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["ITEM","DESCRIPTION","CPT","PRICE"]
["10023540","AC DISCLOCATION W/O MANIPULATION","23540",170]
["10011732","ADDTL NAIL PLATE REMOVED","11732",45]
["10090471","ADMIN OF IMMUN (SINGLE OR COMBO VACC/TOX","90471",21]
["10000008","ADMINISTRATION INFLUENZA VACCINE","G0008",50]
["10002433","ALBUTEROL 0.083%",null,29.63]
["10095117","ALLERGY MULTI INJECTION","95117",20]
["10095115","ALLERGY SINGLE INJECTION","95115",14.26]
["10024267","ANNUAL WELLNESS VISIT INCL PPS, SUBSEQ V","G0439",140]
["10029130","APPLICATION FINGER SPLINT","29130",55]
["10029530","APPLICATION KNEE SUPPORT","29530",70]
["10029105","APPLICATION LONG ARM SPLINT","29105",145]
["10029125","APPLICATION SHORT ARM SPLINT FOREARM/HAN","29125",287]
["10029515","APPLICATION SHORT LEG SPLINT","29515",100]
["10024245","ASPIRATION AND/OR INJ GANGLION CYST","20612",80]
["10011730","AVULSION OF NAIL","11730",140]
["   99004","BAD DEBT RECOVERY",null,0]
["   99001","BAD DEBT WRITE-OFF",null,0]
["   99003","BALANCE TRANSFER",null,0]
["   99015","BCBS  CONTRACTUAL",null,0]
["10000163","BENADRYL LIQUID/ALLERGY RELIEF 5ML DOSE",null,1.17]
["10011442","BENIGN LESION 1.1-2.0 CM  FACE","11442",235]
["10002417","BENZOIN TINCTURE",null,15.22]
["10019101","BIOSPY BREAST","19101",415]
["10002414","BOOSTRIX INJ (TETANUS,DIPTH,PERTUSS)","90715",66.680000000000007]
["10002410","BREAST ASPIRATION","19000",140]
["10000700","BUPIVICAINE HCL INJ 0.5% 150MG/30ML","S0020",20.72]
["10016020","BURN DEBRIDEMENT  SM.","16020",105]
["10051702","CATHETER CHANGE","51702",80]
["10050392","CATHETER INTRO FOR DRAINAGE","50392",164]
["10000696","CEFTRIAXONE 1 GRAM INJ","J0696",24.87]
["   99016","CHARITY CARE",null,0]
["10103491","CLINIC DRUG SCREEN","80305",0]
["10026600","CLOSD TX METACARPAL FX SING W/O MANIPULA","26600",400]
["10027560","CLOSED RED DISLOCATED PATELLA W/O ANESTH","27560",460]
["10024282","CLOSED TX ANKLE DISLOCATION ANEST","27842",1100]
["10028400","CLOSED TX CALCANEUS FX W/O MANIP","28400",400]
["10027788","CLOSED TX DISTAL FIBULA FX W MANIPULATIO","27788",525]
["10027786","CLOSED TX DISTAL FIBULAR FX W/O MANIP","27786",500]
["10199271","CLOSED TX ELBOW","24600",400]
["10024500","CLOSED TX FX HUMERUS W/O MANIPULATION","24500",560]
["10023600","CLOSED TX FX PROXIMAL HUMERAL","23600",304]
["10025605","CLOSED TX FX W/MANIPULATION","25605",675]
["10026775","CLOSED TX INTERPHALANGEAL JOINT DISLOC W","26775",480]
["10026605","CLOSED TX METACARPAL W/MANIPULATION","26605",450]
["10021310","CLOSED TX NASAL BONE W/O MANIPULATION","21310",185]
["10027520","CLOSED TX PATELLAR W/O MANIPULATION","27520",600]
[" 1000421","CLOSED TX RADIAL OF HEAD","24640",170]
