Medi-Cal: Medi-Cal Rates Information

Medi-Cal Rates Information

Medi-Cal Rates as of 05/15/2023 (Codes 87850 thru 94772)

Medi-Cal Rates are updated and effective as of the 15th of the month and published to the Medi-Cal website on the 16th of the month

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Proc Type	Proc Code	Procedure Description	Unit Value	Basic Rate	Child Rate	ER Rate	Conv Ind	ER Ind	Cut-back Ind	Prof %	Rental Rate	Non-Physn. Med.Prac.Ind
M	87850	INFECT AGT DET BY IMMUNA WITH DIR OPTICA	10.10	$10.10	---	--	009	0	0	0.20	$0.00	N
M	87880	INFECT AGT DET BY IMMUNO WITH DIR OPTICA	6.99	$6.99	---	--	009	0	0	0.20	$0.00	N
M	87899	INFECT AGT DET BY IMMUNO WITH DIR OPTICA	4.87	$4.87	---	--	009	0	0	0.20	$0.00	N
M	87900	PHENOTYPE INFECT AGENT DRUG	115.86	$115.86	---	--	009	0	0	0.20	$0.00	Y
M	87901	NFCT AGT GNTYP ALYS HIV1 REV	228.84	$228.84	---	--	009	0	0	0.20	$0.00	N
M	87902	NFCT AGT GNTYP ALYS HEP C	228.84	$228.84	---	--	009	0	0	0.20	$0.00	N
M	87903	PHENOTYPE DNA HIV W/CULTURE	434.36	$434.36	---	--	009	0	0	0.20	$0.00	N
M	87904	PHENOTYPE DNA HIV W/CLT ADD	23.17	$23.17	---	--	009	0	0	0.20	$0.00	N
M	87905	SIALIDASE ENZYME ASSAY	10.86	$10.86	---	--	009	0	0	0.00	$0.00	Y
M	87906	NFCT AGT GNTYP ALYS HIV1	114.42	$114.42	---	--	009	0	0	0.20	$0.00	N
M	87910	NFCT AGT GNTYP ALYS CMV	23.38	$23.38	---	--	009	0	0	0.20	$0.00	N
M	87912	NFCT AGT GNTYP ALYS HEP B	23.38	$23.38	---	--	009	0	0	0.20	$0.00	N
M	87913	NFCT AGT GNTYP ALYS SARSCOV2	0.00	$0.00	---	--	009	0	0	0.00	$0.00	N
M	87999	UNLISTED MICROBIOLOGY PX	0.00	$0.00	---	--	009	0	0	0.20	$0.00	N
M	88104	CYTOPATH FL NONGYN SMEARS	25.82	$25.82	---	--	009	0	0	0.80	$0.00	N
M	88106	CYTOPATH FL NONGYN FILTER	25.82	$25.82	---	--	009	0	0	0.80	$0.00	N
M	88108	CYTOPATH CONCENTRATE TECH	28.92	$28.92	---	--	009	0	0	0.80	$0.00	N
M	88112	CYTOPATH CELL ENHANCE TECH	60.92	$60.92	---	--	009	0	0	0.38	$0.00	N
M	88120	CYTP URNE 3-5 PROBES EA SPEC	363.41	$363.41	---	--	009	0	0	0.89	$0.00	N
M	88121	CYTP URINE 3-5 PROBES CMPTR	307.14	$307.14	---	--	009	0	0	0.88	$0.00	N
M	88130	SEX CHROMATIN IDENTIFICATION	15.97	$15.97	---	--	009	0	0	0.80	$0.00	N
M	88140	SEX CHROMATIN IDENTIFICATION	7.10	$7.10	---	--	009	0	0	0.80	$0.00	N
M	88141	CYTOPATH C/V INTERPRET	10.53	$10.53	---	--	009	0	0	1.00	$0.00	N
M	88142	CYTOPATH C/V THIN LAYER	18.00	$18.00	---	--	009	0	0	0.80	$0.00	N
M	88143	CYTOPATH C/V THIN LAYER REDO	18.43	$18.43	---	--	009	0	0	0.80	$0.00	N
M	88147	CYTOPATH C/V AUTOMATED	12.39	$12.39	---	--	009	0	0	0.80	$0.00	N
M	88148	CYTOPATH C/V AUTO RESCREEN	13.50	$13.50	---	--	009	0	0	0.80	$0.00	N
M	88150	CYTOPATH C/V MANUAL	11.50	$11.50	---	--	009	0	0	0.80	$0.00	Y
M	88152	CYTOPATH C/V AUTO REDO	11.50	$11.50	---	--	009	0	0	0.80	$0.00	N
M	88153	CYTOPATH C/V REDO	11.50	$11.50	---	--	009	0	0	0.80	$0.00	N
M	88155	CYTOPATH C/V INDEX ADD-ON	6.52	$6.52	---	--	009	0	0	0.80	$0.00	N
M	88160	CYTOPATH SMEAR OTHER SOURCE	31.95	$31.95	---	--	009	0	0	0.80	$0.00	N
M	88161	CYTOPATH SMEAR OTHER SOURCE	20.66	$20.66	---	--	009	0	0	0.80	$0.00	N
M	88162	CYTOPATH SMEAR OTHER SOURCE	48.70	$48.70	---	--	009	0	0	0.80	$0.00	N
M	88164	CYTOPATH TBS C/V MANUAL	9.65	$9.65	---	--	009	0	0	0.80	$0.00	N
M	88165	CYTOPATH TBS C/V REDO	11.50	$11.50	---	--	009	0	0	0.80	$0.00	N
M	88166	CYTOPATH TBS C/V AUTO REDO	11.50	$11.50	---	--	009	0	0	0.80	$0.00	N
M	88167	CYTOPATH TBS C/V SELECT	11.50	$11.50	---	--	009	0	0	0.80	$0.00	N
M	88172	CYTP DX EVAL FNA 1ST EA SITE	28.29	$28.29	---	--	009	0	0	0.80	$0.00	N
M	88173	CYTOPATH EVAL FNA REPORT	51.98	$51.98	---	--	009	0	0	0.80	$0.00	N
M	88174	CYTOPATH C/V AUTO IN FLUID	18.29	$18.29	---	--	009	0	0	0.80	$0.00	N
M	88175	CYTOPATH C/V AUTO FLUID REDO	23.50	$23.50	---	--	009	0	0	0.80	$0.00	N
M	88177	CYTP FNA EVAL EA ADDL	21.74	$21.74	---	--	009	0	0	0.22	$0.00	N
M	88182	CELL MARKER STUDY	87.98	$87.98	---	--	009	0	0	0.80	$0.00	N
M	88184	FLOWCYTOMETRY/ TC 1 MARKER	42.18	$42.18	---	--	009	0	0	0.00	$0.00	N
M	88185	FLOWCYTOMETRY/TC ADD-ON	20.68	$20.68	---	--	009	0	0	0.00	$0.00	N
M	88187	FLOWCYTOMETRY/READ 2-8	32.96	$32.96	---	--	009	0	0	1.00	$0.00	N
M	88188	FLOWCYTOMETRY/READ 9-15	55.88	$55.88	---	--	009	0	0	1.00	$0.00	N
M	88189	FLOWCYTOMETRY/READ 16 & >	69.18	$69.18	---	--	009	0	0	1.00	$0.00	N
M	88199	UNLISTED CYTOPATHOLOGY PX	0.00	$0.00	---	--	009	0	0	0.80	$0.00	N
M	88230	TISSUE CULTURE LYMPHOCYTE	100.98	$100.98	---	--	009	0	0	0.80	$0.00	N
M	88233	TISSUE CULTURE SKIN/BIOPSY	125.08	$125.08	---	--	009	0	0	0.80	$0.00	N
M	88235	TISSUE CULTURE PLACENTA	75.03	$75.03	---	--	009	0	0	0.80	$0.00	N
M	88237	TISSUE CULTURE BONE MARROW	99.64	$99.64	---	--	009	0	0	0.80	$0.00	N
M	88239	TISSUE CULTURE TUMOR	131.12	$131.12	---	--	009	0	0	0.80	$0.00	N
M	88240	CELL CRYOPRESERVE/STORAGE	7.99	$7.99	---	--	009	0	0	0.80	$0.00	Y
M	88241	FROZEN CELL PREPARATION	7.99	$7.99	---	--	009	0	0	0.80	$0.00	Y
M	88245	CHROMOSOME ANALYSIS 20-25	151.72	$151.72	---	--	009	0	0	0.80	$0.00	N
M	88248	CHROMOSOME ANALYSIS 50-100	153.93	$153.93	---	--	009	0	0	0.80	$0.00	N
M	88249	CHROMOSOME ANALYSIS 100	153.93	$153.93	---	--	009	0	0	0.80	$0.00	N
M	88261	CHROMOSOME ANALYSIS 5	190.00	$190.00	---	--	009	0	0	0.80	$0.00	N
M	88262	CHROMOSOME ANALYSIS 15-20	107.81	$107.81	---	--	009	0	0	0.80	$0.00	N
M	88263	CHROMOSOME ANALYSIS 45	133.59	$133.59	---	--	009	0	0	0.80	$0.00	N
M	88264	CHROMOSOME ANALYSIS 20-25	115.68	$115.68	---	--	009	0	0	0.80	$0.00	N
M	88267	CHROMOSOME ANALYS PLACENTA	159.80	$159.80	---	--	009	0	0	0.80	$0.00	N
M	88269	CHROMOSOME ANALYS AMNIOTIC	147.84	$147.84	---	--	009	0	0	0.80	$0.00	N
M	88271	CYTOGENETICS DNA PROBE	16.80	$16.80	---	--	009	0	0	0.80	$0.00	N
M	88272	CYTOGENETICS 3-5	29.15	$29.15	---	--	009	0	0	0.80	$0.00	N
M	88273	CYTOGENETICS 10-30	28.56	$28.56	---	--	009	0	0	0.80	$0.00	N
M	88274	CYTOGENETICS 25-99	33.90	$33.90	---	--	009	0	0	0.80	$0.00	N
M	88275	CYTOGENETICS 100-300	31.68	$31.68	---	--	009	0	0	0.80	$0.00	N
M	88280	CHROMOSOME KARYOTYPE STUDY	19.17	$19.17	---	--	009	0	0	0.80	$0.00	N
M	88283	CHROMOSOME BANDING STUDY	9.71	$9.71	---	--	009	0	0	0.80	$0.00	N
M	88285	CHROMOSOME COUNT ADDITIONAL	7.60	$7.60	---	--	009	0	0	0.80	$0.00	N
M	88289	CHROMOSOME STUDY ADDITIONAL	12.08	$12.08	---	--	009	0	0	0.80	$0.00	N
M	88291	CYTO/MOLECULAR REPORT	13.62	$13.62	---	--	009	0	0	1.00	$0.00	N
M	88299	UNLISTED CYTOGENETIC STUDY	0.00	$0.00	---	--	009	0	0	0.80	$0.00	N
M	88300	SURGICAL PATH GROSS	8.37	$8.37	---	--	009	0	0	0.80	$0.00	N
M	88302	TISSUE EXAM BY PATHOLOGIST	20.94	$20.94	---	--	009	0	0	0.80	$0.00	N
M	88304	TISSUE EXAM BY PATHOLOGIST	30.48	$30.48	---	--	009	0	0	0.80	$0.00	Y
M	88305	TISSUE EXAM BY PATHOLOGIST	40.99	$40.99	---	--	009	0	0	0.80	$0.00	Y
M	88307	TISSUE EXAM BY PATHOLOGIST	87.64	$87.64	---	--	009	0	0	0.80	$0.00	N
M	88309	TISSUE EXAM BY PATHOLOGIST	185.47	$185.47	---	--	009	0	0	0.80	$0.00	N
M	88311	DECALCIFY TISSUE	7.90	$7.90	---	--	009	0	0	0.80	$0.00	Y
M	88312	SPECIAL STAINS GROUP 1	32.83	$32.83	---	--	009	0	0	0.80	$0.00	Y
M	88313	SPECIAL STAINS GROUP 2	38.56	$38.56	---	--	009	0	0	0.80	$0.00	Y
M	88314	HISTOCHEMICAL STAINS ADD-ON	43.23	$43.23	---	--	009	0	0	0.80	$0.00	Y
M	88319	ENZYME HISTOCHEMISTRY	68.78	$68.78	---	--	009	0	0	0.80	$0.00	N
M	88321	MICROSLIDE CONSULTATION	60.98	$60.98	---	--	009	0	0	1.00	$0.00	N
M	88323	MICROSLIDE CONSULTATION	88.41	$88.41	---	--	009	0	0	0.80	$0.00	N
M	88325	COMPREHENSIVE REVIEW OF DATA	101.51	$101.51	---	--	009	0	0	0.80	$0.00	N
