.9999999999Percent of total billed charges3.090.736999999999Percent of total billed charges3.360.8999999999Percent of total billed charges3.360.8999999999Percent of total billed charges3.360.8999999999Percent of total billed charges3.093.78
POTASSIUM CHL INJ 20 MEQ/10 ML2500081CDM250RCboth4.23.153.70.88999999999Percent of total billed charges3.230.77999999999Percent of total billed charges3.230.77999999999Percent of total billed charges3.780.9999999999Percent of total billed charges3.780.9999999999Percent of total billed charges3.090.736999999999Percent of total billed charges3.360.8999999999Percent of total billed charges3.360.8999999999Percent of total billed charges3.360.8999999999Percent of total billed charges3.093.78
BRETHINE 1GM INJ2503297CDM250RCboth4.323.243.80.88999999999Percent of total billed charges3.330.77999999999Percent of total billed charges3.330.77999999999Percent of total billed charges3.890.9999999999Percent of total billed charges3.890.9999999999Percent of total billed charges3.180.736999999999Percent of total billed charges3.460.8999999999Percent of total billed charges3.460.8999999999Percent of total billed charges3.460.8999999999Percent of total billed charges3.183.89
SINGULAIR 10MG2502659CDM250RCboth4.533.43.990.88999999999Percent of total billed charges3.490.77999999999Percent of total billed charges3.490.77999999999Percent of total billed charges4.080.9999999999Percent of total billed charges4.080.9999999999Percent of total billed charges3.330.736999999999Percent of total billed charges3.620.8999999999Percent of total billed charges3.620.8999999999Percent of total billed charges3.620.8999999999Percent of total billed charges3.334.08
ATIVAN INJ 2 MG/ML2500060CDM250RCboth4.563.424.010.88999999999Percent of total billed charges3.510.77999999999Percent of total billed charges3.510.77999999999Percent of total billed charges4.10.9999999999Percent of total billed charges4.10.9999999999Percent of total billed charges3.360.736999999999Percent of total billed charges3.650.8999999999Percent of total billed charges3.650.8999999999Percent of total billed charges3.650.8999999999Percent of total billed charges3.364.1
DIGITEK TAB 0.1252509566CDM250RCboth4.63.454.050.88999999999Percent of total billed charges3.540.77999999999Percent of total billed charges3.540.77999999999Percent of total billed charges4.140.9999999999Percent of total billed charges4.140.9999999999Percent of total billed charges3.390.736999999999Percent of total billed charges3.680.8999999999Percent of total billed charges3.680.8999999999Percent of total billed charges3.680.8999999999Percent of total billed charges3.394.14
SUCCINYLCHOLINE INJ 20 MG/ML2500094CDM250RCboth4.63.454.050.88999999999Percent of total billed charges3.540.77999999999Percent of total billed charges3.540.77999999999Percent of total billed charges4.140.9999999999Percent of total billed charges4.140.9999999999Percent of total billed charges3.390.736999999999Percent of total billed charges3.680.8999999999Percent of total billed charges3.680.8999999999Percent of total billed charges3.680.8999999999Percent of total billed charges3.394.14
CELEXA 10MG2506858CDM250RCboth4.853.644.270.88999999999Percent of total billed charges3.730.77999999999Percent of total billed charges3.730.77999999999Percent of total billed charges4.370.9999999999Percent of total billed charges4.370.9999999999Percent of total billed charges3.570.736999999999Percent of total billed charges3.880.8999999999Percent of total billed charges3.880.8999999999Percent of total billed charges3.880.8999999999Percent of total billed charges3.574.37
NORMAL SALINE/P F 100ML2600310CDM250RCboth4.853.644.270.88999999999Percent of total billed charges3.730.77999999999Percent of total billed charges3.730.77999999999Percent of total billed charges4.370.9999999999Percent of total billed charges4.370.9999999999Percent of total billed charges3.570.736999999999Percent of total billed charges3.880.8999999999Percent of total billed charges3.880.8999999999Percent of total billed charges3.880.8999999999Percent of total billed charges3.574.37
CALAMINE LOTION2500089CDM250RCboth4.983.744.380.88999999999Percent of total billed charges3.830.77999999999Percent of total billed charges3.830.77999999999Percent of total billed charges4.480.9999999999Percent of total billed charges4.480.9999999999Percent of total billed charges3.670.736999999999Percent of total billed charges3.980.8999999999Percent of total billed charges3.980.8999999999Percent of total billed charges3.980.8999999999Percent of total billed charges3.674.48
AUGMENTIN 5CC 250MG2501343CDM250RCboth53.754.40.88999999999Percent of total billed charges3.850.77999999999Percent of total billed charges3.850.77999999999Percent of total billed charges4.50.9999999999Percent of total billed charges4.50.9999999999Percent of total billed charges3.680.736999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges3.684.5
Cefdinir 125 mg/5ml2500143CDM250RCboth53.754.40.88999999999Percent of total billed charges3.850.77999999999Percent of total billed charges3.850.77999999999Percent of total billed charges4.50.9999999999Percent of total billed charges4.50.9999999999Percent of total billed charges3.680.736999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges3.684.5
Diflucan 150mg UD #122509965CDM250RCboth53.754.40.88999999999Percent of total billed charges3.850.77999999999Percent of total billed charges3.850.77999999999Percent of total billed charges4.50.9999999999Percent of total billed charges4.50.9999999999Percent of total billed charges3.680.736999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges3.684.5
PHENERGAN 12.5MG SUPP2507037CDM250RCboth53.754.40.88999999999Percent of total billed charges3.850.77999999999Percent of total billed charges3.850.77999999999Percent of total billed charges4.50.9999999999Percent of total billed charges4.50.9999999999Percent of total billed charges3.680.736999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges3.684.5
MORPHINE 10MG INJ2509196CDM250RCboth5.063.84.450.88999999999Percent of total billed charges3.90.77999999999Percent of total billed charges3.90.77999999999Percent of total billed charges4.550.9999999999Percent of total billed charges4.550.9999999999Percent of total billed charges3.720.736999999999Percent of total billed charges4.050.8999999999Percent of total billed charges4.050.8999999999Percent of total billed charges4.050.8999999999Percent of total billed charges3.724.55
MANNITOL INJ 25%2500061CDM250RCboth5.263.954.630.88999999999Percent of total billed charges4.050.77999999999Percent of total billed charges4.050.77999999999Percent of total billed charges4.730.9999999999Percent of total billed charges4.730.9999999999Percent of total billed charges3.870.736999999999Percent of total billed charges4.210.8999999999Percent of total billed charges4.210.8999999999Percent of total billed charges4.210.8999999999Percent of total billed charges3.874.73
COUMADIN 3MG2504078CDM250RCboth5.364.024.720.88999999999Percent of total billed charges4.130.77999999999Percent of total billed charges4.130.77999999999Percent of total billed charges4.820.9999999999Percent of total billed charges4.820.9999999999Percent of total billed charges3.940.736999999999Percent of total billed charges4.290.8999999999Percent of total billed charges4.290.8999999999Percent of total billed charges4.290.8999999999Percent of total billed charges3.944.82
COUMADIN 5MG TAB2504077CDM250RCboth5.544.164.880.88999999999Percent of total billed charges4.270.77999999999Percent of total billed charges4.270.77999999999Percent of total billed charges4.990.9999999999Percent of total billed charges4.990.9999999999Percent of total billed charges4.080.736999999999Percent of total billed charges4.430.8999999999Percent of total billed charges4.430.8999999999Percent of total billed charges4.430.8999999999Percent of total billed charges4.084.99
CIPRO 200MG IV25012000CDM250RCboth5.744.315.050.88999999999Percent of total billed charges4.420.77999999999Percent of total billed charges4.420.77999999999Percent of total billed charges5.170.9999999999Percent of total billed charges5.170.9999999999Percent of total billed charges4.220.736999999999Percent of total billed charges4.590.8999999999Percent of total billed charges4.590.8999999999Percent of total billed charges4.590.8999999999Percent of total billed charges4.225.17
DILTIAZEM ER 120 MG TAB2501334CDM250RCboth5.774.335.080.88999999999Percent of total billed charges4.440.77999999999Percent of total billed charges4.440.77999999999Percent of total billed charges5.190.9999999999Percent of total billed charges5.190.9999999999Percent of total billed charges4.250.736999999999Percent of total billed charges4.620.8999999999Percent of total billed charges4.620.8999999999Percent of total billed charges4.620.8999999999Percent of total billed charges4.255.19
CLEOCIN 300MG2506895CDM250RCboth5.884.415.170.88999999999Percent of total billed charges4.530.77999999999Percent of total billed charges4.530.77999999999Percent of total billed charges5.290.9999999999Percent of total billed charges5.290.9999999999Percent of total billed charges4.330.736999999999Percent of total billed charges4.70.8999999999Percent of total billed charges4.70.8999999999Percent of total billed charges4.70.8999999999Percent of total billed charges4.335.29
AUGMENTIN 875MG/TAB2501796CDM250RCboth64.55.280.88999999999Percent of total billed charges4.620.77999999999Percent of total billed charges4.620.77999999999Percent of total billed charges5.40.9999999999Percent of total billed charges5.40.9999999999Percent of total billed charges4.420.736999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.425.4
DILTIAZEM ER 120MG CAP2501002CDM250RCboth64.55.280.88999999999Percent of total billed charges4.620.77999999999Percent of total billed charges4.620.77999999999Percent of total billed charges5.40.9999999999Percent of total billed charges5.40.9999999999Percent of total billed charges4.420.736999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.425.4
Octreotide 50mcg/mL2504458CDM250RCboth64.55.280.88999999999Percent of total billed charges4.620.77999999999Percent of total billed charges4.620.77999999999Percent of total billed charges5.40.9999999999Percent of total billed charges5.40.9999999999Percent of total billed charges4.420.736999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.425.4
SUCCINYCHORIDE 20ML2509645CDM250RCboth64.55.280.88999999999Percent of total billed charges4.620.77999999999Percent of total billed charges4.620.77999999999Percent of total billed charges5.40.9999999999Percent of total billed charges5.40.9999999999Percent of total billed charges4.420.736999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.425.4
TAMIFLU ORAL SUSPENSION 6 MG/ML2500097CDM250RCboth6.084.565.350.88999999999Percent of total billed charges4.680.77999999999Percent of total billed charges4.680.77999999999Percent of total billed charges5.470.9999999999Percent of total billed charges5.470.9999999999Percent of total billed charges4.470.736999999999Percent of total billed charges4.860.8999999999Percent of total billed charges4.860.8999999999Percent of total billed charges4.860.8999999999Percent of total billed charges4.475.47
CRIXIVAN CAP 400MG2500047CDM250RCboth6.094.575.360.88999999999Percent of total billed charges4.690.77999999999Percent of total billed charges4.690.77999999999Percent of total billed charges5.480.9999999999Percent of total billed charges5.480.9999999999Percent of total billed charges4.480.736999999999Percent of total billed charges4.870.8999999999Percent of total billed charges4.870.8999999999Percent of total billed charges4.870.8999999999Percent of total billed charges4.485.48
Cipro 500mg UD2506208CDM250RCboth6.354.765.590.88999999999Percent of total billed charges4.890.77999999999Percent of total billed charges4.890.77999999999Percent of total billed charges5.720.9999999999Percent of total billed charges5.720.9999999999Percent of total billed charges4.670.736999999999Percent of total billed charges5.080.8999999999Percent of total billed charges5.080.8999999999Percent of total billed charges5.080.8999999999Percent of total billed charges4.675.72
STERILE WATER 5ML INJ2500115CDM250RCboth6.464.855.680.88999999999Percent of total billed charges4.970.77999999999Percent of total billed charges4.970.77999999999Percent of total billed charges5.810.9999999999Percent of total billed charges5.810.9999999999Percent of total billed charges4.750.736999999999Percent of total billed charges5.170.8999999999Percent of total billed charges5.170.8999999999Percent of total billed charges5.170.8999999999Percent of total billed charges4.755.81
BUMEX 0.25MG/ML 2CC INJ2508146CDM250RCboth6.64.955.810.88999999999Percent of total billed charges5.080.77999999999Percent of total billed charges5.080.77999999999Percent of total billed charges5.940.9999999999Percent of total billed charges5.940.9999999999Percent of total billed charges4.860.736999999999Percent of total billed charges5.280.8999999999Percent of total billed charges5.280.8999999999Percent of total billed charges5.280.8999999999Percent of total billed charges4.865.94
Normal Saline 100ml5402640CDM250RCboth6.75.035.90.88999999999Percent of total billed charges5.160.77999999999Percent of total billed charges5.160.77999999999Percent of total billed charges6.030.9999999999Percent of total billed charges6.030.9999999999Percent of total billed charges4.930.736999999999Percent of total billed charges5.360.8999999999Percent of total billed charges5.360.8999999999Percent of total billed charges5.360.8999999999Percent of total billed charges4.936.03
HEPARIN FLUSH 100UNITS/ML2500130CDM250RCboth6.745.065.930.88999999999Percent of total billed charges5.190.77999999999Percent of total billed charges5.190.77999999999Percent of total billed charges6.070.9999999999Percent of total billed charges6.070.9999999999Percent of total billed charges4.960.736999999999Percent of total billed charges5.390.8999999999Percent of total billed charges5.390.8999999999Percent of total billed charges5.390.8999999999Percent of total billed charges4.966.07
NITROFURANTION 100MG CAP2502018CDM250RCboth6.755.065.940.88999999999Percent of total billed charges5.20.77999999999Percent of total billed charges5.20.77999999999Percent of total billed charges6.080.9999999999Percent of total billed charges6.080.9999999999Percent of total billed charges4.970.736999999999Percent of total billed charges5.40.8999999999Percent of total billed charges5.40.8999999999Percent of total billed charges5.40.8999999999Percent of total billed charges4.976.08
MORPHINE 2MG INJ2501213CDM250RCboth6.895.176.060.88999999999Percent of total billed charges5.310.77999999999Percent of total billed charges5.310.77999999999Percent of total billed charges6.20.9999999999Percent of total billed charges6.20.9999999999Percent of total billed charges5.070.736999999999Percent of total billed charges5.510.8999999999Percent of total billed charges5.510.8999999999Percent of total billed charges5.510.8999999999Percent of total billed charges5.076.2
NITROFURANTOIN 50MG CAP2502012CDM250RCboth75.256.160.88999999999Percent of total billed charges5.390.77999999999Percent of total billed charges5.390.77999999999Percent of total billed charges6.30.9999999999Percent of total billed charges6.30.9999999999Percent of total billed charges5.150.736999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.156.3
NS FLUSH 10ML2601146CDM250RCboth75.256.160.88999999999Percent of total billed charges5.390.77999999999Percent of total billed charges5.390.77999999999Percent of total billed charges6.30.9999999999Percent of total billed charges6.30.9999999999Percent of total billed charges5.150.736999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.156.3
Diprivan 100 mg/10ml2504697CDM250RCboth7.25.46.340.88999999999Percent of total billed charges5.540.77999999999Percent of total billed charges5.540.77999999999Percent of total billed charges6.480.9999999999Percent of total billed charges6.480.9999999999Percent of total billed charges5.30.736999999999Percent of total billed charges5.760.8999999999Percent of total billed charges5.760.8999999999Percent of total billed charges5.760.8999999999Percent of total billed charges5.36.48
CARDIZEM 5MG/ML INJ 5ML2508017CDM250RCboth7.475.66.570.88999999999Percent of total billed charges5.750.77999999999Percent of total billed charges5.750.77999999999Percent of total billed charges6.720.9999999999Percent of total billed charges6.720.9999999999Percent of total billed charges5.50.736999999999Percent of total billed charges5.980.8999999999Percent of total billed charges5.980.8999999999Percent of total billed charges5.980.8999999999Percent of total billed charges5.56.72
Glutose 15 3x15gm2504645CDM250RCboth7.95.936.950.88999999999Percent of total billed charges6.080.77999999999Percent of total billed charges6.080.77999999999Percent of total billed charges7.110.9999999999Percent of total billed charges7.110.9999999999Percent of total billed charges5.810.736999999999Percent of total billed charges6.320.8999999999Percent of total billed charges6.320.8999999999Percent of total billed charges6.320.8999999999Percent of total billed charges5.817.11
AFRIN NASAL SPRAY 15ML2506008CDM250RCboth7.985.997.020.88999999999Percent of total billed charges6.140.77999999999Percent of total billed charges6.140.77999999999Percent of total billed charges7.180.9999999999Percent of total billed charges7.180.9999999999Percent of total billed charges5.870.736999999999Percent of total billed charges6.380.8999999999Percent of total billed charges6.380.8999999999Percent of total billed charges6.380.8999999999Percent of total billed charges5.877.18
HYDROCORTISONE CREAM 1OZ TUBE2501332CDM250RCboth7.985.997.020.88999999999Percent of total billed charges6.140.77999999999Percent of total billed charges6.140.77999999999Percent of total billed charges7.180.9999999999Percent of total billed charges7.180.9999999999Percent of total billed charges5.870.736999999999Percent of total billed charges6.380.8999999999Percent of total billed charges6.380.8999999999Percent of total billed charges6.380.8999999999Percent of total billed charges5.877.18
DIFLUCAN 200MG2500107CDM250RCboth867.040.88999999999Percent of total billed charges6.160.77999999999Percent of total billed charges6.160.77999999999Percent of total billed charges7.20.9999999999Percent of total billed charges7.20.9999999999Percent of total billed charges5.890.736999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges5.897.2
FLAGYL 500MG TAB2509259CDM250RCboth867.040.88999999999Percent of total billed charges6.160.77999999999Percent of total billed charges6.160.77999999999Percent of total billed charges7.20.9999999999Percent of total billed charges7.20.9999999999Percent of total billed charges5.890.736999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges5.897.2
HEPARIN 25,000 UNITS BAG2501463CDM250RCboth867.040.88999999999Percent of total billed charges6.160.77999999999Percent of total billed charges6.160.77999999999Percent of total billed charges7.20.9999999999Percent of total billed charges7.20.9999999999Percent of total billed charges5.890.736999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges5.897.2
SOD BICARB 4.2% 10CC2501181CDM250RCboth867.040.88999999999Percent of total billed charges6.160.77999999999Percent of total billed charges6.160.77999999999Percent of total billed charges7.20.9999999999Percent of total billed charges7.20.9999999999Percent of total billed charges5.890.736999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges5.897.2
PREDNISOLONE ORAL SOL 5 MG/5 ML2500082CDM250RCboth8.176.137.190.88999999999Percent of total billed charges6.290.77999999999Percent of total billed charges6.290.77999999999Percent of total billed charges7.350.9999999999Percent of total billed charges7.350.9999999999Percent of total billed charges6.010.736999999999Percent of total billed charges6.540.8999999999Percent of total billed charges6.540.8999999999Percent of total billed charges6.540.8999999999Percent of total billed charges6.017.35
AMPICILLIN INJ 500MG2500009CDM250RCboth8.376.287.370.88999999999Percent of total billed charges6.440.77999999999Percent of total billed charges6.440.77999999999Percent of total billed charges7.530.9999999999Percent of total billed charges7.530.9999999999Percent of total billed charges6.160.736999999999Percent of total billed charges6.70.8999999999Percent of total billed charges6.70.8999999999Percent of total billed charges6.70.8999999999Percent of total billed charges6.167.53
VASOTEC 2.5 MG/2ML INJ25012030CDM250RCboth8.576.437.540.88999999999Percent of total billed charges6.60.77999999999Percent of total billed charges6.60.77999999999Percent of total billed charges7.710.9999999999Percent of total billed charges7.710.9999999999Percent of total billed charges6.310.736999999999Percent of total billed charges6.860.8999999999Percent of total billed charges6.860.8999999999Percent of total billed charges6.860.8999999999Percent of total billed charges6.317.71
PLAVIX 75MG TAB2501197CDM250RCboth8.726.547.670.88999999999Percent of total billed charges6.710.77999999999Percent of total billed charges6.710.77999999999Percent of total billed charges7.850.9999999999Percent of total billed charges7.850.9999999999Percent of total billed charges6.420.736999999999Percent of total billed charges6.980.8999999999Percent of total billed charges6.980.8999999999Percent of total billed charges6.980.8999999999Percent of total billed charges6.427.85
LEXAPRO 10MG TAB2501162CDM250RCboth8.766.577.710.88999999999Percent of total billed charges6.750.77999999999Percent of total billed charges6.750.77999999999Percent of total billed charges7.880.9999999999Percent of total billed charges7.880.9999999999Percent of total billed charges6.450.736999999999Percent of total billed charges7.010.8999999999Percent of total billed charges7.010.8999999999Percent of total billed charges7.010.8999999999Percent of total billed charges6.457.88
Clindamycin 300 mg/5% dextrose 50ml prmx2500141CDM250RCboth96.757.920.88999999999Percent of total billed charges6.930.77999999999Percent of total billed charges6.930.77999999999Percent of total billed charges8.10.9999999999Percent of total billed charges8.10.9999999999Percent of total billed charges6.620.736999999999Percent of total billed charges7.20.8999999999Percent of total billed charges7.20.8999999999Percent of total billed charges7.20.8999999999Percent of total billed charges6.628.1
NITROGLYCERIN 50MG INJ2501166CDM250RCboth96.757.920.88999999999Percent of total billed charges6.930.77999999999Percent of total billed charges6.930.77999999999Percent of total billed charges8.10.9999999999Percent of total billed charges8.10.9999999999Percent of total billed charges6.620.736999999999Percent of total billed charges7.20.8999999999Percent of total billed charges7.20.8999999999Percent of total billed charges7.20.8999999999Percent of total billed charges6.628.1
Levetiracetam 500mg/5ml Vial2500204CDM250RCboth9.196.898.090.88999999999Percent of total billed charges7.080.77999999999Percent of total billed charges7.080.77999999999Percent of total billed charges8.270.9999999999Percent of total billed charges8.270.9999999999Percent of total billed charges6.760.736999999999Percent of total billed charges7.350.8999999999Percent of total billed charges7.350.8999999999Percent of total billed charges7.350.8999999999Percent of total billed charges6.768.27
AMBIEN TAB 10 MG2500119CDM250RCboth9.246.938.130.88999999999Percent of total billed charges7.110.77999999999Percent of total billed charges7.110.77999999999Percent of total billed charges8.320.9999999999Percent of total billed charges8.320.9999999999Percent of total billed charges6.80.736999999999Percent of total billed charges7.390.8999999999Percent of total billed charges7.390.8999999999Percent of total billed charges7.390.8999999999Percent of total billed charges6.88.32
Amoxicillin Susp 400mg/5ml2508899CDM250RCboth9.87.358.620.88999999999Percent of total billed charges7.550.77999999999Percent of total billed charges7.550.77999999999Percent of total billed charges8.820.9999999999Percent of total billed charges8.820.9999999999Percent of total billed charges7.210.736999999999Percent of total billed charges7.840.8999999999Percent of total billed charges7.840.8999999999Percent of total billed charges7.840.8999999999Percent of total billed charges7.218.82
ZOCOR2503039CDM250RCboth9.847.388.660.88999999999Percent of total billed charges7.580.77999999999Percent of total billed charges7.580.77999999999Percent of total billed charges8.860.9999999999Percent of total billed charges8.860.9999999999Percent of total billed charges7.240.736999999999Percent of total billed charges7.870.8999999999Percent of total billed charges7.870.8999999999Percent of total billed charges7.870.8999999999Percent of total billed charges7.248.86
AMOXICILLIN 875MG TAB2506614CDM250RCboth9.97.438.710.88999999999Percent of total billed charges7.620.77999999999Percent of total billed charges7.620.77999999999Percent of total billed charges8.910.9999999999Percent of total billed charges8.910.9999999999Percent of total billed charges7.290.736999999999Percent of total billed charges7.920.8999999999Percent of total billed charges7.920.8999999999Percent of total billed charges7.920.8999999999Percent of total billed charges7.298.91
HEP-LOK2600010CDM250RCboth107.58.80.88999999999Percent of total billed charges7.70.77999999999Percent of total billed charges7.70.77999999999Percent of total billed charges90.9999999999Percent of total billed charges90.9999999999Percent of total billed charges7.360.736999999999Percent of total billed charges80.8999999999Percent of total billed charges80.8999999999Percent of total billed charges80.8999999999Percent of total billed charges7.369
Meropenem 500mg2501669CDM250RCboth107.58.80.88999999999Percent of total billed charges7.70.77999999999Percent of total billed charges7.70.77999999999Percent of total billed charges90.9999999999Percent of total billed charges90.9999999999Percent of total billed charges7.360.736999999999Percent of total billed charges80.8999999999Percent of total billed charges80.8999999999Percent of total billed charges80.8999999999Percent of total billed charges7.369
Ketamine 500mg/10ml (50mg/ml)2508699CDM250RCboth10.087.568.870.88999999999Percent of total billed charges7.760.77999999999Percent of total billed charges7.760.77999999999Percent of total billed charges9.070.9999999999Percent of total billed charges9.070.9999999999Percent of total billed charges7.420.736999999999Percent of total billed charges8.060.8999999999Percent of total billed charges8.060.8999999999Percent of total billed charges8.060.8999999999Percent of total billed charges7.429.07
PROTONIX 40MG PO2501119CDM250RCboth10.537.99.270.88999999999Percent of total billed charges8.110.77999999999Percent of total billed charges8.110.77999999999Percent of total billed charges9.480.9999999999Percent of total billed charges9.480.9999999999Percent of total billed charges7.750.736999999999Percent of total billed charges8.420.8999999999Percent of total billed charges8.420.8999999999Percent of total billed charges8.420.8999999999Percent of total billed charges7.759.48
FOLIC ACID 5MG/ML2503285CDM250RCboth10.838.129.530.88999999999Percent of total billed charges8.340.77999999999Percent of total billed charges8.340.77999999999Percent of total billed charges9.750.9999999999Percent of total billed charges9.750.9999999999Percent of total billed charges7.970.736999999999Percent of total billed charges8.660.8999999999Percent of total billed charges8.660.8999999999Percent of total billed charges8.660.8999999999Percent of total billed charges7.979.75
CIPRO 250MG TAB2506207CDM250RCboth118.259.680.88999999999Percent of total billed charges8.470.77999999999Percent of total billed charges8.470.77999999999Percent of total billed charges9.90.9999999999Percent of total billed charges9.90.9999999999Percent of total billed charges8.10.736999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.19.9
KCL 20MEQ IV 10CC2509255CDM250RCboth118.259.680.88999999999Percent of total billed charges8.470.77999999999Percent of total billed charges8.470.77999999999Percent of total billed charges9.90.9999999999Percent of total billed charges9.90.9999999999Percent of total billed charges8.10.736999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.19.9
PROMETH 50MG INJ2509219CDM250RCboth118.259.680.88999999999Percent of total billed charges8.470.77999999999Percent of total billed charges8.470.77999999999Percent of total billed charges9.90.9999999999Percent of total billed charges9.90.9999999999Percent of total billed charges8.10.736999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.19.9
Atropine ophth sol 1%2500148CDM250RCboth118.259.680.88999999999Percent of total billed charges8.470.77999999999Percent of total billed charges8.470.77999999999Percent of total billed charges9.90.9999999999Percent of total billed charges9.90.9999999999Percent of total billed charges8.10.736999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.19.9
D5 1/2 NS 1000ML2500023CDM250RCboth11.128.349.790.88999999999Percent of total billed charges8.560.77999999999Percent of total billed charges8.560.77999999999Percent of total billed charges10.010.9999999999Percent of total billed charges10.010.9999999999Percent of total billed charges8.180.736999999999Percent of total billed charges8.90.8999999999Percent of total billed charges8.90.8999999999Percent of total billed charges8.90.8999999999Percent of total billed charges8.1810.01
PHENERGAN INJ 50 MG/ML2500084CDM250RCboth11.228.429.870.88999999999Percent of total billed charges8.640.77999999999Percent of total billed charges8.640.77999999999Percent of total billed charges10.10.9999999999Percent of total billed charges10.10.9999999999Percent of total billed charges8.260.736999999999Percent of total billed charges8.980.8999999999Percent of total billed charges8.980.8999999999Percent of total billed charges8.980.8999999999Percent of total billed charges8.2610.1
TRIAMCINOLONE 0.1% CREAM 15 GM2500100CDM250RCboth11.668.7510.260.88999999999Percent of total billed charges8.980.77999999999Percent of total billed charges8.980.77999999999Percent of total billed charges10.490.9999999999Percent of total billed charges10.490.9999999999Percent of total billed charges8.580.736999999999Percent of total billed charges9.330.8999999999Percent of total billed charges9.330.8999999999Percent of total billed charges9.330.8999999999Percent of total billed charges8.5810.49
Romazicon 0.5mg/5ml5402637CDM250RCboth12910.560.88999999999Percent of total billed charges9.240.77999999999Percent of total billed charges9.240.77999999999Percent of total billed charges10.80.9999999999Percent of total billed charges10.80.9999999999Percent of total billed charges8.830.736999999999Percent of total billed charges9.60.8999999999Percent of total billed charges9.60.8999999999Percent of total billed charges9.60.8999999999Percent of total billed charges8.8310.8
MEGACE 10ML SUSP2509455CDM250RCboth12910.560.88999999999Percent of total billed charges9.240.77999999999Percent of total billed charges9.240.77999999999Percent of total billed charges10.80.9999999999Percent of total billed charges10.80.9999999999Percent of total billed charges8.830.736999999999Percent of total billed charges9.60.8999999999Percent of total billed charges9.60.8999999999Percent of total billed charges9.60.8999999999Percent of total billed charges8.8310.8
CLARITHROMYCIN TAB 500MG2500020CDM250RCboth12.039.0210.590.88999999999Percent of total billed charges9.260.77999999999Percent of total billed charges9.260.77999999999Percent of total billed charges10.830.9999999999Percent of total billed charges10.830.9999999999Percent of total billed charges8.850.736999999999Percent of total billed charges9.620.8999999999Percent of total billed charges9.620.8999999999Percent of total billed charges9.620.8999999999Percent of total billed charges8.8510.83
BENICAR 20MG TAB2509036CDM250RCboth12.569.4211.050.88999999999Percent of total billed charges9.670.77999999999Percent of total billed charges9.670.77999999999Percent of total billed charges11.30.9999999999Percent of total billed charges11.30.9999999999Percent of total billed charges9.240.736999999999Percent of total billed charges10.050.8999999999Percent of total billed charges10.050.8999999999Percent of total billed charges10.050.8999999999Percent of total billed charges9.2411.3
1/2 NS 0.45% 1000 ML2500132CDM250RCboth12.69.4511.090.88999999999Percent of total billed charges9.70.77999999999Percent of total billed charges9.70.77999999999Percent of total billed charges11.340.9999999999Percent of total billed charges11.340.9999999999Percent of total billed charges9.270.736999999999Percent of total billed charges10.080.8999999999Percent of total billed charges10.080.8999999999Percent of total billed charges10.080.8999999999Percent of total billed charges9.2711.34
D5 LR 1000ML2500024CDM250RCboth12.69.4511.090.88999999999Percent of total billed charges9.70.77999999999Percent of total billed charges9.70.77999999999Percent of total billed charges11.340.9999999999Percent of total billed charges11.340.9999999999Percent of total billed charges9.270.736999999999Percent of total billed charges10.080.8999999999Percent of total billed charges10.080.8999999999Percent of total billed charges10.080.8999999999Percent of total billed charges9.2711.34