["10025500","CLOSED TX RADIAL SHAFT FRAC W/O MANIP","25500",400]
["10119922","CLOSED TX SHOULDER DISLOCATION W/ANESTHE","23655",450]
["10023650","CLOSED TX SHOULDER DISLOCATION W/MANIP","23650",475]
["10027530","CLOSED TX TIBIA PROXIMAL W/O MANIPULATIO","27530",640]
["10027750","CLOSED TX TIBIAL SHAFT FX W/OUT MANIPULA","27750",550]
["10025530","CLOSED TX ULNAR SHAFT FX NO MANIP","25530",395]
["10026750","CLSD TX DISTAL PHAL FX FINGER THUMB W/O","26750",290]
["10026770","CLSD TX INTERPHALANGEAL JOINT  DISLOCATI","26770",360]
["   99020","COLLECT FEE KS SETOFF",null,0]
["   99019","COLLECTION FEE SETOFF",null,0]
["   99017","COMMERCIAL CONTR",null,0]
["10099244","COMPREHENSIVE CONSULT 40 MIN/MORE","99244",208]
["10199264","CONTINUOUS ABLATION SUPRASCAPULAR NERVE","64642",1200]
["10030901","CONTROL NASAL BLEED","30901",180]
["10030905","CONTROL NASAL BLEED POSTERIOR","30905",405]
["   99009","COURTESY DISCOUNTS",null,0]
["10099291","CRITICAL CARE EVAL AND MANAGEMENT","99291",460]
["10099292","CRITICAL CARE EVAL/MGT ADDITIONAL","99292",200]
["10199251","CRNA GENICULAR NERVE BRANCH W GUID LT","64624LT",2070]
["10199250","CRNA GENICULAR NERVE BRANCH W GUID RT","64624RT",2070]
["10199254","CRNA GENICULAR NERVE BRANCH W GUIDANCE B","6445450",1300]
["10199244","CRNA GENICULAR NERVE BRANCH W GUIDANCE-L","64454-LT",975]
["10199243","CRNA GENICULAR NERVE BRANCH W GUIDANCE-R","64454-RT",975]
["10199270","CRNA INJ ANESTH AGENT AXILLARY NERVE","64417",320]
["10199272","CRNA INJ ANESTH AGENT SUPRASCAP SHOULDER","64640",1200]
["10199273","CRNA INJ ANESTH AGENT SUPRASCAP SHOULDER","6464059",500]
["10199269","CRNA INJ ANESTH AGENT SUPRASCAPULAR","64418",320]
["10199221","CRNA INJ FORAMEN EPIDURAL ADD-ON LEFT","64484",245]
["10199222","CRNA INJ FORAMEN EPIDURAL ADD-ON RIGHT","64484",245]
["10199231","CRNA INJ FORAMEN EPIDURAL BILATERAL","6448350",1120]
["10199220","CRNA INJ FORAMEN EPIDURAL LEFT","64483",560]
["10199223","CRNA INJ FORAMEN EPIDURAL RIGHT","64483",560]
["10199249","CRNA INJ MAJOR JOINT OR BURSA","20610",480]
["10199280","CRNA INJ MAJOR JOINT OR BURSA BILATERAL","2061050",680]
["10199230","CRNA INJ PARAVERT FJNT 1/S 1 LEV - L","64493-LT",400]
["10199229","CRNA INJ PARAVERT FJNT 1/S 1 LEV - R","64493-RT",400]
["10199213","CRNA INJ PARAVERT FJNT 1/S 1 LEV BILATER","6449350KX",800]
["10199256","CRNA INJ PARAVERT FJNT 1/S 1 LEV BILATER","6449350KX",800]
["10199215","CRNA INJ PARAVERT FJNT 1/S 2 LEV LEFT","64494LT",220]
["10199258","CRNA INJ PARAVERT FJNT 1/S 2 LEV LEFT","64494LKX",220]
[" 1099257","CRNA INJ PARAVERT FJNT 1/S 2 LEV RIGHT","64494RKX",220]
["10199214","CRNA INJ PARAVERT FJNT 1/S 2 LEV RIGHT","64494RT",220]
["10199257","CRNA INJ PARAVERT FJNT 1/S 2 LEV RIGHT","64494RKX",220]