M	88329	PATH CONSULT INTROP	32.48	$32.48	---	--	009	0	0	0.80	$0.00	Y
M	88331	PATH CONSULT INTRAOP 1 BLOC	44.52	$44.52	---	--	009	0	0	0.80	$0.00	N
M	88332	PATH CONSULT INTRAOP ADDL	19.39	$19.39	---	--	009	0	0	0.80	$0.00	N
M	88333	INTRAOP CYTO PATH CONSULT 1	79.42	$79.42	---	--	009	0	0	0.63	$0.00	N
M	88334	INTRAOP CYTO PATH CONSULT 2	49.68	$49.68	---	--	009	0	0	0.80	$0.00	N
M	88341	IMMUNOHISTO ANTB ADDL SLIDE	60.62	$60.62	---	--	009	0	0	0.31	$0.00	N
M	88342	IMMUNOHISTO ANTB 1ST STAIN	53.79	$53.79	---	--	009	0	0	0.80	$0.00	N
M	88344	IMMUNOHISTO ANTIBODY SLIDE	104.92	$104.92	---	--	009	0	0	0.33	$0.00	N
M	88346	IMMUNOFLUOR ANTB 1ST STAIN	56.05	$56.05	---	--	009	0	0	0.80	$0.00	N
M	88348	ELECTRON MICROSCOPY	237.71	$237.71	---	--	009	0	0	0.80	$0.00	N
M	88350	IMMUNOFLUOR ANTB ADDL STAIN	64.66	$64.66	---	--	009	0	0	0.38	$0.00	N
M	88355	ANALYSIS SKELETAL MUSCLE	117.31	$117.31	---	--	009	0	0	0.80	$0.00	N
M	88356	ANALYSIS NERVE	180.81	$180.81	---	--	009	0	0	0.80	$0.00	N
M	88358	ANALYSIS TUMOR	66.78	$66.78	---	--	009	0	0	0.80	$0.00	N
M	88360	TUMOR IMMUNOHISTOCHEM/MANUAL	56.74	$56.74	---	--	009	0	0	0.80	$0.00	N
M	88361	TUMOR IMMUNOHISTOCHEM/COMPUT	80.16	$80.16	---	--	009	0	0	0.80	$0.00	N
M	88362	NERVE TEASING PREPARATIONS	180.51	$180.51	---	--	009	0	0	0.80	$0.00	N
M	88363	XM ARCHIVE TISSUE MOLEC ANAL	17.77	$17.77	---	--	009	0	0	0.00	$0.00	N
M	88364	INSITU HYBRIDIZATION (FISH)	87.58	$87.58	---	--	009	0	0	0.21	$0.00	N
M	88365	INSITU HYBRIDIZATION (FISH)	87.58	$87.58	---	--	009	0	0	0.21	$0.00	N
M	88366	INSITU HYBRIDIZATION (FISH)	133.38	$133.38	---	--	009	0	0	0.40	$0.00	N
M	88367	INSITU HYBRIDIZATION AUTO	96.07	$96.07	---	--	009	0	0	0.80	$0.00	N
M	88368	INSITU HYBRIDIZATION MANUAL	75.41	$75.41	---	--	009	0	0	0.80	$0.00	N
M	88369	M/PHMTRC ALYSISHQUANT/SEMIQ	65.87	$65.87	---	--	009	0	0	0.32	$0.00	N
M	88371	PROTEIN WESTERN BLOT TISSUE	19.76	$19.76	---	--	009	0	0	0.80	$0.00	N
M	88372	PROTEIN ANALYSIS W/PROBE	20.97	$20.97	---	--	009	0	0	0.80	$0.00	N
M	88373	M/PHMTRC ALYS ISHQUANT/SEMIQ	54.01	$54.01	---	--	009	0	0	0.33	$0.00	N
M	88374	M/PHMTRC ALYS ISHQUANT/SEMIQ	185.00	$185.00	---	--	009	0	0	0.21	$0.00	N
M	88375	OPTICAL ENDOMICROSCPY INTERP	23.24	$23.24	---	--	009	0	0	0.00	$0.00	N
M	88377	M/PHMTRC ALYS ISHQUANT/SEMIQ	192.08	$192.08	---	--	009	0	0	0.29	$0.00	N
M	88380	MICRODISSECTION LASER	118.82	$118.82	---	--	009	0	0	0.80	$0.00	N
M	88381	MICRODISSECTION MANUAL	112.83	$112.83	---	--	009	0	0	0.80	$0.00	N
M	88387	TISS EXAM MOLECULAR STUDY	30.33	$30.33	---	--	009	0	0	0.20	$0.00	N
M	88388	TISS EX MOLECUL STUDY ADD-ON	30.09	$30.09	---	--	009	0	0	0.20	$0.00	N
M	88399	UNLISTED SURGICAL PATH PX	0.00	$0.00	---	--	009	0	0	0.80	$0.00	N
M	88720	BILIRUBIN TOTAL TRANSCUT	4.30	$4.30	---	$4.30	009	1	0	0.00	$0.00	Y
M	88749	UNLISTED IN VIVO LAB SERVICE	0.00	$0.00	---	--	009	0	0	1.00	$0.00	Y
M	89049	CHCT FOR MAL HYPERTHERMIA	217.68	$217.68	---	--	009	0	0	0.80	$0.00	N
M	89050	BODY FLUID CELL COUNT	3.55	$3.55	---	--	009	0	0	0.80	$0.00	Y
P	89050	BODY FLUID CELL COUNT	5.22	$5.22	---	--	009	0	0	0.80	$0.00	N
M	89051	BODY FLUID CELL COUNT	4.86	$4.86	---	--	009	0	0	0.80	$0.00	N
M	89055	LEUKOCYTE ASSESSMENT FECAL	3.80	$3.80	---	--	009	0	0	0.00	$0.00	N
M	89060	EXAM SYNOVIAL FLUID CRYSTALS	6.36	$6.36	---	--	009	0	0	0.80	$0.00	N
M	89125	SPECIMEN FAT STAIN	4.70	$4.70	---	--	009	0	0	0.80	$0.00	Y
M	89160	EXAM FECES FOR MEAT FIBERS	3.88	$3.88	---	--	009	0	0	0.80	$0.00	N
M	89190	NASAL SMEAR FOR EOSINOPHILS	4.63	$4.63	---	--	009	0	0	0.80	$0.00	N
M	89220	SPUTUM SPECIMEN COLLECTION	10.33	$10.33	---	--	009	0	0	0.80	$0.00	Y
M	89230	COLLECT SWEAT FOR TEST	2.20	$2.20	---	--	009	0	0	0.20	$0.00	N
M	89240	UNLISTED MISC PATH TEST	0.00	$0.00	---	--	009	0	0	0.20	$0.00	N
M	89398	UNLISTED REPROD MED LAB PROC	0.00	$0.00	---	--	009	0	0	0.20	$0.00	N
I	90284	HUMAN IG SC	21.71	$21.71	---	--	030	0	0	0.00	$0.00	Y
I	90371	HEP B IG IM	143.33	$143.33	---	--	030	0	0	0.00	$0.00	Y
I	90375	RABIES IG IM/SC	290.48	$290.48	---	--	030	0	0	0.00	$0.00	Y
I	90376	RABIES IG HEAT TREATED	357.95	$357.95	---	--	030	0	0	0.00	$0.00	Y
I	90377	RABIES IG HT&SOL HUMAN IM/SC	245.66	$245.66	---	--	030	0	0	0.00	$0.00	Y
I	90378	RSV MAB IM 50MG	1706.84	$1706.84	---	--	030	0	0	0.00	$0.00	Y
I	90396	VAR-ZOSTER IG IM	2008.66	$2008.66	---	--	030	0	0	0.00	$0.00	Y
I	90471	IMMUNIZATION ADMIN	4.46	$4.46	---	--	030	0	0	0.00	$0.00	Y
I	90472	IMMUNIZATION ADMIN EACH ADD	17.00	$17.00	---	--	009	0	0	0.00	$0.00	Y
I	90585	BCG VACCINE PERCUT	161.53	$161.53	---	--	030	0	0	0.00	$0.00	Y
I	90587	DENGUE VACC QUAD 3 DOSE SUBQ	103.46	$103.46	---	--	030	0	0	0.00	$0.00	Y
I	90611	SMALLPOX&MONKEYPOX VAC 0.5ML	0.01	$0.01	---	--	009	0	0	0.00	$0.00	Y
I	90619	MENACWY-TT VACCINE IM	300.38	$300.38	---	--	030	0	0	0.00	$0.00	Y
I	90620	MENB-4C VACC 2 DOSE IM	205.01	$205.01	---	--	030	0	0	0.00	$0.00	Y
I	90621	MENB-FHBP VACC 2/3 DOSE IM	171.86	$171.86	---	--	030	0	0	0.00	$0.00	Y
I	90622	VACCINIA VRS VAC 0.3 ML PERQ	0.01	$0.01	---	--	009	0	0	0.00	$0.00	Y
1	90625	CHOLERA VACCINE LIVE ORAL	229.46	$229.46	---	--	030	0	0	0.00	$0.00	Y
I	90626	TIC-BRN ENCEPH VAC 0.25ML IM	285.46	$285.46	---	--	030	0	0	0.00	$0.00	Y
I	90627	TIC-BRN ENCEPH VAC 0.5ML IM	285.46	$285.46	---	--	030	0	0	0.00	$0.00	Y
I	90630	FLU VACC IIV4 NO PRESERVE ID	24.80	$24.80	---	--	030	0	0	0.00	$0.00	Y
I	90632	HEPA VACCINE ADULT IM	73.21	$73.21	---	--	030	0	0	0.00	$0.00	Y
I	90633	HEPA VACCINE PED/ADOL 3 DOSES IM	39.46	$39.46	---	--	030	0	0	0.00	$0.00	Y
I	90636	HEP A/HEP B VACC ADULT IM	119.75	$119.75	---	--	030	0	0	0.00	$0.00	Y
I	90644	HIB-MENCY VACC 6WK-18M0 IM	27.67	$27.67	---	--	030	0	0	0.00	$0.00	Y
I	90647	HIB PRP-OMP VACC 3 DOSE IM	31.76	$31.76	---	--	030	0	0	0.00	$0.00	Y
I	90648	HIB PRP-T VACCINE 4 DOSE IM	20.79	$20.79	---	--	030	0	0	0.00	$0.00	Y
I	90649	4VHPV VACCINE 3 DOSE IM	164.72	$164.72	---	--	030	0	0	0.00	$0.00	Y
I	90650	2VHPV VACCINE 3 DOSE IM	132.59	$132.59	---	--	030	0	0	0.00	$0.00	Y
I	90651	9VHPV VACCINE 2/3 DOSE IM	257.31	$257.31	---	--	030	0	0	0.00	$0.00	Y
I	90653	IIV ADJUVANT VACCINE IM	63.99	$63.99	---	--	030	0	0	0.00	$0.00	Y
I	90654	FLU VACCINE NO PRESERVE, ID	20.36	$20.36	---	--	030	0	0	0.00	$0.00	Y
I	90655	IIV3 VACC NO PRSV 0.25 ML IM	30.51	$30.51	---	--	030	0	0	0.00	$0.00	Y
I	90656	IIV3 VACC NO PRSV 0.5 ML IM	24.23	$24.23	---	--	030	0	0	0.00	$0.00	Y
I	90657	IIV3 VACCINE 6-35 MONTHS IM	10.48	$10.48	---	--	030	0	0	0.00	$0.00	Y
I	90658	IIV3 VACCINE 3 YRS+ IM	22.70	$22.70	---	--	030	0	0	0.00	$0.00	Y
1	90660	FLU VACCINE NASAL	17.88	$17.88	---	--	030	0	0	0.00	$0.00	Y
I	90662	IIV NO PRSV INCREASED AG IM	74.40	$74.40	---	--	030	0	0	0.00	$0.00	Y
I	90670	PCV13 VACCINE IM	262.45	$262.45	---	--	030	0	0	0.00	$0.00	Y
I	90671	PCV15 VACCINE IM	250.66	$250.66	---	--	030	0	0	0.00	$0.00	Y
1	90672	LAIV4 VACCINE INTRANASAL	31.34	$31.34	---	--	030	0	0	0.00	$0.00	Y
I	90673	RIV3 VACCINE NO PRESEV IM	45.07	$45.07	---	--	030	0	0	0.00	$0.00	Y
I	90674	CCIIV4 VAC NO PRSV 0.5 ML IM	36.74	$36.74	---	--	030	0	0	0.00	$0.00	Y
I	90675	RABIES VACCINE IM	296.25	$296.25	---	--	030	0	0	0.00	$0.00	Y
I	90677	PCV20 VACCINE IM	288.18	$288.18	---	--	030	0	0	0.00	$0.00	Y
1	90680	RV5 VACC 3 DOSE LIVE ORAL	94.21	$94.21	---	--	030	0	0	0.00	$0.00	Y
1	90681	RV1 VACC 2 DOSE LIVE ORAL	134.53	$134.53	---	--	030	0	0	0.00	$0.00	Y
I	90682	RIV4 VACC RECOMBINANT DNA IM	74.40	$74.40	---	--	030	0	0	0.00	$0.00	Y
I	90685	IIV4 VACC NO PRSV 0.25 ML IM	26.10	$26.10	---	--	030	0	0	0.00	$0.00	Y