D5W 1000ML2500026CDM250RCboth12.69.4511.090.88999999999Percent of total billed charges9.70.77999999999Percent of total billed charges9.70.77999999999Percent of total billed charges11.340.9999999999Percent of total billed charges11.340.9999999999Percent of total billed charges9.270.736999999999Percent of total billed charges10.080.8999999999Percent of total billed charges10.080.8999999999Percent of total billed charges10.080.8999999999Percent of total billed charges9.2711.34
D5W 250ML2500027CDM250RCboth12.69.4511.090.88999999999Percent of total billed charges9.70.77999999999Percent of total billed charges9.70.77999999999Percent of total billed charges11.340.9999999999Percent of total billed charges11.340.9999999999Percent of total billed charges9.270.736999999999Percent of total billed charges10.080.8999999999Percent of total billed charges10.080.8999999999Percent of total billed charges10.080.8999999999Percent of total billed charges9.2711.34
LACT RING SOL 1000ML2600220CDM250RCboth12.69.4511.090.88999999999Percent of total billed charges9.70.77999999999Percent of total billed charges9.70.77999999999Percent of total billed charges11.340.9999999999Percent of total billed charges11.340.9999999999Percent of total billed charges9.270.736999999999Percent of total billed charges10.080.8999999999Percent of total billed charges10.080.8999999999Percent of total billed charges10.080.8999999999Percent of total billed charges9.2711.34
NORMAL SALINE 250ML2600250CDM250RCboth12.69.4511.090.88999999999Percent of total billed charges9.70.77999999999Percent of total billed charges9.70.77999999999Percent of total billed charges11.340.9999999999Percent of total billed charges11.340.9999999999Percent of total billed charges9.270.736999999999Percent of total billed charges10.080.8999999999Percent of total billed charges10.080.8999999999Percent of total billed charges10.080.8999999999Percent of total billed charges9.2711.34
NORMAL SALINE 500ML2600260CDM250RCboth12.69.4511.090.88999999999Percent of total billed charges9.70.77999999999Percent of total billed charges9.70.77999999999Percent of total billed charges11.340.9999999999Percent of total billed charges11.340.9999999999Percent of total billed charges9.270.736999999999Percent of total billed charges10.080.8999999999Percent of total billed charges10.080.8999999999Percent of total billed charges10.080.8999999999Percent of total billed charges9.2711.34
DIGOXIN INJ 500MCG/2ML2500031CDM250RCboth13.29.911.620.88999999999Percent of total billed charges10.160.77999999999Percent of total billed charges10.160.77999999999Percent of total billed charges11.880.9999999999Percent of total billed charges11.880.9999999999Percent of total billed charges9.720.736999999999Percent of total billed charges10.560.8999999999Percent of total billed charges10.560.8999999999Percent of total billed charges10.560.8999999999Percent of total billed charges9.7211.88
AMIDATE 40MG/ML2506441CDM250RCboth13.3410.0111.740.88999999999Percent of total billed charges10.270.77999999999Percent of total billed charges10.270.77999999999Percent of total billed charges12.010.9999999999Percent of total billed charges12.010.9999999999Percent of total billed charges9.820.736999999999Percent of total billed charges10.670.8999999999Percent of total billed charges10.670.8999999999Percent of total billed charges10.670.8999999999Percent of total billed charges9.8212.01
XOPENEX 0.63 MG/3 ML2500052CDM250RCboth13.410.0511.790.88999999999Percent of total billed charges10.320.77999999999Percent of total billed charges10.320.77999999999Percent of total billed charges12.060.9999999999Percent of total billed charges12.060.9999999999Percent of total billed charges9.860.736999999999Percent of total billed charges10.720.8999999999Percent of total billed charges10.720.8999999999Percent of total billed charges10.720.8999999999Percent of total billed charges9.8612.06
XOPENEX 0.31 MG/3 ML2500051CDM250RCboth13.4110.0611.80.88999999999Percent of total billed charges10.330.77999999999Percent of total billed charges10.330.77999999999Percent of total billed charges12.070.9999999999Percent of total billed charges12.070.9999999999Percent of total billed charges9.870.736999999999Percent of total billed charges10.730.8999999999Percent of total billed charges10.730.8999999999Percent of total billed charges10.730.8999999999Percent of total billed charges9.8712.07
XOPENEX 1.25 MG/0.5ML2501314CDM250RCboth13.4110.0611.80.88999999999Percent of total billed charges10.330.77999999999Percent of total billed charges10.330.77999999999Percent of total billed charges12.070.9999999999Percent of total billed charges12.070.9999999999Percent of total billed charges9.870.736999999999Percent of total billed charges10.730.8999999999Percent of total billed charges10.730.8999999999Percent of total billed charges10.730.8999999999Percent of total billed charges9.8712.07
Dextrose 5% Solution in Water (D5W) 250m5402633CDM250RCboth1410.512.320.88999999999Percent of total billed charges10.780.77999999999Percent of total billed charges10.780.77999999999Percent of total billed charges12.60.9999999999Percent of total billed charges12.60.9999999999Percent of total billed charges10.30.736999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges10.312.6
AMOXIL 250MG/5ML 80ML2501266CDM250RCboth1410.512.320.88999999999Percent of total billed charges10.780.77999999999Percent of total billed charges10.780.77999999999Percent of total billed charges12.60.9999999999Percent of total billed charges12.60.9999999999Percent of total billed charges10.30.736999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges10.312.6
PEDIALYTE 8OZ BOTTLE2505081CDM250RCboth1410.512.320.88999999999Percent of total billed charges10.780.77999999999Percent of total billed charges10.780.77999999999Percent of total billed charges12.60.9999999999Percent of total billed charges12.60.9999999999Percent of total billed charges10.30.736999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges10.312.6
WATER,STERILE 20CC2501236CDM250RCboth1410.512.320.88999999999Percent of total billed charges10.780.77999999999Percent of total billed charges10.780.77999999999Percent of total billed charges12.60.9999999999Percent of total billed charges12.60.9999999999Percent of total billed charges10.30.736999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges10.312.6
ACTOS TAB 15 MG2500080CDM250RCboth14.0110.5112.330.88999999999Percent of total billed charges10.790.77999999999Percent of total billed charges10.790.77999999999Percent of total billed charges12.610.9999999999Percent of total billed charges12.610.9999999999Percent of total billed charges10.310.736999999999Percent of total billed charges11.210.8999999999Percent of total billed charges11.210.8999999999Percent of total billed charges11.210.8999999999Percent of total billed charges10.3112.61
Levofloxacin 750mg/150ml IV2508894CDM250RCboth14.1610.6212.460.88999999999Percent of total billed charges10.90.77999999999Percent of total billed charges10.90.77999999999Percent of total billed charges12.740.9999999999Percent of total billed charges12.740.9999999999Percent of total billed charges10.420.736999999999Percent of total billed charges11.330.8999999999Percent of total billed charges11.330.8999999999Percent of total billed charges11.330.8999999999Percent of total billed charges10.4212.74
VALTREX 500MG CAPLET2502021CDM250RCboth14.4510.8412.720.88999999999Percent of total billed charges11.130.77999999999Percent of total billed charges11.130.77999999999Percent of total billed charges13.010.9999999999Percent of total billed charges13.010.9999999999Percent of total billed charges10.640.736999999999Percent of total billed charges11.560.8999999999Percent of total billed charges11.560.8999999999Percent of total billed charges11.560.8999999999Percent of total billed charges10.6413.01
ADENOCARD 3MG/ML INJ 2ML2509252CDM250RCboth14.8811.1613.090.88999999999Percent of total billed charges11.460.77999999999Percent of total billed charges11.460.77999999999Percent of total billed charges13.390.9999999999Percent of total billed charges13.390.9999999999Percent of total billed charges10.950.736999999999Percent of total billed charges11.90.8999999999Percent of total billed charges11.90.8999999999Percent of total billed charges11.90.8999999999Percent of total billed charges10.9513.39
CLOTIMAZOLE CREAM 1%2500021CDM250RCboth14.9811.2413.180.88999999999Percent of total billed charges11.530.77999999999Percent of total billed charges11.530.77999999999Percent of total billed charges13.480.9999999999Percent of total billed charges13.480.9999999999Percent of total billed charges11.030.736999999999Percent of total billed charges11.980.8999999999Percent of total billed charges11.980.8999999999Percent of total billed charges11.980.8999999999Percent of total billed charges11.0313.48
HEPLOCK IV2600009CDM250RCboth1511.2513.20.88999999999Percent of total billed charges11.550.77999999999Percent of total billed charges11.550.77999999999Percent of total billed charges13.50.9999999999Percent of total billed charges13.50.9999999999Percent of total billed charges11.040.736999999999Percent of total billed charges120.8999999999Percent of total billed charges120.8999999999Percent of total billed charges120.8999999999Percent of total billed charges11.0413.5
Nystatin Powder 15gm2508984CDM250RCboth1511.2513.20.88999999999Percent of total billed charges11.550.77999999999Percent of total billed charges11.550.77999999999Percent of total billed charges13.50.9999999999Percent of total billed charges13.50.9999999999Percent of total billed charges11.040.736999999999Percent of total billed charges120.8999999999Percent of total billed charges120.8999999999Percent of total billed charges120.8999999999Percent of total billed charges11.0413.5
TET/DIPH/TOX ADULT 5ML IN2503373CDM250RCboth1511.2513.20.88999999999Percent of total billed charges11.550.77999999999Percent of total billed charges11.550.77999999999Percent of total billed charges13.50.9999999999Percent of total billed charges13.50.9999999999Percent of total billed charges11.040.736999999999Percent of total billed charges120.8999999999Percent of total billed charges120.8999999999Percent of total billed charges120.8999999999Percent of total billed charges11.0413.5
CALCIUM CHLORIDE 10% INJ2509181CDM250RCboth161214.080.88999999999Percent of total billed charges12.320.77999999999Percent of total billed charges12.320.77999999999Percent of total billed charges14.40.9999999999Percent of total billed charges14.40.9999999999Percent of total billed charges11.780.736999999999Percent of total billed charges12.80.8999999999Percent of total billed charges12.80.8999999999Percent of total billed charges12.80.8999999999Percent of total billed charges11.7814.4
CEFUROXIME AXETIL 500 MG2500135CDM250RCboth161214.080.88999999999Percent of total billed charges12.320.77999999999Percent of total billed charges12.320.77999999999Percent of total billed charges14.40.9999999999Percent of total billed charges14.40.9999999999Percent of total billed charges11.780.736999999999Percent of total billed charges12.80.8999999999Percent of total billed charges12.80.8999999999Percent of total billed charges12.80.8999999999Percent of total billed charges11.7814.4
ROMAZICON 0.5/5ML2502613CDM250RCboth16.2512.1914.30.88999999999Percent of total billed charges12.510.77999999999Percent of total billed charges12.510.77999999999Percent of total billed charges14.630.9999999999Percent of total billed charges14.630.9999999999Percent of total billed charges11.960.736999999999Percent of total billed charges130.8999999999Percent of total billed charges130.8999999999Percent of total billed charges130.8999999999Percent of total billed charges11.9614.63
MARCAINE 0.25% INJ 10ML2506910CDM250RCboth16.5812.4414.590.88999999999Percent of total billed charges12.770.77999999999Percent of total billed charges12.770.77999999999Percent of total billed charges14.920.9999999999Percent of total billed charges14.920.9999999999Percent of total billed charges12.20.736999999999Percent of total billed charges13.260.8999999999Percent of total billed charges13.260.8999999999Percent of total billed charges13.260.8999999999Percent of total billed charges12.214.92
LOVENOX 10MG INJ2500034CDM250RCboth17.8413.3815.70.88999999999Percent of total billed charges13.740.77999999999Percent of total billed charges13.740.77999999999Percent of total billed charges16.060.9999999999Percent of total billed charges16.060.9999999999Percent of total billed charges13.130.736999999999Percent of total billed charges14.270.8999999999Percent of total billed charges14.270.8999999999Percent of total billed charges14.270.8999999999Percent of total billed charges13.1316.06
PULMICORT 0.25MG/2ML2500014CDM250RCboth18.9714.2316.690.88999999999Percent of total billed charges14.610.77999999999Percent of total billed charges14.610.77999999999Percent of total billed charges17.070.9999999999Percent of total billed charges17.070.9999999999Percent of total billed charges13.960.736999999999Percent of total billed charges15.180.8999999999Percent of total billed charges15.180.8999999999Percent of total billed charges15.180.8999999999Percent of total billed charges13.9617.07
Heparin Sodium 30,000 units/30ml2500140CDM250RCboth1914.2516.720.88999999999Percent of total billed charges14.630.77999999999Percent of total billed charges14.630.77999999999Percent of total billed charges17.10.9999999999Percent of total billed charges17.10.9999999999Percent of total billed charges13.980.736999999999Percent of total billed charges15.20.8999999999Percent of total billed charges15.20.8999999999Percent of total billed charges15.20.8999999999Percent of total billed charges13.9817.1
Levoquin 750mg IV2508898CDM250RCboth1914.2516.720.88999999999Percent of total billed charges14.630.77999999999Percent of total billed charges14.630.77999999999Percent of total billed charges17.10.9999999999Percent of total billed charges17.10.9999999999Percent of total billed charges13.980.736999999999Percent of total billed charges15.20.8999999999Percent of total billed charges15.20.8999999999Percent of total billed charges15.20.8999999999Percent of total billed charges13.9817.1
VANCOMYCIN INJ 500 MG2500109CDM250RCboth19.314.4816.980.88999999999Percent of total billed charges14.860.77999999999Percent of total billed charges14.860.77999999999Percent of total billed charges17.370.9999999999Percent of total billed charges17.370.9999999999Percent of total billed charges14.20.736999999999Percent of total billed charges15.440.8999999999Percent of total billed charges15.440.8999999999Percent of total billed charges15.440.8999999999Percent of total billed charges14.217.37
Fluconazole 100mg tab2509652CDM250RCboth19.4214.5717.090.88999999999Percent of total billed charges14.950.77999999999Percent of total billed charges14.950.77999999999Percent of total billed charges17.480.9999999999Percent of total billed charges17.480.9999999999Percent of total billed charges14.290.736999999999Percent of total billed charges15.540.8999999999Percent of total billed charges15.540.8999999999Percent of total billed charges15.540.8999999999Percent of total billed charges14.2917.48
Tranexamic Acid 1000mg2509785CDM250RCboth201517.60.88999999999Percent of total billed charges15.40.77999999999Percent of total billed charges15.40.77999999999Percent of total billed charges180.9999999999Percent of total billed charges180.9999999999Percent of total billed charges14.720.736999999999Percent of total billed charges160.8999999999Percent of total billed charges160.8999999999Percent of total billed charges160.8999999999Percent of total billed charges14.7218
CIPROFLOXACIN OPTH .3% 5ML2502212CDM250RCboth20.415.317.950.88999999999Percent of total billed charges15.710.77999999999Percent of total billed charges15.710.77999999999Percent of total billed charges18.360.9999999999Percent of total billed charges18.360.9999999999Percent of total billed charges15.010.736999999999Percent of total billed charges16.320.8999999999Percent of total billed charges16.320.8999999999Percent of total billed charges16.320.8999999999Percent of total billed charges15.0118.36
VECURONIUM 10MG2509643CDM250RCboth20.415.317.950.88999999999Percent of total billed charges15.710.77999999999Percent of total billed charges15.710.77999999999Percent of total billed charges18.360.9999999999Percent of total billed charges18.360.9999999999Percent of total billed charges15.010.736999999999Percent of total billed charges16.320.8999999999Percent of total billed charges16.320.8999999999Percent of total billed charges16.320.8999999999Percent of total billed charges15.0118.36
PROCAINAMID INJ 1000 MG/ 10 ML2500083CDM250RCboth20.7315.5518.240.88999999999Percent of total billed charges15.960.77999999999Percent of total billed charges15.960.77999999999Percent of total billed charges18.660.9999999999Percent of total billed charges18.660.9999999999Percent of total billed charges15.260.736999999999Percent of total billed charges16.580.8999999999Percent of total billed charges16.580.8999999999Percent of total billed charges16.580.8999999999Percent of total billed charges15.2618.66
MVI-12 IV2509663CDM250RCboth2115.7518.480.88999999999Percent of total billed charges16.170.77999999999Percent of total billed charges16.170.77999999999Percent of total billed charges18.90.9999999999Percent of total billed charges18.90.9999999999Percent of total billed charges15.460.736999999999Percent of total billed charges16.80.8999999999Percent of total billed charges16.80.8999999999Percent of total billed charges16.80.8999999999Percent of total billed charges15.4618.9
CALCIUM CHLORIDE 1G2501196CDM250RCboth21.616.219.010.88999999999Percent of total billed charges16.630.77999999999Percent of total billed charges16.630.77999999999Percent of total billed charges19.440.9999999999Percent of total billed charges19.440.9999999999Percent of total billed charges15.90.736999999999Percent of total billed charges17.280.8999999999Percent of total billed charges17.280.8999999999Percent of total billed charges17.280.8999999999Percent of total billed charges15.919.44
Calcium Gluconate 10% SDV2504688CDM250RCboth21.9616.4719.320.88999999999Percent of total billed charges16.910.77999999999Percent of total billed charges16.910.77999999999Percent of total billed charges19.760.9999999999Percent of total billed charges19.760.9999999999Percent of total billed charges16.160.736999999999Percent of total billed charges17.570.8999999999Percent of total billed charges17.570.8999999999Percent of total billed charges17.570.8999999999Percent of total billed charges16.1619.76
Orphenadrine 30mg/ml Vial2500206CDM250RCboth22.216.6519.540.88999999999Percent of total billed charges17.090.77999999999Percent of total billed charges17.090.77999999999Percent of total billed charges19.980.9999999999Percent of total billed charges19.980.9999999999Percent of total billed charges16.340.736999999999Percent of total billed charges17.760.8999999999Percent of total billed charges17.760.8999999999Percent of total billed charges17.760.8999999999Percent of total billed charges16.3419.98
Kenalog 40 40mg/ml SDV2509165CDM250RCboth22.4616.8519.760.88999999999Percent of total billed charges17.290.77999999999Percent of total billed charges17.290.77999999999Percent of total billed charges20.210.9999999999Percent of total billed charges20.210.9999999999Percent of total billed charges16.530.736999999999Percent of total billed charges17.970.8999999999Percent of total billed charges17.970.8999999999Percent of total billed charges17.970.8999999999Percent of total billed charges16.5320.21
KAYEXALATE SUSPENSION 15 GM/60 ML2500092CDM250RCboth22.516.8819.80.88999999999Percent of total billed charges17.330.77999999999Percent of total billed charges17.330.77999999999Percent of total billed charges20.250.9999999999Percent of total billed charges20.250.9999999999Percent of total billed charges16.560.736999999999Percent of total billed charges180.8999999999Percent of total billed charges180.8999999999Percent of total billed charges180.8999999999Percent of total billed charges16.5620.25
DEXAMETHASONE 10MG/ML2506669CDM250RCboth241821.120.88999999999Percent of total billed charges18.480.77999999999Percent of total billed charges18.480.77999999999Percent of total billed charges21.60.9999999999Percent of total billed charges21.60.9999999999Percent of total billed charges17.660.736999999999Percent of total billed charges19.20.8999999999Percent of total billed charges19.20.8999999999Percent of total billed charges19.20.8999999999Percent of total billed charges17.6621.6
MVI INJ2500070CDM250RCboth24.2818.2121.370.88999999999Percent of total billed charges18.70.77999999999Percent of total billed charges18.70.77999999999Percent of total billed charges21.850.9999999999Percent of total billed charges21.850.9999999999Percent of total billed charges17.870.736999999999Percent of total billed charges19.420.8999999999Percent of total billed charges19.420.8999999999Percent of total billed charges19.420.8999999999Percent of total billed charges17.8721.85
MUCOMYST 20%2501132CDM250RCboth24.5518.4121.60.88999999999Percent of total billed charges18.90.77999999999Percent of total billed charges18.90.77999999999Percent of total billed charges22.10.9999999999Percent of total billed charges22.10.9999999999Percent of total billed charges18.070.736999999999Percent of total billed charges19.640.8999999999Percent of total billed charges19.640.8999999999Percent of total billed charges19.640.8999999999Percent of total billed charges18.0722.1
FLU VACCINE 0.5ML2500041CDM250RCboth2518.75220.88999999999Percent of total billed charges19.250.77999999999Percent of total billed charges19.250.77999999999Percent of total billed charges22.50.9999999999Percent of total billed charges22.50.9999999999Percent of total billed charges18.40.736999999999Percent of total billed charges200.8999999999Percent of total billed charges200.8999999999Percent of total billed charges200.8999999999Percent of total billed charges18.422.5
INFLUENZA VACCINE .5 ML2509644CDM250RCboth2518.75220.88999999999Percent of total billed charges19.250.77999999999Percent of total billed charges19.250.77999999999Percent of total billed charges22.50.9999999999Percent of total billed charges22.50.9999999999Percent of total billed charges18.40.736999999999Percent of total billed charges200.8999999999Percent of total billed charges200.8999999999Percent of total billed charges200.8999999999Percent of total billed charges18.422.5
Prednisolone 15 mg/5ml susp 240ml2508897CDM250RCboth2518.75220.88999999999Percent of total billed charges19.250.77999999999Percent of total billed charges19.250.77999999999Percent of total billed charges22.50.9999999999Percent of total billed charges22.50.9999999999Percent of total billed charges18.40.736999999999Percent of total billed charges200.8999999999Percent of total billed charges200.8999999999Percent of total billed charges200.8999999999Percent of total billed charges18.422.5
MARCAINE 0.5% 30ML INJ2506072CDM250RCboth26.8820.1623.650.88999999999Percent of total billed charges20.70.77999999999Percent of total billed charges20.70.77999999999Percent of total billed charges24.190.9999999999Percent of total billed charges24.190.9999999999Percent of total billed charges19.780.736999999999Percent of total billed charges21.50.8999999999Percent of total billed charges21.50.8999999999Percent of total billed charges21.50.8999999999Percent of total billed charges19.7824.19
TAMIFLU 75MG PO2509680CDM250RCboth27.3220.4924.040.88999999999Percent of total billed charges21.040.77999999999Percent of total billed charges21.040.77999999999Percent of total billed charges24.590.9999999999Percent of total billed charges24.590.9999999999Percent of total billed charges20.110.736999999999Percent of total billed charges21.860.8999999999Percent of total billed charges21.860.8999999999Percent of total billed charges21.860.8999999999Percent of total billed charges20.1124.59
Kenalog 40 40mg/ml MDV2509164CDM250RCboth282124.640.88999999999Percent of total billed charges21.560.77999999999Percent of total billed charges21.560.77999999999Percent of total billed charges25.20.9999999999Percent of total billed charges25.20.9999999999Percent of total billed charges20.610.736999999999Percent of total billed charges22.40.8999999999Percent of total billed charges22.40.8999999999Percent of total billed charges22.40.8999999999Percent of total billed charges20.6125.2
Fentanyl Patch 25mcgl/hr2506799CDM250RCboth28.8421.6325.380.88999999999Percent of total billed charges22.210.77999999999Percent of total billed charges22.210.77999999999Percent of total billed charges25.960.9999999999Percent of total billed charges25.960.9999999999Percent of total billed charges21.230.736999999999Percent of total billed charges23.070.8999999999Percent of total billed charges23.070.8999999999Percent of total billed charges23.070.8999999999Percent of total billed charges21.2325.96
ACTIVATED CHARCOAL2501030CDM250RCboth2921.7525.520.88999999999Percent of total billed charges22.330.77999999999Percent of total billed charges22.330.77999999999Percent of total billed charges26.10.9999999999Percent of total billed charges26.10.9999999999Percent of total billed charges21.340.736999999999Percent of total billed charges23.20.8999999999Percent of total billed charges23.20.8999999999Percent of total billed charges23.20.8999999999Percent of total billed charges21.3426.1
Polytrim ophth 10ml2509988CDM250RCboth2921.7525.520.88999999999Percent of total billed charges22.330.77999999999Percent of total billed charges22.330.77999999999Percent of total billed charges26.10.9999999999Percent of total billed charges26.10.9999999999Percent of total billed charges21.340.736999999999Percent of total billed charges23.20.8999999999Percent of total billed charges23.20.8999999999Percent of total billed charges23.20.8999999999Percent of total billed charges21.3426.1
PROTAMINE INJ 50 MG/5 ML2500086CDM250RCboth29.522.1325.960.88999999999Percent of total billed charges22.720.77999999999Percent of total billed charges22.720.77999999999Percent of total billed charges26.550.9999999999Percent of total billed charges26.550.9999999999Percent of total billed charges21.710.736999999999Percent of total billed charges23.60.8999999999Percent of total billed charges23.60.8999999999Percent of total billed charges23.60.8999999999Percent of total billed charges21.7126.55
EPINEPHRINE AMP 1MG/ML2500037CDM250RCboth3022.526.40.88999999999Percent of total billed charges23.10.77999999999Percent of total billed charges23.10.77999999999Percent of total billed charges270.9999999999Percent of total billed charges270.9999999999Percent of total billed charges22.080.736999999999Percent of total billed charges240.8999999999Percent of total billed charges240.8999999999Percent of total billed charges240.8999999999Percent of total billed charges22.0827
Levofloxacin D5W 500Mg/100Ml2508896CDM250RCboth30.1222.5926.510.88999999999Percent of total billed charges23.190.77999999999Percent of total billed charges23.190.77999999999Percent of total billed charges27.110.9999999999Percent of total billed charges27.110.9999999999Percent of total billed charges22.170.736999999999Percent of total billed charges24.10.8999999999Percent of total billed charges24.10.8999999999Percent of total billed charges24.10.8999999999Percent of total billed charges22.1727.11
PEN G INJ 5,000,000 UNITS2500079CDM250RCboth30.3822.7926.730.88999999999Percent of total billed charges23.390.77999999999Percent of total billed charges23.390.77999999999Percent of total billed charges27.340.9999999999Percent of total billed charges27.340.9999999999Percent of total billed charges22.360.736999999999Percent of total billed charges24.30.8999999999Percent of total billed charges24.30.8999999999Percent of total billed charges24.30.8999999999Percent of total billed charges22.3627.34
ZANTAC 50MG/2ML INJ2503156CDM250RCboth30.9423.2127.230.88999999999Percent of total billed charges23.820.77999999999Percent of total billed charges23.820.77999999999Percent of total billed charges27.850.9999999999Percent of total billed charges27.850.9999999999Percent of total billed charges22.770.736999999999Percent of total billed charges24.750.8999999999Percent of total billed charges24.750.8999999999Percent of total billed charges24.750.8999999999Percent of total billed charges22.7727.85
Cleocin 600mg/4ml2500147CDM250RCboth3123.2527.280.88999999999Percent of total billed charges23.870.77999999999Percent of total billed charges23.870.77999999999Percent of total billed charges27.90.9999999999Percent of total billed charges27.90.9999999999Percent of total billed charges22.820.736999999999Percent of total billed charges24.80.8999999999Percent of total billed charges24.80.8999999999Percent of total billed charges24.80.8999999999Percent of total billed charges22.8227.9
UNASYN 1.5MG2501233CDM250RCboth3123.2527.280.88999999999Percent of total billed charges23.870.77999999999Percent of total billed charges23.870.77999999999Percent of total billed charges27.90.9999999999Percent of total billed charges27.90.9999999999Percent of total billed charges22.820.736999999999Percent of total billed charges24.80.8999999999Percent of total billed charges24.80.8999999999Percent of total billed charges24.80.8999999999Percent of total billed charges22.8227.9
Scopolamine patch 1mg2500149CDM250RCboth3123.2527.280.88999999999Percent of total billed charges23.870.77999999999Percent of total billed charges23.870.77999999999Percent of total billed charges27.90.9999999999Percent of total billed charges27.90.9999999999Percent of total billed charges22.820.736999999999Percent of total billed charges24.80.8999999999Percent of total billed charges24.80.8999999999Percent of total billed charges24.80.8999999999Percent of total billed charges22.8227.9
DOPAMINE/DEX 400MG 250ML BAG2501294CDM250RCboth31.0823.3127.350.88999999999Percent of total billed charges23.930.77999999999Percent of total billed charges23.930.77999999999Percent of total billed charges27.970.9999999999Percent of total billed charges27.970.9999999999Percent of total billed charges22.870.736999999999Percent of total billed charges24.860.8999999999Percent of total billed charges24.860.8999999999Percent of total billed charges24.860.8999999999Percent of total billed charges22.8727.97
AZITHROMYCIN 500MG TAB2501268CDM250RCboth31.1323.3527.390.88999999999Percent of total billed charges23.970.77999999999Percent of total billed charges23.970.77999999999Percent of total billed charges28.020.9999999999Percent of total billed charges28.020.9999999999Percent of total billed charges22.910.736999999999Percent of total billed charges24.90.8999999999Percent of total billed charges24.90.8999999999Percent of total billed charges24.90.8999999999Percent of total billed charges22.9128.02
HYDRALAZINE 20MG INJ2501096CDM250RCboth31.3923.5427.620.88999999999Percent of total billed charges24.170.77999999999Percent of total billed charges24.170.77999999999Percent of total billed charges28.250.9999999999Percent of total billed charges28.250.9999999999Percent of total billed charges23.10.736999999999Percent of total billed charges25.110.8999999999Percent of total billed charges25.110.8999999999Percent of total billed charges25.110.8999999999Percent of total billed charges23.128.25
NEXIUM 40MG CAP2506069CDM250RCboth322428.160.88999999999Percent of total billed charges24.640.77999999999Percent of total billed charges24.640.77999999999Percent of total billed charges28.80.9999999999Percent of total billed charges28.80.9999999999Percent of total billed charges23.550.736999999999Percent of total billed charges25.60.8999999999Percent of total billed charges25.60.8999999999Percent of total billed charges25.60.8999999999Percent of total billed charges23.5528.8
Orphenadrine 30mg/ml vial2508983CDM250RCboth322428.160.88999999999Percent of total billed charges24.640.77999999999Percent of total billed charges24.640.77999999999Percent of total billed charges28.80.9999999999Percent of total billed charges28.80.9999999999Percent of total billed charges23.550.736999999999Percent of total billed charges25.60.8999999999Percent of total billed charges25.60.8999999999Percent of total billed charges25.60.8999999999Percent of total billed charges23.5528.8
GOLYTELY SOL 3840ML2508081CDM250RCboth3324.7529.040.88999999999Percent of total billed charges25.410.77999999999Percent of total billed charges25.410.77999999999Percent of total billed charges29.70.9999999999Percent of total billed charges29.70.9999999999Percent of total billed charges24.290.736999999999Percent of total billed charges26.40.8999999999Percent of total billed charges26.40.8999999999Percent of total billed charges26.40.8999999999Percent of total billed charges24.2929.7
TAMIFLU CAP 30 MG2500096CDM250RCboth33.4425.0829.430.88999999999Percent of total billed charges25.750.77999999999Percent of total billed charges25.750.77999999999Percent of total billed charges30.10.9999999999Percent of total billed charges30.10.9999999999Percent of total billed charges24.610.736999999999Percent of total billed charges26.750.8999999999Percent of total billed charges26.750.8999999999Percent of total billed charges26.750.8999999999Percent of total billed charges24.6130.1
D-5-W, 250ML2600160CDM250RCboth3425.529.920.88999999999Percent of total billed charges26.180.77999999999Percent of total billed charges26.180.77999999999Percent of total billed charges30.60.9999999999Percent of total billed charges30.60.9999999999Percent of total billed charges25.020.736999999999Percent of total billed charges27.20.8999999999Percent of total billed charges27.20.8999999999Percent of total billed charges27.20.8999999999Percent of total billed charges25.0230.6