["10199217","CRNA INJ PARAVERT FJNT 1/S 3 LEV LEFT","64495-L",220]
["10199260","CRNA INJ PARAVERT FJNT 1/S 3 LEV LEFT","64495LKX",220]
["10199216","CRNA INJ PARAVERT FJNT 1/S 3 LEV RIGHT","64495-R",220]
["10199259","CRNA INJ PARAVERT FJNT 1/S 3 LEV RIGHT","64495RKX",220]
["10199247","CRNA INJ PARAVERTEBRAL FACET 2ND LEV-L","64491-LT",400]
["10199246","CRNA INJ PARAVERTEBRAL FACET 2ND LEV-R","64491-RT",400]
["10199245","CRNA INJ PARAVERTEBRAL FACET JOINT W/GUI","64490-50",800]
["10199248","CRNA INJ PARAVERTEBRAL LUMB OR THORACIC","64520",675]
["10199252","CRNA INJ SACROILIAC JT BILATERAL","2709650",1440]
["10199265","CRNA INJ SACROILIAC W GUIDANCE","27096",450]
["10199266","CRNA INJ SM JT OR BURSA","20605",280]
["10199219","CRNA INTERLAMINAR CERVICAL THORACIC","62321",625]
["10199253","CRNA INTERLAMINAR LUMB OR SACRAL W GUIDA","62323",750]
["10199274","CRNA INTERM JOINT OR BURSA","20606",480]
["10199226","CRNA MAJOR JOINT OR BURSA W/GUIDANCE","20611R",120]
["10199275","CRNA OCCIPITAL BLOCK","64405",595]
["10199235","CRNA RADIO ABLAT CERV THORAC 1ST JT-LT","64633-LT",1900]
["10199237","CRNA RADIO ABLAT CERV THORAC 1ST JT-RT","64633-LT",1900]
["10199236","CRNA RADIO ABLAT CERV THORAC EA ADD-LT","64634-LT",900]
["10199241","CRNA RADIO ABLAT CERV THORAC EA ADD-LT","64636LT",900]
["10199238","CRNA RADIO ABLAT CERV THORAC EA ADD-RT","64634-RT",900]
["10199242","CRNA RADIO ABLAT CERV THORAC EA ADD-RT","64636RT",900]
["10199261","CRNA RADIO ABLAT LUMB SACRAL 1ST JT BILA","6463550",2400]
["10199239","CRNA RADIO ABLAT LUMB SACRAL 1ST JT-LT","64635LT",1900]
["10199240","CRNA RADIO ABLAT LUMB SACRAL 1ST JT-RT","64635RT",1900]
["10199234","CRNA SCIATIC NERVE BLOCK - BILATERAL","64445-50",240]
["10199233","CRNA SCIATIC NERVE BLOCK - L","64445-LT",120]
["10199232","CRNA SCIATIC NERVE BLOCK - R","64445-RT",120]
["10199224","CRNA SMALL JOINT","20600",90]
["10199228","CRNA SMALL JOINT BILATERAL","20600-50",180]
["10199227","CRNA TRIGG POINT INJ 3 OR MORE MUS-BILAT","2055350",210]
["10199218","CRNA TRIGGER POINT INJ 1-2 MUSCLES","20552",140]
["10103420","CYANOCOBALAM 1000MCG/ML (B-12)1EA=1ML","J3420",30.2]
["10011000","DEBRIDEMENT SKIN INFECTED","11000",70]
["10011042","DEBRIDEMENT SKIN SUBCU","11042",276]
["10024249","DEBRIDMENT OF BONE","11044",390]
["10001030","DEPO MEDROL 40 MG","J1030",32.4]
["10199268","DEPRESSION SCREENING","G0444",35]
["10001200","DIPHENHYDRAM INJ 50 MG(BENADRYL)","J1200",20.59]
["10026670","DISLOCATE FINGER W/CLOSED MANIPULATION","26670",430]
["10026641","DISLOCATION THUMB","26641",470]
["10024262","DRAINAGE ABCESS CYST HEMATOMA","40800",270]
["10024269","DRAINAGE ABSCESS CYST HEMATOMA","41800",360]
["10002425","DRYSOL SOL 20% EA=1ML",null,1.25]