I	90686	IIV4 VACC NO PRSV 0.5 ML IM	25.98	$25.98	---	--	030	0	0	0.00	$0.00	Y
I	90687	IIV4 VACCINE SPLT 0.25 ML IM	14.70	$14.70	---	--	030	0	0	0.00	$0.00	Y
I	90688	IIV4 VACCINE SPLT 0.5 ML IM	24.94	$24.94	---	--	030	0	0	0.00	$0.00	Y
I	90689	VACC IIV4 NO PRSRV 0.25ML IM	0.00	$0.00	---	--	030	0	0	0.00	$0.00	Y
1	90690	TYPHOID VACCINE ORAL	98.96	$98.96	---	--	030	0	0	0.00	$0.00	Y
I	90691	THYPHOID VACCINE IM	111.81	$111.81	---	--	030	0	0	0.00	$0.00	Y
I	90694	VACC AIIV4 NO PRSRV 0.5ML IM	76.14	$76.14	---	--	030	0	0	0.00	$0.00	Y
I	90696	DTAP-IPV VACCINE 4-6 YEAS IM	59.35	$59.35	---	--	030	0	0	0.00	$0.00	Y
I	90697	DTAP-IPV-HIB-HEPB VACCINE IM	139.78	$139.78	---	--	030	0	0	0.00	$0.00	Y
I	90698	DTAP-IPV/HIB VACCINE IM	106.89	$106.89	---	--	030	0	0	0.00	$0.00	Y
I	90700	DTAP VACCINE, < 7 YRS, IM	29.19	$29.19	---	--	030	0	0	0.00	$0.00	Y
I	90702	TD VACC UNDER 7 YRS IM	65.97	$65.97	---	--	030	0	0	0.00	$0.00	Y
I	90707	MMR VACCINE SC	89.52	$89.52	---	--	030	0	0	0.00	$0.00	Y
I	90710	MMRV VACCINE SC	251.48	$251.48	---	--	030	0	0	0.00	$0.00	Y
I	90713	POLIOVIRUS IPV SC/IM	42.45	$42.45	---	--	030	0	0	0.00	$0.00	Y
I	90714	TD VACC NO PRESV 7 YRS+ IM	33.45	$33.45	---	--	030	0	0	0.00	$0.00	Y
I	90715	TDAP VACCINE >7 IM	41.22	$41.22	---	--	030	0	0	0.00	$0.00	Y
I	90716	VAR VACCINE LIVE SUBQ	154.69	$154.69	---	--	030	0	0	0.00	$0.00	Y
I	90717	YELLOW FEVER VACCINE SUBQ	175.53	$175.53	---	--	030	0	0	0.00	$0.00	Y
I	90723	DTAP-HEP B-IPV VACCINE IM	90.76	$90.76	---	--	030	0	0	0.00	$0.00	Y
I	90732	PPSV23 VACC 2 YRS+ SUBQ/IM	137.93	$137.93	---	--	030	0	0	0.00	$0.00	Y
I	90733	MPSV4 VACCINE SUBQ	126.88	$126.88	---	--	030	0	0	0.00	$0.00	Y
I	90734	MCV4 MENACWY VACCINE IM	146.24	$146.24	---	--	030	0	0	0.00	$0.00	Y
I	90736	HZV VACCINE LIVE SUBQ	217.13	$217.13	---	--	030	0	0	0.00	$0.00	Y
I	90738	INACTIVATED JE VACC IM	264.40	$264.40	---	--	030	0	0	0.00	$0.00	Y
I	90739	HEPB VACC 2/4 DOSE ADULT IM	156.54	$156.54	---	--	030	0	0	0.00	$0.00	Y
I	90740	HEPB VACC 3 DOSE IMMUNSUP IM	150.79	$150.79	---	--	030	0	0	0.00	$0.00	Y
I	90743	HEPB VACC 2 DOSE ADOLESC IM	66.74	$66.74	---	--	030	0	0	0.00	$0.00	Y
I	90744	HEPB VACC 3 DOSE PED/ADOL IM	33.50	$33.50	---	--	030	0	0	0.00	$0.00	Y
I	90746	HEPB VACCINE 3 DOSE ADULT IM	74.84	$74.84	---	--	030	0	0	0.00	$0.00	Y
I	90747	HEPB VACC 4 DOSE IMMUNSUP IM	145.21	$145.21	---	--	030	0	0	0.00	$0.00	Y
I	90748	HIB-HEPB VACCINE IM	46.35	$46.35	---	--	030	0	0	0.00	$0.00	Y
I	90750	HZV VACC RECOMBINANT IM NJX	176.03	$176.03	---	--	030	0	0	0.00	$0.00	Y
I	90756	CCIIV4 VACC ABX FREE IM	35.04	$35.04	---	--	030	0	0	0.00	$0.00	Y
I	90758	ZAIRE EBOLAVIRUS VAC LIVE IM	0.00	$0.00	---	--	030	0	0	0.00	$0.00	Y
I	90759	HEP B VAC 3AG 10MCG 3 DOS IM	78.28	$78.28	---	--	030	0	0	0.00	$0.00	Y
Q	90785	PSYTX COMPLEX INTERACTIVE	4.73	$3.88	---	--	007	0	0	0.00	$0.00	N
N	90785	PSYTX COMPLEX INTERACTIVE	4.73	$3.88	---	$4.92	007	1	0	0.00	$0.00	Y
N	90791	PSYCH DIAGNOSTIC EVALUATION	156.19	$128.08	---	$162.44	007	1	0	0.00	$0.00	Y
Q	90791	PSYCH DIAGNOSTIC EVALUATION	156.19	$128.08	---	--	007	0	0	0.00	$0.00	N
N	90792	PSYCH DIAG EVAL W/MED SRVCS	125.91	$103.25	---	$130.95	007	1	0	0.00	$0.00	Y
N	90832	PSYTX PT&/FAMILY 30 MINUTES	64.47	$52.87	---	$67.05	007	1	0	0.00	$0.00	Y
Q	90832	PSYTX PT&/FAMILY 30 MINUTES	18.98	$18.98	---	--	009	0	0	0.00	$0.00	Y
V	90832	PSYTX PT&/FAMILY 30 MINUTES	64.47	$52.87	---	$67.05	007	1	0	0.00	$0.00	Y
N	90833	PSYTX W PT W E/M 30 MIN	42.06	$34.49	---	$43.74	007	1	0	0.00	$0.00	Y
N	90834	PSYTX PT&/FAMILY 45 MINUTES	81.90	$67.16	---	$85.18	007	1	0	0.00	$0.00	Y
Q	90834	PSYTX PT&/FAMILY 45 MINUTES	81.90	$67.16	---	--	007	0	0	0.00	$0.00	N
N	90836	PSYTX W PT W E/M 45 MIN	68.32	$56.02	---	$71.05	007	1	0	0.00	$0.00	Y
N	90837	PSYTX PT&/FAMILY 60 MINUTES	119.54	$98.02	---	$124.32	007	1	0	0.00	$0.00	Y
Q	90837	PSYTX PT&/FAMILY 60 MINUTES	38.01	$38.01	---	--	009	0	0	0.00	$0.00	Y
G	90837	PSYTX OFF 45-50 MIN	51.00	$51.00	---	--	009	0	0	0.00	$0.00	Y
N	90838	PSYTX W PT W E/M 60 MIN	110.45	$90.57	---	$114.87	007	1	0	0.00	$0.00	Y
N	90839	PSYTX CRISIS INITIAL 60 MIN	38.01	$38.01	---	$38.01	009	1	0	0.00	$0.00	Y
Q	90839	PSYTX CRISIS INITIAL 60 MIN	38.01	$38.01	---	--	009	0	0	0.00	$0.00	N
Q	90840	PSYTX CRISIS EA ADDL 30 MIN	18.98	$18.98	---	--	009	0	0	0.00	$0.00	N
N	90840	PSYTX CRISIS EA ADDL 30 MIN	18.98	$18.98	---	$18.98	009	1	0	0.00	$0.00	Y
N	90846	FAMILY PSYTX W/O PATIENT	86.64	$86.64	---	--	009	0	0	0.00	$0.00	Y
Q	90846	FAMILY PSYCHOTHERAPY	86.64	$86.64	---	--	009	0	0	0.00	$0.00	N
G	90846	FAMILY PSYCHOTHERAPY	51.00	$51.00	---	--	009	0	0	0.00	$0.00	Y
G	90847	FAMILY PSYCHOTHERAPY WITH PT PRESENT	51.00	$51.00	---	--	009	0	0	0.00	$0.00	Y
Q	90847	FAMILY PSCHOTHERAPY WITH PT PRESENT	89.65	$89.65	---	--	009	0	0	0.00	$0.00	N
N	90847	FAMILY PSYTX W/PATIENT	89.65	$89.65	---	$89.65	009	1	0	0.00	$0.00	Y
N	90849	MULTIPLE FAMILY GROUP PSYTX	31.85	$31.85	---	--	009	0	0	0.00	$0.00	Y
Q	90849	MULTIPLE FAMILY GROUP PSYTX	31.85	$31.85	---	--	009	0	0	0.00	$0.00	N
Q	90853	GROUP PSYCHOTHERAPY	14.48	$14.48	---	--	009	0	0	0.00	$0.00	Y
N	90853	GROUP PSYCHOTHERAPY	4.23	$3.47	---	$4.40	007	1	1	0.00	$0.00	Y
N	90870	ELECTROCONVULSIVE THERAPY	92.40	$75.77	---	$96.10	007	1	0	0.00	$0.00	Y
N	90880	HYPNOTHERAPY	63.55	$52.11	---	$66.09	007	1	1	0.00	$0.00	Y
Q	90880	HYPNOTHERAPY	63.55	$52.11	---	--	007	0	0	0.00	$0.00	N
N	90899	UNLISTED PSYC SVC/THERAPY	0.00	$0.00	---	--	007	1	0	0.00	$0.00	Y
N	90935	HEMODIALYSIS ONE EVALUATION	69.02	$56.60	---	$71.78	007	1	0	0.00	$0.00	Y
N	90937	HEMODIALYSIS REPEATED EVAL	187.02	$153.36	---	$194.50	007	1	0	0.00	$0.00	Y
N	90940	HEMODIALYSIS ACCESS STUDY	126.23	$103.51	---	$131.28	007	1	0	0.00	$0.00	Y
N	90945	DIALYSIS ONE EVALUATION	88.00	$72.16	---	$91.52	007	1	0	0.00	$0.00	Y
N	90947	DIALYSIS REPEATED EVAL	132.00	$108.24	---	$137.28	007	1	0	0.00	$0.00	Y
N	90951	ESRD SERV 4 VISITS P MO <2YR	82.10	$821.00	$895.71	--	001	0	0	0.00	$0.00	Y
N	90952	ESRD SERV 2-3 VSTS P MO <2YR	0.00	$0.00	---	--	001	0	0	0.00	$0.00	Y
N	90953	ESRD SERV 1 VISIT P MO <2YRS	0.00	$0.00	---	--	001	0	0	0.00	$0.00	Y
N	90954	ESRD SERV 4 VSTS P MO 2-11	66.41	$664.10	$724.53	--	001	0	0	0.00	$0.00	Y
N	90955	ESRD SRV 2-3 VSTS P MO 2-11	37.78	$377.80	$412.18	--	001	0	0	0.00	$0.00	Y
N	90956	ESRD SRV 1 VISIT P MO 2-11	25.60	$256.00	$279.30	--	001	0	0	0.00	$0.00	Y
N	90957	ESRD SRV 4 VSTS P MO 12-19	53.53	$535.30	$584.01	--	001	0	0	0.00	$0.00	Y
N	90958	ESRD SRV 2-3 VSTS P MO 12-19	36.19	$361.90	$394.83	--	001	0	0	0.00	$0.00	Y
N	90959	ESRD SERV 1 VST P MO 12-19	23.74	$237.40	$259.00	--	001	0	0	0.00	$0.00	Y
N	90960	ESRD SRV 4 VISITS P MO 20+	24.00	$240.00	$261.84	--	001	0	0	0.00	$0.00	Y
N	90961	ESRD SRV 2-3 VSTS P MO 20+	19.32	$193.20	$210.78	--	001	0	0	0.00	$0.00	Y
N	90962	ESRD SERV 1 VISIT P MO 20+	13.93	$139.30	$151.98	--	001	0	0	0.00	$0.00	Y
N	90963	ESRD HOME PT SERV P MO <2YRS	45.97	$459.70	$501.53	--	001	0	0	0.00	$0.00	Y
N	90964	ESRD HOME PT SERV P MO 2-11	38.15	$381.50	$416.22	--	001	0	0	0.00	$0.00	Y
N	90965	ESRD HOME PT SERV P MO 12-19	36.30	$363.00	$396.03	--	001	0	0	0.00	$0.00	Y
N	90966	ESRD HOME PT SERV P MO 20+	19.09	$190.90	$208.27	--	001	0	0	0.00	$0.00	Y
N	90967	ESRD HOME PT SERV P DAY <2	1.67	$16.70	$18.22	$20.74	001	1	0	0.00	$0.00	Y
N	90968	ESRD HOME PT SRV P DAY 2-11	1.28	$12.80	$13.96	$15.90	001	1	0	0.00	$0.00	Y
N	90969	*09ESRD HOME PT SRV P DAY 12-19	1.25	$12.50	$13.64	$15.53	001	1	0	0.00	$0.00	Y
N	90970	ESRD HOME PT SERV P DAY 20+	0.67	$6.70	$7.31	$8.32	001	1	0	0.00	$0.00	Y