LANTUS INSULLIN2509420CDM250RCboth34.0325.5229.950.88999999999Percent of total billed charges26.20.77999999999Percent of total billed charges26.20.77999999999Percent of total billed charges30.630.9999999999Percent of total billed charges30.630.9999999999Percent of total billed charges25.050.736999999999Percent of total billed charges27.220.8999999999Percent of total billed charges27.220.8999999999Percent of total billed charges27.220.8999999999Percent of total billed charges25.0530.63
UNASYN 3GM INJ2508023CDM250RCboth34.4325.8230.30.88999999999Percent of total billed charges26.510.77999999999Percent of total billed charges26.510.77999999999Percent of total billed charges30.990.9999999999Percent of total billed charges30.990.9999999999Percent of total billed charges25.340.736999999999Percent of total billed charges27.540.8999999999Percent of total billed charges27.540.8999999999Percent of total billed charges27.540.8999999999Percent of total billed charges25.3430.99
D-5-W, 1000ML2600150CDM250RCboth3526.2530.80.88999999999Percent of total billed charges26.950.77999999999Percent of total billed charges26.950.77999999999Percent of total billed charges31.50.9999999999Percent of total billed charges31.50.9999999999Percent of total billed charges25.760.736999999999Percent of total billed charges280.8999999999Percent of total billed charges280.8999999999Percent of total billed charges280.8999999999Percent of total billed charges25.7631.5
NORMAL SALINE/P F 50ML2600107CDM250RCboth3526.2530.80.88999999999Percent of total billed charges26.950.77999999999Percent of total billed charges26.950.77999999999Percent of total billed charges31.50.9999999999Percent of total billed charges31.50.9999999999Percent of total billed charges25.760.736999999999Percent of total billed charges280.8999999999Percent of total billed charges280.8999999999Percent of total billed charges280.8999999999Percent of total billed charges25.7631.5
PHENERGAN 25MG SUPPOSITORY2507030CDM250RCboth35.4126.5631.160.88999999999Percent of total billed charges27.270.77999999999Percent of total billed charges27.270.77999999999Percent of total billed charges31.870.9999999999Percent of total billed charges31.870.9999999999Percent of total billed charges26.060.736999999999Percent of total billed charges28.330.8999999999Percent of total billed charges28.330.8999999999Percent of total billed charges28.330.8999999999Percent of total billed charges26.0631.87
ERYTHROMYCIN EYE OINT 0.5 3.525021214CDM250RCboth35.9226.9431.610.88999999999Percent of total billed charges27.660.77999999999Percent of total billed charges27.660.77999999999Percent of total billed charges32.330.9999999999Percent of total billed charges32.330.9999999999Percent of total billed charges26.440.736999999999Percent of total billed charges28.740.8999999999Percent of total billed charges28.740.8999999999Percent of total billed charges28.740.8999999999Percent of total billed charges26.4432.33
Fosphenytoin PE 100mg/2ml vial2509876CDM250RCboth362731.680.88999999999Percent of total billed charges27.720.77999999999Percent of total billed charges27.720.77999999999Percent of total billed charges32.40.9999999999Percent of total billed charges32.40.9999999999Percent of total billed charges26.50.736999999999Percent of total billed charges28.80.8999999999Percent of total billed charges28.80.8999999999Percent of total billed charges28.80.8999999999Percent of total billed charges26.532.4
JANUVIA 25MG2506859CDM250RCboth36.127.0831.770.88999999999Percent of total billed charges27.80.77999999999Percent of total billed charges27.80.77999999999Percent of total billed charges32.490.9999999999Percent of total billed charges32.490.9999999999Percent of total billed charges26.570.736999999999Percent of total billed charges28.880.8999999999Percent of total billed charges28.880.8999999999Percent of total billed charges28.880.8999999999Percent of total billed charges26.5732.49
ENULOSE 10G/15ML 473ML2501202CDM250RCboth3727.7532.560.88999999999Percent of total billed charges28.490.77999999999Percent of total billed charges28.490.77999999999Percent of total billed charges33.30.9999999999Percent of total billed charges33.30.9999999999Percent of total billed charges27.230.736999999999Percent of total billed charges29.60.8999999999Percent of total billed charges29.60.8999999999Percent of total billed charges29.60.8999999999Percent of total billed charges27.2333.3
DOBUTREX 250 MG INJ2501201CDM250RCboth3727.7532.560.88999999999Percent of total billed charges28.490.77999999999Percent of total billed charges28.490.77999999999Percent of total billed charges33.30.9999999999Percent of total billed charges33.30.9999999999Percent of total billed charges27.230.736999999999Percent of total billed charges29.60.8999999999Percent of total billed charges29.60.8999999999Percent of total billed charges29.60.8999999999Percent of total billed charges27.2333.3
Potassium Chloride Liquid 20 meq/15ml2506389CDM250RCboth37.227.932.740.88999999999Percent of total billed charges28.640.77999999999Percent of total billed charges28.640.77999999999Percent of total billed charges33.480.9999999999Percent of total billed charges33.480.9999999999Percent of total billed charges27.380.736999999999Percent of total billed charges29.760.8999999999Percent of total billed charges29.760.8999999999Percent of total billed charges29.760.8999999999Percent of total billed charges27.3833.48
SULFACETA SOD/PRED OPHTH 10%2500095CDM250RCboth37.528.13330.88999999999Percent of total billed charges28.880.77999999999Percent of total billed charges28.880.77999999999Percent of total billed charges33.750.9999999999Percent of total billed charges33.750.9999999999Percent of total billed charges27.60.736999999999Percent of total billed charges300.8999999999Percent of total billed charges300.8999999999Percent of total billed charges300.8999999999Percent of total billed charges27.633.75
VANCOMYCIN INJ 1 GM2500108CDM250RCboth38.528.8833.880.88999999999Percent of total billed charges29.650.77999999999Percent of total billed charges29.650.77999999999Percent of total billed charges34.650.9999999999Percent of total billed charges34.650.9999999999Percent of total billed charges28.340.736999999999Percent of total billed charges30.80.8999999999Percent of total billed charges30.80.8999999999Percent of total billed charges30.80.8999999999Percent of total billed charges28.3434.65
MAGNESIUM SULFATE 50%2500125CDM250RCboth39.7229.7934.950.88999999999Percent of total billed charges30.580.77999999999Percent of total billed charges30.580.77999999999Percent of total billed charges35.750.9999999999Percent of total billed charges35.750.9999999999Percent of total billed charges29.230.736999999999Percent of total billed charges31.780.8999999999Percent of total billed charges31.780.8999999999Percent of total billed charges31.780.8999999999Percent of total billed charges29.2335.75
BACITRACIN OINT 30GM2502015CDM250RCboth4130.7536.080.88999999999Percent of total billed charges31.570.77999999999Percent of total billed charges31.570.77999999999Percent of total billed charges36.90.9999999999Percent of total billed charges36.90.9999999999Percent of total billed charges30.180.736999999999Percent of total billed charges32.80.8999999999Percent of total billed charges32.80.8999999999Percent of total billed charges32.80.8999999999Percent of total billed charges30.1836.9
LACT RING SOL 500ML2600221CDM250RCboth4130.7536.080.88999999999Percent of total billed charges31.570.77999999999Percent of total billed charges31.570.77999999999Percent of total billed charges36.90.9999999999Percent of total billed charges36.90.9999999999Percent of total billed charges30.180.736999999999Percent of total billed charges32.80.8999999999Percent of total billed charges32.80.8999999999Percent of total billed charges32.80.8999999999Percent of total billed charges30.1836.9
Orphenadrine2500208CDM250RCboth4130.7536.080.88999999999Percent of total billed charges31.570.77999999999Percent of total billed charges31.570.77999999999Percent of total billed charges36.90.9999999999Percent of total billed charges36.90.9999999999Percent of total billed charges30.180.736999999999Percent of total billed charges32.80.8999999999Percent of total billed charges32.80.8999999999Percent of total billed charges32.80.8999999999Percent of total billed charges30.1836.9
Ketoconzaole 2% cream2500145CDM250RCboth4231.536.960.88999999999Percent of total billed charges32.340.77999999999Percent of total billed charges32.340.77999999999Percent of total billed charges37.80.9999999999Percent of total billed charges37.80.9999999999Percent of total billed charges30.910.736999999999Percent of total billed charges33.60.8999999999Percent of total billed charges33.60.8999999999Percent of total billed charges33.60.8999999999Percent of total billed charges30.9137.8
NITROGLY/DEXT 200MCG/ML 250ML2501297CDM250RCboth46.3834.7940.810.88999999999Percent of total billed charges35.710.77999999999Percent of total billed charges35.710.77999999999Percent of total billed charges41.740.9999999999Percent of total billed charges41.740.9999999999Percent of total billed charges34.140.736999999999Percent of total billed charges37.10.8999999999Percent of total billed charges37.10.8999999999Percent of total billed charges37.10.8999999999Percent of total billed charges34.1441.74
ONDANSETRON 4MG/5ML 50ML SOL2509986CDM250RCboth47.9735.9842.210.88999999999Percent of total billed charges36.940.77999999999Percent of total billed charges36.940.77999999999Percent of total billed charges43.170.9999999999Percent of total billed charges43.170.9999999999Percent of total billed charges35.310.736999999999Percent of total billed charges38.380.8999999999Percent of total billed charges38.380.8999999999Percent of total billed charges38.380.8999999999Percent of total billed charges35.3143.17
LEVOPHED 1MG/ML 4ML2501285CDM250RCboth48.5536.4142.720.88999999999Percent of total billed charges37.380.77999999999Percent of total billed charges37.380.77999999999Percent of total billed charges43.70.9999999999Percent of total billed charges43.70.9999999999Percent of total billed charges35.730.736999999999Percent of total billed charges38.840.8999999999Percent of total billed charges38.840.8999999999Percent of total billed charges38.840.8999999999Percent of total billed charges35.7343.7
FENTANYL PATCH 50MCG/HR2500040CDM250RCboth52.7239.5446.390.88999999999Percent of total billed charges40.590.77999999999Percent of total billed charges40.590.77999999999Percent of total billed charges47.450.9999999999Percent of total billed charges47.450.9999999999Percent of total billed charges38.80.736999999999Percent of total billed charges42.180.8999999999Percent of total billed charges42.180.8999999999Percent of total billed charges42.180.8999999999Percent of total billed charges38.847.45
DONNATAL ELIXIR 5ML2501091CDM250RCboth53.3440.0146.940.88999999999Percent of total billed charges41.070.77999999999Percent of total billed charges41.070.77999999999Percent of total billed charges48.010.9999999999Percent of total billed charges48.010.9999999999Percent of total billed charges39.260.736999999999Percent of total billed charges42.670.8999999999Percent of total billed charges42.670.8999999999Percent of total billed charges42.670.8999999999Percent of total billed charges39.2648.01
NYSTATIN POWDER 10,000 UNITS2500077CDM250RCboth54.9241.1948.330.88999999999Percent of total billed charges42.290.77999999999Percent of total billed charges42.290.77999999999Percent of total billed charges49.430.9999999999Percent of total billed charges49.430.9999999999Percent of total billed charges40.420.736999999999Percent of total billed charges43.940.8999999999Percent of total billed charges43.940.8999999999Percent of total billed charges43.940.8999999999Percent of total billed charges40.4249.43
ZOSYN 4.5 PIPERACILLIN2500005CDM250RCboth55.141.3348.490.88999999999Percent of total billed charges42.430.77999999999Percent of total billed charges42.430.77999999999Percent of total billed charges49.590.9999999999Percent of total billed charges49.590.9999999999Percent of total billed charges40.550.736999999999Percent of total billed charges44.080.8999999999Percent of total billed charges44.080.8999999999Percent of total billed charges44.080.8999999999Percent of total billed charges40.5549.59
SOLU-CORTEF 250MG/2ML VIAL2508225CDM250RCboth59.6244.7252.470.88999999999Percent of total billed charges45.910.77999999999Percent of total billed charges45.910.77999999999Percent of total billed charges53.660.9999999999Percent of total billed charges53.660.9999999999Percent of total billed charges43.880.736999999999Percent of total billed charges47.70.8999999999Percent of total billed charges47.70.8999999999Percent of total billed charges47.70.8999999999Percent of total billed charges43.8853.66
TETRACAINE OPHTH 0.5% UD2500098CDM250RCboth60.3445.2653.10.88999999999Percent of total billed charges46.460.77999999999Percent of total billed charges46.460.77999999999Percent of total billed charges54.310.9999999999Percent of total billed charges54.310.9999999999Percent of total billed charges44.410.736999999999Percent of total billed charges48.270.8999999999Percent of total billed charges48.270.8999999999Percent of total billed charges48.270.8999999999Percent of total billed charges44.4154.31
Hurricane Spray 2oz2509062CDM250RCboth60.3845.2953.130.88999999999Percent of total billed charges46.490.77999999999Percent of total billed charges46.490.77999999999Percent of total billed charges54.340.9999999999Percent of total billed charges54.340.9999999999Percent of total billed charges44.440.736999999999Percent of total billed charges48.30.8999999999Percent of total billed charges48.30.8999999999Percent of total billed charges48.30.8999999999Percent of total billed charges44.4454.34
Ofloxacin Otic soln 0.3%2500144CDM250RCboth6246.554.560.88999999999Percent of total billed charges47.740.77999999999Percent of total billed charges47.740.77999999999Percent of total billed charges55.80.9999999999Percent of total billed charges55.80.9999999999Percent of total billed charges45.630.736999999999Percent of total billed charges49.60.8999999999Percent of total billed charges49.60.8999999999Percent of total billed charges49.60.8999999999Percent of total billed charges45.6355.8
ADENOSINE 12MG/4ML2500002CDM250RCboth62.446.854.910.88999999999Percent of total billed charges48.050.77999999999Percent of total billed charges48.050.77999999999Percent of total billed charges56.160.9999999999Percent of total billed charges56.160.9999999999Percent of total billed charges45.930.736999999999Percent of total billed charges49.920.8999999999Percent of total billed charges49.920.8999999999Percent of total billed charges49.920.8999999999Percent of total billed charges45.9356.16
CORTISPORIN OINT 1/2OZ TUBE2509567CDM250RCboth6347.2555.440.88999999999Percent of total billed charges48.510.77999999999Percent of total billed charges48.510.77999999999Percent of total billed charges56.70.9999999999Percent of total billed charges56.70.9999999999Percent of total billed charges46.370.736999999999Percent of total billed charges50.40.8999999999Percent of total billed charges50.40.8999999999Percent of total billed charges50.40.8999999999Percent of total billed charges46.3756.7
POLYETHYLENE GLYCOL NF POWDER2500001CDM250RCboth63.9247.9456.250.88999999999Percent of total billed charges49.220.77999999999Percent of total billed charges49.220.77999999999Percent of total billed charges57.530.9999999999Percent of total billed charges57.530.9999999999Percent of total billed charges47.050.736999999999Percent of total billed charges51.140.8999999999Percent of total billed charges51.140.8999999999Percent of total billed charges51.140.8999999999Percent of total billed charges47.0557.53
PAIN EASE SPRAY2500042CDM250RCboth685159.840.88999999999Percent of total billed charges52.360.77999999999Percent of total billed charges52.360.77999999999Percent of total billed charges61.20.9999999999Percent of total billed charges61.20.9999999999Percent of total billed charges50.050.736999999999Percent of total billed charges54.40.8999999999Percent of total billed charges54.40.8999999999Percent of total billed charges54.40.8999999999Percent of total billed charges50.0561.2
NITRO-DRIP 250 ML PER VIAL2508094CDM250RCboth6951.7560.720.88999999999Percent of total billed charges53.130.77999999999Percent of total billed charges53.130.77999999999Percent of total billed charges62.10.9999999999Percent of total billed charges62.10.9999999999Percent of total billed charges50.780.736999999999Percent of total billed charges55.20.8999999999Percent of total billed charges55.20.8999999999Percent of total billed charges55.20.8999999999Percent of total billed charges50.7862.1
ZITHROMAX 300MG/15ML SUSP2504729CDM250RCboth69.7652.3261.390.88999999999Percent of total billed charges53.720.77999999999Percent of total billed charges53.720.77999999999Percent of total billed charges62.780.9999999999Percent of total billed charges62.780.9999999999Percent of total billed charges51.340.736999999999Percent of total billed charges55.810.8999999999Percent of total billed charges55.810.8999999999Percent of total billed charges55.810.8999999999Percent of total billed charges51.3462.78
AUGMENTIN 400MG/57MG/5ML2500008CDM250RCboth75.556.6366.440.88999999999Percent of total billed charges58.140.77999999999Percent of total billed charges58.140.77999999999Percent of total billed charges67.950.9999999999Percent of total billed charges67.950.9999999999Percent of total billed charges55.570.736999999999Percent of total billed charges60.40.8999999999Percent of total billed charges60.40.8999999999Percent of total billed charges60.40.8999999999Percent of total billed charges55.5767.95
Ofirmev vial 1000mg/100ml2508999CDM250RCboth78.2258.6768.830.88999999999Percent of total billed charges60.230.77999999999Percent of total billed charges60.230.77999999999Percent of total billed charges70.40.9999999999Percent of total billed charges70.40.9999999999Percent of total billed charges57.570.736999999999Percent of total billed charges62.580.8999999999Percent of total billed charges62.580.8999999999Percent of total billed charges62.580.8999999999Percent of total billed charges57.5770.4
NEOSPORIN OPHTH OINT2501272CDM250RCboth78.8159.1169.350.88999999999Percent of total billed charges60.680.77999999999Percent of total billed charges60.680.77999999999Percent of total billed charges70.930.9999999999Percent of total billed charges70.930.9999999999Percent of total billed charges580.736999999999Percent of total billed charges63.050.8999999999Percent of total billed charges63.050.8999999999Percent of total billed charges63.050.8999999999Percent of total billed charges5870.93
EPHEDRINE INJ 50MG/ML2500035CDM250RCboth79.1659.3769.660.88999999999Percent of total billed charges60.950.77999999999Percent of total billed charges60.950.77999999999Percent of total billed charges71.240.9999999999Percent of total billed charges71.240.9999999999Percent of total billed charges58.260.736999999999Percent of total billed charges63.330.8999999999Percent of total billed charges63.330.8999999999Percent of total billed charges63.330.8999999999Percent of total billed charges58.2671.24
IMITREX 6MG INJ2501208CDM250RCboth86.464.876.030.88999999999Percent of total billed charges66.530.77999999999Percent of total billed charges66.530.77999999999Percent of total billed charges77.760.9999999999Percent of total billed charges77.760.9999999999Percent of total billed charges63.590.736999999999Percent of total billed charges69.120.8999999999Percent of total billed charges69.120.8999999999Percent of total billed charges69.120.8999999999Percent of total billed charges63.5977.76
VITAMIN K INJECTION2502698CDM250RCboth86.8365.1276.410.88999999999Percent of total billed charges66.860.77999999999Percent of total billed charges66.860.77999999999Percent of total billed charges78.150.9999999999Percent of total billed charges78.150.9999999999Percent of total billed charges63.910.736999999999Percent of total billed charges69.460.8999999999Percent of total billed charges69.460.8999999999Percent of total billed charges69.460.8999999999Percent of total billed charges63.9178.15
Sulfacetamide Ophth 10% 15 ml2503337CDM250RCboth91.568.6380.520.88999999999Percent of total billed charges70.460.77999999999Percent of total billed charges70.460.77999999999Percent of total billed charges82.350.9999999999Percent of total billed charges82.350.9999999999Percent of total billed charges67.340.736999999999Percent of total billed charges73.20.8999999999Percent of total billed charges73.20.8999999999Percent of total billed charges73.20.8999999999Percent of total billed charges67.3482.35
ALBUTEROL INHALER2504728CDM250RCboth99.6574.7487.690.88999999999Percent of total billed charges76.730.77999999999Percent of total billed charges76.730.77999999999Percent of total billed charges89.690.9999999999Percent of total billed charges89.690.9999999999Percent of total billed charges73.340.736999999999Percent of total billed charges79.720.8999999999Percent of total billed charges79.720.8999999999Percent of total billed charges79.720.8999999999Percent of total billed charges73.3489.69
LIDOCAINE 4% TOPICAL SOLU 1ML2506430CDM250RCboth10780.2594.160.88999999999Percent of total billed charges82.390.77999999999Percent of total billed charges82.390.77999999999Percent of total billed charges96.30.9999999999Percent of total billed charges96.30.9999999999Percent of total billed charges78.750.736999999999Percent of total billed charges85.60.8999999999Percent of total billed charges85.60.8999999999Percent of total billed charges85.60.8999999999Percent of total billed charges78.7596.3
Avelox 400mg IV2504657CDM250RCboth1128498.560.88999999999Percent of total billed charges86.240.77999999999Percent of total billed charges86.240.77999999999Percent of total billed charges100.80.9999999999Percent of total billed charges100.80.9999999999Percent of total billed charges82.430.736999999999Percent of total billed charges89.60.8999999999Percent of total billed charges89.60.8999999999Percent of total billed charges89.60.8999999999Percent of total billed charges82.43100.8
CORTISPORIN OTIC SOLN2501199CDM250RCboth151.02113.27132.90.88999999999Percent of total billed charges116.290.77999999999Percent of total billed charges116.290.77999999999Percent of total billed charges135.920.9999999999Percent of total billed charges135.920.9999999999Percent of total billed charges111.150.736999999999Percent of total billed charges120.820.8999999999Percent of total billed charges120.820.8999999999Percent of total billed charges120.820.8999999999Percent of total billed charges111.15135.92
BENTYL 10MG 2ML INJ2507025CDM250RCboth151.3113.48133.140.88999999999Percent of total billed charges116.50.77999999999Percent of total billed charges116.50.77999999999Percent of total billed charges136.170.9999999999Percent of total billed charges136.170.9999999999Percent of total billed charges111.360.736999999999Percent of total billed charges121.040.8999999999Percent of total billed charges121.040.8999999999Percent of total billed charges121.040.8999999999Percent of total billed charges111.36136.17
TAMIFLU LIQ SUS 12MG/ML 25ML2509682CDM250RCboth153114.75134.640.88999999999Percent of total billed charges117.810.77999999999Percent of total billed charges117.810.77999999999Percent of total billed charges137.70.9999999999Percent of total billed charges137.70.9999999999Percent of total billed charges112.610.736999999999Percent of total billed charges122.40.8999999999Percent of total billed charges122.40.8999999999Percent of total billed charges122.40.8999999999Percent of total billed charges112.61137.7
KETOROLAC OPHTH 0.5%2500050CDM250RCboth160.3120.23141.060.88999999999Percent of total billed charges123.430.77999999999Percent of total billed charges123.430.77999999999Percent of total billed charges144.270.9999999999Percent of total billed charges144.270.9999999999Percent of total billed charges117.980.736999999999Percent of total billed charges128.240.8999999999Percent of total billed charges128.240.8999999999Percent of total billed charges128.240.8999999999Percent of total billed charges117.98144.27
Neomycin, Polymyxin B Sulfate, Hydrocort2509967CDM250RCboth167125.25146.960.88999999999Percent of total billed charges128.590.77999999999Percent of total billed charges128.590.77999999999Percent of total billed charges150.30.9999999999Percent of total billed charges150.30.9999999999Percent of total billed charges122.910.736999999999Percent of total billed charges133.60.8999999999Percent of total billed charges133.60.8999999999Percent of total billed charges133.60.8999999999Percent of total billed charges122.91150.3
LOVENOX 100MG2506033CDM250RCboth180135158.40.88999999999Percent of total billed charges138.60.77999999999Percent of total billed charges138.60.77999999999Percent of total billed charges1620.9999999999Percent of total billed charges1620.9999999999Percent of total billed charges132.480.736999999999Percent of total billed charges1440.8999999999Percent of total billed charges1440.8999999999Percent of total billed charges1440.8999999999Percent of total billed charges132.48162
PNEUMO 23 VAC INJ2500104CDM250RCboth180.33135.25158.690.88999999999Percent of total billed charges138.850.77999999999Percent of total billed charges138.850.77999999999Percent of total billed charges162.30.9999999999Percent of total billed charges162.30.9999999999Percent of total billed charges132.720.736999999999Percent of total billed charges144.260.8999999999Percent of total billed charges144.260.8999999999Percent of total billed charges144.260.8999999999Percent of total billed charges132.72162.3
Cardene 20mg/200ml IV Premix2506477CDM250RCboth182.97137.23161.010.88999999999Percent of total billed charges140.890.77999999999Percent of total billed charges140.890.77999999999Percent of total billed charges164.670.9999999999Percent of total billed charges164.670.9999999999Percent of total billed charges134.670.736999999999Percent of total billed charges146.380.8999999999Percent of total billed charges146.380.8999999999Percent of total billed charges146.380.8999999999Percent of total billed charges134.67164.67
Glucagon 1mg kit2504656CDM250RCboth250187.52200.88999999999Percent of total billed charges192.50.77999999999Percent of total billed charges192.50.77999999999Percent of total billed charges2250.9999999999Percent of total billed charges2250.9999999999Percent of total billed charges1840.736999999999Percent of total billed charges2000.8999999999Percent of total billed charges2000.8999999999Percent of total billed charges2000.8999999999Percent of total billed charges184225
HALOPERIDOL 100MG/ML 5DV 5ML2500230CDM250RCboth264198232.320.88999999999Percent of total billed charges203.280.77999999999Percent of total billed charges203.280.77999999999Percent of total billed charges237.60.9999999999Percent of total billed charges237.60.9999999999Percent of total billed charges194.30.736999999999Percent of total billed charges211.20.8999999999Percent of total billed charges211.20.8999999999Percent of total billed charges211.20.8999999999Percent of total billed charges194.3237.6
EPI PEN 0.15MG2500036CDM250RCboth281.25210.94247.50.88999999999Percent of total billed charges216.560.77999999999Percent of total billed charges216.560.77999999999Percent of total billed charges253.130.9999999999Percent of total billed charges253.130.9999999999Percent of total billed charges2070.736999999999Percent of total billed charges2250.8999999999Percent of total billed charges2250.8999999999Percent of total billed charges2250.8999999999Percent of total billed charges207253.13
VASOPRESSIN2500126CDM250RCboth301.05225.79264.920.88999999999Percent of total billed charges231.810.77999999999Percent of total billed charges231.810.77999999999Percent of total billed charges270.950.9999999999Percent of total billed charges270.950.9999999999Percent of total billed charges221.570.736999999999Percent of total billed charges240.840.8999999999Percent of total billed charges240.840.8999999999Percent of total billed charges240.840.8999999999Percent of total billed charges221.57270.95
Daptomycin 500mg SDV2500139CDM250RCboth306229.5269.280.88999999999Percent of total billed charges235.620.77999999999Percent of total billed charges235.620.77999999999Percent of total billed charges275.40.9999999999Percent of total billed charges275.40.9999999999Percent of total billed charges225.220.736999999999Percent of total billed charges244.80.8999999999Percent of total billed charges244.80.8999999999Percent of total billed charges244.80.8999999999Percent of total billed charges225.22275.4
ALBUMIN 25% 100ML INJ2506064CDM250RCboth337.5253.132970.88999999999Percent of total billed charges259.880.77999999999Percent of total billed charges259.880.77999999999Percent of total billed charges303.750.9999999999Percent of total billed charges303.750.9999999999Percent of total billed charges248.40.736999999999Percent of total billed charges2700.8999999999Percent of total billed charges2700.8999999999Percent of total billed charges2700.8999999999Percent of total billed charges248.4303.75
Epi pen 0.3mg2506977CDM250RCboth370.51277.88326.050.88999999999Percent of total billed charges285.290.77999999999Percent of total billed charges285.290.77999999999Percent of total billed charges333.460.9999999999Percent of total billed charges333.460.9999999999Percent of total billed charges272.70.736999999999Percent of total billed charges296.410.8999999999Percent of total billed charges296.410.8999999999Percent of total billed charges296.410.8999999999Percent of total billed charges272.7333.46
EPINEPHRINE 1:1000 30ML INJ2501282CDM250RCboth493369.75433.840.88999999999Percent of total billed charges379.610.77999999999Percent of total billed charges379.610.77999999999Percent of total billed charges443.70.9999999999Percent of total billed charges443.70.9999999999Percent of total billed charges362.850.736999999999Percent of total billed charges394.40.8999999999Percent of total billed charges394.40.8999999999Percent of total billed charges394.40.8999999999Percent of total billed charges362.85443.7
NITROPRESS 50MG2501218CDM250RCboth540405475.20.88999999999Percent of total billed charges415.80.77999999999Percent of total billed charges415.80.77999999999Percent of total billed charges4860.9999999999Percent of total billed charges4860.9999999999Percent of total billed charges397.440.736999999999Percent of total billed charges4320.8999999999Percent of total billed charges4320.8999999999Percent of total billed charges4320.8999999999Percent of total billed charges397.44486
Santyl ointment2500209CDM250RCboth580435510.40.88999999999Percent of total billed charges446.60.77999999999Percent of total billed charges446.60.77999999999Percent of total billed charges5220.9999999999Percent of total billed charges5220.9999999999Percent of total billed charges426.880.736999999999Percent of total billed charges4640.8999999999Percent of total billed charges4640.8999999999Percent of total billed charges4640.8999999999Percent of total billed charges426.88522
ORENCIA 250MG/VIAL25053341CDM250RCboth845633.75743.60.88999999999Percent of total billed charges650.650.77999999999Percent of total billed charges650.650.77999999999Percent of total billed charges760.50.9999999999Percent of total billed charges760.50.9999999999Percent of total billed charges621.920.736999999999Percent of total billed charges6760.8999999999Percent of total billed charges6760.8999999999Percent of total billed charges6760.8999999999Percent of total billed charges621.92760.5
Remdesivir 100mg inj2501490CDM250RCboth11008259680.88999999999Percent of total billed charges8470.77999999999Percent of total billed charges8470.77999999999Percent of total billed charges9900.9999999999Percent of total billed charges9900.9999999999Percent of total billed charges809.60.736999999999Percent of total billed charges8800.8999999999Percent of total billed charges8800.8999999999Percent of total billed charges8800.8999999999Percent of total billed charges809.6990
Dalvance 500mg2509989CDM250RCboth3300247529040.88999999999Percent of total billed charges25410.77999999999Percent of total billed charges25410.77999999999Percent of total billed charges29700.9999999999Percent of total billed charges29700.9999999999Percent of total billed charges2428.80.736999999999Percent of total billed charges26400.8999999999Percent of total billed charges26400.8999999999Percent of total billed charges26400.8999999999Percent of total billed charges2428.82970
CROFAB INJ2500022CDM250RCboth5756.44317.35065.630.88999999999Percent of total billed charges4432.430.77999999999Percent of total billed charges4432.430.77999999999Percent of total billed charges5180.760.9999999999Percent of total billed charges5180.760.9999999999Percent of total billed charges4236.710.736999999999Percent of total billed charges4605.120.8999999999Percent of total billed charges4605.120.8999999999Percent of total billed charges4605.120.8999999999Percent of total billed charges4236.715180.76
TN KASE2501024CDM250RCboth10551.367913.529285.20.88999999999Percent of total billed charges8124.550.77999999999Percent of total billed charges8124.550.77999999999Percent of total billed charges9496.220.9999999999Percent of total billed charges9496.220.9999999999Percent of total billed charges7765.80.736999999999Percent of total billed charges8441.090.8999999999Percent of total billed charges8441.090.8999999999Percent of total billed charges8441.090.8999999999Percent of total billed charges7765.89496.22
LIDOCAINE 1% 1CC2501262CDM250RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
LIDOCAINE 1% INJ 100 MG/10 ML2500129CDM250RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
LIDOCAINE 1% W/EPI 1CC2502013CDM250RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