["10090702","DT INJECTION-7 YR OLD & YOUNGER","90702",18]
["10001056","DT INJECTION-7YR OLD AND OLDER","90714",43.76]
["10069210","EAR WASH INSTRUMENTATION","69210",70]
["10199267","EAR WASH LAVAGE","69209",70]
["10099285","EMERGENCY DEPT VISIT HIGH COMPLEXITY","99285",300]
["10099282","EMERGENCY DEPT VISIT LOW COMPLEXITY","99282",70]
["10099283","EMERGENCY DEPT VISIT MODERATE COMPLEXITY","99283",145]
["10099281","EMERGENCY DEPT VISIT(STRAIGHTFORWARD)","99281",60]
["   99008","EMPLOYEE DISCOUNTS",null,0]
["10002430","EPINEPHRINE 1MG/1ML (1:1000)","J0171",22.65]
["10024242","ESTAB COMPREH PREV MEDICINE (40-64)","99396",170]
["10011740","EVACUATION OF SUB HEMATOMA","11740",65]
["10011402","EXC LESION 1.0-2.0CM","11402",210]
["10011622","EXC LESION MALG 1.1-2.0","11622",320]
["10011643","EXC LESION MALIG FACE 2-3 CM","11643",395]
["10011623","EXC MALG LESION SCALP NECK HANDS FT","11623",375]
["10024226","EXCIS BENIGN TRUNK,ARMS,LEGS OVER 4CM","11406",895]
["10011640","EXCISION BASAL CELL CA FA UP TO 0.5CM","11640",530]
["10011443","EXCISION BENIGN LESION 2.1-3 CM","11443",375]
["10011444","EXCISION BENIGN LESION 3.1-4.0","11444",350]
["10011404","EXCISION BENIGN LESION 3.1-4.0CM","11404",275]
["10011440","EXCISION BENIGN LESION FACE 0.5CM OR LES","11440",170]
["10011420","EXCISION BENIGN LESION NECK SCALP HAN FT","11420",155]
["10011424","EXCISION BENIGN LESION NECK SCALP HAN FT","11424",295]
["10011421","EXCISION BENIGN LESION SCALP NECK HANDS","11421",195]
["10011422","EXCISION BENIGN LESION SCALP NECK HANDS","11422",220]
["10011423","EXCISION BENIGN LESION SCALP NECK HANDS","11423",255]
["10011401","EXCISION LESION","11401",190]
["10011403","EXCISION LESION LEG 2.1-3.0 CM","11403",240]
["10011446","EXCISION LESION OVER 4.0CM FACE EARS EYE","11446",490]
["10002429","EXCISION MALIG LESION FACE 0.5-1CM","11641",320]
["10011642","EXCISION MALIG LESION FACE 1-2CM","11642",340]
["10011644","EXCISION MALIG LESION FACE 3.1-4.0 CM","11644",490]
["10011621","EXCISION MALIG LESION TRUNK ARM LEG","11621",285]
["10011604","EXCISION MALIG LESION TRUNK ARMS LEGS","11604",390]
["10011400","EXCISION OF LESION 0.5","11400",155]
["10011441","EXCISION OF LESION/EAR 0.5-1CM","11441",210]
["10011750","EXCISION OF NAIL & MATRIX PARTIAL/COMPLE","11750",260]
["10011765","EXICISION OF NAIL FOLD  TOE","11765",210]
["10027340","EXISION BURSA PERPATELLAR CYST","27340",465]
["10026418","EXTENSOR TENDON REPAIR  SINGLE","26418",900]
["10024248","FACE TO FACE FOR MOBILITY DEVICE","G0372",15]
["10024230","FECAL OCCULT BLOOD (CARD TEST)","82270",0]
["10024261","FEMORAL NERVE SINGLE","64447",380]
["10025565","FRAC RADIUS W/MANIP RADIAL UNDERSHAFT","25565",640]
["10025560","FRAC RADIUS W/O MAINP RADIAL UNDERSHAFT","25560",400]