N	90989	DIALYSIS TRAINING COMPLETE	667.40	$667.40	---	--	009	0	0	0.00	$0.00	Y
N	90993	DIALYSIS TRAINING INCOMPL	33.98	$27.86	---	$35.34	007	1	0	0.00	$0.00	Y
N	90997	HEMOPERFUSION	106.91	$87.67	---	$111.19	007	1	0	0.00	$0.00	Y
N	90999	UNLISTED DIALYSIS PROCEDURE	0.00	$0.00	---	--	007	1	0	0.00	$0.00	Y
N	91010	ESOPHAGUS MOTILITY STUDY	84.28	$69.11	---	$87.65	007	1	1	0.79	$0.00	Y
N	91013	ESOPHGL MOTIL W/STIM/PERFUS	25.29	$20.74	---	$26.30	007	1	0	0.00	$0.00	N
N	91020	GASTRIC MOTILITY STUDIES	112.30	$92.09	---	$116.79	007	1	1	0.82	$0.00	Y
N	91022	DUODENAL MOTILITY STUDY	115.85	$95.00	---	--	007	0	0	0.82	$0.00	Y
N	91030	ACID PERFUSION OF ESOPHAGUS	49.34	$40.46	---	$51.31	007	1	1	0.87	$0.00	Y
N	91034	GASTROESOPHAGEAL REFLUX TEST	94.65	$77.61	---	--	007	0	0	0.78	$0.00	Y
N	91035	G-ESOPH REFLX TST W/ELECTROD	124.91	$102.43	---	--	007	0	0	0.71	$0.00	Y
N	91037	ESOPH IMPED FUNCTION TEST	163.68	$134.22	---	--	007	0	0	0.78	$0.00	Y
N	91038	ESOPH IMPED FUNCT TEST > 1HR	138.83	$113.84	---	--	007	0	0	0.71	$0.00	Y
N	91040	ESOPH BALLOON DISTENSION TST	508.05	$416.60	---	--	007	0	0	0.00	$0.00	Y
N	91065	BREATH HYDROGEN TEST	32.96	$27.03	---	$34.28	007	1	1	0.72	$0.00	Y
N	91110	GI TRC IMG INTRAL ESOPH-ILE	980.84	$804.29	---	$1020.07	007	1	0	0.15	$0.00	Y
N	91112	GI WIRELESS CAPSULE MEASURE	1318.38	$1081.07	---	--	007	0	0	0.00	$0.00	Y
N	91113	GI TRC IMG INTRAL COLON I&R	1084.45	$889.25	---	--	007	0	0	0.00	$0.00	Y
N	91122	ANAL PRESSURE RECORD	73.62	$60.37	---	$76.56	007	1	1	0.78	$0.00	Y
N	91132	ELECTROGASTROGRAPHY	114.68	$94.04	---	$119.27	007	1	0	0.72	$0.00	Y
N	91133	ELECTROGASTROGRAPHY W/TEST	137.62	$112.85	---	$143.12	007	1	0	0.72	$0.00	Y
N	91200	LIVER ELASTOGRAPHY	39.09	$32.05	---	--	007	0	0	0.39	$0.00	Y
N	91299	UNLISTED DX GI PROCEDURE	0.00	$0.00	---	--	007	1	0	0.00	$0.00	Y
N	92002	EYE EXAM NEW PATIENT	45.30	$37.15	---	$47.11	007	1	1	0.00	$0.00	Y
1	92002	EYE EXAM NEW PATIENT	32.80	$32.80	---	$32.80	009	1	1	0.00	$0.00	Y
1	92004	EYE EXAM NEW PATIENT	39.44	$39.44	---	--	009	0	0	0.00	$0.00	Y
N	92004	EYE EXAM NEW PATIENT	60.71	$49.78	---	$63.14	007	1	1	0.00	$0.00	Y
N	92012	EYE EXAM ESTABLISH PATIENT	45.30	$37.15	---	$47.11	007	1	1	0.00	$0.00	Y
1	92012	EYE EXAM ESTABLISH PATIENT	22.59	$22.59	---	--	009	0	0	0.00	$0.00	Y
1	92014	EYE EXAM&TX ESTAB PT 1/>VST	39.44	$39.44	---	--	009	0	0	0.00	$0.00	Y
N	92014	EYE EXAM&TX ESTAB PT 1/>VST	46.87	$38.43	---	$48.74	007	1	1	0.00	$0.00	Y
N	92015	DETERMINE REFRACTIVE STATE	9.77	$8.01	---	--	007	0	0	0.00	$0.00	Y
1	92015	DETERMINE REFRACTIVE STATE	9.77	$8.01	---	--	007	0	0	0.00	$0.00	Y
N	92018	NEW EYE EXAM & TREATMENT	58.39	$47.88	---	$60.73	007	1	0	0.00	$0.00	Y
N	92019	EYE EXAM & TREATMENT	52.56	$43.10	---	$54.66	007	1	0	0.00	$0.00	Y
N	92020	GONIOSCOPY (SEPARATE PROCEDURE)	23.43	$19.21	---	$24.37	007	1	1	0.00	$0.00	Y
1	92020	GONIOSCOPY (SEPARATE PROCEDURE)	16.40	$16.40	---	$16.40	009	1	1	0.00	$0.00	Y
1	92025	CORNEAL TOPOGRAPHY	26.82	$26.82	---	--	009	0	0	0.80	$0.00	Y
N	92025	CORNEAL TOPOGRAPHY	32.71	$26.82	---	--	007	0	0	0.80	$0.00	Y
N	92060	SENSORIMOTOR EXAM WITH MULTI MEASUREMNTS	41.20	$33.78	---	$42.85	007	1	1	0.78	$0.00	Y
1	92060	SENSORIMOTOR EXAM WITH MULTI MEASUREMNTS	41.20	$33.78	---	--	007	0	0	0.78	$0.00	Y
1	92071	CONTACT LENS FITTING FOR TX	39.07	$32.04	---	$40.63	007	1	0	0.00	$0.00	Y
N	92071	CONTACT LENS FITTING FOR TX	39.07	$32.04	---	$40.63	007	1	0	0.00	$0.00	Y
N	92072	FIT CONTAC LENS FOR MANAGMNT	124.31	$101.93	---	$129.28	007	1	0	0.00	$0.00	Y
1	92072	FIT CONTAC LENS FOR MANAGMNT	124.31	$101.93	---	$129.28	007	1	0	0.00	$0.00	Y
1	92081	VISUAL FIELD EXAMINATION(S)	16.40	$16.40	---	$16.40	009	1	1	0.00	$0.00	Y
N	92081	VISUAL FIELD EXAMINATION(S)	40.18	$32.95	---	$41.79	007	1	1	0.77	$0.00	Y
N	92082	VISUAL FIELD EXAMINATION(S)	41.55	$34.07	---	$43.21	007	1	1	0.77	$0.00	Y
1	92082	VISUAL FIELD EXAMINATION(S)	22.14	$22.14	---	$22.14	009	1	1	0.00	$0.00	Y
1	92083	VISUAL FIELD EXAMINATION(S)	22.14	$22.14	---	$22.14	009	1	1	0.00	$0.00	Y
N	92083	VISUAL FIELD EXAMINATION(S)	37.21	$30.51	---	$38.70	007	1	1	0.78	$0.00	Y
N	92100	SERIAL TONOMETRY (SEPARATE PROCEDURE)	35.28	$28.93	---	$36.69	007	1	0	0.00	$0.00	Y
1	92100	SERIAL TONOMETRY (SEPARATE PROCEDURE)	28.93	$28.93	---	$28.93	009	1	0	0.00	$0.00	Y
1	92132	CMPTR OPHTH DX IMG ANT SEGMT	32.24	$32.24	---	$32.24	009	1	0	0.56	$0.00	Y
N	92132	CMPTR OPHTH DX IMG ANT SEGMT	32.24	$26.44	---	$33.53	007	1	0	0.56	$0.00	Y
N	92133	CMPTR OPHTH IMG OPTIC NERVE	39.33	$32.25	---	$40.90	007	1	0	0.64	$0.00	Y
1	92133	CMPTR OPHTH IMG OPTIC NERVE	39.33	$39.33	---	$39.33	009	1	0	0.64	$0.00	Y
1	92134	CPTR OPHTH DX IMG POST SEGMT	39.33	$39.33	---	$39.33	009	1	0	0.64	$0.00	Y
N	92134	CPTR OPHTH DX IMG POST SEGMT	39.33	$32.25	---	$40.90	007	1	0	0.64	$0.00	Y
N	92136	OPHTHALMIC BIOMETRY	81.88	$67.14	---	--	007	0	0	0.34	$0.00	Y
N	92201	OPSCPY EXTND RTA DRAW UNI/BI	26.96	$22.11	---	--	007	0	0	0.00	$0.00	Y
N	92202	OPSCPY EXTND ON/MAC DRAW	17.10	$14.02	---	--	007	0	0	0.00	$0.00	Y
N	92227	IMG RTA DETCJ/MNTR DS STAFF	10.72	$10.72	---	--	007	0	0	0.00	$0.00	Y
1	92227	IMG RTA DETCJ/MNTR DS STAFF	10.72	$10.72	---	--	009	0	0	0.00	$0.00	Y
1	92228	IMG RTA DETC/MNTR DS PHY/QHP	26.66	$26.66	---	--	009	0	0	0.56	$0.00	Y
N	92228	IMG RTA DETC/MNTR DS PHY/QHP	26.66	$26.66	---	--	007	0	0	0.56	$0.00	Y
N	92229	IMG RTA DETC/MNTR DS POC ALY	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
1	92229	IMG RTA DETC/MNTR DS POC ALY	0.00	$0.00	---	--	009	0	0	0.00	$0.00	Y
N	92230	FLUORESCEIN ANGIOSCOPY WITH INTERPRET	56.63	$46.44	---	$58.90	007	1	1	0.00	$0.00	Y
N	92235	FLUORESCEIN ANGIOGRAPHY,INC MULT IMAGING	99.67	$81.73	---	$103.66	007	1	1	0.56	$0.00	Y
N	92240	ICG ANGIOGRAPHY	90.23	$73.99	---	$93.84	007	1	0	0.60	$0.00	Y
N	92242	FLUORESCEIN ICG ANGIOGRAPHY	253.37	$207.76	---	--	007	0	0	0.23	$0.00	Y
N	92250	FUNDUS PHOTOGRAPHY WITH INTERPRETATION	42.13	$42.13	---	--	009	0	1	0.78	$0.00	Y
1	92250	FUNDUS PHOTOGRAPHY WITH INTERPRETATION	42.13	$42.13	---	--	009	0	0	0.00	$0.00	Y
N	92260	OPHTHALMOSCOPY/DYNAMOMETRY	40.00	$32.80	---	$41.60	007	1	1	0.00	$0.00	Y
N	92265	EYE MUSCLE EVALUATION	51.51	$42.24	---	$53.57	007	1	1	0.77	$0.00	Y
N	92270	ELECTRO-OCULOGRAPHY	40.60	$33.29	---	$42.22	007	1	1	0.78	$0.00	Y
N	92273	FULL FIELD ERG W/I&R	149.85	$122.88	---	--	007	0	0	0.00	$0.00	Y
N	92274	MULTIFOCAL ERG W/I&R	100.80	$82.66	---	--	007	0	0	0.00	$0.00	Y
N	92283	COLOR VISION EXAMINATION	20.48	$16.79	---	$21.30	007	1	1	0.77	$0.00	Y
N	92284	DX DARK ADAPTATION EXAM I&R	24.87	$20.39	---	$25.86	007	1	1	0.77	$0.00	Y
1	92284	DX DARK ADAPTATION EXAM I&R	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
1	92310	CONTACT LENS FITTING	36.40	$36.40	---	$36.40	009	1	1	0.00	$0.00	Y
N	92310	CONTACT LENS FITTING	44.39	$36.40	---	$46.17	007	1	1	0.00	$0.00	Y
N	92311	SPECIAL CONTACT LENS FITTING	44.72	$36.67	---	$46.51	007	1	1	0.00	$0.00	Y
1	92311	SPECIAL CONTACT LENS FITTING	36.40	$36.40	---	$36.40	009	1	1	0.00	$0.00	Y
1	92312	CONTACT LENS FITTING	36.40	$36.40	---	$36.40	009	1	1	0.00	$0.00	Y
N	92312	CONTACT LENS FITTING	53.45	$43.83	---	$55.59	007	1	1	0.00	$0.00	Y
N	92313	CONTACT LENS FITTING	40.18	$32.95	---	$41.79	007	1	1	0.00	$0.00	Y
N	92314	PRESCRIPTION OF CONTACT LENS	43.95	$36.04	---	$45.71	007	1	1	0.00	$0.00	Y
N	92315	RX CNTACT LENS APHAKIA 1 EYE	43.95	$36.04	---	$45.71	007	1	1	0.00	$0.00	Y
N	92316	RX CNTACT LENS APHAKIA 2 EYE	58.15	$47.68	---	$60.48	007	1	1	0.00	$0.00	Y