LIDOCAINE 2% PER CC2506623CDM250RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
LIDOCAINE 2% PER CC2506624CDM250RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
LIDOCAINE 2% SYR 100 MG/5 ML2500056CDM250RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
Lidocaine Jel 2% 5ml #102509678CDM250RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
LIDOCAINE VISCOUS 2% 15 ML UD2500057CDM250RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
VITAMIN B-12 INJ2508114CDMJ3420CPT251RCboth118.259.680.88999999999Percent of total billed charges8.470.77999999999Percent of total billed charges8.470.77999999999Percent of total billed charges9.90.9999999999Percent of total billed charges9.90.9999999999Percent of total billed charges8.10.736999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.19.9
ATROPINE 1MG/10ML ABBO2501045CDMJ7636CPT251RCboth5037.5440.88999999999Percent of total billed charges38.50.77999999999Percent of total billed charges38.50.77999999999Percent of total billed charges450.9999999999Percent of total billed charges450.9999999999Percent of total billed charges36.80.736999999999Percent of total billed charges400.8999999999Percent of total billed charges400.8999999999Percent of total billed charges400.8999999999Percent of total billed charges36.845
ACETAMIN 500MG GEL CAP2503459CDM251RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
ACETAMIN ELIX 5ML2503323CDM251RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
ACETAMIN/COD ELIX 5CC2509033CDM251RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
CLONIDINE 0.1MG TAB2509142CDM251RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
DIAZEPAM 5MG TAB2509163CDM251RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
DOCUSATE SOD 100MG CAD2501021CDM251RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
GLYBURIDE 5MG TAB2509690CDM251RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
GLYCERINE SUPP ADULT2507024CDM251RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
HYDROCHOLROTHIZIDE 25MG T2503522CDM251RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
HYDROXYZINE 25MG CAP2501151CDM251RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
IBUPROFEN 400MG TAB2503174CDM251RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
LOPERAMIDE 2MG CAP2508079CDM251RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
PROMETH 25MG TAB2503375CDM251RCboth1.010.760.890.88999999999Percent of total billed charges0.780.77999999999Percent of total billed charges0.780.77999999999Percent of total billed charges0.910.9999999999Percent of total billed charges0.910.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.810.8999999999Percent of total billed charges0.810.8999999999Percent of total billed charges0.810.8999999999Percent of total billed charges0.740.91
FUROSEMIDE 20MG TAB2503220CDM251RCboth1.030.770.910.88999999999Percent of total billed charges0.790.77999999999Percent of total billed charges0.790.77999999999Percent of total billed charges0.930.9999999999Percent of total billed charges0.930.9999999999Percent of total billed charges0.760.736999999999Percent of total billed charges0.820.8999999999Percent of total billed charges0.820.8999999999Percent of total billed charges0.820.8999999999Percent of total billed charges0.760.93
ACETAMIN/COD #3 TAB2503460CDM251RCboth1.220.921.070.88999999999Percent of total billed charges0.940.77999999999Percent of total billed charges0.940.77999999999Percent of total billed charges1.10.9999999999Percent of total billed charges1.10.9999999999Percent of total billed charges0.90.736999999999Percent of total billed charges0.980.8999999999Percent of total billed charges0.980.8999999999Percent of total billed charges0.980.8999999999Percent of total billed charges0.91.1
ACETAMIN 650MG SUPP2507001CDM251RCboth1.411.061.240.88999999999Percent of total billed charges1.090.77999999999Percent of total billed charges1.090.77999999999Percent of total billed charges1.270.9999999999Percent of total billed charges1.270.9999999999Percent of total billed charges1.040.736999999999Percent of total billed charges1.130.8999999999Percent of total billed charges1.130.8999999999Percent of total billed charges1.130.8999999999Percent of total billed charges1.041.27
TEMAZEPAM 15MG CAP2509407CDM251RCboth1.421.071.250.88999999999Percent of total billed charges1.090.77999999999Percent of total billed charges1.090.77999999999Percent of total billed charges1.280.9999999999Percent of total billed charges1.280.9999999999Percent of total billed charges1.050.736999999999Percent of total billed charges1.140.8999999999Percent of total billed charges1.140.8999999999Percent of total billed charges1.140.8999999999Percent of total billed charges1.051.28
MECLIZINE 12.5MG TAB2508074CDM251RCboth1.431.071.260.88999999999Percent of total billed charges1.10.77999999999Percent of total billed charges1.10.77999999999Percent of total billed charges1.290.9999999999Percent of total billed charges1.290.9999999999Percent of total billed charges1.050.736999999999Percent of total billed charges1.140.8999999999Percent of total billed charges1.140.8999999999Percent of total billed charges1.140.8999999999Percent of total billed charges1.051.29
ULTRAM 50MG TAB2503253CDM251RCboth1.591.191.40.88999999999Percent of total billed charges1.220.77999999999Percent of total billed charges1.220.77999999999Percent of total billed charges1.430.9999999999Percent of total billed charges1.430.9999999999Percent of total billed charges1.170.736999999999Percent of total billed charges1.270.8999999999Percent of total billed charges1.270.8999999999Percent of total billed charges1.270.8999999999Percent of total billed charges1.171.43
ATENOLOL 50MG TAB2509422CDM251RCboth1.691.271.490.88999999999Percent of total billed charges1.30.77999999999Percent of total billed charges1.30.77999999999Percent of total billed charges1.520.9999999999Percent of total billed charges1.520.9999999999Percent of total billed charges1.240.736999999999Percent of total billed charges1.350.8999999999Percent of total billed charges1.350.8999999999Percent of total billed charges1.350.8999999999Percent of total billed charges1.241.52
LORAZEPAM 1MG TAB2508101CDM251RCboth1.761.321.550.88999999999Percent of total billed charges1.360.77999999999Percent of total billed charges1.360.77999999999Percent of total billed charges1.580.9999999999Percent of total billed charges1.580.9999999999Percent of total billed charges1.30.736999999999Percent of total billed charges1.410.8999999999Percent of total billed charges1.410.8999999999Percent of total billed charges1.410.8999999999Percent of total billed charges1.31.58
CYCLOBENZAPRINE HCL 10MG2503185CDM251RCboth1.941.461.710.88999999999Percent of total billed charges1.490.77999999999Percent of total billed charges1.490.77999999999Percent of total billed charges1.750.9999999999Percent of total billed charges1.750.9999999999Percent of total billed charges1.430.736999999999Percent of total billed charges1.550.8999999999Percent of total billed charges1.550.8999999999Percent of total billed charges1.550.8999999999Percent of total billed charges1.431.75
AMPICILLIN 250MG CAP2503161CDM251RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
ASA 325MG EC TAB2503145CDM251RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
ASA TAB 325MG TAB2503035CDM251RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
ASPIRIN CHILDREN TAB2504023CDM251RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
CEPHALEXIN 250MG2501059CDM251RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
DICYCLOMINE HCL 20MG CAP2506918CDM251RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
DIPHENHYDRAMINE 25MG CAP2509272CDM251RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
FERROUS SULFATE 5ML LIQUID2509236CDM251RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
GUAIFEN DM 10ML SYRUP2508097CDM251RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
GUAIFENSIN/DM 5ML SYRUP2508121CDM251RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
IBUPROFEN 600MG TAB2503176CDM251RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
M. O. M. LIQ 30MG2505094CDM251RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
NTG S.L. 0.4MG TAB2503277CDM251RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
METOPROLOL 50MG TAB2503225CDM251RCboth2.231.671.960.88999999999Percent of total billed charges1.720.77999999999Percent of total billed charges1.720.77999999999Percent of total billed charges2.010.9999999999Percent of total billed charges2.010.9999999999Percent of total billed charges1.640.736999999999Percent of total billed charges1.780.8999999999Percent of total billed charges1.780.8999999999Percent of total billed charges1.780.8999999999Percent of total billed charges1.642.01
NITROGLYCERIN 30GM OINT2501044CDM251RCboth2.842.132.50.88999999999Percent of total billed charges2.190.77999999999Percent of total billed charges2.190.77999999999Percent of total billed charges2.560.9999999999Percent of total billed charges2.560.9999999999Percent of total billed charges2.090.736999999999Percent of total billed charges2.270.8999999999Percent of total billed charges2.270.8999999999Percent of total billed charges2.270.8999999999Percent of total billed charges2.092.56
ACETAMIN 325MG SUPP2508051CDM251RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
MAG SUL 50% 2ML INJ2503180CDM251RCboth3.792.843.340.88999999999Percent of total billed charges2.920.77999999999Percent of total billed charges2.920.77999999999Percent of total billed charges3.410.9999999999Percent of total billed charges3.410.9999999999Percent of total billed charges2.790.736999999999Percent of total billed charges3.030.8999999999Percent of total billed charges3.030.8999999999Percent of total billed charges3.030.8999999999Percent of total billed charges2.793.41
CEPHALEXIN 500MG CAP2509474CDM251RCboth433.520.88999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.60.9999999999Percent of total billed charges3.60.9999999999Percent of total billed charges2.940.736999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges2.943.6
DOXYCYCLINE 100MG TAB2503164CDM251RCboth4.743.564.170.88999999999Percent of total billed charges3.650.77999999999Percent of total billed charges3.650.77999999999Percent of total billed charges4.270.9999999999Percent of total billed charges4.270.9999999999Percent of total billed charges3.490.736999999999Percent of total billed charges3.790.8999999999Percent of total billed charges3.790.8999999999Percent of total billed charges3.790.8999999999Percent of total billed charges3.494.27
XANAX 0.5MG TAB PO2509435CDM251RCboth53.754.40.88999999999Percent of total billed charges3.850.77999999999Percent of total billed charges3.850.77999999999Percent of total billed charges4.50.9999999999Percent of total billed charges4.50.9999999999Percent of total billed charges3.680.736999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges3.684.5
CEFAZOLIN 1GM INJ2503525CDM251RCboth5.223.924.590.88999999999Percent of total billed charges4.020.77999999999Percent of total billed charges4.020.77999999999Percent of total billed charges4.70.9999999999Percent of total billed charges4.70.9999999999Percent of total billed charges3.840.736999999999Percent of total billed charges4.180.8999999999Percent of total billed charges4.180.8999999999Percent of total billed charges4.180.8999999999Percent of total billed charges3.844.7
PHENAZOP HCL 100MGTAB2503350CDM251RCboth5.44.054.750.88999999999Percent of total billed charges4.160.77999999999Percent of total billed charges4.160.77999999999Percent of total billed charges4.860.9999999999Percent of total billed charges4.860.9999999999Percent of total billed charges3.970.736999999999Percent of total billed charges4.320.8999999999Percent of total billed charges4.320.8999999999Percent of total billed charges4.320.8999999999Percent of total billed charges3.974.86
DIAZEPAM 5MG/ML INJ2509406CDM251RCboth8.756.567.70.88999999999Percent of total billed charges6.740.77999999999Percent of total billed charges6.740.77999999999Percent of total billed charges7.880.9999999999Percent of total billed charges7.880.9999999999Percent of total billed charges6.440.736999999999Percent of total billed charges70.8999999999Percent of total billed charges70.8999999999Percent of total billed charges70.8999999999Percent of total billed charges6.447.88
DEMEROL 50MG INJ2509202CDM251RCboth8.786.597.730.88999999999Percent of total billed charges6.760.77999999999Percent of total billed charges6.760.77999999999Percent of total billed charges7.90.9999999999Percent of total billed charges7.90.9999999999Percent of total billed charges6.460.736999999999Percent of total billed charges7.020.8999999999Percent of total billed charges7.020.8999999999Percent of total billed charges7.020.8999999999Percent of total billed charges6.467.9
FUROSEMIDE 20MG INJ2509173CDM251RCboth9.897.428.70.88999999999Percent of total billed charges7.620.77999999999Percent of total billed charges7.620.77999999999Percent of total billed charges8.90.9999999999Percent of total billed charges8.90.9999999999Percent of total billed charges7.280.736999999999Percent of total billed charges7.910.8999999999Percent of total billed charges7.910.8999999999Percent of total billed charges7.910.8999999999Percent of total billed charges7.288.9
THIAMINE 100MG INJ 1CC2508080CDM251RCboth10.6789.390.88999999999Percent of total billed charges8.220.77999999999Percent of total billed charges8.220.77999999999Percent of total billed charges9.60.9999999999Percent of total billed charges9.60.9999999999Percent of total billed charges7.850.736999999999Percent of total billed charges8.540.8999999999Percent of total billed charges8.540.8999999999Percent of total billed charges8.540.8999999999Percent of total billed charges7.859.6
ERYTHROMYCIN OPH 3.5GM O/2505108CDM251RCboth12910.560.88999999999Percent of total billed charges9.240.77999999999Percent of total billed charges9.240.77999999999Percent of total billed charges10.80.9999999999Percent of total billed charges10.80.9999999999Percent of total billed charges8.830.736999999999Percent of total billed charges9.60.8999999999Percent of total billed charges9.60.8999999999Percent of total billed charges9.60.8999999999Percent of total billed charges8.8310.8
EPINEPH 1/10000 INJ2509097CDM251RCboth14.410.812.670.88999999999Percent of total billed charges11.090.77999999999Percent of total billed charges11.090.77999999999Percent of total billed charges12.960.9999999999Percent of total billed charges12.960.9999999999Percent of total billed charges10.60.736999999999Percent of total billed charges11.520.8999999999Percent of total billed charges11.520.8999999999Percent of total billed charges11.520.8999999999Percent of total billed charges10.612.96
DIAZEPAM 10MG INJ2509308CDM251RCboth161214.080.88999999999Percent of total billed charges12.320.77999999999Percent of total billed charges12.320.77999999999Percent of total billed charges14.40.9999999999Percent of total billed charges14.40.9999999999Percent of total billed charges11.780.736999999999Percent of total billed charges12.80.8999999999Percent of total billed charges12.80.8999999999Percent of total billed charges12.80.8999999999Percent of total billed charges11.7814.4
PEPCID 20MG INJ2509231CDM251RCboth161214.080.88999999999Percent of total billed charges12.320.77999999999Percent of total billed charges12.320.77999999999Percent of total billed charges14.40.9999999999Percent of total billed charges14.40.9999999999Percent of total billed charges11.780.736999999999Percent of total billed charges12.80.8999999999Percent of total billed charges12.80.8999999999Percent of total billed charges12.80.8999999999Percent of total billed charges11.7814.4
SILVER SULFA CREA 50GM2503392CDM251RCboth2317.2520.240.88999999999Percent of total billed charges17.710.77999999999Percent of total billed charges17.710.77999999999Percent of total billed charges20.70.9999999999Percent of total billed charges20.70.9999999999Percent of total billed charges16.930.736999999999Percent of total billed charges18.40.8999999999Percent of total billed charges18.40.8999999999Percent of total billed charges18.40.8999999999Percent of total billed charges16.9320.7
DEXTROSE 50% 50ML INJ2509083CDM251RCboth241821.120.88999999999Percent of total billed charges18.480.77999999999Percent of total billed charges18.480.77999999999Percent of total billed charges21.60.9999999999Percent of total billed charges21.60.9999999999Percent of total billed charges17.660.736999999999Percent of total billed charges19.20.8999999999Percent of total billed charges19.20.8999999999Percent of total billed charges19.20.8999999999Percent of total billed charges17.6621.6
SOD BICARB 50MEQ/50ML INJ2509250CDM251RCboth25.3419.0122.30.88999999999Percent of total billed charges19.510.77999999999Percent of total billed charges19.510.77999999999Percent of total billed charges22.810.9999999999Percent of total billed charges22.810.9999999999Percent of total billed charges18.650.736999999999Percent of total billed charges20.270.8999999999Percent of total billed charges20.270.8999999999Percent of total billed charges20.270.8999999999Percent of total billed charges18.6522.81
METRONIDAZOLE 500MG 5MG/M2509079CDM251RCboth3425.529.920.88999999999Percent of total billed charges26.180.77999999999Percent of total billed charges26.180.77999999999Percent of total billed charges30.60.9999999999Percent of total billed charges30.60.9999999999Percent of total billed charges25.020.736999999999Percent of total billed charges27.20.8999999999Percent of total billed charges27.20.8999999999Percent of total billed charges27.20.8999999999Percent of total billed charges25.0230.6
EPINEPHRINE 1-1000 INJ2509003CDM251RCboth3526.2530.80.88999999999Percent of total billed charges26.950.77999999999Percent of total billed charges26.950.77999999999Percent of total billed charges31.50.9999999999Percent of total billed charges31.50.9999999999Percent of total billed charges25.760.736999999999Percent of total billed charges280.8999999999Percent of total billed charges280.8999999999Percent of total billed charges280.8999999999Percent of total billed charges25.7631.5
VERAPAMIL 5MG INJ2508189CDM251RCboth3727.7532.560.88999999999Percent of total billed charges28.490.77999999999Percent of total billed charges28.490.77999999999Percent of total billed charges33.30.9999999999Percent of total billed charges33.30.9999999999Percent of total billed charges27.230.736999999999Percent of total billed charges29.60.8999999999Percent of total billed charges29.60.8999999999Percent of total billed charges29.60.8999999999Percent of total billed charges27.2333.3
SILVER SULF 1% CREAMTUBE2503336CDM251RCboth37.0827.8132.630.88999999999Percent of total billed charges28.550.77999999999Percent of total billed charges28.550.77999999999Percent of total billed charges33.370.9999999999Percent of total billed charges33.370.9999999999Percent of total billed charges27.290.736999999999Percent of total billed charges29.660.8999999999Percent of total billed charges29.660.8999999999Percent of total billed charges29.660.8999999999Percent of total billed charges27.2933.37
AMPICILLIN 1000MG INJ2508182CDM251RCboth4533.7539.60.88999999999Percent of total billed charges34.650.77999999999Percent of total billed charges34.650.77999999999Percent of total billed charges40.50.9999999999Percent of total billed charges40.50.9999999999Percent of total billed charges33.120.736999999999Percent of total billed charges360.8999999999Percent of total billed charges360.8999999999Percent of total billed charges360.8999999999Percent of total billed charges33.1240.5
LIDOCAINE VISC 2% 20ML2509210CDM251RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
Initial hydration up to 1 hr26096360CDM96360CPT260RCboth11082.596.80.88999999999Percent of total billed charges84.70.77999999999Percent of total billed charges84.70.77999999999Percent of total billed charges990.9999999999Percent of total billed charges990.9999999999Percent of total billed charges80.960.736999999999Percent of total billed charges880.8999999999Percent of total billed charges880.8999999999Percent of total billed charges880.8999999999Percent of total billed charges80.9699
Hydration, ea additional hr26096361CDM96361CPT260RCboth3929.2534.320.88999999999Percent of total billed charges30.030.77999999999Percent of total billed charges30.030.77999999999Percent of total billed charges35.10.9999999999Percent of total billed charges35.10.9999999999Percent of total billed charges28.70.736999999999Percent of total billed charges31.20.8999999999Percent of total billed charges31.20.8999999999Percent of total billed charges31.20.8999999999Percent of total billed charges28.735.1
Initial Infusion up to 1 hr26096365CDM96365CPT260RCboth206154.5181.280.88999999999Percent of total billed charges158.620.77999999999Percent of total billed charges158.620.77999999999Percent of total billed charges185.40.9999999999Percent of total billed charges185.40.9999999999Percent of total billed charges151.620.736999999999Percent of total billed charges164.80.8999999999Percent of total billed charges164.80.8999999999Percent of total billed charges164.80.8999999999Percent of total billed charges151.62185.4
Infusion-each additional hour26096366CDM96366CPT260RCboth6347.2555.440.88999999999Percent of total billed charges48.510.77999999999Percent of total billed charges48.510.77999999999Percent of total billed charges56.70.9999999999Percent of total billed charges56.70.9999999999Percent of total billed charges46.370.736999999999Percent of total billed charges50.40.8999999999Percent of total billed charges50.40.8999999999Percent of total billed charges50.40.8999999999Percent of total billed charges46.3756.7
Sequential infusion up to 1 hr26096367CDM96367CPT260RCboth9067.579.20.88999999999Percent of total billed charges69.30.77999999999Percent of total billed charges69.30.77999999999Percent of total billed charges810.9999999999Percent of total billed charges810.9999999999Percent of total billed charges66.240.736999999999Percent of total billed charges720.8999999999Percent of total billed charges720.8999999999Percent of total billed charges720.8999999999Percent of total billed charges66.2481
Concurrent infusion26096368CDM96368CPT260RCboth6145.7553.680.88999999999Percent of total billed charges46.970.77999999999Percent of total billed charges46.970.77999999999Percent of total billed charges54.90.9999999999Percent of total billed charges54.90.9999999999Percent of total billed charges44.90.736999999999Percent of total billed charges48.80.8999999999Percent of total billed charges48.80.8999999999Percent of total billed charges48.80.8999999999Percent of total billed charges44.954.9
IV Push, intra-arterial26096373CDM96373CPT260RCboth5541.2548.40.88999999999Percent of total billed charges42.350.77999999999Percent of total billed charges42.350.77999999999Percent of total billed charges49.50.9999999999Percent of total billed charges49.50.9999999999Percent of total billed charges40.480.736999999999Percent of total billed charges440.8999999999Percent of total billed charges440.8999999999Percent of total billed charges440.8999999999Percent of total billed charges40.4849.5
Initial push or infusion less than 16 mi26096374CDM96374CPT260RCboth1128498.560.88999999999Percent of total billed charges86.240.77999999999Percent of total billed charges86.240.77999999999Percent of total billed charges100.80.9999999999Percent of total billed charges100.80.9999999999Percent of total billed charges82.430.736999999999Percent of total billed charges89.60.8999999999Percent of total billed charges89.60.8999999999Percent of total billed charges89.60.8999999999Percent of total billed charges82.43100.8
IV Push, each push different drug26096375CDM96375CPT260RCboth483642.240.88999999999Percent of total billed charges36.960.77999999999Percent of total billed charges36.960.77999999999Percent of total billed charges43.20.9999999999Percent of total billed charges43.20.9999999999Percent of total billed charges35.330.736999999999Percent of total billed charges38.40.8999999999Percent of total billed charges38.40.8999999999Percent of total billed charges38.40.8999999999Percent of total billed charges35.3343.2
IV push, each same drug >30 min interval26096376CDM96376CPT260RCboth483642.240.88999999999Percent of total billed charges36.960.77999999999Percent of total billed charges36.960.77999999999Percent of total billed charges43.20.9999999999Percent of total billed charges43.20.9999999999Percent of total billed charges35.330.736999999999Percent of total billed charges38.40.8999999999Percent of total billed charges38.40.8999999999Percent of total billed charges38.40.8999999999Percent of total billed charges35.3343.2
ADMIN INJECTION SUBCUTANEOUS26096372CDM96372CPT260RCboth6347.2555.440.88999999999Percent of total billed charges48.510.77999999999Percent of total billed charges48.510.77999999999Percent of total billed charges56.70.9999999999Percent of total billed charges56.70.9999999999Percent of total billed charges46.370.736999999999Percent of total billed charges50.40.8999999999Percent of total billed charges50.40.8999999999Percent of total billed charges50.40.8999999999Percent of total billed charges46.3756.7
Regen-Cov Infusion/SubQ260001CDMM0243CPT260RCboth850637.57480.88999999999Percent of total billed charges654.50.77999999999Percent of total billed charges654.50.77999999999Percent of total billed charges7650.9999999999Percent of total billed charges7650.9999999999Percent of total billed charges625.60.736999999999Percent of total billed charges6800.8999999999Percent of total billed charges6800.8999999999Percent of total billed charges6800.8999999999Percent of total billed charges625.6765
BIOPATCH PROTECTIVE DISK2502501CDM260RCboth2720.2523.760.88999999999Percent of total billed charges20.790.77999999999Percent of total billed charges20.790.77999999999Percent of total billed charges24.30.9999999999Percent of total billed charges24.30.9999999999Percent of total billed charges19.870.736999999999Percent of total billed charges21.60.8999999999Percent of total billed charges21.60.8999999999Percent of total billed charges21.60.8999999999Percent of total billed charges19.8724.3
INJECTION,ANTIBIOTIC2602003CDM260RCboth6649.558.080.88999999999Percent of total billed charges50.820.77999999999Percent of total billed charges50.820.77999999999Percent of total billed charges59.40.9999999999Percent of total billed charges59.40.9999999999Percent of total billed charges48.580.736999999999Percent of total billed charges52.80.8999999999Percent of total billed charges52.80.8999999999Percent of total billed charges52.80.8999999999Percent of total billed charges48.5859.4
IV PUMP/PER DAY2601465CDM260RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
IV PUMP PER HOUR2601461CDM261RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
INCENTIVE SPIROMETRY2703086CDM94010CPT270RCboth11082.596.80.88999999999Percent of total billed charges84.70.77999999999Percent of total billed charges84.70.77999999999Percent of total billed charges990.9999999999Percent of total billed charges990.9999999999Percent of total billed charges80.960.736999999999Percent of total billed charges880.8999999999Percent of total billed charges880.8999999999Percent of total billed charges880.8999999999Percent of total billed charges80.9699
URINAL W/COVER,DISPOSABLE2700411CDMA5102CPT270RCboth53.754.40.88999999999Percent of total billed charges3.850.77999999999Percent of total billed charges3.850.77999999999Percent of total billed charges4.50.9999999999Percent of total billed charges4.50.9999999999Percent of total billed charges3.680.736999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges3.684.5
PAD TELFA 4X4 /EA2702703CDM270RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
PEDI URETHRAL CATHETER 6FR2701500CDM270RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
SYRINGE 30MIL2709664CDM270RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
ABD WET PRUF PADS 5X92701257CDM270RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
Chlorhexidine Scrub Brush2705654CDM270RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
GAUZE BANDAGE 3 INCH2700450CDM270RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
STERILE EAR WICK27070101CDM270RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
CATHETER-SUCTION CONTROL2700291CDM270RCboth433.520.88999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.60.9999999999Percent of total billed charges3.60.9999999999Percent of total billed charges2.940.736999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges2.943.6
NEBULIZER MASK DISPOSABLE2700651CDM270RCboth433.520.88999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.60.9999999999Percent of total billed charges3.60.9999999999Percent of total billed charges2.940.736999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges2.943.6
SPONGE-DRAIN 4X4/PKG-22700557CDM270RCboth433.520.88999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.60.9999999999Percent of total billed charges3.60.9999999999Percent of total billed charges2.940.736999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges2.943.6
SUCTION CATHETER ALL SIZES2701000CDM270RCboth433.520.88999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.60.9999999999Percent of total billed charges3.60.9999999999Percent of total billed charges2.940.736999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges2.943.6
SUTURE REMOVAL KIT2701277CDM270RCboth433.520.88999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.60.9999999999Percent of total billed charges3.60.9999999999Percent of total billed charges2.940.736999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges2.943.6
TEG IV DRESSING2700262CDM270RCboth433.520.88999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.60.9999999999Percent of total billed charges3.60.9999999999Percent of total billed charges2.940.736999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges2.943.6
TUBING O2 7FT VINYL DISP2701115CDM270RCboth433.520.88999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.60.9999999999Percent of total billed charges3.60.9999999999Percent of total billed charges2.940.736999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges2.943.6
KERLIX ROLL 2"2703079CDM270RCboth53.754.40.88999999999Percent of total billed charges3.850.77999999999Percent of total billed charges3.850.77999999999Percent of total billed charges4.50.9999999999Percent of total billed charges4.50.9999999999Percent of total billed charges3.680.736999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges3.684.5
LEVER LOCK CANNULA2700020CDM270RCboth53.754.40.88999999999Percent of total billed charges3.850.77999999999Percent of total billed charges3.850.77999999999Percent of total billed charges4.50.9999999999Percent of total billed charges4.50.9999999999Percent of total billed charges3.680.736999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges3.684.5
PREP SOLUTION 2 OZ2700140CDM270RCboth53.754.40.88999999999Percent of total billed charges3.850.77999999999Percent of total billed charges3.850.77999999999Percent of total billed charges4.50.9999999999Percent of total billed charges4.50.9999999999Percent of total billed charges3.680.736999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges3.684.5
Sams finger splint roll2704699CDM270RCboth53.754.40.88999999999Percent of total billed charges3.850.77999999999Percent of total billed charges3.850.77999999999Percent of total billed charges4.50.9999999999Percent of total billed charges4.50.9999999999Percent of total billed charges3.680.736999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges3.684.5
SPECIPAN COL UNIT SPECIMEN2702566CDM270RCboth53.754.40.88999999999Percent of total billed charges3.850.77999999999Percent of total billed charges3.850.77999999999Percent of total billed charges4.50.9999999999Percent of total billed charges4.50.9999999999Percent of total billed charges3.680.736999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges3.684.5
STAPLE REMOVAL KIT2701276CDM270RCboth53.754.40.88999999999Percent of total billed charges3.850.77999999999Percent of total billed charges3.850.77999999999Percent of total billed charges4.50.9999999999Percent of total billed charges4.50.9999999999Percent of total billed charges3.680.736999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges3.684.5
2" CAST PADDING2702759CDM270RCboth64.55.280.88999999999Percent of total billed charges4.620.77999999999Percent of total billed charges4.620.77999999999Percent of total billed charges5.40.9999999999Percent of total billed charges5.40.9999999999Percent of total billed charges4.420.736999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.425.4
CALCULI STRAINER2707187CDM270RCboth64.55.280.88999999999Percent of total billed charges4.620.77999999999Percent of total billed charges4.620.77999999999Percent of total billed charges5.40.9999999999Percent of total billed charges5.40.9999999999Percent of total billed charges4.420.736999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.425.4
SYRG-EAR-ULCER BULB 2OZ/E2700408CDM270RCboth64.55.280.88999999999Percent of total billed charges4.620.77999999999Percent of total billed charges4.620.77999999999Percent of total billed charges5.40.9999999999Percent of total billed charges5.40.9999999999Percent of total billed charges4.420.736999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.425.4
3" CAST PADDING2702957CDM270RCboth75.256.160.88999999999Percent of total billed charges5.390.77999999999Percent of total billed charges5.390.77999999999Percent of total billed charges6.30.9999999999Percent of total billed charges6.30.9999999999Percent of total billed charges5.150.736999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.156.3