["10028470","FRACTURE METATARSAL OF FOOT CLOSED","28470",350]
["10021800","FRACTURE RIBS","21800",160]
["10024530","FRACTURE SUPRA CONDYLAR HUMEROUS","24530",470]
["10001041","FUL-GLO TEST 1MG OPTH",null,5.84]
["10027816","FX ANKLE CLOSED","27816",405]
["10027824","FX DISTAL TIBIA CLOSED","27824",395]
["10026755","FX DISTSAL PHALANGEAL W MANIPULATION","26755",287]
["10024560","FX EPICONDYLE (ELBOW) CLOSED","24560",405]
["10028505","FX GREAT TOE  OPEN","28505",840]
["10027780","FX PROXIMAL FIBULA","27780",475]
["10024650","FX RADIAL HEAD W/O MANIPULATION","24650",425]
["10028510","FX TOE OTHER THAN 1ST GREAT TOE","28510",225]
["10025650","FX ULNARSTYLOID W/O MANIPULATION","25650",495]
["10025680","FX WRIST CLOSED","25680",650]
["10023500","FX/CLAVICLE","23500",340]
["10026765","FX/DISTAL PHAL  OPEN","26765",625]
["10025600","FX/DISTAL RADIUS (NO REDUCTION)","25600",410]
["10028490","FX/GREAT TOE","28490",220]
["10026725","FX/PHALANX-PHALANGES (W/ REDUCTION)","26725",420]
["10099999","HOME VISIT 30 MIN/MORE","99348",79]
["10027603","I & D ABCESS  LEG","27603",700]
["10026011","I & D ABCESS FINGER  COMPLICATED","26011",495]
["10010061","I & D CYST COMPLICATED","10061",260]
["10002418","I & D FOREARM AND/OR WRIST;DEEP ABSCESS","25028",655]
["10010060","I & D SEBACEOUS CYST","10060",150]
["10010120","I & R FOREIGN BODY","10120",190]
["10046083","I&D HEMORHOID","46083",265]
["10010140","INCISION & DRAINAGE HEMATOMA SEROMA OR","10140",210]
["10024243","INCISION AND DRAIN VUVA/PERINEAL ABSCESS","56405",160]
["10199276","INCISION DRAIN COMPLICATED","10121",250]
["10058100","INDROMETRIAL BIOPSY","58100",200]
["10090657","INFLUENZA VACCINE","90688",47.08]
["10024231","INITIAL (SBS) NURS FAC (25 MIN/MORE)","99304",120]
["10024233","INITIAL (SBS) NURS FAC (45 MIN/MORE)","99306",220]
["10024232","INITIAL (SBS) NURS FAC(35 MIN OR MORE)","99305",170]
["10024244","INITIAL COMPREH PREV MEDICINE (12-17)","99384",150]
["10024241","INITIAL COMPREH PREV MEDICINE (18-39)","99385",155]
["10024258","INITIAL PREV (1 THRU 4)","99382",165]
["10024254","INITIAL PREV (5 THRU 11)","99383",160]
["10016000","INITIAL TX BURN W/O DEBRIDMENT","16000",90]
["10199292","INITIT IP/OB CARE HIGH COMPL 75 MIN/MORE","99223",230]
["10199291","INITIT IP/OB CARE MOD COMPL 55 MIN/MORE","99222",190]
["10099221","INITIT IP/OB CARE NEW/ESTAB 40 MIN/MORE","99221",140]
["10020550","INJ  TRIGGER POINT","20550",100]
["10024271","INJECTION ANESTH OTHER PERIPHERAL NERVE","64450",100]
["10024278","INJECTION GREATER OCCIPITAL NERVE","64405",125]
["10020610","INJECTION JOINT LG SHOULDER, KNEE,HIP","20610",140]
["10020605","INJECTION JOINT MED ELBOW,WRIST,ANKLE","20605",110]