N	92317	RX CORNEOSCLERAL CNTACT LENS	32.38	$26.55	---	$33.68	007	1	1	0.00	$0.00	Y
N	92325	MODIFICATION OF CONTACT LENS	14.89	$12.21	---	$15.49	007	1	1	0.00	$0.00	Y
N	92340	FIT SPECTACLES MONOFOCAL	10.77	$10.77	---	--	009	0	1	0.00	$0.00	Y
1	92340	FIT SPECTACLES MONOFOCAL	10.77	$10.77	---	--	009	0	1	0.00	$0.00	Y
1	92341	FIT SPECTACLES BIFOCAL	15.90	$15.90	---	--	009	0	1	0.00	$0.00	Y
N	92341	FIT SPECTACLES BIFOCAL	15.90	$15.90	---	--	009	0	1	0.00	$0.00	Y
N	92342	FIT SPECTACLES MULTIFOCAL	21.88	$21.88	---	--	009	0	1	0.00	$0.00	Y
1	92342	FIT SPECTACLES MULTIFOCAL	21.88	$21.88	---	--	009	0	1	0.00	$0.00	Y
1	92352	FIT APHAKIA SPECTCL MONOFOCL	10.77	$10.77	---	--	009	0	1	0.00	$0.00	Y
N	92352	FIT APHAKIA SPECTCL MONOFOCL	10.77	$10.77	---	--	009	0	1	0.00	$0.00	Y
N	92353	FIT APHAKIA SPECTCL MULTIFOC	15.90	$15.90	---	$15.90	009	1	1	0.00	$0.00	N
1	92353	FIT APHAKIA SPECTCL MULTIFOC	15.90	$15.90	---	--	009	0	1	0.00	$0.00	Y
1	92370	REPAIR & ADJUST SPECTACLES	6.30	$6.30	---	--	009	0	0	0.00	$0.00	Y
N	92370	REPAIR & ADJUST SPECTACLES	6.30	$6.30	---	--	009	0	0	0.00	$0.00	Y
N	92371	REPAIR & ADJUST SPECTACLES	6.30	$6.30	---	--	009	0	0	0.00	$0.00	Y
1	92371	REPAIR & ADJUST SPECTACLES	6.30	$6.30	---	--	009	0	0	0.00	$0.00	Y
1	92499	UNLISTED OPH SVC/PROCEDURE	0.00	$0.00	---	--	008	0	0	0.00	$0.00	Y
N	92499	UNLISTED OPH SVC/PROCEDURE	0.00	$0.00	---	--	008	0	1	0.00	$0.00	Y
N	92502	EAR AND THROAT EXAMINATION	75.32	$61.76	---	$78.33	007	1	1	0.00	$0.00	Y
N	92504	EAR MICROSCOPY EXAMINATION	20.30	$16.65	---	$21.11	007	1	1	0.00	$0.00	Y
N	92507	SPEECH/HEARING THERAPY	36.24	$29.72	---	$37.69	007	1	1	0.00	$0.00	Y
E	92507	IND SPEECH/LANG/VOICE TRMT	56.41	$56.41	---	--	009	0	0	0.00	$0.00	Y
E	92508	GRP SPEECH/LANG/VOICE TRMT	2.46	$2.46	---	--	009	0	0	0.00	$0.00	Y
N	92508	TREATMENT OF SPEECH, LANG. VOICE GROUP	25.17	$20.64	---	$26.18	007	1	1	0.00	$0.00	Y
N	92511	NASOPHARYNGOSCOPY	50.96	$41.79	---	$53.00	007	1	1	0.00	$0.00	Y
N	92512	NASAL FUNCTION STUDIES	29.98	$24.58	---	$31.18	007	1	1	0.00	$0.00	Y
N	92516	FACIAL NERVE FUNCTION STUDIES	23.96	$19.65	---	$24.92	007	1	1	0.00	$0.00	Y
N	92520	LARYNGEAL FUNCTION STUDIES	36.74	$30.13	---	$38.21	007	1	1	0.00	$0.00	Y
N	92521	EVALUATION OF SPEECH FLUENCY	74.98	$74.98	---	--	009	0	0	0.00	$0.00	Y
E	92521	EVALUATION OF SPEECH FLUENCY	62.81	$62.81	---	--	009	0	0	0.00	$0.00	Y
E	92522	EVAL OF SPEECH SOUND PRODUCTION	53.84	$53.84	---	--	009	0	0	0.00	$0.00	Y
N	92522	EVALUATE SPEECH PRODUCTION	64.11	$64.11	---	--	009	0	0	0.00	$0.00	Y
N	92523	SPEECH SOUND LANG COMPREHEN	130.58	$130.58	---	--	009	0	0	0.00	$0.00	Y
E	92523	SPEECH SOUND LANG COMPREHEN	107.68	$107.68	---	--	009	0	0	0.00	$0.00	Y
E	92524	BEHAVRAL QUALIT ANALYS VOICE	53.84	$53.84	---	--	009	0	0	0.00	$0.00	Y
N	92524	BEHAVRAL QUALIT ANALYS VOICE	62.08	$62.08	---	--	009	0	0	0.00	$0.00	Y
N	92526	TREAT OF SWALLOWING DYSFUN AND/OR ORAL	41.24	$33.82	---	$42.89	007	1	1	0.00	$0.00	Y
N	92531	SPONTANEOUS NYSTAGMUS STUDY	0.00	$0.00	---	--	007	1	1	0.00	$0.00	Y
N	92532	POSITIONAL NYSTAGMUS TEST	0.00	$0.00	---	--	007	1	1	0.00	$0.00	Y
N	92533	CALORIC VESTIBULAR TEST	33.98	$27.86	---	$35.34	007	1	1	0.00	$0.00	Y
N	92534	OPTOKINETIC NYSTAGMUS TEST	0.00	$0.00	---	--	007	1	1	0.00	$0.00	Y
N	92537	CALORIC VSTBLR TEST W/REC	43.08	$35.33	---	--	007	0	1	0.00	$0.00	Y
N	92538	CALORIC VSTBLR TEST W/REC	21.87	$17.93	---	--	007	0	1	0.00	$0.00	Y
N	92540	BASIC VESTIBULAR EVALUATION	100.16	$82.13	---	--	007	0	0	0.78	$0.00	Y
N	92541	SPONTANEOUS NYSTAGMUS TEST	17.77	$14.57	---	$18.48	007	1	1	0.40	$0.00	Y
N	92542	POSITIONAL NYSTAGMUS TEST	16.99	$13.93	---	$17.67	007	1	1	0.40	$0.00	Y
N	92544	OPTOKINETIC NYSTAGMUS TEST	16.99	$13.93	---	$17.67	007	1	1	0.40	$0.00	Y
N	92545	OSCILLATING TRACKING TEST	16.99	$13.93	---	$17.67	007	1	1	0.40	$0.00	Y
N	92546	SINUSOIDAL VERTICAL AXIS ROTATIONAL TEST	16.99	$13.93	---	$17.67	007	1	1	0.40	$0.00	Y
N	92547	SUPPLEMENTAL ELECTRICAL TEST	16.99	$13.93	---	$17.67	007	1	1	0.40	$0.00	Y
N	92550	TYMPANOMETRY & REFLEX THRESH	21.55	$17.67	---	--	007	0	0	0.00	$0.00	Y
N	92551	PURE TONE HEARING TEST AIR	1.02	$10.20	$11.13	$12.67	053	1	1	0.00	$0.00	Y
E	92551	PURE TONE HEARING TEST AIR	8.30	$8.30	---	--	009	0	0	0.00	$0.00	Y
E	92552	PURE TONE AUDIOMETRY AIR	12.45	$12.45	---	--	009	0	0	0.00	$0.00	Y
N	92552	PURE TONE AUDIOMETRY AIR	1.53	$15.30	$16.69	$19.00	053	1	1	0.00	$0.00	Y
N	92553	AUDIOMETRY AIR & BONE	2.04	$20.40	$22.26	$25.34	053	1	1	0.00	$0.00	Y
N	92555	SPEECH AUDIOMETRY THRESHOLD	1.12	$11.20	$12.22	$13.91	053	1	1	0.00	$0.00	Y
N	92556	SPEECH AUDIOMETRY COMPLETE	2.70	$27.00	$29.46	$33.53	053	1	1	0.00	$0.00	Y
N	92557	COMPREHENSIVE AUDIOMETRY THRESHOLD EVAL	49.83	$40.86	---	$51.82	007	1	1	0.00	$0.00	Y
E	92557	AUDIOLOGY EVALUATION	181.49	$181.49	---	--	009	0	0	0.00	$0.00	Y
N	92558	*12EVOKED AUDITORY TEST QUAL	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
N	92562	LOUDNESS BALANCE TEST	9.39	$7.70	---	$9.77	007	1	1	0.00	$0.00	Y
N	92563	TONE DECAY HEARING TEST	8.73	$7.16	---	$9.08	007	1	1	0.00	$0.00	Y
N	92565	STENGER TEST PURE TONE	11.33	$9.29	---	$11.78	007	1	1	0.00	$0.00	Y
N	92568	ACOUSTIC REFL THRESHOLD TST	11.32	$9.28	---	$11.77	007	1	1	0.00	$0.00	Y
N	92570	ACOUSTIC IMMITANCE TESTING	32.73	$26.84	---	--	007	0	0	0.00	$0.00	Y
N	92571	FILTERED SPEECH HEARING TEST	11.62	$9.53	---	$12.08	007	1	1	0.00	$0.00	Y
N	92572	STAGGERED SPONDAIC WORD TEST	2.54	$2.08	---	$2.64	007	1	1	0.00	$0.00	Y
N	92575	SENSORINEURAL ACUITY TEST	9.07	$7.44	---	$9.43	007	1	1	0.00	$0.00	Y
N	92576	SYNTHETIC SENTENCE TEST	14.72	$12.07	---	$15.31	007	1	1	0.00	$0.00	Y
N	92577	STENGER TEST SPEECH	16.60	$13.61	---	$17.26	007	1	1	0.00	$0.00	Y
N	92579	VISUAL REINFORCEMENT AUDIOMETRY (VRA)	31.01	$25.43	---	$32.25	007	1	1	0.00	$0.00	Y
N	92582	CONDITIONING PLAY AUDIOMETRY	38.06	$38.06	---	--	009	0	1	0.00	$0.00	Y
N	92587	EVOKED AUDITORY TEST LIMITED	4.10	$41.00	$44.73	$50.92	053	1	0	0.15	$0.00	Y
N	92588	COMPREHENSIVE OR DIAGNOSTIC EVAL	62.51	$51.26	---	$65.01	007	1	0	0.30	$0.00	Y
N	92590	HEARING AID EXAM ONE EAR	41.90	$34.36	---	$43.58	007	1	1	0.00	$0.00	Y
N	92591	HEARING AID EXAM BOTH EARS	41.90	$34.36	---	$43.58	007	1	1	0.00	$0.00	Y
N	92594	ELECTRO HEARNG AID TEST ONE	20.32	$20.32	---	--	009	0	1	0.00	$0.00	Y
N	92595	ELECTRO HEARNG AID TST BOTH	37.30	$37.30	---	--	009	0	1	0.00	$0.00	Y
N	92597	ORAL SPEECH DEVICE EVAL	99.87	$81.89	---	$103.86	007	1	1	0.00	$0.00	Y
N	92601	COCHLEAR IMPLT F/UP EXAM <7	140.16	$114.93	---	--	007	0	0	0.00	$0.00	Y
N	92602	REPROGRAM COCHLEAR IMPLT <7	98.24	$80.56	---	--	007	0	0	0.00	$0.00	Y
N	92603	COCHLEAR IMPLT F/UP EXAM 7/>	94.29	$77.32	---	--	007	0	0	0.00	$0.00	Y
N	92604	REPROGRAM COCHLEAR IMPLT 7/>	64.24	$52.68	---	--	007	0	0	0.00	$0.00	Y
N	92605	EX FOR NONSPEECH DEVICE RX	42.39	$34.76	---	$44.09	007	1	1	0.00	$0.00	Y
N	92606	NONSPEECH DEVICE SERVICE	42.39	$34.76	---	--	007	0	0	0.00	$0.00	Y
N	92607	EX FOR SPEECH DEVICE RX 1HR	117.04	$95.97	---	$121.72	007	1	1	0.00	$0.00	Y
N	92608	EX FOR SPEECH DEVICE RX ADDL	22.93	$18.80	---	--	007	0	0	0.00	$0.00	Y
N	92609	USE OF SPEECH DEVICE SERVICE	63.35	$51.95	---	--	007	0	0	0.00	$0.00	Y
N	92610	EVALUATE SWALLOWING FUNCTION	59.49	$48.78	---	$61.87	007	1	1	0.00	$0.00	Y
N	92611	MOTION FLUOROSCOPY/SWALLOW	48.72	$39.95	---	$50.67	007	1	1	0.00	$0.00	Y
N	92612	ENDOSCOPY SWALLOW (FEES) VID	140.15	$114.92	---	--	007	0	0	0.00	$0.00	Y
N	92613	ENDOSCOPY SWALLOW (FEES) I&R	41.13	$33.73	---	--	007	0	0	0.00	$0.00	Y