ANGIOCATH 14G2600014CDM270RCboth75.256.160.88999999999Percent of total billed charges5.390.77999999999Percent of total billed charges5.390.77999999999Percent of total billed charges6.30.9999999999Percent of total billed charges6.30.9999999999Percent of total billed charges5.150.736999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.156.3
CHLORAPREP APPLICATOR2700644CDM270RCboth75.256.160.88999999999Percent of total billed charges5.390.77999999999Percent of total billed charges5.390.77999999999Percent of total billed charges6.30.9999999999Percent of total billed charges6.30.9999999999Percent of total billed charges5.150.736999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.156.3
ELECTRODE MONIT ADULT RED DOT2703178CDM270RCboth75.256.160.88999999999Percent of total billed charges5.390.77999999999Percent of total billed charges5.390.77999999999Percent of total billed charges6.30.9999999999Percent of total billed charges6.30.9999999999Percent of total billed charges5.150.736999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.156.3
HEP-LOCK EXTENSION2700631CDM270RCboth75.256.160.88999999999Percent of total billed charges5.390.77999999999Percent of total billed charges5.390.77999999999Percent of total billed charges6.30.9999999999Percent of total billed charges6.30.9999999999Percent of total billed charges5.150.736999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.156.3
IRRG 0.9% NACL 250ML2706164CDM270RCboth75.256.160.88999999999Percent of total billed charges5.390.77999999999Percent of total billed charges5.390.77999999999Percent of total billed charges6.30.9999999999Percent of total billed charges6.30.9999999999Percent of total billed charges5.150.736999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.156.3
IRRG-0.9% NACL 1OOOML2706175CDM270RCboth75.256.160.88999999999Percent of total billed charges5.390.77999999999Percent of total billed charges5.390.77999999999Percent of total billed charges6.30.9999999999Percent of total billed charges6.30.9999999999Percent of total billed charges5.150.736999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.156.3
IRRG-H20 250ML2706335CDM270RCboth75.256.160.88999999999Percent of total billed charges5.390.77999999999Percent of total billed charges5.390.77999999999Percent of total billed charges6.30.9999999999Percent of total billed charges6.30.9999999999Percent of total billed charges5.150.736999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.156.3
IRRG-H20 500ML2706325CDM270RCboth75.256.160.88999999999Percent of total billed charges5.390.77999999999Percent of total billed charges5.390.77999999999Percent of total billed charges6.30.9999999999Percent of total billed charges6.30.9999999999Percent of total billed charges5.150.736999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.156.3
OPTIFOAM SACRAL DRESSING 10X92708500CDM270RCboth75.256.160.88999999999Percent of total billed charges5.390.77999999999Percent of total billed charges5.390.77999999999Percent of total billed charges6.30.9999999999Percent of total billed charges6.30.9999999999Percent of total billed charges5.150.736999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.156.3
PEDI OXYGEN MASK EA2700008CDM270RCboth75.256.160.88999999999Percent of total billed charges5.390.77999999999Percent of total billed charges5.390.77999999999Percent of total billed charges6.30.9999999999Percent of total billed charges6.30.9999999999Percent of total billed charges5.150.736999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.156.3
SPLINT-FINGER FOLDOVER W/FOAM2701789CDM270RCboth75.256.160.88999999999Percent of total billed charges5.390.77999999999Percent of total billed charges5.390.77999999999Percent of total billed charges6.30.9999999999Percent of total billed charges6.30.9999999999Percent of total billed charges5.150.736999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.156.3
TRACHEAL TUBE HOLDER2701476CDM270RCboth75.256.160.88999999999Percent of total billed charges5.390.77999999999Percent of total billed charges5.390.77999999999Percent of total billed charges6.30.9999999999Percent of total billed charges6.30.9999999999Percent of total billed charges5.150.736999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.156.3
5-0 Vicryl FS-2 Suture2704569CDM270RCboth867.040.88999999999Percent of total billed charges6.160.77999999999Percent of total billed charges6.160.77999999999Percent of total billed charges7.20.9999999999Percent of total billed charges7.20.9999999999Percent of total billed charges5.890.736999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges5.897.2
ANGIOCATH 16G2600016CDM270RCboth867.040.88999999999Percent of total billed charges6.160.77999999999Percent of total billed charges6.160.77999999999Percent of total billed charges7.20.9999999999Percent of total billed charges7.20.9999999999Percent of total billed charges5.890.736999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges5.897.2
BANDAGE-ACE ELASTIC 2 IN/2703001CDM270RCboth867.040.88999999999Percent of total billed charges6.160.77999999999Percent of total billed charges6.160.77999999999Percent of total billed charges7.20.9999999999Percent of total billed charges7.20.9999999999Percent of total billed charges5.890.736999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges5.897.2
COBAN DRESSING 2"2700285CDM270RCboth867.040.88999999999Percent of total billed charges6.160.77999999999Percent of total billed charges6.160.77999999999Percent of total billed charges7.20.9999999999Percent of total billed charges7.20.9999999999Percent of total billed charges5.890.736999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges5.897.2
FINGER SPLINT-FOAM 1/2"2701328CDM270RCboth867.040.88999999999Percent of total billed charges6.160.77999999999Percent of total billed charges6.160.77999999999Percent of total billed charges7.20.9999999999Percent of total billed charges7.20.9999999999Percent of total billed charges5.890.736999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges5.897.2
PICC and CVC Dressing change kit2700657CDM270RCboth867.040.88999999999Percent of total billed charges6.160.77999999999Percent of total billed charges6.160.77999999999Percent of total billed charges7.20.9999999999Percent of total billed charges7.20.9999999999Percent of total billed charges5.890.736999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges5.897.2
4" CAST PADDING2702956CDM270RCboth96.757.920.88999999999Percent of total billed charges6.930.77999999999Percent of total billed charges6.930.77999999999Percent of total billed charges8.10.9999999999Percent of total billed charges8.10.9999999999Percent of total billed charges6.620.736999999999Percent of total billed charges7.20.8999999999Percent of total billed charges7.20.8999999999Percent of total billed charges7.20.8999999999Percent of total billed charges6.628.1
BANDAGE-ACE ELASTIC 3 IN/2703002CDM270RCboth96.757.920.88999999999Percent of total billed charges6.930.77999999999Percent of total billed charges6.930.77999999999Percent of total billed charges8.10.9999999999Percent of total billed charges8.10.9999999999Percent of total billed charges6.620.736999999999Percent of total billed charges7.20.8999999999Percent of total billed charges7.20.8999999999Percent of total billed charges7.20.8999999999Percent of total billed charges6.628.1
AEROSOL MASK2702927CDM270RCboth107.58.80.88999999999Percent of total billed charges7.70.77999999999Percent of total billed charges7.70.77999999999Percent of total billed charges90.9999999999Percent of total billed charges90.9999999999Percent of total billed charges7.360.736999999999Percent of total billed charges80.8999999999Percent of total billed charges80.8999999999Percent of total billed charges80.8999999999Percent of total billed charges7.369
ANGIOCATH 18G2600018CDM270RCboth107.58.80.88999999999Percent of total billed charges7.70.77999999999Percent of total billed charges7.70.77999999999Percent of total billed charges90.9999999999Percent of total billed charges90.9999999999Percent of total billed charges7.360.736999999999Percent of total billed charges80.8999999999Percent of total billed charges80.8999999999Percent of total billed charges80.8999999999Percent of total billed charges7.369
ANGIOCATH 20G2600020CDM270RCboth107.58.80.88999999999Percent of total billed charges7.70.77999999999Percent of total billed charges7.70.77999999999Percent of total billed charges90.9999999999Percent of total billed charges90.9999999999Percent of total billed charges7.360.736999999999Percent of total billed charges80.8999999999Percent of total billed charges80.8999999999Percent of total billed charges80.8999999999Percent of total billed charges7.369
FINGER SPLINT2700459CDM270RCboth107.58.80.88999999999Percent of total billed charges7.70.77999999999Percent of total billed charges7.70.77999999999Percent of total billed charges90.9999999999Percent of total billed charges90.9999999999Percent of total billed charges7.360.736999999999Percent of total billed charges80.8999999999Percent of total billed charges80.8999999999Percent of total billed charges80.8999999999Percent of total billed charges7.369
FINGER SPLINT 3 1/4"/EA2700460CDM270RCboth107.58.80.88999999999Percent of total billed charges7.70.77999999999Percent of total billed charges7.70.77999999999Percent of total billed charges90.9999999999Percent of total billed charges90.9999999999Percent of total billed charges7.360.736999999999Percent of total billed charges80.8999999999Percent of total billed charges80.8999999999Percent of total billed charges80.8999999999Percent of total billed charges7.369
FINGER SPLINT-TOAD/LARGE2700443CDM270RCboth107.58.80.88999999999Percent of total billed charges7.70.77999999999Percent of total billed charges7.70.77999999999Percent of total billed charges90.9999999999Percent of total billed charges90.9999999999Percent of total billed charges7.360.736999999999Percent of total billed charges80.8999999999Percent of total billed charges80.8999999999Percent of total billed charges80.8999999999Percent of total billed charges7.369
IRRG-0.9% NACL 500ML2706165CDM270RCboth107.58.80.88999999999Percent of total billed charges7.70.77999999999Percent of total billed charges7.70.77999999999Percent of total billed charges90.9999999999Percent of total billed charges90.9999999999Percent of total billed charges7.360.736999999999Percent of total billed charges80.8999999999Percent of total billed charges80.8999999999Percent of total billed charges80.8999999999Percent of total billed charges7.369
STATLOCK DEVICE2706548CDM270RCboth107.58.80.88999999999Percent of total billed charges7.70.77999999999Percent of total billed charges7.70.77999999999Percent of total billed charges90.9999999999Percent of total billed charges90.9999999999Percent of total billed charges7.360.736999999999Percent of total billed charges80.8999999999Percent of total billed charges80.8999999999Percent of total billed charges80.8999999999Percent of total billed charges7.369
BANDAGE-ACE ELASTIC 4 IN/2703019CDM270RCboth118.259.680.88999999999Percent of total billed charges8.470.77999999999Percent of total billed charges8.470.77999999999Percent of total billed charges9.90.9999999999Percent of total billed charges9.90.9999999999Percent of total billed charges8.10.736999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.19.9
CATHETER-RESTRAINT/EA2701193CDM270RCboth118.259.680.88999999999Percent of total billed charges8.470.77999999999Percent of total billed charges8.470.77999999999Percent of total billed charges9.90.9999999999Percent of total billed charges9.90.9999999999Percent of total billed charges8.10.736999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.19.9
DISP VAGINAL SPECLUM ALL SIZE2702536CDM270RCboth118.259.680.88999999999Percent of total billed charges8.470.77999999999Percent of total billed charges8.470.77999999999Percent of total billed charges9.90.9999999999Percent of total billed charges9.90.9999999999Percent of total billed charges8.10.736999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.19.9
EXTENSION TUBE2605313CDM270RCboth118.259.680.88999999999Percent of total billed charges8.470.77999999999Percent of total billed charges8.470.77999999999Percent of total billed charges9.90.9999999999Percent of total billed charges9.90.9999999999Percent of total billed charges8.10.736999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.19.9
NON-REBREATH O2 MASK2701322CDM270RCboth12910.560.88999999999Percent of total billed charges9.240.77999999999Percent of total billed charges9.240.77999999999Percent of total billed charges10.80.9999999999Percent of total billed charges10.80.9999999999Percent of total billed charges8.830.736999999999Percent of total billed charges9.60.8999999999Percent of total billed charges9.60.8999999999Percent of total billed charges9.60.8999999999Percent of total billed charges8.8310.8
STYLET-ADULT2705130CDM270RCboth12910.560.88999999999Percent of total billed charges9.240.77999999999Percent of total billed charges9.240.77999999999Percent of total billed charges10.80.9999999999Percent of total billed charges10.80.9999999999Percent of total billed charges8.830.736999999999Percent of total billed charges9.60.8999999999Percent of total billed charges9.60.8999999999Percent of total billed charges9.60.8999999999Percent of total billed charges8.8310.8
THERAHONEY GEL 0.5OZ2708694CDM270RCboth12910.560.88999999999Percent of total billed charges9.240.77999999999Percent of total billed charges9.240.77999999999Percent of total billed charges10.80.9999999999Percent of total billed charges10.80.9999999999Percent of total billed charges8.830.736999999999Percent of total billed charges9.60.8999999999Percent of total billed charges9.60.8999999999Percent of total billed charges9.60.8999999999Percent of total billed charges8.8310.8
ICE PACK DISPOSABLE2700176CDM270RCboth12910.560.88999999999Percent of total billed charges9.240.77999999999Percent of total billed charges9.240.77999999999Percent of total billed charges10.80.9999999999Percent of total billed charges10.80.9999999999Percent of total billed charges8.830.736999999999Percent of total billed charges9.60.8999999999Percent of total billed charges9.60.8999999999Percent of total billed charges9.60.8999999999Percent of total billed charges8.8310.8
NORMAL SALINE 1000ML2600270CDM270RCboth12.69.4511.090.88999999999Percent of total billed charges9.70.77999999999Percent of total billed charges9.70.77999999999Percent of total billed charges11.340.9999999999Percent of total billed charges11.340.9999999999Percent of total billed charges9.270.736999999999Percent of total billed charges10.080.8999999999Percent of total billed charges10.080.8999999999Percent of total billed charges10.080.8999999999Percent of total billed charges9.2711.34
ANGIOCATH 24G2600024CDM270RCboth1410.512.320.88999999999Percent of total billed charges10.780.77999999999Percent of total billed charges10.780.77999999999Percent of total billed charges12.60.9999999999Percent of total billed charges12.60.9999999999Percent of total billed charges10.30.736999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges10.312.6
MASTISOL LIQUID ADHESIVE2704602CDM270RCboth1410.512.320.88999999999Percent of total billed charges10.780.77999999999Percent of total billed charges10.780.77999999999Percent of total billed charges12.60.9999999999Percent of total billed charges12.60.9999999999Percent of total billed charges10.30.736999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges10.312.6
Medihoney Gel2705568CDM270RCboth1410.512.320.88999999999Percent of total billed charges10.780.77999999999Percent of total billed charges10.780.77999999999Percent of total billed charges12.60.9999999999Percent of total billed charges12.60.9999999999Percent of total billed charges10.30.736999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges10.312.6
Single use Vaginal Speculum w/light2709688CDM270RCboth1410.512.320.88999999999Percent of total billed charges10.780.77999999999Percent of total billed charges10.780.77999999999Percent of total billed charges12.60.9999999999Percent of total billed charges12.60.9999999999Percent of total billed charges10.30.736999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges10.312.6
Sterile H20 w/nebulizer adapter2704566CDM270RCboth1410.512.320.88999999999Percent of total billed charges10.780.77999999999Percent of total billed charges10.780.77999999999Percent of total billed charges12.60.9999999999Percent of total billed charges12.60.9999999999Percent of total billed charges10.30.736999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges10.312.6
SUTURE PROLENE 4-02704500CDM270RCboth1410.512.320.88999999999Percent of total billed charges10.780.77999999999Percent of total billed charges10.780.77999999999Percent of total billed charges12.60.9999999999Percent of total billed charges12.60.9999999999Percent of total billed charges10.30.736999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges10.312.6
SUTURES PROLENE 3-02705319CDM270RCboth1410.512.320.88999999999Percent of total billed charges10.780.77999999999Percent of total billed charges10.780.77999999999Percent of total billed charges12.60.9999999999Percent of total billed charges12.60.9999999999Percent of total billed charges10.30.736999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges10.312.6
6" CAST PADDING2702955CDM270RCboth1511.2513.20.88999999999Percent of total billed charges11.550.77999999999Percent of total billed charges11.550.77999999999Percent of total billed charges13.50.9999999999Percent of total billed charges13.50.9999999999Percent of total billed charges11.040.736999999999Percent of total billed charges120.8999999999Percent of total billed charges120.8999999999Percent of total billed charges120.8999999999Percent of total billed charges11.0413.5
ANGIOCATH 22G2600022CDM270RCboth1511.2513.20.88999999999Percent of total billed charges11.550.77999999999Percent of total billed charges11.550.77999999999Percent of total billed charges13.50.9999999999Percent of total billed charges13.50.9999999999Percent of total billed charges11.040.736999999999Percent of total billed charges120.8999999999Percent of total billed charges120.8999999999Percent of total billed charges120.8999999999Percent of total billed charges11.0413.5
ANGIOCATH PRO PLUS 20G26000020CDM270RCboth1511.2513.20.88999999999Percent of total billed charges11.550.77999999999Percent of total billed charges11.550.77999999999Percent of total billed charges13.50.9999999999Percent of total billed charges13.50.9999999999Percent of total billed charges11.040.736999999999Percent of total billed charges120.8999999999Percent of total billed charges120.8999999999Percent of total billed charges120.8999999999Percent of total billed charges11.0413.5
BANDAGE-ACE ELASTIC 6 IN/2703021CDM270RCboth1511.2513.20.88999999999Percent of total billed charges11.550.77999999999Percent of total billed charges11.550.77999999999Percent of total billed charges13.50.9999999999Percent of total billed charges13.50.9999999999Percent of total billed charges11.040.736999999999Percent of total billed charges120.8999999999Percent of total billed charges120.8999999999Percent of total billed charges120.8999999999Percent of total billed charges11.0413.5
ENDOTRACHEAL TUBE & SAFETY SET2704880CDM270RCboth1511.2513.20.88999999999Percent of total billed charges11.550.77999999999Percent of total billed charges11.550.77999999999Percent of total billed charges13.50.9999999999Percent of total billed charges13.50.9999999999Percent of total billed charges11.040.736999999999Percent of total billed charges120.8999999999Percent of total billed charges120.8999999999Percent of total billed charges120.8999999999Percent of total billed charges11.0413.5
PLAIN PACKING STRIP 1/4"2703346CDM270RCboth1511.2513.20.88999999999Percent of total billed charges11.550.77999999999Percent of total billed charges11.550.77999999999Percent of total billed charges13.50.9999999999Percent of total billed charges13.50.9999999999Percent of total billed charges11.040.736999999999Percent of total billed charges120.8999999999Percent of total billed charges120.8999999999Percent of total billed charges120.8999999999Percent of total billed charges11.0413.5
OXYGEN per hour2700029CDM270RCboth161214.080.88999999999Percent of total billed charges12.320.77999999999Percent of total billed charges12.320.77999999999Percent of total billed charges14.40.9999999999Percent of total billed charges14.40.9999999999Percent of total billed charges11.780.736999999999Percent of total billed charges12.80.8999999999Percent of total billed charges12.80.8999999999Percent of total billed charges12.80.8999999999Percent of total billed charges11.7814.4
SECONDARY MEDICATION SET2606635CDM270RCboth1813.515.840.88999999999Percent of total billed charges13.860.77999999999Percent of total billed charges13.860.77999999999Percent of total billed charges16.20.9999999999Percent of total billed charges16.20.9999999999Percent of total billed charges13.250.736999999999Percent of total billed charges14.40.8999999999Percent of total billed charges14.40.8999999999Percent of total billed charges14.40.8999999999Percent of total billed charges13.2516.2
Hydofera Blue wound dressing2709687CDM270RCboth19.6514.7417.290.88999999999Percent of total billed charges15.130.77999999999Percent of total billed charges15.130.77999999999Percent of total billed charges17.690.9999999999Percent of total billed charges17.690.9999999999Percent of total billed charges14.460.736999999999Percent of total billed charges15.720.8999999999Percent of total billed charges15.720.8999999999Percent of total billed charges15.720.8999999999Percent of total billed charges14.4617.69
ENEMA KIT BUCKET2703510CDM270RCboth2115.7518.480.88999999999Percent of total billed charges16.170.77999999999Percent of total billed charges16.170.77999999999Percent of total billed charges18.90.9999999999Percent of total billed charges18.90.9999999999Percent of total billed charges15.460.736999999999Percent of total billed charges16.80.8999999999Percent of total billed charges16.80.8999999999Percent of total billed charges16.80.8999999999Percent of total billed charges15.4618.9
ET TUBE/ ALL SIZES2705649CDM270RCboth2115.7518.480.88999999999Percent of total billed charges16.170.77999999999Percent of total billed charges16.170.77999999999Percent of total billed charges18.90.9999999999Percent of total billed charges18.90.9999999999Percent of total billed charges15.460.736999999999Percent of total billed charges16.80.8999999999Percent of total billed charges16.80.8999999999Percent of total billed charges16.80.8999999999Percent of total billed charges15.4618.9
IV START PAK2605312CDM270RCboth2115.7518.480.88999999999Percent of total billed charges16.170.77999999999Percent of total billed charges16.170.77999999999Percent of total billed charges18.90.9999999999Percent of total billed charges18.90.9999999999Percent of total billed charges15.460.736999999999Percent of total billed charges16.80.8999999999Percent of total billed charges16.80.8999999999Percent of total billed charges16.80.8999999999Percent of total billed charges15.4618.9
AIRWAY-NASO-PHARYNGEAL ALL SIZ2700630CDM270RCboth2216.519.360.88999999999Percent of total billed charges16.940.77999999999Percent of total billed charges16.940.77999999999Percent of total billed charges19.80.9999999999Percent of total billed charges19.80.9999999999Percent of total billed charges16.190.736999999999Percent of total billed charges17.60.8999999999Percent of total billed charges17.60.8999999999Percent of total billed charges17.60.8999999999Percent of total billed charges16.1919.8
IODOFORM PACKING STRIP 1/4"2703345CDM270RCboth2216.519.360.88999999999Percent of total billed charges16.940.77999999999Percent of total billed charges16.940.77999999999Percent of total billed charges19.80.9999999999Percent of total billed charges19.80.9999999999Percent of total billed charges16.190.736999999999Percent of total billed charges17.60.8999999999Percent of total billed charges17.60.8999999999Percent of total billed charges17.60.8999999999Percent of total billed charges16.1919.8
BETADINE SOLUTION SCRUB2703195CDM270RCboth2317.2520.240.88999999999Percent of total billed charges17.710.77999999999Percent of total billed charges17.710.77999999999Percent of total billed charges20.70.9999999999Percent of total billed charges20.70.9999999999Percent of total billed charges16.930.736999999999Percent of total billed charges18.40.8999999999Percent of total billed charges18.40.8999999999Percent of total billed charges18.40.8999999999Percent of total billed charges16.9320.7
CONTROL-A-FLO EX SET2601042CDM270RCboth241821.120.88999999999Percent of total billed charges18.480.77999999999Percent of total billed charges18.480.77999999999Percent of total billed charges21.60.9999999999Percent of total billed charges21.60.9999999999Percent of total billed charges17.660.736999999999Percent of total billed charges19.20.8999999999Percent of total billed charges19.20.8999999999Percent of total billed charges19.20.8999999999Percent of total billed charges17.6621.6
EZ Stabilizer2604566CDM270RCboth241821.120.88999999999Percent of total billed charges18.480.77999999999Percent of total billed charges18.480.77999999999Percent of total billed charges21.60.9999999999Percent of total billed charges21.60.9999999999Percent of total billed charges17.660.736999999999Percent of total billed charges19.20.8999999999Percent of total billed charges19.20.8999999999Percent of total billed charges19.20.8999999999Percent of total billed charges17.6621.6
PRIMARY TUBING2607697CDM270RCboth241821.120.88999999999Percent of total billed charges18.480.77999999999Percent of total billed charges18.480.77999999999Percent of total billed charges21.60.9999999999Percent of total billed charges21.60.9999999999Percent of total billed charges17.660.736999999999Percent of total billed charges19.20.8999999999Percent of total billed charges19.20.8999999999Percent of total billed charges19.20.8999999999Percent of total billed charges17.6621.6
SUTURE 4-0 VICRYLE FS-22702591CDM270RCboth241821.120.88999999999Percent of total billed charges18.480.77999999999Percent of total billed charges18.480.77999999999Percent of total billed charges21.60.9999999999Percent of total billed charges21.60.9999999999Percent of total billed charges17.660.736999999999Percent of total billed charges19.20.8999999999Percent of total billed charges19.20.8999999999Percent of total billed charges19.20.8999999999Percent of total billed charges17.6621.6
COLOSTOMY-DRAIN BAG-1 1/22700795CDM270RCboth2518.75220.88999999999Percent of total billed charges19.250.77999999999Percent of total billed charges19.250.77999999999Percent of total billed charges22.50.9999999999Percent of total billed charges22.50.9999999999Percent of total billed charges18.40.736999999999Percent of total billed charges200.8999999999Percent of total billed charges200.8999999999Percent of total billed charges200.8999999999Percent of total billed charges18.422.5
CONTINU-FLO SOL SET 10 DROP/ML2605315CDM270RCboth2518.75220.88999999999Percent of total billed charges19.250.77999999999Percent of total billed charges19.250.77999999999Percent of total billed charges22.50.9999999999Percent of total billed charges22.50.9999999999Percent of total billed charges18.40.736999999999Percent of total billed charges200.8999999999Percent of total billed charges200.8999999999Percent of total billed charges200.8999999999Percent of total billed charges18.422.5
Disposable tracheal tub Bougie/Pedi2704563CDM270RCboth2518.75220.88999999999Percent of total billed charges19.250.77999999999Percent of total billed charges19.250.77999999999Percent of total billed charges22.50.9999999999Percent of total billed charges22.50.9999999999Percent of total billed charges18.40.736999999999Percent of total billed charges200.8999999999Percent of total billed charges200.8999999999Percent of total billed charges200.8999999999Percent of total billed charges18.422.5
Disposable tracheal tube Bougie/Adult2704567CDM270RCboth2518.75220.88999999999Percent of total billed charges19.250.77999999999Percent of total billed charges19.250.77999999999Percent of total billed charges22.50.9999999999Percent of total billed charges22.50.9999999999Percent of total billed charges18.40.736999999999Percent of total billed charges200.8999999999Percent of total billed charges200.8999999999Percent of total billed charges200.8999999999Percent of total billed charges18.422.5
OPTIFOAM GENTLE SACRAL DRESSIN2708693CDM270RCboth2518.75220.88999999999Percent of total billed charges19.250.77999999999Percent of total billed charges19.250.77999999999Percent of total billed charges22.50.9999999999Percent of total billed charges22.50.9999999999Percent of total billed charges18.40.736999999999Percent of total billed charges200.8999999999Percent of total billed charges200.8999999999Percent of total billed charges200.8999999999Percent of total billed charges18.422.5
Aquacel Wound dressing2709686CDM270RCboth25.1218.8422.110.88999999999Percent of total billed charges19.340.77999999999Percent of total billed charges19.340.77999999999Percent of total billed charges22.610.9999999999Percent of total billed charges22.610.9999999999Percent of total billed charges18.490.736999999999Percent of total billed charges20.10.8999999999Percent of total billed charges20.10.8999999999Percent of total billed charges20.10.8999999999Percent of total billed charges18.4922.61
CAUTERY HANDSWITCH PENCIL2701140CDM270RCboth2619.522.880.88999999999Percent of total billed charges20.020.77999999999Percent of total billed charges20.020.77999999999Percent of total billed charges23.40.9999999999Percent of total billed charges23.40.9999999999Percent of total billed charges19.140.736999999999Percent of total billed charges20.80.8999999999Percent of total billed charges20.80.8999999999Percent of total billed charges20.80.8999999999Percent of total billed charges19.1423.4
TRAY-IRRIGATION W/70CC SYRINGE2705501CDM270RCboth2619.522.880.88999999999Percent of total billed charges20.020.77999999999Percent of total billed charges20.020.77999999999Percent of total billed charges23.40.9999999999Percent of total billed charges23.40.9999999999Percent of total billed charges19.140.736999999999Percent of total billed charges20.80.8999999999Percent of total billed charges20.80.8999999999Percent of total billed charges20.80.8999999999Percent of total billed charges19.1423.4
BAG-LEG DRAINAGE/EA2703128CDM270RCboth2720.2523.760.88999999999Percent of total billed charges20.790.77999999999Percent of total billed charges20.790.77999999999Percent of total billed charges24.30.9999999999Percent of total billed charges24.30.9999999999Percent of total billed charges19.870.736999999999Percent of total billed charges21.60.8999999999Percent of total billed charges21.60.8999999999Percent of total billed charges21.60.8999999999Percent of total billed charges19.8724.3
BLOOD TUBING/ALARIS IV PUMP2601477CDM270RCboth2720.2523.760.88999999999Percent of total billed charges20.790.77999999999Percent of total billed charges20.790.77999999999Percent of total billed charges24.30.9999999999Percent of total billed charges24.30.9999999999Percent of total billed charges19.870.736999999999Percent of total billed charges21.60.8999999999Percent of total billed charges21.60.8999999999Percent of total billed charges21.60.8999999999Percent of total billed charges19.8724.3
MEPILEX BORDER ALL SIZES4203795CDM270RCboth282124.640.88999999999Percent of total billed charges21.560.77999999999Percent of total billed charges21.560.77999999999Percent of total billed charges25.20.9999999999Percent of total billed charges25.20.9999999999Percent of total billed charges20.610.736999999999Percent of total billed charges22.40.8999999999Percent of total billed charges22.40.8999999999Percent of total billed charges22.40.8999999999Percent of total billed charges20.6125.2
BOOT-UNA EA2700250CDM270RCboth2921.7525.520.88999999999Percent of total billed charges22.330.77999999999Percent of total billed charges22.330.77999999999Percent of total billed charges26.10.9999999999Percent of total billed charges26.10.9999999999Percent of total billed charges21.340.736999999999Percent of total billed charges23.20.8999999999Percent of total billed charges23.20.8999999999Percent of total billed charges23.20.8999999999Percent of total billed charges21.3426.1
COUDE FOLEY CATHETER ALL SIZE2702635CDM270RCboth2921.7525.520.88999999999Percent of total billed charges22.330.77999999999Percent of total billed charges22.330.77999999999Percent of total billed charges26.10.9999999999Percent of total billed charges26.10.9999999999Percent of total billed charges21.340.736999999999Percent of total billed charges23.20.8999999999Percent of total billed charges23.20.8999999999Percent of total billed charges23.20.8999999999Percent of total billed charges21.3426.1
HIBICLENS 4OZ2706324CDM270RCboth2921.7525.520.88999999999Percent of total billed charges22.330.77999999999Percent of total billed charges22.330.77999999999Percent of total billed charges26.10.9999999999Percent of total billed charges26.10.9999999999Percent of total billed charges21.340.736999999999Percent of total billed charges23.20.8999999999Percent of total billed charges23.20.8999999999Percent of total billed charges23.20.8999999999Percent of total billed charges21.3426.1
4-ETHILON P32700723CDM270RCboth3123.2527.280.88999999999Percent of total billed charges23.870.77999999999Percent of total billed charges23.870.77999999999Percent of total billed charges27.90.9999999999Percent of total billed charges27.90.9999999999Percent of total billed charges22.820.736999999999Percent of total billed charges24.80.8999999999Percent of total billed charges24.80.8999999999Percent of total billed charges24.80.8999999999Percent of total billed charges22.8227.9