["10020600","INJECTION JOINT SM FINGERS,TOES","20600",95]
["10024247","INJECTION(S) SING OR MULT TRIG 3 OR MORE","20553",100]
["10024246","INJECTION(S) SING OR MULT TRIGGER PT(S)","20552",75]
["10031500","INSERT EMERGENCY AIRWAY","31500",200]
["10058300","INSERTION IUD","58300",95]
["10024224","INSERTION NEXPLANON","11981",180]
["10012053","INTERMEDIATE CLOSURE FACE 5.1-7.5CM","12053",435]
["10012036","INTERMEDIATE LAYER CLOSURE LAC 20.1-30CM","12036",525]
["10011900","INTRA LESIONAL INJECTION","11900",70]
["10099236","IP/OBSERV CARE HIGH COMP SAME DAY 85 MIN","99236",249]
["10099234","IP/OBSERV CARE LOW COMP SAME DAY 45 MIN/","99234",154]
["10099235","IP/OBSERV CARE MOD COMP SAME DAY 70 MIN/","99235",194]
["10099233","IP/OBSERV CARE SUBSEQUEN HIGH 50 MIN/MO","99233",118]
["10099231","IP/OBSERV CARE SUBSEQUENT LOW 25 MIN/MOR","99231",60]
["10099232","IP/OBSERV CARE SUBSEQUENT MOD 35 MIN/MOR","99232",82]
["10099238","IP/OBSERV DISCHARGE 30 MIN OR LESS","99238",125]
["10099239","IP/OBSERV DISCHARGE 30 MIN OR MORE","99239",121]
["10002432","IPRATROP/ALBUT (DUONEB) 3ML",null,29.63]
["10020551","JOINT INJ SHOULD HIP KNEE","20551",70]
["10099393","KAN BE HEALTH SCREENING (5-11 YR OLDS)","99393",140]
["10099392","KAN BE HEALTHY SCREENING (1-4 YR OLDS)","99392",135]
["10024239","KBH SCREEN ESTABLISHED  (LESS THAN 1 YR)","99391",120]
["10099394","KBH SCREENING (12-17 YEARS)","99394",145]
["10024236","KBH SCREENING (18-39 YEARS)","99395",150]
["10024273","KDOT PHYSICAL","99455",160]
["10003301","KENALOG 40MG/ML","J3301",30.57]
["10002400","KETOROLAC 30MG INJ","J1885",22.36]
["10002426","KETOROLAC 60MG/2ML","J1885",23.98]
["10012011","LACERATION SUTURE F E N L <2.5 CM","12011",250]
["10012013","LACERATION SUTURE F E N L 2.6 - 5.0 CM","12013",300]
["10012014","LACERATION SUTURE F E N L 5.1 - 7.5 CM","12014",325]
["10012032","LACERATION SUTURE INTER 2.6-7.5CM","12032",375]
["10012001","LACERATION SUTURE S T EX < 2.5 CM","12001",140]
["10012002","LACERATION SUTURE S T EX 2.6 - 7.5 CM","12002",135]
["10012004","LACERATION SUTURE S T EX 7.6 - 12.5 CM","12004",160]
["10012044","LAYER CLOSURE NECK HANDS FEET OR EXTERNA","12044",455]
["10012046","LAYER CLOSURE NECK/HAND/FT","12046",595]
["10012034","LAYERED CLOSURE 10 CM","12034",400]
["10012054","LAYERED CLOSURE 7.6CM - 12.5 CM","12054",600]
["10012051","LAYERED CLOSURE FACE LIP NOSE 2.5CM OR L","12051",330]
["10012052","LAYERED CLOSURE LACER FACE EAR ETC","12052",385]
["10012041","LAYERED CLOSURE NECK/HANDS/FEET","12041",305]
["10012031","LAYERED CLOSURE WOUND SCALP TRUNK","12031",305]
["10017000","LESION DESTRUCTION (1)","17000",387]
["10002416","LESION DESTRUCTION (2-14)","17003",10]
["10017004","LESION DESTRUCTION 15>","17004",233]