N	92614	LARYNGOSCOPIC SENSORY VID	104.51	$85.70	---	--	007	0	0	0.00	$0.00	Y
N	92615	LARYNGOSCOPIC SENSORY I&R	34.46	$28.26	---	--	007	0	0	0.00	$0.00	Y
N	92616	FEES W/LARYNGEAL SENSE TEST	144.41	$118.42	---	--	007	0	0	0.00	$0.00	Y
N	92617	FEES W/LARYNGEAL SENSE I&R	45.70	$37.47	---	--	007	0	0	0.00	$0.00	Y
N	92618	EX FOR NONSPEECH DEV RX ADD	33.59	$27.54	---	--	007	0	0	0.00	$0.00	Y
N	92620	AUDITORY FUNCTION 60 MIN	49.70	$40.75	---	$51.69	007	1	1	0.00	$0.00	Y
N	92621	AUDITORY FUNCTION + 15 MIN	12.33	$10.11	---	$12.82	007	1	1	0.00	$0.00	Y
N	92625	TINNITUS ASSESSMENT	48.87	$40.07	---	$50.82	007	1	1	0.00	$0.00	Y
N	92626	EVAL AUD FUNCJ 1ST HOUR	24.45	$20.05	---	--	007	0	1	0.00	$0.00	Y
N	92627	EVAL AUD FUNCJ EA ADDL 15	24.45	$20.05	---	--	007	0	1	0.00	$0.00	Y
N	92630	AUD REHAB PRELING HEAR LOSS	0.00	$0.00	---	--	007	0	1	0.00	$0.00	Y
N	92633	AUD REHAB POSTLING HEAR LOSS	0.00	$0.00	---	--	007	0	1	0.00	$0.00	Y
N	92650	AEP SCR AUDITORY POTENTIAL	31.32	$25.68	---	--	007	0	0	0.00	$0.00	Y
N	92651	AEP HEARING STATUS DETER I&R	98.32	$80.62	---	--	007	0	0	0.00	$0.00	Y
N	92652	AEP THRSHLD EST MLT FREQ I&R	127.61	$104.64	---	--	007	0	0	0.00	$0.00	Y
N	92653	AEP NEURODIAGNOSTIC I&R	93.81	$76.92	---	--	007	0	0	0.00	$0.00	Y
N	92700	UNLISTED ORL SERVICE/PX	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
N	92920	PRQ CARDIAC ANGIOPLAST 1 ART	530.64	$435.12	---	--	007	0	0	0.00	$0.00	Y
N	92921	PRQ CARDIAC ANGIO ADDL ART	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
N	92924	PRQ CARD ANGIO/ATHRECT 1 ART	630.81	$517.26	---	--	007	0	0	0.00	$0.00	Y
N	92925	PRQ CARD ANGIO/ATHRECT ADDL	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
N	92928	PRQ CARD STENT W/ANGIO 1 VSL	589.08	$483.05	---	--	007	0	0	0.00	$0.00	Y
N	92929	PRQ CARD STENT W/ANGIO ADDL	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
N	92933	PRQ CARD STENT/ATH/ANGIO	658.72	$540.15	---	--	007	0	0	0.00	$0.00	Y
N	92934	PRQ CARD STENT/ATH/ANGIO	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
N	92937	PRQ REVASC BYP GRAFT 1 VSL	588.36	$482.46	---	--	007	0	0	0.00	$0.00	Y
N	92938	PRQ REVASC BYP GRAFT ADDL	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
N	92941	PRQ CARD REVASC MI 1 VSL	659.98	$541.18	---	--	007	0	0	0.00	$0.00	Y
N	92943	PRQ CARD REVASC CHRONIC 1VSL	659.98	$541.18	---	--	007	0	0	0.00	$0.00	Y
N	92944	PRQ CARD REVASC CHRONIC ADDL	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
N	92950	HEART/LUNG RESUSCITATION CPR	11.50	$115.00	$125.47	$142.83	053	1	0	0.00	$0.00	Y
N	92953	TEMPORARY EXTERNAL PACING	24.88	$20.40	---	$25.88	007	1	1	0.00	$0.00	Y
N	92960	CARDIOVERSION ELECTRIC EXT	122.46	$122.46	---	--	009	0	0	0.00	$0.00	Y
N	92961	CARDIOVERSION ELECTRIC INT	210.71	$172.78	---	$219.14	007	1	0	0.00	$0.00	Y
N	92970	CARDIOASSIST INTERNAL	229.87	$188.49	---	$239.06	007	1	0	0.00	$0.00	Y
N	92971	CARDIOASSIST EXTERNAL	96.63	$79.24	---	$100.50	007	1	0	0.00	$0.00	Y
N	92973	PRQ CORONARY MECH THROMBECT	178.91	$146.71	---	$186.07	007	1	0	0.00	$0.00	Y
N	92974	CATH PLACE CARDIO BRACHYTX	194.11	$159.17	---	$201.87	007	1	0	0.00	$0.00	Y
N	92975	DISSOLVE CLOT HEART VESSEL	410.72	$336.79	---	$427.15	007	1	0	0.00	$0.00	Y
N	92977	DISSOLVE CLOT HEART VESSEL	304.18	$249.43	---	$316.35	007	1	0	0.00	$0.00	Y
N	92978	ENDOLUMINL IVUS OCT C 1ST	58.95	$225.19	---	--	005	0	0	0.37	$0.00	Y
N	92979	ENDOLUMINL IVUS OCT C EA	36.07	$137.79	---	--	005	0	0	0.48	$0.00	Y
N	92986	REVISION OF AORTIC VALVE	1177.90	$965.88	---	$1225.02	007	1	0	0.00	$0.00	Y
O	92986	REVISION OF AORTIC VALVE	235.59	$193.18	---	$245.01	007	1	0	0.00	$0.00	Y
O	92987	PERCUTANEOUS BALLOON VALVULOPLASTY VALVE	254.60	$208.77	---	$264.78	007	1	0	0.00	$0.00	Y
N	92987	PERCUTANEOUS BALLOON VALVULOPLASTY VALVE	1272.99	$1043.85	---	$1323.91	007	1	0	0.00	$0.00	Y
N	92990	REVISION OF PULONARY VALVE	998.80	$819.02	---	$1038.75	007	1	0	0.00	$0.00	Y
O	92990	REVISION OF PULMONARY VALVE	199.76	$163.80	---	$207.75	007	1	0	0.00	$0.00	Y
N	92997	PUL ART BALLOON REPR PERCUT	664.40	$544.81	---	--	007	0	0	0.00	$0.00	Y
N	92998	PUL ART BALLOON REPR PERCUT	345.99	$283.71	---	--	007	0	0	0.00	$0.00	Y
N	93000	ELECTROCARDIOGRAM COMPLETE	35.00	$28.70	---	$36.40	007	1	1	0.00	$0.00	Y
N	93005	ELECTROCARDIOGRAM TRACING	20.00	$16.40	---	$20.80	007	1	1	0.00	$0.00	Y
1	93005	ELECTROCARDIOGRAM TRACING	7.43	$7.43	---	$7.43	009	1	1	0.00	$0.00	Y
N	93010	ELECTROCARDIOGRAM REPORT	15.00	$12.30	---	$15.60	007	1	1	0.00	$0.00	Y
N	93015	CARDIOVASCULAR STRESS TEST	116.96	$95.91	---	$121.64	007	1	1	0.00	$0.00	Y
N	93016	CARDIOVASCULAR STRESS TEST	29.96	$24.57	---	$31.16	007	1	0	0.00	$0.00	Y
N	93017	CARDIOVASCULAR STRESS TEST	64.02	$52.50	---	$66.58	007	1	1	0.00	$0.00	Y
N	93018	CARDIOVASCULAR STRESS TEST	22.98	$18.84	---	$23.90	007	1	1	0.00	$0.00	Y
N	93024	CARDIAC DRUG STRESS TEST	127.48	$104.53	---	$132.58	007	1	0	0.70	$0.00	Y
N	93025	MICROVOLT T-WAVE ASSESS	284.49	$233.28	---	--	007	0	0	0.70	$0.00	Y
N	93040	RHYTHM ECG WITH REPORT	15.94	$13.07	---	$16.58	007	1	1	0.00	$0.00	Y
N	93041	RHYTHM ECG TRACING	6.26	$5.13	---	$6.51	007	1	1	0.00	$0.00	Y
1	93041	RHYTHM ECG TRACING	16.07	$16.07	---	$16.07	009	1	1	0.00	$0.00	Y
N	93042	RHYTHM ECG REPORT	10.40	$8.53	---	$10.82	007	1	1	0.00	$0.00	Y
N	93050	ART PRESSURE WAVEFORM ANALYS	18.76	$15.38	---	--	007	0	0	0.47	$0.00	Y
N	93224	ECG MONIT/REPRT UP TO 48 HRS	135.17	$110.84	---	--	007	0	0	0.00	$0.00	Y
N	93225	ECG MONIT/REPRT UP TO 48 HRS	36.37	$29.82	---	--	007	0	0	0.00	$0.00	Y
N	93226	ECG MONIT/REPRT UP TO 48 HRS	68.22	$55.94	---	--	007	0	0	0.00	$0.00	Y
N	93227	ECG MONIT/REPRT UP TO 48 HRS	30.59	$25.08	---	--	007	0	0	0.00	$0.00	Y
N	93228	REMOTE 30 DAY ECG REV/REPORT	26.28	$21.55	---	--	007	0	0	0.00	$0.00	Y
N	93229	REMOTE 30 DAY ECG TECH SUPP	823.12	$674.96	---	--	007	0	0	0.00	$0.00	Y
N	93241	EXT ECG>48HR<7D REC SCAN A/R	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
N	93242	EXT ECG>48HR<7D RECORDING	17.11	$14.03	---	--	007	0	0	0.00	$0.00	Y
N	93243	EXT ECG>48HR<7D SCAN A/R	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
N	93244	EXT ECG>48HR<7D REV&INTERPJ	25.68	$21.06	---	--	007	0	0	0.00	$0.00	Y
N	93245	EXT ECG>7D<15D REC SCAN A/R	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
N	93246	EXT ECG>7D<15D RECORDING	17.11	$14.03	---	--	007	0	0	0.00	$0.00	Y
N	93247	EXT ECG>7D<15D SCAN A/R	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
N	93248	EXT ECG>7D<15D REV&INTERPJ	28.25	$23.17	---	--	007	0	0	0.00	$0.00	Y
N	93260	PRGRMG DEV EVAL IMPLTBL SYS	72.01	$59.05	---	--	007	0	0	0.65	$0.00	Y
N	93261	INTERROGATE SUBQ DEFIB	66.01	$54.13	---	--	007	0	0	0.62	$0.00	Y
N	93264	REM MNTR WRLS P-ART PRS SNR	54.54	$44.72	---	--	007	0	0	0.00	$0.00	Y
N	93268	ECG RECORD/REVIEW	172.49	$141.44	---	--	007	0	0	0.00	$0.00	Y
N	93270	REMOTE 30 DAY ECG REV/REPORT	36.37	$29.82	---	--	007	0	0	0.00	$0.00	Y
N	93271	ECG/MONITORING AND ANALYSIS	97.32	$79.80	---	--	007	0	0	0.00	$0.00	Y
N	93272	ECG/REVIEW INTERPRET ONLY	26.52	$21.75	---	--	007	0	0	0.00	$0.00	Y
N	93278	ECG/SIGNAL - AVERAGED	32.82	$26.91	---	--	007	0	0	0.39	$0.00	Y
N	93279	PM DEVICE PROGR EVAL SNGL	59.50	$48.79	---	--	007	0	0	0.63	$0.00	Y
N	93280	PM DEVICE PROGR EVAL DUAL	70.62	$57.91	---	--	007	0	0	0.64	$0.00	Y
N	93281	PM DEVICE PROGR EVAL MULTI	82.55	$67.69	---	--	007	0	0	0.64	$0.00	Y
N	93282	PRGRMG EVAL IMPLANTABLE DFB	76.04	$62.35	---	--	007	0	0	0.65	$0.00	Y
N	93283	PRGRMG EVAL IMPLANTABLE DFB	92.56	$75.90	---	--	007	0	0	0.67	$0.00	Y