GRIPPER PAC NEEDLE2606618CDM270RCboth3123.2527.280.88999999999Percent of total billed charges23.870.77999999999Percent of total billed charges23.870.77999999999Percent of total billed charges27.90.9999999999Percent of total billed charges27.90.9999999999Percent of total billed charges22.820.736999999999Percent of total billed charges24.80.8999999999Percent of total billed charges24.80.8999999999Percent of total billed charges24.80.8999999999Percent of total billed charges22.8227.9
ECLIPSE NEBULIZER2700652CDM270RCboth322428.160.88999999999Percent of total billed charges24.640.77999999999Percent of total billed charges24.640.77999999999Percent of total billed charges28.80.9999999999Percent of total billed charges28.80.9999999999Percent of total billed charges23.550.736999999999Percent of total billed charges25.60.8999999999Percent of total billed charges25.60.8999999999Percent of total billed charges25.60.8999999999Percent of total billed charges23.5528.8
SUCTION CANISTER2700063CDM270RCboth322428.160.88999999999Percent of total billed charges24.640.77999999999Percent of total billed charges24.640.77999999999Percent of total billed charges28.80.9999999999Percent of total billed charges28.80.9999999999Percent of total billed charges23.550.736999999999Percent of total billed charges25.60.8999999999Percent of total billed charges25.60.8999999999Percent of total billed charges25.60.8999999999Percent of total billed charges23.5528.8
SUTURE 6-0 PROLENE2702597CDM270RCboth322428.160.88999999999Percent of total billed charges24.640.77999999999Percent of total billed charges24.640.77999999999Percent of total billed charges28.80.9999999999Percent of total billed charges28.80.9999999999Percent of total billed charges23.550.736999999999Percent of total billed charges25.60.8999999999Percent of total billed charges25.60.8999999999Percent of total billed charges25.60.8999999999Percent of total billed charges23.5528.8
BURETROL ADD-ON SET2606617CDM270RCboth3324.7529.040.88999999999Percent of total billed charges25.410.77999999999Percent of total billed charges25.410.77999999999Percent of total billed charges29.70.9999999999Percent of total billed charges29.70.9999999999Percent of total billed charges24.290.736999999999Percent of total billed charges26.40.8999999999Percent of total billed charges26.40.8999999999Percent of total billed charges26.40.8999999999Percent of total billed charges24.2929.7
MEPILEX DRESSING 9X92708695CDM270RCboth3324.7529.040.88999999999Percent of total billed charges25.410.77999999999Percent of total billed charges25.410.77999999999Percent of total billed charges29.70.9999999999Percent of total billed charges29.70.9999999999Percent of total billed charges24.290.736999999999Percent of total billed charges26.40.8999999999Percent of total billed charges26.40.8999999999Percent of total billed charges26.40.8999999999Percent of total billed charges24.2929.7
SPLINT-COLLES WRIST & FOREMAN2701785CDM270RCboth3324.7529.040.88999999999Percent of total billed charges25.410.77999999999Percent of total billed charges25.410.77999999999Percent of total billed charges29.70.9999999999Percent of total billed charges29.70.9999999999Percent of total billed charges24.290.736999999999Percent of total billed charges26.40.8999999999Percent of total billed charges26.40.8999999999Percent of total billed charges26.40.8999999999Percent of total billed charges24.2929.7
Sams 36" Splint roll/any size2704495CDM270RCboth3425.529.920.88999999999Percent of total billed charges26.180.77999999999Percent of total billed charges26.180.77999999999Percent of total billed charges30.60.9999999999Percent of total billed charges30.60.9999999999Percent of total billed charges25.020.736999999999Percent of total billed charges27.20.8999999999Percent of total billed charges27.20.8999999999Percent of total billed charges27.20.8999999999Percent of total billed charges25.0230.6
SUTURE 5-0 PROLENE2702596CDM270RCboth3425.529.920.88999999999Percent of total billed charges26.180.77999999999Percent of total billed charges26.180.77999999999Percent of total billed charges30.60.9999999999Percent of total billed charges30.60.9999999999Percent of total billed charges25.020.736999999999Percent of total billed charges27.20.8999999999Percent of total billed charges27.20.8999999999Percent of total billed charges27.20.8999999999Percent of total billed charges25.0230.6
TED ST0CK-SMALL--LONG-THIG2700082CDM270RCboth3425.529.920.88999999999Percent of total billed charges26.180.77999999999Percent of total billed charges26.180.77999999999Percent of total billed charges30.60.9999999999Percent of total billed charges30.60.9999999999Percent of total billed charges25.020.736999999999Percent of total billed charges27.20.8999999999Percent of total billed charges27.20.8999999999Percent of total billed charges27.20.8999999999Percent of total billed charges25.0230.6
OXISENSOR EACH2700011CDM270RCboth3526.2530.80.88999999999Percent of total billed charges26.950.77999999999Percent of total billed charges26.950.77999999999Percent of total billed charges31.50.9999999999Percent of total billed charges31.50.9999999999Percent of total billed charges25.760.736999999999Percent of total billed charges280.8999999999Percent of total billed charges280.8999999999Percent of total billed charges280.8999999999Percent of total billed charges25.7631.5
Back Support2705699CDM270RCboth362731.680.88999999999Percent of total billed charges27.720.77999999999Percent of total billed charges27.720.77999999999Percent of total billed charges32.40.9999999999Percent of total billed charges32.40.9999999999Percent of total billed charges26.50.736999999999Percent of total billed charges28.80.8999999999Percent of total billed charges28.80.8999999999Percent of total billed charges28.80.8999999999Percent of total billed charges26.532.4
BAG-URINARY DRAIN/EA2703033CDM270RCboth362731.680.88999999999Percent of total billed charges27.720.77999999999Percent of total billed charges27.720.77999999999Percent of total billed charges32.40.9999999999Percent of total billed charges32.40.9999999999Percent of total billed charges26.50.736999999999Percent of total billed charges28.80.8999999999Percent of total billed charges28.80.8999999999Percent of total billed charges28.80.8999999999Percent of total billed charges26.532.4
SPLINT COLLES PADDED ALL SIZES2702780CDM270RCboth362731.680.88999999999Percent of total billed charges27.720.77999999999Percent of total billed charges27.720.77999999999Percent of total billed charges32.40.9999999999Percent of total billed charges32.40.9999999999Percent of total billed charges26.50.736999999999Percent of total billed charges28.80.8999999999Percent of total billed charges28.80.8999999999Percent of total billed charges28.80.8999999999Percent of total billed charges26.532.4
CENTRAL LINE DRESSING TRAY2700655CDM270RCboth3727.7532.560.88999999999Percent of total billed charges28.490.77999999999Percent of total billed charges28.490.77999999999Percent of total billed charges33.30.9999999999Percent of total billed charges33.30.9999999999Percent of total billed charges27.230.736999999999Percent of total billed charges29.60.8999999999Percent of total billed charges29.60.8999999999Percent of total billed charges29.60.8999999999Percent of total billed charges27.2333.3
COLOPLAST COLOSTOMY POUCH2704562CDM270RCboth3727.7532.560.88999999999Percent of total billed charges28.490.77999999999Percent of total billed charges28.490.77999999999Percent of total billed charges33.30.9999999999Percent of total billed charges33.30.9999999999Percent of total billed charges27.230.736999999999Percent of total billed charges29.60.8999999999Percent of total billed charges29.60.8999999999Percent of total billed charges29.60.8999999999Percent of total billed charges27.2333.3
DISPOSABLE LARYNGOSCOPE BLADE2700098CDM270RCboth3727.7532.560.88999999999Percent of total billed charges28.490.77999999999Percent of total billed charges28.490.77999999999Percent of total billed charges33.30.9999999999Percent of total billed charges33.30.9999999999Percent of total billed charges27.230.736999999999Percent of total billed charges29.60.8999999999Percent of total billed charges29.60.8999999999Percent of total billed charges29.60.8999999999Percent of total billed charges27.2333.3
SUCTION MACHINE SET UP2701810CDM270RCboth3727.7532.560.88999999999Percent of total billed charges28.490.77999999999Percent of total billed charges28.490.77999999999Percent of total billed charges33.30.9999999999Percent of total billed charges33.30.9999999999Percent of total billed charges27.230.736999999999Percent of total billed charges29.60.8999999999Percent of total billed charges29.60.8999999999Percent of total billed charges29.60.8999999999Percent of total billed charges27.2333.3
Y-TYPE BLOOD/SOLUTION SET2600704CDM270RCboth3727.7532.560.88999999999Percent of total billed charges28.490.77999999999Percent of total billed charges28.490.77999999999Percent of total billed charges33.30.9999999999Percent of total billed charges33.30.9999999999Percent of total billed charges27.230.736999999999Percent of total billed charges29.60.8999999999Percent of total billed charges29.60.8999999999Percent of total billed charges29.60.8999999999Percent of total billed charges27.2333.3
4' CASTING TAPE2701488CDM270RCboth3828.533.440.88999999999Percent of total billed charges29.260.77999999999Percent of total billed charges29.260.77999999999Percent of total billed charges34.20.9999999999Percent of total billed charges34.20.9999999999Percent of total billed charges27.970.736999999999Percent of total billed charges30.40.8999999999Percent of total billed charges30.40.8999999999Percent of total billed charges30.40.8999999999Percent of total billed charges27.9734.2
VENTED NITROGLYCERIN SET2606616CDM270RCboth403035.20.88999999999Percent of total billed charges30.80.77999999999Percent of total billed charges30.80.77999999999Percent of total billed charges360.9999999999Percent of total billed charges360.9999999999Percent of total billed charges29.440.736999999999Percent of total billed charges320.8999999999Percent of total billed charges320.8999999999Percent of total billed charges320.8999999999Percent of total billed charges29.4436
4-0 ETHILON P22700721CDM270RCboth4130.7536.080.88999999999Percent of total billed charges31.570.77999999999Percent of total billed charges31.570.77999999999Percent of total billed charges36.90.9999999999Percent of total billed charges36.90.9999999999Percent of total billed charges30.180.736999999999Percent of total billed charges32.80.8999999999Percent of total billed charges32.80.8999999999Percent of total billed charges32.80.8999999999Percent of total billed charges30.1836.9
ALARIS PRIMARY IV TUBING2600251CDM270RCboth4130.7536.080.88999999999Percent of total billed charges31.570.77999999999Percent of total billed charges31.570.77999999999Percent of total billed charges36.90.9999999999Percent of total billed charges36.90.9999999999Percent of total billed charges30.180.736999999999Percent of total billed charges32.80.8999999999Percent of total billed charges32.80.8999999999Percent of total billed charges32.80.8999999999Percent of total billed charges30.1836.9
CLAVICAL SPLINT/LARGE2701384CDM270RCboth4130.7536.080.88999999999Percent of total billed charges31.570.77999999999Percent of total billed charges31.570.77999999999Percent of total billed charges36.90.9999999999Percent of total billed charges36.90.9999999999Percent of total billed charges30.180.736999999999Percent of total billed charges32.80.8999999999Percent of total billed charges32.80.8999999999Percent of total billed charges32.80.8999999999Percent of total billed charges30.1836.9
CLAVICAL SPLINT/MEDIUM2701383CDM270RCboth4130.7536.080.88999999999Percent of total billed charges31.570.77999999999Percent of total billed charges31.570.77999999999Percent of total billed charges36.90.9999999999Percent of total billed charges36.90.9999999999Percent of total billed charges30.180.736999999999Percent of total billed charges32.80.8999999999Percent of total billed charges32.80.8999999999Percent of total billed charges32.80.8999999999Percent of total billed charges30.1836.9
BAG VALVE MASK2700024CDM270RCboth4231.536.960.88999999999Percent of total billed charges32.340.77999999999Percent of total billed charges32.340.77999999999Percent of total billed charges37.80.9999999999Percent of total billed charges37.80.9999999999Percent of total billed charges30.910.736999999999Percent of total billed charges33.60.8999999999Percent of total billed charges33.60.8999999999Percent of total billed charges33.60.8999999999Percent of total billed charges30.9137.8
INSUFFLATOR TUBING2700270CDM270RCboth4231.536.960.88999999999Percent of total billed charges32.340.77999999999Percent of total billed charges32.340.77999999999Percent of total billed charges37.80.9999999999Percent of total billed charges37.80.9999999999Percent of total billed charges30.910.736999999999Percent of total billed charges33.60.8999999999Percent of total billed charges33.60.8999999999Percent of total billed charges33.60.8999999999Percent of total billed charges30.9137.8
TELEMETRY PER DAY2701861CDM270RCboth4231.536.960.88999999999Percent of total billed charges32.340.77999999999Percent of total billed charges32.340.77999999999Percent of total billed charges37.80.9999999999Percent of total billed charges37.80.9999999999Percent of total billed charges30.910.736999999999Percent of total billed charges33.60.8999999999Percent of total billed charges33.60.8999999999Percent of total billed charges33.60.8999999999Percent of total billed charges30.9137.8
CO2 DETECTOR2705963CDM270RCboth443338.720.88999999999Percent of total billed charges33.880.77999999999Percent of total billed charges33.880.77999999999Percent of total billed charges39.60.9999999999Percent of total billed charges39.60.9999999999Percent of total billed charges32.380.736999999999Percent of total billed charges35.20.8999999999Percent of total billed charges35.20.8999999999Percent of total billed charges35.20.8999999999Percent of total billed charges32.3839.6
Disposable Nosebleed Tray2703320CDM270RCboth4533.7539.60.88999999999Percent of total billed charges34.650.77999999999Percent of total billed charges34.650.77999999999Percent of total billed charges40.50.9999999999Percent of total billed charges40.50.9999999999Percent of total billed charges33.120.736999999999Percent of total billed charges360.8999999999Percent of total billed charges360.8999999999Percent of total billed charges360.8999999999Percent of total billed charges33.1240.5
GRANULEX WOUND SPRAY2701447CDM270RCboth4735.2541.360.88999999999Percent of total billed charges36.190.77999999999Percent of total billed charges36.190.77999999999Percent of total billed charges42.30.9999999999Percent of total billed charges42.30.9999999999Percent of total billed charges34.590.736999999999Percent of total billed charges37.60.8999999999Percent of total billed charges37.60.8999999999Percent of total billed charges37.60.8999999999Percent of total billed charges34.5942.3
WRIST SPLINT/ELASTIC MED LFT2701394CDM270RCboth4735.2541.360.88999999999Percent of total billed charges36.190.77999999999Percent of total billed charges36.190.77999999999Percent of total billed charges42.30.9999999999Percent of total billed charges42.30.9999999999Percent of total billed charges34.590.736999999999Percent of total billed charges37.60.8999999999Percent of total billed charges37.60.8999999999Percent of total billed charges37.60.8999999999Percent of total billed charges34.5942.3
GLIDESCOPE GVL STAT2704800CDM270RCboth523945.760.88999999999Percent of total billed charges40.040.77999999999Percent of total billed charges40.040.77999999999Percent of total billed charges46.80.9999999999Percent of total billed charges46.80.9999999999Percent of total billed charges38.270.736999999999Percent of total billed charges41.60.8999999999Percent of total billed charges41.60.8999999999Percent of total billed charges41.60.8999999999Percent of total billed charges38.2746.8
Disp Pressure Infusor Bag2706655CDM270RCboth564249.280.88999999999Percent of total billed charges43.120.77999999999Percent of total billed charges43.120.77999999999Percent of total billed charges50.40.9999999999Percent of total billed charges50.40.9999999999Percent of total billed charges41.220.736999999999Percent of total billed charges44.80.8999999999Percent of total billed charges44.80.8999999999Percent of total billed charges44.80.8999999999Percent of total billed charges41.2250.4
Disposable CPAP Mask2705598CDM270RCboth564249.280.88999999999Percent of total billed charges43.120.77999999999Percent of total billed charges43.120.77999999999Percent of total billed charges50.40.9999999999Percent of total billed charges50.40.9999999999Percent of total billed charges41.220.736999999999Percent of total billed charges44.80.8999999999Percent of total billed charges44.80.8999999999Percent of total billed charges44.80.8999999999Percent of total billed charges41.2250.4
DISP VENTILATOR CURCUIT27012121CDM270RCboth6347.2555.440.88999999999Percent of total billed charges48.510.77999999999Percent of total billed charges48.510.77999999999Percent of total billed charges56.70.9999999999Percent of total billed charges56.70.9999999999Percent of total billed charges46.370.736999999999Percent of total billed charges50.40.8999999999Percent of total billed charges50.40.8999999999Percent of total billed charges50.40.8999999999Percent of total billed charges46.3756.7
Skinstitch Surgical Glue2705698CDM270RCboth6347.2555.440.88999999999Percent of total billed charges48.510.77999999999Percent of total billed charges48.510.77999999999Percent of total billed charges56.70.9999999999Percent of total billed charges56.70.9999999999Percent of total billed charges46.370.736999999999Percent of total billed charges50.40.8999999999Percent of total billed charges50.40.8999999999Percent of total billed charges50.40.8999999999Percent of total billed charges46.3756.7
TED STOCK-L-LONG-THIGH/EA2700088CDM270RCboth6347.2555.440.88999999999Percent of total billed charges48.510.77999999999Percent of total billed charges48.510.77999999999Percent of total billed charges56.70.9999999999Percent of total billed charges56.70.9999999999Percent of total billed charges46.370.736999999999Percent of total billed charges50.40.8999999999Percent of total billed charges50.40.8999999999Percent of total billed charges50.40.8999999999Percent of total billed charges46.3756.7
RHINO ROCKET NASAL PACKING2703753CDM270RCboth6548.7557.20.88999999999Percent of total billed charges50.050.77999999999Percent of total billed charges50.050.77999999999Percent of total billed charges58.50.9999999999Percent of total billed charges58.50.9999999999Percent of total billed charges47.840.736999999999Percent of total billed charges520.8999999999Percent of total billed charges520.8999999999Percent of total billed charges520.8999999999Percent of total billed charges47.8458.5
COUDE FOLEY CATH TRAY2709696CDM270RCboth6649.558.080.88999999999Percent of total billed charges50.820.77999999999Percent of total billed charges50.820.77999999999Percent of total billed charges59.40.9999999999Percent of total billed charges59.40.9999999999Percent of total billed charges48.580.736999999999Percent of total billed charges52.80.8999999999Percent of total billed charges52.80.8999999999Percent of total billed charges52.80.8999999999Percent of total billed charges48.5859.4
OB ALTRA GUARD OBSTETRIC PACK2704859CDM270RCboth6649.558.080.88999999999Percent of total billed charges50.820.77999999999Percent of total billed charges50.820.77999999999Percent of total billed charges59.40.9999999999Percent of total billed charges59.40.9999999999Percent of total billed charges48.580.736999999999Percent of total billed charges52.80.8999999999Percent of total billed charges52.80.8999999999Percent of total billed charges52.80.8999999999Percent of total billed charges48.5859.4
PLAIN GUT SUTURE/ALL SIZES2702580CDM270RCboth6649.558.080.88999999999Percent of total billed charges50.820.77999999999Percent of total billed charges50.820.77999999999Percent of total billed charges59.40.9999999999Percent of total billed charges59.40.9999999999Percent of total billed charges48.580.736999999999Percent of total billed charges52.80.8999999999Percent of total billed charges52.80.8999999999Percent of total billed charges52.80.8999999999Percent of total billed charges48.5859.4
PROXIMATE SKIN STAPLER2701471CDM270RCboth7455.565.120.88999999999Percent of total billed charges56.980.77999999999Percent of total billed charges56.980.77999999999Percent of total billed charges66.60.9999999999Percent of total billed charges66.60.9999999999Percent of total billed charges54.460.736999999999Percent of total billed charges59.20.8999999999Percent of total billed charges59.20.8999999999Percent of total billed charges59.20.8999999999Percent of total billed charges54.4666.6
AMBU BAG - ADULT2701318CDM270RCboth8362.2573.040.88999999999Percent of total billed charges63.910.77999999999Percent of total billed charges63.910.77999999999Percent of total billed charges74.70.9999999999Percent of total billed charges74.70.9999999999Percent of total billed charges61.090.736999999999Percent of total billed charges66.40.8999999999Percent of total billed charges66.40.8999999999Percent of total billed charges66.40.8999999999Percent of total billed charges61.0974.7
Combat Tourniquet5402634CDM270RCboth9369.7581.840.88999999999Percent of total billed charges71.610.77999999999Percent of total billed charges71.610.77999999999Percent of total billed charges83.70.9999999999Percent of total billed charges83.70.9999999999Percent of total billed charges68.450.736999999999Percent of total billed charges74.40.8999999999Percent of total billed charges74.40.8999999999Percent of total billed charges74.40.8999999999Percent of total billed charges68.4583.7
J-SPLINT 2"UNIVERSAL-LONG2703456CDM270RCboth9369.7581.840.88999999999Percent of total billed charges71.610.77999999999Percent of total billed charges71.610.77999999999Percent of total billed charges83.70.9999999999Percent of total billed charges83.70.9999999999Percent of total billed charges68.450.736999999999Percent of total billed charges74.40.8999999999Percent of total billed charges74.40.8999999999Percent of total billed charges74.40.8999999999Percent of total billed charges68.4583.7
King LT-D airway kits all sizes2705566CDM270RCboth10075880.88999999999Percent of total billed charges770.77999999999Percent of total billed charges770.77999999999Percent of total billed charges900.9999999999Percent of total billed charges900.9999999999Percent of total billed charges73.60.736999999999Percent of total billed charges800.8999999999Percent of total billed charges800.8999999999Percent of total billed charges800.8999999999Percent of total billed charges73.690
King L-T-D airway kits5402636CDM270RCboth10780.2594.160.88999999999Percent of total billed charges82.390.77999999999Percent of total billed charges82.390.77999999999Percent of total billed charges96.30.9999999999Percent of total billed charges96.30.9999999999Percent of total billed charges78.750.736999999999Percent of total billed charges85.60.8999999999Percent of total billed charges85.60.8999999999Percent of total billed charges85.60.8999999999Percent of total billed charges78.7596.3
Combat Z-fold Gauze5402635CDM270RCboth1088195.040.88999999999Percent of total billed charges83.160.77999999999Percent of total billed charges83.160.77999999999Percent of total billed charges97.20.9999999999Percent of total billed charges97.20.9999999999Percent of total billed charges79.490.736999999999Percent of total billed charges86.40.8999999999Percent of total billed charges86.40.8999999999Percent of total billed charges86.40.8999999999Percent of total billed charges79.4997.2
Disposable CPAP kit2705596CDM270RCboth11384.7599.440.88999999999Percent of total billed charges87.010.77999999999Percent of total billed charges87.010.77999999999Percent of total billed charges101.70.9999999999Percent of total billed charges101.70.9999999999Percent of total billed charges83.170.736999999999Percent of total billed charges90.40.8999999999Percent of total billed charges90.40.8999999999Percent of total billed charges90.40.8999999999Percent of total billed charges83.17101.7
RESUSCITATION-EMERG2701317CDM270RCboth11485.5100.320.88999999999Percent of total billed charges87.780.77999999999Percent of total billed charges87.780.77999999999Percent of total billed charges102.60.9999999999Percent of total billed charges102.60.9999999999Percent of total billed charges83.90.736999999999Percent of total billed charges91.20.8999999999Percent of total billed charges91.20.8999999999Percent of total billed charges91.20.8999999999Percent of total billed charges83.9102.6
CARDIAC MON PER DAY2701311CDM270RCboth147110.25129.360.88999999999Percent of total billed charges113.190.77999999999Percent of total billed charges113.190.77999999999Percent of total billed charges132.30.9999999999Percent of total billed charges132.30.9999999999Percent of total billed charges108.190.736999999999Percent of total billed charges117.60.8999999999Percent of total billed charges117.60.8999999999Percent of total billed charges117.60.8999999999Percent of total billed charges108.19132.3
PAD-PACING ELECTRODE-ADULT2701498CDM270RCboth152114133.760.88999999999Percent of total billed charges117.040.77999999999Percent of total billed charges117.040.77999999999Percent of total billed charges136.80.9999999999Percent of total billed charges136.80.9999999999Percent of total billed charges111.870.736999999999Percent of total billed charges121.60.8999999999Percent of total billed charges121.60.8999999999Percent of total billed charges121.60.8999999999Percent of total billed charges111.87136.8
Combat Z-fold Gauze2705678CDM270RCboth153114.75134.640.88999999999Percent of total billed charges117.810.77999999999Percent of total billed charges117.810.77999999999Percent of total billed charges137.70.9999999999Percent of total billed charges137.70.9999999999Percent of total billed charges112.610.736999999999Percent of total billed charges122.40.8999999999Percent of total billed charges122.40.8999999999Percent of total billed charges122.40.8999999999Percent of total billed charges112.61137.7
Disp Chest Tube Insertion Tray2701460CDM270RCboth161120.75141.680.88999999999Percent of total billed charges123.970.77999999999Percent of total billed charges123.970.77999999999Percent of total billed charges144.90.9999999999Percent of total billed charges144.90.9999999999Percent of total billed charges118.50.736999999999Percent of total billed charges128.80.8999999999Percent of total billed charges128.80.8999999999Percent of total billed charges128.80.8999999999Percent of total billed charges118.5144.9
EMERG CARE/CRASH CART2701316CDM270RCboth177132.75155.760.88999999999Percent of total billed charges136.290.77999999999Percent of total billed charges136.290.77999999999Percent of total billed charges159.30.9999999999Percent of total billed charges159.30.9999999999Percent of total billed charges130.270.736999999999Percent of total billed charges141.60.8999999999Percent of total billed charges141.60.8999999999Percent of total billed charges141.60.8999999999Percent of total billed charges130.27159.3
COMBI-TUBE2701126CDM270RCboth191143.25168.080.88999999999Percent of total billed charges147.070.77999999999Percent of total billed charges147.070.77999999999Percent of total billed charges171.90.9999999999Percent of total billed charges171.90.9999999999Percent of total billed charges140.580.736999999999Percent of total billed charges152.80.8999999999Percent of total billed charges152.80.8999999999Percent of total billed charges152.80.8999999999Percent of total billed charges140.58171.9
Percutaneous Sheath Introducer Kit2602544CDM270RCboth194145.5170.720.88999999999Percent of total billed charges149.380.77999999999Percent of total billed charges149.380.77999999999Percent of total billed charges174.60.9999999999Percent of total billed charges174.60.9999999999Percent of total billed charges142.780.736999999999Percent of total billed charges155.20.8999999999Percent of total billed charges155.20.8999999999Percent of total billed charges155.20.8999999999Percent of total billed charges142.78174.6
OXYGEN INCL EQUIP MAX2700147CDM270RCboth202151.5177.760.88999999999Percent of total billed charges155.540.77999999999Percent of total billed charges155.540.77999999999Percent of total billed charges181.80.9999999999Percent of total billed charges181.80.9999999999Percent of total billed charges148.670.736999999999Percent of total billed charges161.60.8999999999Percent of total billed charges161.60.8999999999Percent of total billed charges161.60.8999999999Percent of total billed charges148.67181.8
OXYGEN HUMIDIFIER EQT. DAILY2700026CDM270RCboth239179.25210.320.88999999999Percent of total billed charges184.030.77999999999Percent of total billed charges184.030.77999999999Percent of total billed charges215.10.9999999999Percent of total billed charges215.10.9999999999Percent of total billed charges175.90.736999999999Percent of total billed charges191.20.8999999999Percent of total billed charges191.20.8999999999Percent of total billed charges191.20.8999999999Percent of total billed charges175.9215.1
INTRAOSSEOUS INFUSION SET2601150CDM270RCboth287215.25252.560.88999999999Percent of total billed charges220.990.77999999999Percent of total billed charges220.990.77999999999Percent of total billed charges258.30.9999999999Percent of total billed charges258.30.9999999999Percent of total billed charges211.230.736999999999Percent of total billed charges229.60.8999999999Percent of total billed charges229.60.8999999999Percent of total billed charges229.60.8999999999Percent of total billed charges211.23258.3
ANKLE BRACE/AIR-STIRRUP2701876CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
ANKLE BRACE/MEDIUM2701870CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
ANKLE/GEL SUPPORT2704350CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
ARM BOARD-PADDED-LARGE-EA2703010CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
ARM SLING/LARGE2703276CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
ARM SLING/MEDIUM2703275CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
ARM SLING/PEDIATRIC-SMALL2703278CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
ARM SLING/X-LARGE2703277CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
BANDAGE-KLING STRETCH 2'X2700427CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
BANDAGE-KLING STRETCH 6"2700428CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
CARPAL TUNNEL PROTECT/L&R2701397CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
CERVICAL COLLAR PHILADELPHIA2703265CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
CERVICAL COLLAR/LARGE2701154CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
CRUTCHES LARGE2702450CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
CRUTCHES MED 5'.2" X 5'.10"2702451CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
CRUTCHES SM 4'.6" X 5'.2"2702452CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
DISP CLIPPER BLADE ASSEMBLY2704481CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
DISP PEDI/ADULT PULSE OX27025344CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
DISPOSABLE TELEMETRY POUCH2701644CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
ELASTIC ANKLE SUPPORT A SIZE2701878CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
ELASTIC KNEE SUPPORT XLARGE2709002CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
ENVELOPE ARM SLING/SM2703274CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
HEEL PROTECTOR2701796CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
KNEE HINGE BRACE ALL SIZES2700036CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
KNEE IMMOBIL/16"2700970CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
KNEE IMMOBILIZER/SMALL2700955CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
KNEE IMMOBILIZER/UNIVERSAL 24'2700978CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
KNEE IMOBILIZER/MEDIUM2700956CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
KNEE SUPP/ELASTIC ALL SIZE2709005CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
LG WRIST/THUMB SUPPORT (UNIV)2702679CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
MEDIUM- SIDEKICK BOOT WALKER2701788CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
PAD-OB/EA2703036CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
PLASTER SPLINT 3"X 15" LONG2709914CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
POST-UP SANDAL ( ANY SIZE)2702489CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
RIB BELT/UNIVERSAL-MALE2703848CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
Sam Pelvic Slling all sizes2704580CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
SHOULDER IMMOBILIZER/LG2701794CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
SHOULDER IMMOBILIZER/MEDI2701792CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
WRIST/THUMB SUPPORT LT, L2701367CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
WRIST/THUMB SUPPORT LT, M2701368CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
Disp warming blanket, adult2709685CDM270RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
DRESSING-ADAPTIC 3X8/EA2700486CDM272RCboth10.750.880.88999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.770.77999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.90.9999999999Percent of total billed charges0.740.736999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.80.8999999999Percent of total billed charges0.740.9