["10199279","LESION DESTRUCTION 2.1-3.0CM MALIG","17263",265]
["10024270","LESION DIAMETER 1.1 - 2.0 CM","11307",180]
["10024263","LESION REMOVAL 0.6 TO 1.0 CM","11311",170]
["10011601","LESION REMOVAL TRUNK ARMS MALIG 0.6-1.0","11601",285]
["10024252","LESION REMOVAL TWO TO FOUR LESIONS","11056",85]
["10024280","LESIONS 15 OR MORE","17111",125]
["10000695","LIDO/EPI 1% INJ 1:100000 PER ML","J3490",1.1399999999999999]
["10000697","LIDO/EPI INJ 2% CHG PER ML","J3490",1.23]
["10000699","LIDOCAINE 2% CHG PER ML","J3490",1.1399999999999999]
["10099208","LIDOCAINE INJ 1% 500MG/50ML CHG PER ML","J3490",1.0900000000000001]
["10029065","LONG ARM CAST","29065",165]
["10011620","MALIG LESION OF NECK .5 CM OR LESS","11620",245]
["10024256","MALIG LESION OF TRUNK OVER 4.0 CM","11606",560]
["10011602","MALIGNANT LESION 1.1-2.0 CM","11602",310]
["10011603","MALIGNANT LESION 2.1-3.0 CM","11603",355]
["10024257","MALIGNANT LESION SCALP 3.1-4.0 CM","11624",420]
["   99014","MEDICAID CONTRACTUAL",null,0]
["   99018","MEDICARE CONTR",null,0]
["10101055","MEDROXYPR(DEPO PROVA)150MG/1ML","J1050",95.43]
["10007302","MIRENA INTRAUTERINE SYSTEM","J7298",1288.95]
["10002421","MULTISTIX STRIP",null,0]
["10025622","NAVICULAR FX  CLOSED","25622",475]
["10024260","NEW PATIENT PREVENT 40-64","99386",175]
["10099209","NEXPLANON 68MG","J7307",1178.6300000000001]
["10000164","NITROSTAT SUB 0.4MG",null,5.28]
["   99999","NO CHARGE",null,0]
["10097602","NON SELECTIVE DEBRIDEMENT","97602",40]
["10024235","NURS FAC (SBS) DISCH 30 MIN OR MORE","99316",135]
["10024234","NURS FAC (SBS) DISCHARGE 30 MIN OR LESS","99315",95]
["10099337","NURSING HOME ESTAB MOD/HIGH COMP 30 MIN/","99309",95]
["10099336","NURSING HOME VISIT ESTAB  MOD(15 MIN/MOR","99308",70]
["10017110","O/S WART REMOVAL","17110",140]
["10099211","OFFICE VISIT EST/LEV I","99211",60]
["10099212","OFFICE VISIT EST/LEV II (10-19 MIN)","99212",80]
["10099213","OFFICE VISIT EST/LEV III (20-29 MIN)","99213",115]
["10099214","OFFICE VISIT EST/LEV IV (30-39 MIN)","99214",180]
["10099215","OFFICE VISIT EST/LEV V (40-54 MIN)","99215",230]
["10099202","OFFICE VISIT NEW LEV II (15-29 MIN)","99202",120]
["10099204","OFFICE VISIT NEW LEV IV (45-59 MIN)","99204",200]
["10099205","OFFICE VISIT NEW LEV V (60-74 MIN)","99205",240]
["10099203","OFFICE VISIT NEW/LEV III (30-44 MIN)","99203",128]
["10002402","ONDANSETRON 4MG/2ML INJ","J2405",21.03]
["10002401","ORPHENADRINE INJ 60MG/2ML","J2360",34.79]
["10011200","OS/SKIN TAG REMOVAL","11200",110]
["10099284","OUTPT HOSP LEVEL IV","99284",200]
["10024253","PAIRING/CUTTING BENIGN HYPERKERATOTIC","11055",70]
["   99010","PAT MISC ADJUSTMENT",null,0]
["   99006","PATIENT REFUND",null,0]
["10002411","PESSARY INSERTION","57160",90]