N	93284	PRGRMG EVAL IMPLANTABLE DFB	108.45	$88.93	---	--	007	0	0	0.68	$0.00	Y
N	93285	PRGRMG DEV EVAL SCRMS IP	51.50	$42.23	---	--	007	0	0	0.60	$0.00	Y
N	93286	PERI-PX PACEMAKER DEVICE EVL	29.07	$23.84	---	--	007	0	0	0.53	$0.00	Y
N	93287	PERI-PX ICD DEVICE EVAL&PRGR	38.04	$31.19	---	--	007	0	0	0.60	$0.00	Y
N	93288	PM DEVICE EVAL IN PERSON	46.37	$38.02	---	--	007	0	0	0.54	$0.00	Y
N	93289	ICD DEVICE INTERROGATE	70.98	$58.20	---	--	007	0	0	0.64	$0.00	Y
N	93290	ICM DEVICE EVAL	33.41	$27.40	---	--	007	0	0	0.65	$0.00	Y
N	93291	ILR DEVICE INTERROGATE	44.30	$36.33	---	--	007	0	0	0.58	$0.00	Y
N	93292	WCD DEVICE INTERROGATE	44.66	$36.62	---	--	007	0	0	0.57	$0.00	Y
N	93293	PM PHONE R-STRIP DEVICE EVAL	64.40	$52.81	---	--	007	0	0	0.27	$0.00	Y
N	93294	PM DEVICE INTERROGATE REMOTE	38.22	$31.34	---	--	007	0	0	0.00	$0.00	Y
N	93295	ICD DEVICE INTERROGAT REMOTE	69.22	$56.76	---	--	007	0	0	0.00	$0.00	Y
N	93296	PM/ICD REMOTE TECH SERV	41.41	$33.96	---	--	007	0	0	0.00	$0.00	Y
N	93297	ICM DEVICE INTERROGAT REMOTE	26.28	$21.55	---	--	007	0	0	0.00	$0.00	Y
N	93298	ILR DEVICE INTERROGAT REMOTE	30.82	$25.27	---	--	007	0	0	0.00	$0.00	Y
N	93303	ECHO TRANSTHORACIC	186.16	$152.65	---	$193.61	007	1	0	0.36	$0.00	Y
N	93304	ECHO TRANSTHORACIC	101.80	$83.48	---	$105.87	007	1	0	0.41	$0.00	Y
N	93306	TTE W/DOPPLER COMPLETE	292.39	$239.76	---	--	007	0	0	0.26	$0.00	Y
N	93307	TTE W/O DOPPLER COMPLETE	183.05	$150.10	---	--	007	0	0	0.40	$0.00	Y
N	93308	TTE F-UP OR LMTD	91.52	$75.05	---	--	007	0	0	0.40	$0.00	Y
N	93312	ECHO TRANSESOPHAGEAL	189.93	$155.74	---	--	007	0	0	0.75	$0.00	Y
N	93315	ECHO TRANSESOPHAGEAL	235.65	$193.23	---	--	007	0	0	0.75	$0.00	Y
N	93318	ECHO TRANSESOPHAGEAL INTRAOP	312.19	$256.00	---	--	007	0	0	0.75	$0.00	Y
N	93319	3D ECHO IMG CGEN CAR ANOMAL	67.13	$55.05	---	--	007	0	0	0.00	$0.00	Y
N	93320	DOPPLER ECHO EXAM HEART	93.38	$76.57	---	$97.12	007	1	0	0.40	$0.00	Y
N	93321	DOPPLER ECHO EXAM HEART	47.49	$38.94	---	$49.39	007	1	0	0.40	$0.00	Y
N	93325	DOPPLER COLOR FLOW ADD-ON	94.98	$77.88	---	$98.78	007	1	0	0.03	$0.00	Y
N	93350	STRESS TTE ONLY	117.22	$96.12	---	--	007	0	0	0.50	$0.00	Y
N	93351	STRESS TTE COMPLETE	301.57	$247.29	---	--	007	0	0	0.50	$0.00	Y
N	93352	ADMIN ECG CONTRAST AGENT	42.40	$34.77	---	--	007	0	0	0.00	$0.00	Y
N	93355	ECHO TRANSESOPHAGEAL (TEE)	235.68	$193.26	---	--	007	0	0	0.00	$0.00	Y
N	93356	MYOCRD STRAIN IMG SPCKL TRCK	44.74	$36.69	---	--	007	0	0	0.00	$0.00	Y
N	93451	RIGHT HEART CATH	851.99	$698.63	---	$886.07	007	1	0	0.17	$0.00	Y
N	93452	LEFT HRT CATH W/VENTRCLGRPHY	930.32	$762.86	---	$967.53	007	1	0	0.28	$0.00	Y
N	93453	R&L HRT CATH W/VENTRICLGRPHY	1217.61	$998.44	---	$1266.31	007	1	0	0.28	$0.00	Y
N	93454	CORONARY ARTERY ANGIO S&I	960.55	$787.65	---	$998.97	007	1	0	0.27	$0.00	Y
N	93455	CORONARY ART/GRFT ANGIO S&I	1121.33	$919.49	---	$1166.18	007	1	0	0.27	$0.00	Y
N	93456	R HRT CORONARY ARTERY ANGIO	1201.23	$985.01	---	$1249.28	007	1	0	0.28	$0.00	Y
N	93457	R HRT ART/GRFT ANGIO	1361.88	$1116.74	---	$1416.36	007	1	0	0.28	$0.00	Y
N	93458	L HRT ARTERY/VENTRICLE ANGIO	1158.55	$950.01	---	$1204.89	007	1	0	0.27	$0.00	Y
N	93459	L HRT ART/GRFT ANGIO	1278.74	$1048.57	---	$1329.89	007	1	0	0.28	$0.00	Y
N	93460	R&L HRT ART/VENTRICLE ANGIO	1366.21	$1120.29	---	$1420.86	007	1	0	0.29	$0.00	Y
N	93461	R&L HRT ART/VENTRICLE ANGIO	1567.79	$1285.59	---	$1630.50	007	1	0	0.28	$0.00	Y
N	93462	L HRT CATH TRNSPTL PUNCTURE	201.39	$165.14	---	$209.45	007	1	0	0.00	$0.00	Y
N	93463	DRUG ADMIN & HEMODYNMIC MEAS	107.26	$87.95	---	$111.55	007	1	0	0.00	$0.00	Y
N	93464	EXERCISE W/HEMODYNAMIC MEAS	274.16	$224.81	---	$285.13	007	1	0	0.34	$0.00	Y
N	93503	RIGHT HEART CATHETERIZATION	154.85	$126.98	---	$161.04	007	1	0	0.00	$0.00	Y
N	93505	BIOPSY OF HEART LINING	289.95	$237.76	---	$301.55	007	1	0	0.78	$0.00	Y
N	93563	NJX CGEN CAR CTH SLCTV C ANG	57.20	$46.90	---	$59.49	007	1	0	0.00	$0.00	Y
N	93564	NJX CGEN CAR CATH SLCTV OPAC	58.09	$47.63	---	$60.41	007	1	0	0.00	$0.00	Y
N	93565	NJX CAR CTH SLCTV LV/LA ANG	43.94	$36.03	---	$45.70	007	1	0	0.00	$0.00	Y
N	93566	NJX CAR CTH SLCTV RV/RA ANG	188.65	$154.69	---	$196.20	007	1	0	0.00	$0.00	Y
N	93567	NJX CAR CTH SPRVLV AORTGRPHY	113.66	$93.20	---	$118.21	007	1	0	0.00	$0.00	Y
N	93568	NJX CAR CTH NSLC P-ART ANGRP	113.66	$93.20	---	$118.21	007	1	0	0.00	$0.00	Y
N	93569	NJX CTH SLCT P-ART ANGRP UNI	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
N	93571	HEART FLOW RESERVE MEASURE	296.11	$242.81	---	$307.95	007	1	0	0.33	$0.00	Y
N	93572	HEART FLOW RESERVE MEASURE	274.11	$224.77	---	--	007	0	0	0.28	$0.00	Y
N	93573	NJX CATH SLCT P-ART ANGRP BI	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
N	93574	NJX CATH SLCT PULM VN ANGRPH	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
N	93575	NJX CATH SLCT P ANGRPH MAPCA	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
N	93580	TRANSCATH CLOSURE OF ASD	736.49	$603.92	---	--	007	0	0	0.00	$0.00	Y
N	93581	TRANSCATH CLOSURE OF VSD	927.71	$760.72	---	--	007	0	0	0.00	$0.00	Y
N	93582	PERQ TRANSCATH CLOSURE PDA	689.35	$565.26	---	--	007	0	0	0.00	$0.00	Y
N	93583	PERQ TRANSCATH SEPTAL REDUXN	613.67	$503.21	---	--	007	0	0	0.00	$0.00	Y
N	93590	PERQ TRANSCATH CLS MITRAL	1006.03	$1006.03	---	--	009	0	0	0.00	$0.00	Y
N	93591	PERQ TRANSCATH CLS AORTIC	835.12	$835.12	---	--	009	0	0	0.00	$0.00	Y
N	93592	PERQ TRANSCATH CLOSURE EACH	367.38	$367.38	---	--	009	0	0	0.00	$0.00	Y
N	93593	R HRT CATH CHD NML NT CNJ	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
N	93594	R HRT CATH CHD ABNL NT CNJ	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
N	93595	L HRT CATH CHD NM/ABN NT CNJ	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
N	93596	R&L HRT CATH CHD NML NT CNJ	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
N	93597	R&L HRT CATH CHD ABNL NT CNJ	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
N	93598	CAR OUTP MEAS DRG CATH CHD	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
N	93600	BUNDLE OF HIS RECORDING	199.33	$163.45	---	$207.30	007	1	0	0.72	$0.00	Y
N	93602	INTRA-ATRIAL RECORDING	129.12	$105.88	---	$134.28	007	1	0	0.77	$0.00	Y
N	93603	RIGHT VENTRICULAR RECORDING	194.28	$159.31	---	$202.05	007	1	0	0.71	$0.00	Y
N	93609	MAP TACHYCARDIA ADD-ON	358.49	$293.96	---	$372.83	007	1	0	0.82	$0.00	Y
N	93610	INTRA-ATRIAL PACING	129.12	$105.88	---	$134.28	007	1	0	0.79	$0.00	Y
N	93612	INTRAVENTRICULAR PACING	129.12	$105.88	---	$134.28	007	1	0	0.76	$0.00	Y
N	93613	ELECTROPHYS MAP 3D ADD-ON	381.15	$312.54	---	--	007	0	0	0.76	$0.00	Y
N	93615	ESOPHAGEAL RECORDING	100.00	$82.00	---	$104.00	007	1	0	0.80	$0.00	Y
N	93616	ESOPHAGEAL RECORDING WITH PACING	114.00	$93.48	---	$118.56	007	1	0	0.90	$0.00	Y
N	93618	HEART RHYTHM PACING	215.76	$176.92	---	$224.39	007	1	0	0.71	$0.00	Y
N	93619	ELECTROPHYSIOLOGY EVALUATION	727.39	$596.46	---	$756.49	007	1	0	0.70	$0.00	Y
N	93620	ELECTROPHYSIOLOGY EVALUATION	852.85	$699.34	---	$886.96	007	1	0	0.73	$0.00	Y
N	93621	ELECTROPHYSIOLOGY EVALUATION	852.85	$699.34	---	$886.96	007	1	0	0.70	$0.00	Y
N	93622	ELECTROPHYSIOLOGY EVALUATION	852.85	$699.34	---	$886.96	007	1	0	0.70	$0.00	Y
N	93623	STIMULATION PACING HEART	0.00	$0.00	---	--	007	1	0	0.00	$0.00	Y
N	93624	ELECTROPHYSIOLOGIC STUDY	348.32	$285.62	---	$362.25	007	1	0	0.79	$0.00	Y
N	93631	HEART PACING MAPPING	684.94	$561.65	---	$712.34	007	1	0	0.67	$0.00	Y
N	93640	EVALUATION HEART DEVICE	589.52	$483.41	---	$613.10	007	1	0	0.59	$0.00	Y
N	93641	ELECTROPHYSIOLOGY EVALUATION	662.27	$543.06	---	$688.76	007	1	0	0.64	$0.00	Y