AIRWAY-DUAL CHANNEL-L-ADU2700521CDM272RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
PADS-TELFA 2X3/EA2700560CDM272RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
PADS-TELFA 3X4/EA2700391CDM272RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
PADS-TELFA 3X8/EA2700417CDM272RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
PEDIATRIC URINE COLLECTOR2700189CDM272RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
SPONGE-GAUZE ST. 4X4 PKG2700322CDM272RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
SWABSTICK W/IODINE2706162CDM272RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
SYRINGE ONLY 20ML LUER LOK TIP270309661CDM272RCboth21.51.760.88999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.540.77999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.80.9999999999Percent of total billed charges1.470.736999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.60.8999999999Percent of total billed charges1.471.8
GAUZE BANDAGE 2"2700451CDM272RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
GAUZE SPONGES 2 INCH2708322CDM272RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
STERILE COTTON TIP APPLICATORS2704560CDM272RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
STERILE FIELD2701600CDM272RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
STERILE FIELD-FENESTRATED2701601CDM272RCboth32.252.640.88999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.310.77999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.70.9999999999Percent of total billed charges2.210.736999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.40.8999999999Percent of total billed charges2.212.7
CATH ALL-PURPOSE 14FR/EA2700339CDM272RCboth433.520.88999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.60.9999999999Percent of total billed charges3.60.9999999999Percent of total billed charges2.940.736999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges2.943.6
DRESSING IV TEGADERM 2-3/82700282CDM272RCboth433.520.88999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.60.9999999999Percent of total billed charges3.60.9999999999Percent of total billed charges2.940.736999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges2.943.6
GAUZE-VASELINE 1X8/EA2700553CDM272RCboth433.520.88999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.60.9999999999Percent of total billed charges3.60.9999999999Percent of total billed charges2.940.736999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges2.943.6
STERI STRIP-SKN CLOSU 1/22701268CDM272RCboth433.520.88999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.60.9999999999Percent of total billed charges3.60.9999999999Percent of total billed charges2.940.736999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges2.943.6
SYRING ONLY 60ML LUER LOK TIP270309663CDM272RCboth433.520.88999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.080.77999999999Percent of total billed charges3.60.9999999999Percent of total billed charges3.60.9999999999Percent of total billed charges2.940.736999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges3.20.8999999999Percent of total billed charges2.943.6
COLOSTOMY-TAIL CLOSUR PIN2700589CDM272RCboth53.754.40.88999999999Percent of total billed charges3.850.77999999999Percent of total billed charges3.850.77999999999Percent of total billed charges4.50.9999999999Percent of total billed charges4.50.9999999999Percent of total billed charges3.680.736999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges3.684.5
DISPOSABLE SCAPLES #10,11,152704649CDM272RCboth53.754.40.88999999999Percent of total billed charges3.850.77999999999Percent of total billed charges3.850.77999999999Percent of total billed charges4.50.9999999999Percent of total billed charges4.50.9999999999Percent of total billed charges3.680.736999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges3.684.5
DRESSING STERILE 4X4'S 10/PKG2700394CDM272RCboth53.754.40.88999999999Percent of total billed charges3.850.77999999999Percent of total billed charges3.850.77999999999Percent of total billed charges4.50.9999999999Percent of total billed charges4.50.9999999999Percent of total billed charges3.680.736999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges3.684.5
GLOVES, STERILE SURGICAL2700001CDM272RCboth53.754.40.88999999999Percent of total billed charges3.850.77999999999Percent of total billed charges3.850.77999999999Percent of total billed charges4.50.9999999999Percent of total billed charges4.50.9999999999Percent of total billed charges3.680.736999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges3.684.5
NASAL CANNULA2700010CDM272RCboth53.754.40.88999999999Percent of total billed charges3.850.77999999999Percent of total billed charges3.850.77999999999Percent of total billed charges4.50.9999999999Percent of total billed charges4.50.9999999999Percent of total billed charges3.680.736999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges3.684.5
SURGICAL BLADE2705648CDM272RCboth53.754.40.88999999999Percent of total billed charges3.850.77999999999Percent of total billed charges3.850.77999999999Percent of total billed charges4.50.9999999999Percent of total billed charges4.50.9999999999Percent of total billed charges3.680.736999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges40.8999999999Percent of total billed charges3.684.5
CATHETER-FOLEY 12FR 5CC/E2703151CDM272RCboth64.55.280.88999999999Percent of total billed charges4.620.77999999999Percent of total billed charges4.620.77999999999Percent of total billed charges5.40.9999999999Percent of total billed charges5.40.9999999999Percent of total billed charges4.420.736999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.425.4
CATHETER-FOLEY 20FR-5CC/E2700164CDM272RCboth64.55.280.88999999999Percent of total billed charges4.620.77999999999Percent of total billed charges4.620.77999999999Percent of total billed charges5.40.9999999999Percent of total billed charges5.40.9999999999Percent of total billed charges4.420.736999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.425.4
CATHETER-FOLEY 2WY,14FR,52700974CDM272RCboth64.55.280.88999999999Percent of total billed charges4.620.77999999999Percent of total billed charges4.620.77999999999Percent of total billed charges5.40.9999999999Percent of total billed charges5.40.9999999999Percent of total billed charges4.420.736999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.425.4
CATHETER-FOLEY 2WY,16FR052703570CDM272RCboth64.55.280.88999999999Percent of total billed charges4.620.77999999999Percent of total billed charges4.620.77999999999Percent of total billed charges5.40.9999999999Percent of total billed charges5.40.9999999999Percent of total billed charges4.420.736999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.425.4
CATHETER-FOLEY 2WY,18FR,52700153CDM272RCboth64.55.280.88999999999Percent of total billed charges4.620.77999999999Percent of total billed charges4.620.77999999999Percent of total billed charges5.40.9999999999Percent of total billed charges5.40.9999999999Percent of total billed charges4.420.736999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.425.4
OXYGEN MASK2700128CDM272RCboth64.55.280.88999999999Percent of total billed charges4.620.77999999999Percent of total billed charges4.620.77999999999Percent of total billed charges5.40.9999999999Percent of total billed charges5.40.9999999999Percent of total billed charges4.420.736999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.425.4
STERI STRIP-SKN CLOSU1/4X2707350CDM272RCboth64.55.280.88999999999Percent of total billed charges4.620.77999999999Percent of total billed charges4.620.77999999999Percent of total billed charges5.40.9999999999Percent of total billed charges5.40.9999999999Percent of total billed charges4.420.736999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.425.4
STERILE EYE PAD OVAL EA2707047CDM272RCboth64.55.280.88999999999Percent of total billed charges4.620.77999999999Percent of total billed charges4.620.77999999999Percent of total billed charges5.40.9999999999Percent of total billed charges5.40.9999999999Percent of total billed charges4.420.736999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.425.4
SUCTION INST W/TUBING2700432CDM272RCboth64.55.280.88999999999Percent of total billed charges4.620.77999999999Percent of total billed charges4.620.77999999999Percent of total billed charges5.40.9999999999Percent of total billed charges5.40.9999999999Percent of total billed charges4.420.736999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.80.8999999999Percent of total billed charges4.425.4
BOWL-STERILE UTILITY DISP.2700260CDM272RCboth75.256.160.88999999999Percent of total billed charges5.390.77999999999Percent of total billed charges5.390.77999999999Percent of total billed charges6.30.9999999999Percent of total billed charges6.30.9999999999Percent of total billed charges5.150.736999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.156.3
DRESSING IV TAGADERM 4X42700283CDM272RCboth75.256.160.88999999999Percent of total billed charges5.390.77999999999Percent of total billed charges5.390.77999999999Percent of total billed charges6.30.9999999999Percent of total billed charges6.30.9999999999Percent of total billed charges5.150.736999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.156.3
GAUZE-KERLIX 4.5" ROLL STERILE2700360CDM272RCboth75.256.160.88999999999Percent of total billed charges5.390.77999999999Percent of total billed charges5.390.77999999999Percent of total billed charges6.30.9999999999Percent of total billed charges6.30.9999999999Percent of total billed charges5.150.736999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.60.8999999999Percent of total billed charges5.156.3
BASIN W/ STERILE 4X4'S2700130CDM272RCboth867.040.88999999999Percent of total billed charges6.160.77999999999Percent of total billed charges6.160.77999999999Percent of total billed charges7.20.9999999999Percent of total billed charges7.20.9999999999Percent of total billed charges5.890.736999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges5.897.2
DRESSING-XEROFORM 5X9/EA2703435CDM272RCboth867.040.88999999999Percent of total billed charges6.160.77999999999Percent of total billed charges6.160.77999999999Percent of total billed charges7.20.9999999999Percent of total billed charges7.20.9999999999Percent of total billed charges5.890.736999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges5.897.2
SUCTION CONNECTING TUBING2700434CDM272RCboth867.040.88999999999Percent of total billed charges6.160.77999999999Percent of total billed charges6.160.77999999999Percent of total billed charges7.20.9999999999Percent of total billed charges7.20.9999999999Percent of total billed charges5.890.736999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges5.897.2
SUCTION INSTRUMENT-YANKAUER2700433CDM272RCboth867.040.88999999999Percent of total billed charges6.160.77999999999Percent of total billed charges6.160.77999999999Percent of total billed charges7.20.9999999999Percent of total billed charges7.20.9999999999Percent of total billed charges5.890.736999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges6.40.8999999999Percent of total billed charges5.897.2
CATHETER FOLEY 28 FR2700150CDM272RCboth96.757.920.88999999999Percent of total billed charges6.930.77999999999Percent of total billed charges6.930.77999999999Percent of total billed charges8.10.9999999999Percent of total billed charges8.10.9999999999Percent of total billed charges6.620.736999999999Percent of total billed charges7.20.8999999999Percent of total billed charges7.20.8999999999Percent of total billed charges7.20.8999999999Percent of total billed charges6.628.1
5-0 ETHILON2700722CDM272RCboth118.259.680.88999999999Percent of total billed charges8.470.77999999999Percent of total billed charges8.470.77999999999Percent of total billed charges9.90.9999999999Percent of total billed charges9.90.9999999999Percent of total billed charges8.10.736999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.19.9
NASOGASTRIC TUBE2704725CDM272RCboth118.259.680.88999999999Percent of total billed charges8.470.77999999999Percent of total billed charges8.470.77999999999Percent of total billed charges9.90.9999999999Percent of total billed charges9.90.9999999999Percent of total billed charges8.10.736999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.80.8999999999Percent of total billed charges8.19.9
EYE EXAM TRAY NT+OR2705307CDM272RCboth12910.560.88999999999Percent of total billed charges9.240.77999999999Percent of total billed charges9.240.77999999999Percent of total billed charges10.80.9999999999Percent of total billed charges10.80.9999999999Percent of total billed charges8.830.736999999999Percent of total billed charges9.60.8999999999Percent of total billed charges9.60.8999999999Percent of total billed charges9.60.8999999999Percent of total billed charges8.8310.8
PEDI-NASAL CANNULA2700005CDM272RCboth12910.560.88999999999Percent of total billed charges9.240.77999999999Percent of total billed charges9.240.77999999999Percent of total billed charges10.80.9999999999Percent of total billed charges10.80.9999999999Percent of total billed charges8.830.736999999999Percent of total billed charges9.60.8999999999Percent of total billed charges9.60.8999999999Percent of total billed charges9.60.8999999999Percent of total billed charges8.8310.8
SUTURE WIRE CLIP 15R EA2701473CDM272RCboth1410.512.320.88999999999Percent of total billed charges10.780.77999999999Percent of total billed charges10.780.77999999999Percent of total billed charges12.60.9999999999Percent of total billed charges12.60.9999999999Percent of total billed charges10.30.736999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges10.312.6
SUTURE WIRE CLIP PS-35R/E2701472CDM272RCboth1410.512.320.88999999999Percent of total billed charges10.780.77999999999Percent of total billed charges10.780.77999999999Percent of total billed charges12.60.9999999999Percent of total billed charges12.60.9999999999Percent of total billed charges10.30.736999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges10.312.6
SYRING-TUBE-TOOMEY 70CC/2700516CDM272RCboth1410.512.320.88999999999Percent of total billed charges10.780.77999999999Percent of total billed charges10.780.77999999999Percent of total billed charges12.60.9999999999Percent of total billed charges12.60.9999999999Percent of total billed charges10.30.736999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges10.312.6
DRESSING IV TEGADERM 6X82700280CDM272RCboth2115.7518.480.88999999999Percent of total billed charges16.170.77999999999Percent of total billed charges16.170.77999999999Percent of total billed charges18.90.9999999999Percent of total billed charges18.90.9999999999Percent of total billed charges15.460.736999999999Percent of total billed charges16.80.8999999999Percent of total billed charges16.80.8999999999Percent of total billed charges16.80.8999999999Percent of total billed charges15.4618.9
FOLEY CATHETER INSERTION TRAY2703149CDM272RCboth2619.522.880.88999999999Percent of total billed charges20.020.77999999999Percent of total billed charges20.020.77999999999Percent of total billed charges23.40.9999999999Percent of total billed charges23.40.9999999999Percent of total billed charges19.140.736999999999Percent of total billed charges20.80.8999999999Percent of total billed charges20.80.8999999999Percent of total billed charges20.80.8999999999Percent of total billed charges19.1423.4
IODOFORM-GAUZE 1/4"5S/E2700790CDM272RCboth2921.7525.520.88999999999Percent of total billed charges22.330.77999999999Percent of total billed charges22.330.77999999999Percent of total billed charges26.10.9999999999Percent of total billed charges26.10.9999999999Percent of total billed charges21.340.736999999999Percent of total billed charges23.20.8999999999Percent of total billed charges23.20.8999999999Percent of total billed charges23.20.8999999999Percent of total billed charges21.3426.1
FEMALE CATH KIT WITH GLOVES & WIPES2707185CDM272RCboth3022.526.40.88999999999Percent of total billed charges23.10.77999999999Percent of total billed charges23.10.77999999999Percent of total billed charges270.9999999999Percent of total billed charges270.9999999999Percent of total billed charges22.080.736999999999Percent of total billed charges240.8999999999Percent of total billed charges240.8999999999Percent of total billed charges240.8999999999Percent of total billed charges22.0827
CHEST TUBE2700333CDM272RCboth322428.160.88999999999Percent of total billed charges24.640.77999999999Percent of total billed charges24.640.77999999999Percent of total billed charges28.80.9999999999Percent of total billed charges28.80.9999999999Percent of total billed charges23.550.736999999999Percent of total billed charges25.60.8999999999Percent of total billed charges25.60.8999999999Percent of total billed charges25.60.8999999999Percent of total billed charges23.5528.8
TUBE-SALEM SUMP ALL SIZES2700069CDM272RCboth322428.160.88999999999Percent of total billed charges24.640.77999999999Percent of total billed charges24.640.77999999999Percent of total billed charges28.80.9999999999Percent of total billed charges28.80.9999999999Percent of total billed charges23.550.736999999999Percent of total billed charges25.60.8999999999Percent of total billed charges25.60.8999999999Percent of total billed charges25.60.8999999999Percent of total billed charges23.5528.8
ENDOTRACHEAL TUBE ALL SIZES2702907CDM272RCboth3526.2530.80.88999999999Percent of total billed charges26.950.77999999999Percent of total billed charges26.950.77999999999Percent of total billed charges31.50.9999999999Percent of total billed charges31.50.9999999999Percent of total billed charges25.760.736999999999Percent of total billed charges280.8999999999Percent of total billed charges280.8999999999Percent of total billed charges280.8999999999Percent of total billed charges25.7631.5
SUTURE 3-0 ETHILON270669TH3CDM272RCboth403035.20.88999999999Percent of total billed charges30.80.77999999999Percent of total billed charges30.80.77999999999Percent of total billed charges360.9999999999Percent of total billed charges360.9999999999Percent of total billed charges29.440.736999999999Percent of total billed charges320.8999999999Percent of total billed charges320.8999999999Percent of total billed charges320.8999999999Percent of total billed charges29.4436
6.0 EHTILON2703234CDM272RCboth4130.7536.080.88999999999Percent of total billed charges31.570.77999999999Percent of total billed charges31.570.77999999999Percent of total billed charges36.90.9999999999Percent of total billed charges36.90.9999999999Percent of total billed charges30.180.736999999999Percent of total billed charges32.80.8999999999Percent of total billed charges32.80.8999999999Percent of total billed charges32.80.8999999999Percent of total billed charges30.1836.9
CATHETER-URETHRAL TRAY2701122CDM272RCboth4231.536.960.88999999999Percent of total billed charges32.340.77999999999Percent of total billed charges32.340.77999999999Percent of total billed charges37.80.9999999999Percent of total billed charges37.80.9999999999Percent of total billed charges30.910.736999999999Percent of total billed charges33.60.8999999999Percent of total billed charges33.60.8999999999Percent of total billed charges33.60.8999999999Percent of total billed charges30.9137.8
NASAL PACKING-RHINO ROCKET2703754CDM272RCboth4634.540.480.88999999999Percent of total billed charges35.420.77999999999Percent of total billed charges35.420.77999999999Percent of total billed charges41.40.9999999999Percent of total billed charges41.40.9999999999Percent of total billed charges33.860.736999999999Percent of total billed charges36.80.8999999999Percent of total billed charges36.80.8999999999Percent of total billed charges36.80.8999999999Percent of total billed charges33.8641.4
CATH TRAY/ CATH/ BAG 18 FRENCH2703160CDM272RCboth6347.2555.440.88999999999Percent of total billed charges48.510.77999999999Percent of total billed charges48.510.77999999999Percent of total billed charges56.70.9999999999Percent of total billed charges56.70.9999999999Percent of total billed charges46.370.736999999999Percent of total billed charges50.40.8999999999Percent of total billed charges50.40.8999999999Percent of total billed charges50.40.8999999999Percent of total billed charges46.3756.7
DIS WOUND CLOSURE INST TRAY2705381CDM272RCboth6347.2555.440.88999999999Percent of total billed charges48.510.77999999999Percent of total billed charges48.510.77999999999Percent of total billed charges56.70.9999999999Percent of total billed charges56.70.9999999999Percent of total billed charges46.370.736999999999Percent of total billed charges50.40.8999999999Percent of total billed charges50.40.8999999999Percent of total billed charges50.40.8999999999Percent of total billed charges46.3756.7
ASPIRATION/TRAOSSEOUS NEEDLE2700040CDM272RCboth6548.7557.20.88999999999Percent of total billed charges50.050.77999999999Percent of total billed charges50.050.77999999999Percent of total billed charges58.50.9999999999Percent of total billed charges58.50.9999999999Percent of total billed charges47.840.736999999999Percent of total billed charges520.8999999999Percent of total billed charges520.8999999999Percent of total billed charges520.8999999999Percent of total billed charges47.8458.5
FOLEY CATHETER TRAY 16R-5CC2706014CDM272RCboth685159.840.88999999999Percent of total billed charges52.360.77999999999Percent of total billed charges52.360.77999999999Percent of total billed charges61.20.9999999999Percent of total billed charges61.20.9999999999Percent of total billed charges50.050.736999999999Percent of total billed charges54.40.8999999999Percent of total billed charges54.40.8999999999Percent of total billed charges54.40.8999999999Percent of total billed charges50.0561.2
TRAY-SUTURE/LACERATION2705380CDM272RCboth846373.920.88999999999Percent of total billed charges64.680.77999999999Percent of total billed charges64.680.77999999999Percent of total billed charges75.60.9999999999Percent of total billed charges75.60.9999999999Percent of total billed charges61.820.736999999999Percent of total billed charges67.20.8999999999Percent of total billed charges67.20.8999999999Percent of total billed charges67.20.8999999999Percent of total billed charges61.8275.6
CHEST DRAINAGE UNIT2703915CDM272RCboth9369.7581.840.88999999999Percent of total billed charges71.610.77999999999Percent of total billed charges71.610.77999999999Percent of total billed charges83.70.9999999999Percent of total billed charges83.70.9999999999Percent of total billed charges68.450.736999999999Percent of total billed charges74.40.8999999999Percent of total billed charges74.40.8999999999Percent of total billed charges74.40.8999999999Percent of total billed charges68.4583.7
DERMABOND2704948CDM272RCboth10981.7595.920.88999999999Percent of total billed charges83.930.77999999999Percent of total billed charges83.930.77999999999Percent of total billed charges98.10.9999999999Percent of total billed charges98.10.9999999999Percent of total billed charges80.220.736999999999Percent of total billed charges87.20.8999999999Percent of total billed charges87.20.8999999999Percent of total billed charges87.20.8999999999Percent of total billed charges80.2298.1
BANDAGE-KLING STRETCH 4"X2700542CDM272RCboth0.88999999999Percent of total billed charges0.77999999999Percent of total billed charges0.77999999999Percent of total billed charges0.9999999999Percent of total billed charges0.9999999999Percent of total billed charges0.736999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges0.8999999999Percent of total billed charges
COLLECTION OF VENOUS BLOOD3000410CDM36415CPT300RCboth1410.512.320.88999999999Percent of total billed charges10.780.77999999999Percent of total billed charges10.780.77999999999Percent of total billed charges12.60.9999999999Percent of total billed charges12.60.9999999999Percent of total billed charges10.30.736999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges11.20.8999999999Percent of total billed charges10.312.6
PANEL: GENERAL HEALTH3000459CDM80050CPT300RCboth495371.25435.60.88999999999Percent of total billed charges381.150.77999999999Percent of total billed charges381.150.77999999999Percent of total billed charges445.50.9999999999Percent of total billed charges445.50.9999999999Percent of total billed charges364.320.736999999999Percent of total billed charges3960.8999999999Percent of total billed charges3960.8999999999Percent of total billed charges3960.8999999999Percent of total billed charges364.32445.5
GENTAMICIN3000498CDM80170CPT300RCboth846373.920.88999999999Percent of total billed charges64.680.77999999999Percent of total billed charges64.680.77999999999Percent of total billed charges75.60.9999999999Percent of total billed charges75.60.9999999999Percent of total billed charges61.820.736999999999Percent of total billed charges67.20.8999999999Percent of total billed charges67.20.8999999999Percent of total billed charges67.20.8999999999Percent of total billed charges61.8275.6
CARBAMAZEDINE3000062CDM80201CPT300RCboth8261.572.160.88999999999Percent of total billed charges63.140.77999999999Percent of total billed charges63.140.77999999999Percent of total billed charges73.80.9999999999Percent of total billed charges73.80.9999999999Percent of total billed charges60.350.736999999999Percent of total billed charges65.60.8999999999Percent of total billed charges65.60.8999999999Percent of total billed charges65.60.8999999999Percent of total billed charges60.3573.8
LAMORIGINE30080299CDM80299CPT300RCboth9369.7581.840.88999999999Percent of total billed charges71.610.77999999999Percent of total billed charges71.610.77999999999Percent of total billed charges83.70.9999999999Percent of total billed charges83.70.9999999999Percent of total billed charges68.450.736999999999Percent of total billed charges74.40.8999999999Percent of total billed charges74.40.8999999999Percent of total billed charges74.40.8999999999Percent of total billed charges68.4583.7
URINE DIPSTICK81002CDM81002CPT300RCboth15.4511.5913.60.88999999999Percent of total billed charges11.90.77999999999Percent of total billed charges11.90.77999999999Percent of total billed charges13.910.9999999999Percent of total billed charges13.910.9999999999Percent of total billed charges11.370.736999999999Percent of total billed charges12.360.8999999999Percent of total billed charges12.360.8999999999Percent of total billed charges12.360.8999999999Percent of total billed charges11.3713.91
URINALYSIS, AUTOMATED W/O MICR3001527CDM81003CPT300RCboth3828.533.440.88999999999Percent of total billed charges29.260.77999999999Percent of total billed charges29.260.77999999999Percent of total billed charges34.20.9999999999Percent of total billed charges34.20.9999999999Percent of total billed charges27.970.736999999999Percent of total billed charges30.40.8999999999Percent of total billed charges30.40.8999999999Percent of total billed charges30.40.8999999999Percent of total billed charges27.9734.2
ACETONE SERUM3000040CDM82009CPT300RCboth2317.2520.240.88999999999Percent of total billed charges17.710.77999999999Percent of total billed charges17.710.77999999999Percent of total billed charges20.70.9999999999Percent of total billed charges20.70.9999999999Percent of total billed charges16.930.736999999999Percent of total billed charges18.40.8999999999Percent of total billed charges18.40.8999999999Percent of total billed charges18.40.8999999999Percent of total billed charges16.9320.7
ACTH3000383CDM82024CPT300RCboth12996.75113.520.88999999999Percent of total billed charges99.330.77999999999Percent of total billed charges99.330.77999999999Percent of total billed charges116.10.9999999999Percent of total billed charges116.10.9999999999Percent of total billed charges94.940.736999999999Percent of total billed charges103.20.8999999999Percent of total billed charges103.20.8999999999Percent of total billed charges103.20.8999999999Percent of total billed charges94.94116.1
ACTH ADRENOCORTICOTRPHIC HORM3000160CDM82024CPT300RCboth12996.75113.520.88999999999Percent of total billed charges99.330.77999999999Percent of total billed charges99.330.77999999999Percent of total billed charges116.10.9999999999Percent of total billed charges116.10.9999999999Percent of total billed charges94.940.736999999999Percent of total billed charges103.20.8999999999Percent of total billed charges103.20.8999999999Percent of total billed charges103.20.8999999999Percent of total billed charges94.94116.1
ALDOLASE3000118CDM82085CPT300RCboth403035.20.88999999999Percent of total billed charges30.80.77999999999Percent of total billed charges30.80.77999999999Percent of total billed charges360.9999999999Percent of total billed charges360.9999999999Percent of total billed charges29.440.736999999999Percent of total billed charges320.8999999999Percent of total billed charges320.8999999999Percent of total billed charges320.8999999999Percent of total billed charges29.4436
ALPHA-1-ANTITRYPSIN3000367CDM82103CPT300RCboth5440.547.520.88999999999Percent of total billed charges41.580.77999999999Percent of total billed charges41.580.77999999999Percent of total billed charges48.60.9999999999Percent of total billed charges48.60.9999999999Percent of total billed charges39.740.736999999999Percent of total billed charges43.20.8999999999Percent of total billed charges43.20.8999999999Percent of total billed charges43.20.8999999999Percent of total billed charges39.7448.6
ANDROSTENEDIONE3001710CDM82157CPT300RCboth218163.5191.840.88999999999Percent of total billed charges167.860.77999999999Percent of total billed charges167.860.77999999999Percent of total billed charges196.20.9999999999Percent of total billed charges196.20.9999999999Percent of total billed charges160.450.736999999999Percent of total billed charges174.40.8999999999Percent of total billed charges174.40.8999999999Percent of total billed charges174.40.8999999999Percent of total billed charges160.45196.2
CALCIUM3000812CDM82300CPT300RCboth443338.720.88999999999Percent of total billed charges33.880.77999999999Percent of total billed charges33.880.77999999999Percent of total billed charges39.60.9999999999Percent of total billed charges39.60.9999999999Percent of total billed charges32.380.736999999999Percent of total billed charges35.20.8999999999Percent of total billed charges35.20.8999999999Percent of total billed charges35.20.8999999999Percent of total billed charges32.3839.6
CARCINOEMBRYONIC ANTIGEN (CEA)3001579CDM82378CPT300RCboth1128498.560.88999999999Percent of total billed charges86.240.77999999999Percent of total billed charges86.240.77999999999Percent of total billed charges100.80.9999999999Percent of total billed charges100.80.9999999999Percent of total billed charges82.430.736999999999Percent of total billed charges89.60.8999999999Percent of total billed charges89.60.8999999999Percent of total billed charges89.60.8999999999Percent of total billed charges82.43100.8
ASSAY OF CERULOPLASMIN30082390CDM82390CPT300RCboth564249.280.88999999999Percent of total billed charges43.120.77999999999Percent of total billed charges43.120.77999999999Percent of total billed charges50.40.9999999999Percent of total billed charges50.40.9999999999Percent of total billed charges41.220.736999999999Percent of total billed charges44.80.8999999999Percent of total billed charges44.80.8999999999Percent of total billed charges44.80.8999999999Percent of total billed charges41.2250.4
Lacosamide30082542LCDM82542CPT300RCboth886677.440.88999999999Percent of total billed charges67.760.77999999999Percent of total billed charges67.760.77999999999Percent of total billed charges79.20.9999999999Percent of total billed charges79.20.9999999999Percent of total billed charges64.770.736999999999Percent of total billed charges70.40.8999999999Percent of total billed charges70.40.8999999999Percent of total billed charges70.40.8999999999Percent of total billed charges64.7779.2
DHEA3000315CDM82626CPT300RCboth172129151.360.88999999999Percent of total billed charges132.440.77999999999Percent of total billed charges132.440.77999999999Percent of total billed charges154.80.9999999999Percent of total billed charges154.80.9999999999Percent of total billed charges126.590.736999999999Percent of total billed charges137.60.8999999999Percent of total billed charges137.60.8999999999Percent of total billed charges137.60.8999999999Percent of total billed charges126.59154.8
ESTRADIOL3000491CDM82670CPT300RCboth11687102.080.88999999999Percent of total billed charges89.320.77999999999Percent of total billed charges89.320.77999999999Percent of total billed charges104.40.9999999999Percent of total billed charges104.40.9999999999Percent of total billed charges85.380.736999999999Percent of total billed charges92.80.8999999999Percent of total billed charges92.80.8999999999Percent of total billed charges92.80.8999999999Percent of total billed charges85.38104.4
IGM30016743CDM82784CPT300RCboth725463.360.88999999999Percent of total billed charges55.440.77999999999Percent of total billed charges55.440.77999999999Percent of total billed charges64.80.9999999999Percent of total billed charges64.80.9999999999Percent of total billed charges52.990.736999999999Percent of total billed charges57.60.8999999999Percent of total billed charges57.60.8999999999Percent of total billed charges57.60.8999999999Percent of total billed charges52.9964.8
GAMMA GT (GGT)3003854CDM82977CPT300RCboth4936.7543.120.88999999999Percent of total billed charges37.730.77999999999Percent of total billed charges37.730.77999999999Percent of total billed charges44.10.9999999999Percent of total billed charges44.10.9999999999Percent of total billed charges36.060.736999999999Percent of total billed charges39.20.8999999999Percent of total billed charges39.20.8999999999Percent of total billed charges39.20.8999999999Percent of total billed charges36.0644.1
LUTEINIZING HORMONE (LH)3000488CDM83002CPT300RCboth8563.7574.80.88999999999Percent of total billed charges65.450.77999999999Percent of total billed charges65.450.77999999999Percent of total billed charges76.50.9999999999Percent of total billed charges76.50.9999999999Percent of total billed charges62.560.736999999999Percent of total billed charges680.8999999999Percent of total billed charges680.8999999999Percent of total billed charges680.8999999999Percent of total billed charges62.5676.5
ANTI SMOOTH3000136CDM83516CPT300RCboth151113.25132.880.88999999999Percent of total billed charges116.270.77999999999Percent of total billed charges116.270.77999999999Percent of total billed charges135.90.9999999999Percent of total billed charges135.90.9999999999Percent of total billed charges111.140.736999999999Percent of total billed charges120.80.8999999999Percent of total billed charges120.80.8999999999Percent of total billed charges120.80.8999999999Percent of total billed charges111.14135.9
Free Kappa & Lambda Light chains, Quanti30083883CDM83883CPT300RCboth12090105.60.88999999999Percent of total billed charges92.40.77999999999Percent of total billed charges92.40.77999999999Percent of total billed charges1080.9999999999Percent of total billed charges1080.9999999999Percent of total billed charges88.320.736999999999Percent of total billed charges960.8999999999Percent of total billed charges960.8999999999Percent of total billed charges960.8999999999Percent of total billed charges88.32108
METHYMALONIC ACID3000568CDM83921CPT300RCboth11888.5103.840.88999999999Percent of total billed charges90.860.77999999999Percent of total billed charges90.860.77999999999Percent of total billed charges106.20.9999999999Percent of total billed charges106.20.9999999999Percent of total billed charges86.850.736999999999Percent of total billed charges94.40.8999999999Percent of total billed charges94.40.8999999999Percent of total billed charges94.40.8999999999Percent of total billed charges86.85106.2
URINE OSMOLALITY3000188CDM83935CPT300RCboth886677.440.88999999999Percent of total billed charges67.760.77999999999Percent of total billed charges67.760.77999999999Percent of total billed charges79.20.9999999999Percent of total billed charges79.20.9999999999Percent of total billed charges64.770.736999999999Percent of total billed charges70.40.8999999999Percent of total billed charges70.40.8999999999Percent of total billed charges70.40.8999999999Percent of total billed charges64.7779.2
Calprotectin, stool30083993CDM83993CPT300RCboth260195228.80.88999999999Percent of total billed charges200.20.77999999999Percent of total billed charges200.20.77999999999Percent of total billed charges2340.9999999999Percent of total billed charges2340.9999999999Percent of total billed charges191.360.736999999999Percent of total billed charges2080.8999999999Percent of total billed charges2080.8999999999Percent of total billed charges2080.8999999999Percent of total billed charges191.36234
ALKALINE PHOSPHATASE ISOENZYME3000563CDM84080CPT300RCboth7455.565.120.88999999999Percent of total billed charges56.980.77999999999Percent of total billed charges56.980.77999999999Percent of total billed charges66.60.9999999999Percent of total billed charges66.60.9999999999Percent of total billed charges54.460.736999999999Percent of total billed charges59.20.8999999999Percent of total billed charges59.20.8999999999Percent of total billed charges59.20.8999999999Percent of total billed charges54.4666.6
17OHP 17 HYDROXYPREGNENOLONE3000116CDM84143CPT300RCboth148111130.240.88999999999Percent of total billed charges113.960.77999999999Percent of total billed charges113.960.77999999999Percent of total billed charges133.20.9999999999Percent of total billed charges133.20.9999999999Percent of total billed charges108.930.736999999999Percent of total billed charges118.40.8999999999Percent of total billed charges118.40.8999999999Percent of total billed charges118.40.8999999999Percent of total billed charges108.93133.2
PSA30084153CDM84153CPT300RCboth156117137.280.88999999999Percent of total billed charges120.120.77999999999Percent of total billed charges120.120.77999999999Percent of total billed charges140.40.9999999999Percent of total billed charges140.40.9999999999Percent of total billed charges114.820.736999999999Percent of total billed charges124.80.8999999999Percent of total billed charges124.80.8999999999Percent of total billed charges124.80.8999999999Percent of total billed charges114.82140.4
TRIGLYCERIDES3000334CDM84478CPT300RCboth4130.7536.080.88999999999Percent of total billed charges31.570.77999999999Percent of total billed charges31.570.77999999999Percent of total billed charges36.90.9999999999Percent of total billed charges36.90.9999999999Percent of total billed charges30.180.736999999999Percent of total billed charges32.80.8999999999Percent of total billed charges32.80.8999999999Percent of total billed charges32.80.8999999999Percent of total billed charges30.1836.9
T3 REVERSE30084482CDM84482CPT300RCboth2720.2523.760.88999999999Percent of total billed charges20.790.77999999999Percent of total billed charges20.790.77999999999Percent of total billed charges24.30.9999999999Percent of total billed charges24.30.9999999999Percent of total billed charges19.870.736999999999Percent of total billed charges21.60.8999999999Percent of total billed charges21.60.8999999999Percent of total billed charges21.60.8999999999Percent of total billed charges19.8724.3
URIC ACID3000560CDM84560CPT300RCboth443338.720.88999999999Percent of total billed charges33.880.77999999999Percent of total billed charges33.880.77999999999Percent of total billed charges39.60.9999999999Percent of total billed charges39.60.9999999999Percent of total billed charges32.380.736999999999Percent of total billed charges35.20.8999999999Percent of total billed charges35.20.8999999999Percent of total billed charges35.20.8999999999Percent of total billed charges32.3839.6
VITAMIN K3000572CDM84597CPT300RCboth215161.25189.20.88999999999Percent of total billed charges165.550.77999999999Percent of total billed charges165.550.77999999999Percent of total billed charges193.50.9999999999Percent of total billed charges193.50.9999999999Percent of total billed charges158.240.736999999999Percent of total billed charges1720.8999999999Percent of total billed charges1720.8999999999Percent of total billed charges1720.8999999999Percent of total billed charges158.24193.5
RETICULOCYTE COUNT3000468CDM85045CPT300RCboth282124.640.88999999999Percent of total billed charges21.560.77999999999Percent of total billed charges21.560.77999999999Percent of total billed charges25.20.9999999999Percent of total billed charges25.20.9999999999Percent of total billed charges20.610.736999999999Percent of total billed charges22.40.8999999999Percent of total billed charges22.40.8999999999Percent of total billed charges22.40.8999999999Percent of total billed charges20.6125.2
BLOOD SMEAR STUDY3000362CDM85060CPT300RCboth2720.2523.760.88999999999Percent of total billed charges20.790.77999999999Percent of total billed charges20.790.77999999999Percent of total billed charges24.30.9999999999Percent of total billed charges24.30.9999999999Percent of total billed charges19.870.736999999999Percent of total billed charges21.60.8999999999Percent of total billed charges21.60.8999999999Percent of total billed charges21.60.8999999999Percent of total billed charges19.8724.3
Sickle Cell Test30085660CDM85660CPT300RCboth201517.60.88999999999Percent of total billed charges15.40.77999999999Percent of total billed charges15.40.77999999999Percent of total billed charges180.9999999999Percent of total billed charges180.9999999999Percent of total billed charges14.720.736999999999Percent of total billed charges160.8999999999Percent of total billed charges160.8999999999Percent of total billed charges160.8999999999Percent of total billed charges14.7218
ANTISTREPTOLYSIN O (ASO TITER)3000355CDM86060CPT300RCboth2921.7525.520.88999999999Percent of total billed charges22.330.77999999999Percent of total billed charges22.330.77999999999Percent of total billed charges26.10.9999999999Percent of total billed charges26.10.9999999999Percent of total billed charges21.340.736999999999Percent of total billed charges23.20.8999999999Percent of total billed charges23.20.8999999999Percent of total billed charges23.20.8999999999Percent of total billed charges21.3426.1
C4 & C3 COMPLEMENT GROUP3001794CDM86160CPT300RCboth8362.2573.040.88999999999Percent of total billed charges63.910.77999999999Percent of total billed charges63.910.77999999999Percent of total billed charges74.70.9999999999Percent of total billed charges74.70.9999999999Percent of total billed charges61.090.736999999999Percent of total billed charges66.40.8999999999Percent of total billed charges66.40.8999999999Percent of total billed charges66.40.8999999999Percent of total billed charges61.0974.7
COMPLEMENT C-43000056CDM86160CPT300RCboth8362.2573.040.88999999999Percent of total billed charges63.910.77999999999Percent of total billed charges63.910.77999999999Percent of total billed charges74.70.9999999999Percent of total billed charges74.70.9999999999Percent of total billed charges61.090.736999999999Percent of total billed charges66.40.8999999999Percent of total billed charges66.40.8999999999Percent of total billed charges66.40.8999999999Percent of total billed charges61.0974.7
COMPLEMENT COMPONENT C3C3000054CDM86160CPT300RCboth8362.2573.040.88999999999Percent of total billed charges63.910.77999999999Percent of total billed charges63.910.77999999999Percent of total billed charges74.70.9999999999Percent of total billed charges74.70.9999999999Percent of total billed charges61.090.736999999999Percent of total billed charges66.40.8999999999Percent of total billed charges66.40.8999999999Percent of total billed charges66.40.8999999999Percent of total billed charges61.0974.7
DNA ANTIBODY DOUBLE STANDED3000484CDM86225CPT300RCboth7153.2562.480.88999999999Percent of total billed charges54.670.77999999999Percent of total billed charges54.670.77999999999Percent of total billed charges63.90.9999999999Percent of total billed charges63.90.9999999999Percent of total billed charges52.260.736999999999Percent of total billed charges56.80.8999999999Percent of total billed charges56.80.8999999999Percent of total billed charges56.80.8999999999Percent of total billed charges52.2663.9
Anti RNP Ab30086235CDM86235CPT300RCboth151113.25132.880.88999999999Percent of total billed charges116.270.77999999999Percent of total billed charges116.270.77999999999Percent of total billed charges135.90.9999999999Percent of total billed charges135.90.9999999999Percent of total billed charges111.140.736999999999Percent of total billed charges120.80.8999999999Percent of total billed charges120.80.8999999999Percent of total billed charges120.80.8999999999Percent of total billed charges111.14135.9
JO-1 ANTIBODY3000165CDM86235CPT300RCboth151113.25132.880.88999999999Percent of total billed charges116.270.77999999999Percent of total billed charges116.270.77999999999Percent of total billed charges135.90.9999999999Percent of total billed charges135.90.9999999999Percent of total billed charges111.140.736999999999Percent of total billed charges120.80.8999999999Percent of total billed charges120.80.8999999999Percent of total billed charges120.80.8999999999Percent of total billed charges111.14135.9
ANCA INFLAMMATORY BOWELDISEASE3000122CDM86255CPT300RCboth168126147.840.88999999999Percent of total billed charges129.360.77999999999Percent of total billed charges129.360.77999999999Percent of total billed charges151.20.9999999999Percent of total billed charges151.20.9999999999Percent of total billed charges123.650.736999999999Percent of total billed charges134.40.8999999999Percent of total billed charges134.40.8999999999Percent of total billed charges134.40.8999999999Percent of total billed charges123.65151.2
Striated Muscles Antibody3000001CDM86255CPT300RCboth168126147.840.88999999999Percent of total billed charges129.360.77999999999Percent of total billed charges129.360.77999999999Percent of total billed charges151.20.9999999999Percent of total billed charges151.20.9999999999Percent of total billed charges123.650.736999999999Percent of total billed charges134.40.8999999999Percent of total billed charges134.40.8999999999Percent of total billed charges134.40.8999999999Percent of total billed charges123.65151.2
Myocardial Antibody3000002CDM86256CPT300RCboth1047891.520.88999999999Percent of total billed charges80.080.77999999999Percent of total billed charges80.080.77999999999Percent of total billed charges93.60.9999999999Percent of total billed charges93.60.9999999999Percent of total billed charges76.540.736999999999Percent of total billed charges83.20.8999999999Percent of total billed charges83.20.8999999999Percent of total billed charges83.20.8999999999Percent of total billed charges76.5493.6
CA 15-33000536CDM86300CPT300RCboth12291.5107.360.88999999999Percent of total billed charges93.940.77999999999Percent of total billed charges93.940.77999999999Percent of total billed charges109.80.9999999999Percent of total billed charges109.80.9999999999Percent of total billed charges89.790.736999999999Percent of total billed charges97.60.8999999999Percent of total billed charges97.60.8999999999Percent of total billed charges97.60.8999999999Percent of total billed charges89.79109.8
CA 19-93000163CDM86301CPT300RCboth10981.7595.920.88999999999Percent of total billed charges83.930.77999999999Percent of total billed charges83.930.77999999999Percent of total billed charges98.10.9999999999Percent of total billed charges98.10.9999999999Percent of total billed charges80.220.736999999999Percent of total billed charges87.20.8999999999Percent of total billed charges87.20.8999999999Percent of total billed charges87.20.8999999999Percent of total billed charges80.2298.1
CA 125 (CANCER MARKER)3001564CDM86304CPT300RCboth725463.360.88999999999Percent of total billed charges55.440.77999999999Percent of total billed charges55.440.77999999999Percent of total billed charges64.80.9999999999Percent of total billed charges64.80.9999999999Percent of total billed charges52.990.736999999999Percent of total billed charges57.60.8999999999Percent of total billed charges57.60.8999999999Percent of total billed charges57.60.8999999999Percent of total billed charges52.9964.8
RHEUMATOID ARTHRITIS QUANTITAT3000483CDM86431CPT300RCboth2720.2523.760.88999999999Percent of total billed charges20.790.77999999999Percent of total billed charges20.790.77999999999Percent of total billed charges24.30.9999999999Percent of total billed charges24.30.9999999999Percent of total billed charges19.870.736999999999Percent of total billed charges21.60.8999999999Percent of total billed charges21.60.8999999999Percent of total billed charges21.60.8999999999Percent of total billed charges19.8724.3
ASPERGILLUS ABS3000224CDM86606CPT300RCboth1088195.040.88999999999Percent of total billed charges83.160.77999999999Percent of total billed charges83.160.77999999999Percent of total billed charges97.20.9999999999Percent of total billed charges97.20.9999999999Percent of total billed charges79.490.736999999999Percent of total billed charges86.40.8999999999Percent of total billed charges86.40.8999999999Percent of total billed charges86.40.8999999999Percent of total billed charges79.4997.2
BLASTOMYCES ANTIBODY30086612CDM86612CPT300RCboth3727.7532.560.88999999999Percent of total billed charges28.490.77999999999Percent of total billed charges28.490.77999999999Percent of total billed charges33.30.9999999999Percent of total billed charges33.30.9999999999Percent of total billed charges27.230.736999999999Percent of total billed charges29.60.8999999999Percent of total billed charges29.60.8999999999Percent of total billed charges29.60.8999999999Percent of total billed charges27.2333.3
LYME DISEASE3001825CDM86617CPT300RCboth886677.440.88999999999Percent of total billed charges67.760.77999999999Percent of total billed charges67.760.77999999999Percent of total billed charges79.20.9999999999Percent of total billed charges79.20.9999999999Percent of total billed charges64.770.736999999999Percent of total billed charges70.40.8999999999Percent of total billed charges70.40.8999999999Percent of total billed charges70.40.8999999999Percent of total billed charges64.7779.2
COCCIDIOIDES ANTIBODY3000157CDM86635CPT300RCboth10578.7592.40.88999999999Percent of total billed charges80.850.77999999999Percent of total billed charges80.850.77999999999Percent of total billed charges94.50.9999999999Percent of total billed charges94.50.9999999999Percent of total billed charges77.280.736999999999Percent of total billed charges840.8999999999Percent of total billed charges840.8999999999Percent of total billed charges840.8999999999Percent of total billed charges77.2894.5
HERPES SIMPLEX TYPE 2 AB'S3000461CDM86694CPT300RCboth523945.760.88999999999Percent of total billed charges40.040.77999999999Percent of total billed charges40.040.77999999999Percent of total billed charges46.80.9999999999Percent of total billed charges46.80.9999999999Percent of total billed charges38.270.736999999999Percent of total billed charges41.60.8999999999Percent of total billed charges41.60.8999999999Percent of total billed charges41.60.8999999999Percent of total billed charges38.2746.8
HERPES SIMPLEX TYPE I AB3000106CDM86695CPT300RCboth6347.2555.440.88999999999Percent of total billed charges48.510.77999999999Percent of total billed charges48.510.77999999999Percent of total billed charges56.70.9999999999Percent of total billed charges56.70.9999999999Percent of total billed charges46.370.736999999999Percent of total billed charges50.40.8999999999Percent of total billed charges50.40.8999999999Percent of total billed charges50.40.8999999999Percent of total billed charges46.3756.7
HEPATITIS B SURFACE ANTIBODY3000344CDM86706CPT300RCboth685159.840.88999999999Percent of total billed charges52.360.77999999999Percent of total billed charges52.360.77999999999Percent of total billed charges61.20.9999999999Percent of total billed charges61.20.9999999999Percent of total billed charges50.050.736999999999Percent of total billed charges54.40.8999999999Percent of total billed charges54.40.8999999999Percent of total billed charges54.40.8999999999Percent of total billed charges50.0561.2
VARICELLA TITER IGM3000200CDM86787CPT300RCboth9369.7581.840.88999999999Percent of total billed charges71.610.77999999999Percent of total billed charges71.610.77999999999Percent of total billed charges83.70.9999999999Percent of total billed charges83.70.9999999999Percent of total billed charges68.450.736999999999Percent of total billed charges74.40.8999999999Percent of total billed charges74.40.8999999999Percent of total billed charges74.40.8999999999Percent of total billed charges68.4583.7
HEPATITIS C AB3000508CDM86803CPT300RCboth685159.840.88999999999Percent of total billed charges52.360.77999999999Percent of total billed charges52.360.77999999999Percent of total billed charges61.20.9999999999Percent of total billed charges61.20.9999999999Percent of total billed charges50.050.736999999999Percent of total billed charges54.40.8999999999Percent of total billed charges54.40.8999999999Percent of total billed charges54.40.8999999999Percent of total billed charges50.0561.2
HLAB 27 ANTIGEN3000427CDM86812CPT300RCboth137102.75120.560.88999999999Percent of total billed charges105.490.77999999999Percent of total billed charges105.490.77999999999Percent of total billed charges123.30.9999999999Percent of total billed charges123.30.9999999999Percent of total billed charges100.830.736999999999Percent of total billed charges109.60.8999999999Percent of total billed charges109.60.8999999999Percent of total billed charges109.60.8999999999Percent of total billed charges100.83123.3
ANTIBODY SCREEN KH-MOTHERS3000339CDM86885CPT300RCboth11082.596.80.88999999999Percent of total billed charges84.70.77999999999Percent of total billed charges84.70.77999999999Percent of total billed charges990.9999999999Percent of total billed charges990.9999999999Percent of total billed charges80.960.736999999999Percent of total billed charges880.8999999999Percent of total billed charges880.8999999999Percent of total billed charges880.8999999999Percent of total billed charges80.9699
RH PHENOTYPE30086906CDM86906CPT300RCboth7556.25660.88999999999Percent of total billed charges57.750.77999999999Percent of total billed charges57.750.77999999999Percent of total billed charges67.50.9999999999Percent of total billed charges67.50.9999999999Percent of total billed charges55.20.736999999999Percent of total billed charges600.8999999999Percent of total billed charges600.8999999999Percent of total billed charges600.8999999999Percent of total billed charges55.267.5
COOMBS-CROSSMATCH3900300CDM86921CPT300RCboth11082.596.80.88999999999Percent of total billed charges84.70.77999999999Percent of total billed charges84.70.77999999999Percent of total billed charges990.9999999999Percent of total billed charges990.9999999999Percent of total billed charges80.960.736999999999Percent of total billed charges880.8999999999Percent of total billed charges880.8999999999Percent of total billed charges880.8999999999Percent of total billed charges80.9699
CULTURE: URINE, CATH3000041CDM87088CPT300RCboth322428.160.88999999999Percent of total billed charges24.640.77999999999Percent of total billed charges24.640.77999999999Percent of total billed charges28.80.9999999999Percent of total billed charges28.80.9999999999Percent of total billed charges23.550.736999999999Percent of total billed charges25.60.8999999999Percent of total billed charges25.60.8999999999Percent of total billed charges25.60.8999999999Percent of total billed charges23.5528.8
ASPERGILLUS AG IA30087305CDM87305CPT300RCboth6145.7553.680.88999999999Percent of total billed charges46.970.77999999999Percent of total billed charges46.970.77999999999Percent of total billed charges54.90.9999999999Percent of total billed charges54.90.9999999999Percent of total billed charges44.90.736999999999Percent of total billed charges48.80.8999999999Percent of total billed charges48.80.8999999999Percent of total billed charges48.80.8999999999Percent of total billed charges44.954.9
HEPATITIS B SURFACE AG HBSAG3000514CDM87340CPT300RCboth685159.840.88999999999Percent of total billed charges52.360.77999999999Percent of total billed charges52.360.77999999999Percent of total billed charges61.20.9999999999Percent of total billed charges61.20.9999999999Percent of total billed charges50.050.736999999999Percent of total billed charges54.40.8999999999Percent of total billed charges54.40.8999999999Percent of total billed charges54.40.8999999999Percent of total billed charges50.0561.2
HEPATITIS B E ANTIGEN HBEAG3000515CDM87350CPT300RCboth685159.840.88999999999Percent of total billed charges52.360.77999999999Percent of total billed charges52.360.77999999999Percent of total billed charges61.20.9999999999Percent of total billed charges61.20.9999999999Percent of total billed charges50.050.736999999999Percent of total billed charges54.40.8999999999Percent of total billed charges54.40.8999999999Percent of total billed charges54.40.8999999999Percent of total billed charges50.0561.2
Histoplasma Antigen, Urine30087385CDM87385CPT300RCboth2001501760.88999999999Percent of total billed charges1540.77999999999Percent of total billed charges1540.77999999999Percent of total billed charges1800.9999999999Percent of total billed charges1800.9999999999Percent of total billed charges147.20.736999999999Percent of total billed charges1600.8999999999Percent of total billed charges1600.8999999999Percent of total billed charges1600.8999999999Percent of total billed charges147.2180
Clostridium difficile PCR30087493CDM87493CPT300RCboth350262.53080.88999999999Percent of total billed charges269.50.77999999999Percent of total billed charges269.50.77999999999Percent of total billed charges3150.9999999999Percent of total billed charges3150.9999999999Percent of total billed charges257.60.736999999999Percent of total billed charges2800.8999999999Percent of total billed charges2800.8999999999Percent of total billed charges2800.8999999999Percent of total billed charges257.6315
HERPES SIMPLEX VIRUS-DNA PROBE3000373CDM87528CPT300RCboth685159.840.88999999999Percent of total billed charges52.360.77999999999Percent of total billed charges52.360.77999999999Percent of total billed charges61.20.9999999999Percent of total billed charges61.20.9999999999Percent of total billed charges50.050.736999999999Percent of total billed charges54.40.8999999999Percent of total billed charges54.40.8999999999Percent of total billed charges54.40.8999999999Percent of total billed charges50.0561.2
COVID-19 REFERENCE LAB30087798BCDM87635CPT300RCboth250187.52200.88999999999Percent of total billed charges192.50.77999999999Percent of total billed charges192.50.77999999999Percent of total billed charges2250.9999999999Percent of total billed charges2250.9999999999Percent of total billed charges1840.736999999999Percent of total billed charges2000.8999999999Percent of total billed charges2000.8999999999Percent of total billed charges2000.8999999999Percent of total billed charges184225
Cryptococcus Antigen30087899CDM87899CPT300RCboth12593.751100.88999999999Percent of total billed charges96.250.77999999999Percent of total billed charges96.250.77999999999Percent of total billed charges112.50.9999999999Percent of total billed charges112.50.9999999999Percent of total billed charges920.736999999999Percent of total billed charges1000.8999999999Percent of total billed charges1000.8999999999Percent of total billed charges1000.8999999999Percent of total billed charges92112.5
KOH PREP3000530CDM88108CPT300RCboth3022.526.40.88999999999Percent of total billed charges23.10.77999999999Percent of total billed charges23.10.77999999999Percent of total billed charges270.9999999999Percent of total billed charges270.9999999999Percent of total billed charges22.080.736999999999Percent of total billed charges240.8999999999Percent of total billed charges240.8999999999Percent of total billed charges240.8999999999Percent of total billed charges22.0827
STOOL LUEKOCYTES3000138CDM89055CPT300RCboth403035.20.88999999999Percent of total billed charges30.80.77999999999Percent of total billed charges30.80.77999999999Percent of total billed charges360.9999999999Percent of total billed charges360.9999999999Percent of total billed charges29.440.736999999999Percent of total billed charges320.8999999999Percent of total billed charges320.8999999999Percent of total billed charges320.8999999999Percent of total billed charges29.4436
CRYSTAL IDENTIFICATION3000151CDM89060CPT300RCboth6347.2555.440.88999999999Percent of total billed charges48.510.77999999999Percent of total billed charges48.510.77999999999Percent of total billed charges56.70.9999999999Percent of total billed charges56.70.9999999999Percent of total billed charges46.370.736999999999Percent of total billed charges50.40.8999999999Percent of total billed charges50.40.8999999999Percent of total billed charges50.40.8999999999Percent of total billed charges46.3756.7
CYCLOSPORINE3001738CDM80158CPT300RCboth12996.75113.520.88999999999Percent of total billed charges99.330.77999999999Percent of total billed charges99.330.77999999999Percent of total billed charges116.10.9999999999Percent of total billed charges116.10.9999999999Percent of total billed charges94.940.736999999999Percent of total billed charges103.20.8999999999Percent of total billed charges103.20.8999999999Percent of total billed charges103.20.8999999999Percent of total billed charges94.94116.1
Topiramate30080201CDM80201CPT300RCboth8261.572.160.88999999999Percent of total billed charges63.140.77999999999Percent of total billed charges63.140.77999999999Percent of total billed charges73.80.9999999999Percent of total billed charges73.80.9999999999Percent of total billed charges60.350.736999999999Percent of total billed charges65.60.8999999999Percent of total billed charges65.60.8999999999Percent of total billed charges65.60.8999999999Percent of total billed charges60.3573.8
VANCOMYCIN3000456CDM80202CPT300RCboth846373.920.88999999999Percent of total billed charges64.680.77999999999Percent of total billed charges64.680.77999999999Percent of total billed charges75.60.9999999999Percent of total billed charges75.60.9999999999Percent of total billed charges61.820.736999999999Percent of total billed charges67.20.8999999999Percent of total billed charges67.20.8999999999Percent of total billed charges67.20.8999999999Percent of total billed charges61.8275.6
Dexamethasone3000008CDM80299CPT300RCboth9369.7581.840.88999999999Percent of total billed charges71.610.77999999999Percent of total billed charges71.610.77999999999Percent of total billed charges83.70.9999999999Percent of total billed charges83.70.9999999999Percent of total billed charges68.450.736999999999Percent of total billed charges74.40.8999999999Percent of total billed charges74.40.8999999999Percent of total billed charges74.40.8999999999Percent of total billed charges68.4583.7
ASSAY OF NICOTINE30083887CDM80307CPT300RCboth11586.25101.20.88999999999Percent of total billed charges88.550.77999999999Percent of total billed charges88.550.77999999999Percent of total billed charges103.50.9999999999Percent of total billed charges103.50.9999999999Percent of total billed charges84.640.736999999999Percent of total billed charges920.8999999999Percent of total billed charges920.8999999999Percent of total billed charges920.8999999999Percent of total billed charges84.64103.5
Lab fentanyl30080307CDM80307CPT300RCboth11586.25101.20.88999999999Percent of total billed charges88.550.77999999999Percent of total billed charges88.550.77999999999Percent of total billed charges103.50.9999999999Percent of total billed charges103.50.9999999999Percent of total billed charges84.640.736999999999Percent of total billed charges920.8999999999Percent of total billed charges920.8999999999Percent of total billed charges920.8999999999Percent of total billed charges84.64103.5
Methamphetamine Conf; whole blood30080324CDM80324CPT300RCboth446334.5392.480.88999999999Percent of total billed charges343.420.77999999999Percent of total billed charges343.420.77999999999Percent of total billed charges401.40.9999999999Percent of total billed charges401.40.9999999999Percent of total billed charges328.260.736999999999Percent of total billed charges356.80.8999999999Percent of total billed charges356.80.8999999999Percent of total billed charges356.80.8999999999Percent of total billed charges328.26401.4
Fentanyl & Metabolite30080354CDM80354CPT300RCboth215161.25189.20.88999999999Percent of total billed charges165.550.77999999999Percent of total billed charges165.550.77999999999Percent of total billed charges193.50.9999999999Percent of total billed charges193.50.9999999999Percent of total billed charges158.240.736999999999Percent of total billed charges1720.8999999999Percent of total billed charges1720.8999999999Percent of total billed charges1720.8999999999Percent of total billed charges158.24193.5
Path cln SF 5-2030080503CDM80503CPT300RCboth3526.2530.80.88999999999Percent of total billed charges26.950.77999999999Percent of total billed charges26.950.77999999999Percent of total billed charges31.50.9999999999Percent of total billed charges31.50.9999999999Percent of total billed charges25.760.736999999999Percent of total billed charges280.8999999999Percent of total billed charges280.8999999999Percent of total billed charges280.8999999999Percent of total billed charges25.7631.5
Hemochrom Hered DNA30081256CDM81256CPT300RCboth3002252640.88999999999Percent of total billed charges2310.77999999999Percent of total billed charges2310.77999999999Percent of total billed charges2700.9999999999Percent of total billed charges2700.9999999999Percent of total billed charges220.80.736999999999Percent of total billed charges2400.8999999999Percent of total billed charges2400.8999999999Percent of total billed charges2400.8999999999Percent of total billed charges220.8270
Alpha Globin DNA panel30081257CDM81257CPT300RCboth1020765897.60.88999999999Percent of total billed charges785.40.77999999999Percent of total billed charges785.40.77999999999Percent of total billed charges9180.9999999999Percent of total billed charges9180.9999999999Percent of total billed charges750.720.736999999999Percent of total billed charges8160.8999999999Percent of total billed charges8160.8999999999Percent of total billed charges8160.8999999999Percent of total billed charges750.72918
Jak 2 mutation analysis30081270CDM81270CPT300RCboth580435510.40.88999999999Percent of total billed charges446.60.77999999999Percent of total billed charges446.60.77999999999Percent of total billed charges5220.9999999999Percent of total billed charges5220.9999999999Percent of total billed charges426.880.736999999999Percent of total billed charges4640.8999999999Percent of total billed charges4640.8999999999Percent of total billed charges4640.8999999999Percent of total billed charges426.88522
MTHFR30081291CDM81291CPT300RCboth170127.5149.60.88999999999Percent of total billed charges130.90.77999999999Percent of total billed charges130.90.77999999999Percent of total billed charges1530.9999999999Percent of total billed charges1530.9999999999Percent of total billed charges125.120.736999999999Percent of total billed charges1360.8999999999Percent of total billed charges1360.8999999999Percent of total billed charges1360.8999999999Percent of total billed charges125.12153
Aplipoprotein A1 and B30083695CDM82172CPT300RCboth190142.5167.20.88999999999Percent of total billed charges146.30.77999999999Percent of total billed charges146.30.77999999999Percent of total billed charges</