N	93642	ELECTROPHYSIOLOGY EVALUATION	640.06	$524.85	---	$665.66	007	1	0	0.63	$0.00	Y
N	93644	ELECTROPHYSIOLOGY EVALUATION	317.85	$260.64	---	$330.56	007	1	0	0.62	$0.00	Y
N	93650	ABLATE HEART DYSRHYTHM FOCUS	872.82	$715.71	---	$907.73	007	1	0	0.00	$0.00	Y
N	93653	EP & ABLATE SUPRAVENT ARRHYT	804.22	$659.46	---	$836.39	007	1	0	0.00	$0.00	Y
N	93654	EP & ABLATE VENTRIC TACHY	1073.44	$880.22	---	$1116.38	007	1	0	0.00	$0.00	Y
N	93655	ABLATE ARRHYTHMIA ADD ON	402.20	$329.80	---	$418.29	007	1	0	0.00	$0.00	Y
N	93656	TX ATRIAL FIB PULM VEIN ISOL	1073.74	$880.47	---	$1116.69	007	1	0	0.00	$0.00	Y
N	93657	TX L/R ATRIAL FIB ADDL	402.40	$329.97	---	$418.50	007	1	0	0.00	$0.00	Y
N	93660	TILT TABLE EVALUATION	0.00	$0.00	---	--	007	1	0	0.00	$0.00	Y
N	93662	INTRACARDIAC ECG (ICE)	329.95	$270.56	---	$343.15	007	1	0	0.49	$0.00	Y
N	93702	BIS XTRACELL FLUID ANALYSIS	128.21	$105.13	---	--	007	0	0	0.00	$0.00	Y
N	93724	ELECT ANALYSIS OF ANTITACH PACEMAKER SYS	335.34	$274.98	---	$348.75	007	1	0	0.65	$0.00	Y
N	93745	SET-UP CARDIOVERT-DEFIBRILL	90.52	$74.23	---	$94.14	007	1	1	0.00	$0.00	Y
N	93750	INTERROGATION VAD IN PERSON	54.01	$44.29	---	--	007	0	0	0.00	$0.00	Y
N	93784	AMBL BP MNTR W/SOFTWARE	59.03	$48.40	---	--	007	0	0	0.00	$0.00	Y
N	93786	AMBL BP MNTR W/SW REC ONLY	33.40	$27.39	---	--	007	0	0	0.00	$0.00	Y
N	93788	AMBL BP MNTR W/SW A/R	5.87	$4.81	---	--	007	0	0	0.00	$0.00	Y
N	93790	AMBL BP MNTR W/SW I&R	19.70	$16.15	---	--	007	0	0	0.00	$0.00	Y
N	93793	ANTICOAG MGMT PT WARFARIN	10.53	$10.53	---	--	007	0	0	0.00	$0.00	Y
N	93797	CARDIAC REHAB	17.64	$14.46	---	--	007	0	0	0.00	$0.00	Y
N	93798	CARDIAC REHAB/MONITOR	27.14	$22.25	---	--	007	0	0	0.00	$0.00	Y
N	93799	UNLISTED CV SVC/PROCEDURE	0.00	$0.00	---	--	007	1	0	0.00	$0.00	Y
P	93799	UNLISTED CV SVC/PROCEDURE	0.00	$0.00	---	--	019	0	0	0.00	$0.00	Y
N	93880	EXTRACRANIAL BILAT STUDY	191.02	$156.64	---	$198.66	007	1	1	0.25	$0.00	Y
N	93882	EXTRACRANIAL UNI/LTD STUDY	92.98	$76.24	---	$96.70	007	1	1	0.14	$0.00	Y
N	93886	INTRACRANIAL COMPLETE STUDY	238.88	$195.88	---	$248.44	007	1	1	0.21	$0.00	Y
N	93888	INTRACRANIAL LIMITED STUDY	158.73	$130.16	---	$165.08	007	1	1	0.21	$0.00	Y
N	93890	TCD VASOREACTIVITY STUDY	257.61	$211.24	---	$267.91	007	1	1	0.40	$0.00	Y
N	93892	TCD EMBOLI DETECT W/O INJ	274.24	$224.88	---	$285.21	007	1	1	0.40	$0.00	Y
N	93893	TCD EMBOLI DETECT W/INJ	268.79	$220.41	---	$279.54	007	1	1	0.40	$0.00	Y
N	93922	UPR/L XTREMITY ART 2 LEVELS	63.54	$52.10	---	$66.08	007	1	0	0.32	$0.00	Y
N	93923	UPR/LXTR ART STDY 3+ LVLS	118.73	$97.36	---	$123.48	007	1	0	0.31	$0.00	Y
N	93924	LWR XTR VASC STDY BILAT	129.78	$106.42	---	$134.97	007	1	0	0.31	$0.00	Y
N	93925	LOWER EXTREMITY STUDY	118.13	$96.87	---	$122.86	007	1	1	0.25	$0.00	Y
P	93925	LOWER EXTREMITY STUDY	118.13	$96.87	---	--	019	0	1	0.25	$0.00	Y
P	93926	DUPLEX SCAN LOWER EXTREMITY ARTERIES OR	103.52	$84.89	---	--	019	0	1	0.14	$0.00	Y
N	93926	DUPLEX SCAN LOWER EXTREMITY ARTERIES OR	103.52	$84.89	---	$107.66	007	1	1	0.14	$0.00	Y
N	93930	UPPER EXTREMITY STUDY	113.43	$93.01	---	$117.97	007	1	1	0.21	$0.00	Y
N	93931	DUPLEX SCAN UPPER EXTREMITY ARTERIES OR	101.05	$82.86	---	$105.09	007	1	1	0.21	$0.00	Y
N	93970	EXTREMITY STUDY	205.17	$168.24	---	$213.38	007	1	1	0.28	$0.00	Y
N	93971	DUPLEX SCAN EXTREMITY VEINS INC RESPONSE	103.12	$84.56	---	$107.24	007	1	1	0.16	$0.00	Y
N	93975	VISCERAL VASCULAR STUDY	229.07	$187.84	---	$238.23	007	1	1	0.35	$0.00	Y
N	93976	DUPLEX SCAN ARTER INFLW/VENOUS OUTFLW AB	188.68	$154.72	---	$196.23	007	1	1	0.21	$0.00	Y
N	93978	VISCERAL VASCULAR STUDY	200.18	$164.15	---	$208.19	007	1	1	0.27	$0.00	Y
N	93979	DUPLEX STDY AORTA,INF VENA CAVA,ILIAC VA	96.74	$79.33	---	$100.61	007	1	1	0.15	$0.00	Y
N	93980	PENILE VASCULAR STUDY	201.97	$165.62	---	$210.05	007	1	0	0.30	$0.00	Y
N	93981	PENILE VASCULAR STUDY	151.59	$124.30	---	$157.65	007	1	0	0.14	$0.00	Y
N	93985	DUP-SCAN HEMO COMPL BI STD	301.63	$247.34	---	--	007	0	0	0.00	$0.00	Y
N	93986	DUP-SCAN HEMO COMPL UNI STD	174.36	$142.98	---	--	007	0	0	0.00	$0.00	Y
N	93990	DUPLEX SCAN OF HEMODIALYSIS ACCESS	87.50	$71.75	---	$91.00	007	1	1	0.14	$0.00	Y
N	93998	UNLISTD NONINVAS VASC DX STD	0.00	$0.00	---	--	007	1	1	0.00	$0.00	Y
N	94002	VENT MGMT INPAT INIT DAY	4.48	$44.80	$48.88	--	053	0	0	0.00	$0.00	Y
N	94003	VENT MGMT INPAT SUBQ DAY	3.53	$35.30	$38.51	--	053	0	0	0.00	$0.00	Y
N	94010	BREATHING CAPACITY TEST	30.00	$24.60	---	$31.20	007	1	1	0.40	$0.00	Y
N	94011	SPIROMETRY UP TO 2 YRS OLD	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
N	94012	SPIRMTRY W/BRNCHDIL INF-2 YR	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
N	94013	MEAS LUNG VOL THRU 2 YRS	0.00	$0.00	---	--	007	0	0	0.00	$0.00	Y
N	94014	PATIENT RECORDED SPIROMETRY	46.23	$37.91	---	$48.08	007	1	0	0.00	$0.00	Y
N	94015	PATIENT RECORDED SPIROMETRY	17.60	$14.43	---	$18.30	007	1	0	0.00	$0.00	Y
N	94016	REVIEW PATIENT SPIROMETRY	28.63	$23.48	---	$29.78	007	1	0	0.00	$0.00	Y
N	94060	EVALUATION OF WHEEZING	54.91	$45.03	---	$57.11	007	1	1	0.40	$0.00	Y
N	94150	VITAL CAPACITY TEST	6.79	$5.57	---	$7.06	007	1	0	0.40	$0.00	Y
N	94200	LUNG FUNCTION TEST (MBC/MVV)	20.00	$16.40	---	$20.80	007	1	0	0.40	$0.00	Y
N	94375	RESPIRATORY FLOW VOLUME LOOP	28.32	$23.22	---	$29.45	007	1	0	0.40	$0.00	Y
N	94450	HYPOXIA RESPONSE CURVE	29.51	$24.20	---	$30.69	007	1	0	0.40	$0.00	Y
N	94617	EXERCISE TST BRNCSPSM W/ECG	105.42	$86.45	---	--	007	0	0	0.33	$0.00	Y
N	94618	PULMONARY STRESS TESTING	36.73	$30.12	---	--	007	0	0	0.65	$0.00	Y
E	94618	RESPIRATORY THERAPY ASSESSMENT	12.08	$12.08	---	--	009	0	0	0.00	$0.00	Y
N	94619	EXERCISE TST BRNCSPSM WO ECG	81.14	$66.53	---	--	007	0	0	0.00	$0.00	Y
N	94621	PULM STRESS TEST/COMPLEX	121.48	$99.61	---	$126.34	007	1	0	0.42	$0.00	Y
N	94625	PHY/QHP OP PULM RHB W/O MNTR	72.33	$59.31	---	--	007	0	0	0.00	$0.00	Y
N	94626	PHY/QHP OP PULM RHB W/MNTR	81.88	$67.14	---	--	007	0	0	0.00	$0.00	Y
N	94640	AIRWAY INHALATION TREATMENT	1.17	$11.70	$12.76	$14.53	053	1	0	0.00	$0.00	Y
N	94642	AEROSOL INHALATION OF PENTAMIDINE	8.59	$85.90	$93.72	$106.69	053	1	0	0.00	$0.00	Y
N	94644	CBT 1ST HOUR	1.70	$17.00	$18.55	$21.11	053	1	0	0.00	$0.00	Y
N	94645	CBT EACH ADDL HOUR	1.24	$12.40	$13.53	$15.40	053	1	0	0.00	$0.00	Y
N	94660	POS AIRWAY PRESSURE CPAP	4.08	$40.80	$44.51	$50.67	053	1	1	0.00	$0.00	Y
N	94662	NEG PRESS VENTILATION CNP	2.80	$28.00	$30.55	$34.78	053	1	1	0.00	$0.00	Y
N	94664	EVALUATE PT USE OF INHALER	0.86	$8.60	$9.38	$10.68	053	1	1	0.00	$0.00	Y
N	94667	CHEST WALL MANIPULATION	1.99	$19.90	$21.71	$24.72	053	1	1	0.00	$0.00	Y
N	94668	CHEST WALL MANIPULATION	1.17	$11.70	$12.76	$14.53	053	1	1	0.00	$0.00	Y
N	94669	MECHANICAL CHEST WALL OSCILL	31.66	$25.96	---	--	007	0	0	0.00	$0.00	Y
N	94680	EXHALED AIR ANALYSIS O2	50.00	$41.00	---	$52.00	007	1	1	0.40	$0.00	Y
N	94681	EXHALED AIR ANALYSIS O2/CO2	100.00	$82.00	---	$104.00	007	1	1	0.40	$0.00	Y
N	94690	EXHALED AIR ANALYSIS	18.12	$14.86	---	$18.84	007	1	1	0.40	$0.00	Y
N	94726	PULM FUNCT TST PLETHYSMOGRAP	58.65	$48.09	---	--	007	0	0	0.21	$0.00	Y
N	94727	PULM FUNCTION TEST BY GAS	45.88	$37.62	---	--	007	0	0	0.27	$0.00	Y
N	94728	AIRWY RESIST BY OSCILLOMETRY	45.88	$37.62	---	$47.72	007	1	0	0.27	$0.00	Y
N	94729	CO/MEMBANE DIFFUSE CAPACITY	58.78	$48.20	---	$61.13	007	1	0	0.14	$0.00	Y
N	94760	MEASURE BLOOD OXYGEN LEVEL	6.82	$5.59	---	$7.09	007	1	0	0.00	$0.00	Y
N	94772	BREATH RECORDING INFANT	4.38	$43.80	$47.79	$54.40	001	1	1	0.00	$0.00	Y