["10026720","PHALANGEAL SHAFT FX CLOSED","26720",300]
["10000009","PNEUMOVAC INJECTION (PATIENT OWN)","G0009",0]
["10090732","PNEUMOVAX","90732",70]
["   99011","PR AR DEDUCTION",null,0]
["10024238","PREVENTITIVE EST PT 65 AND OVER","99397",170]
["   99007","PRIOR BAD DEBT",null,0]
["10002404","PROMETHAZINE 25 MG","J2550",21.34]
["10000165","PROMETHAZINE INJ 50MG/ML","J2550",23.49]
["10002409","PROPARACAINE (EYE DROPS) PER DROP",null,5.0599999999999996]
["10199255","PUNCH BIOPSY EA ADDITIONAL","11105",55]
["10024272","PUNCH BIOPSY SINGLE LESION","11104",155]
["10010160","PUNCTURE ASPIRATION ABCESS/CYST","10160",165]
["10040804","REMOVAL EMBEDDED FOREING BODY MOUTH","40804",240]
["10065220","REMOVAL FB/CORNEA","65220",95]
["10065205","REMOVAL FB/EXT EYE","65205",95]
["10069200","REMOVAL FOREIGN BODY EXTERNAL AUDITORY","69200",139]
["10067938","REMOVAL FOREIGN BODY EYELID","67938",291]
["10020520","REMOVAL FOREIGN BODY FINGER OR HAND","20520",300]
["10028190","REMOVAL FOREIGN BODY FOOT","28190",320]
["10030300","REMOVAL FOREIGN BODY FROM NOSE","30300",247]
["10042809","REMOVAL FOREIGN BODY PHARYNX","42809",250]
["10024200","REMOVAL FOREIGN BODY UPPER ARM/ELBOW","24200",265]
["10058301","REMOVAL IUD","58301",120]
["10011720","REMOVAL NAIL ANY METHOD","11720",45]
["10024225","REMOVAL NEXPLANON","11982",195]
["10020670","REMOVAL OF IMPLANT SUPERFICIAL(EG. PINI","20670",576]
["10041110","REMOVAL TONGUE LESION","41110",270]
["10024268","REMOVAL/INSERTION NEXPLANON","11983",290]
["10011010","REMOVE FOREIGN BODY SKIN & SUB","11010",600]
["10012016","REPAIR LACERATION (15CM)","12016",263]
["10012006","REPAIR LACERATION 20.1-30.0CM","12006",245]
["10015050","REPAIR LACERATION W GRAFT","15050",700]
["10011760","REPAIR NAIL BED","11760",240]
["10012015","REPAIR WOUND FACE 7.6CM-12.5CM","12015",425]
["50000106","RETURN CHECK",null,0]
["   99005","RETURNED CHECK",null,0]
["10028530","SESAMOID FX  CLOSED","28530",150]
["10024259","SHAVE LESION FACE EARS NOSE","11310",140]
["10199263","SHAVING LESION DERMAN 1.1-2.0 CM","11302",200]
["10024277","SHAVING LESION TRUNK,ARM,LEG 0.6-1.0 CM","11301",165]
["10011306","SHAVING OF EPIDERMAL OR DERMAL LESION","11306",150]
["10024264","SHAVING SCALP NECK .5 OR LESS","11305",130]
["10011300","SHAVING SINGLE LESION TRUNK 0.5 CM OR LE","11300",120]
["10029075","SHORT ARM CAST","29075",140]
["10029405","SHORT LEG CAST","29405",150]
["10099206","SILVADENE CREAM 1%",null,41.81]
["10002408","SILVER NITRATE APPLICATOR",null,4.76]
["10012005","SIMPLE REPAIR SCALP/NECK/TRUNK","12005",205]
["10012007","SIMPLE REPAIR SUPERFICIAL OVER 30CM","12007",280]
["   99002","SMALL BALANCE ADJUSTMENT",null,0]
["10002930","SOLU MEDROL 125MG","J2930",35.53]
["10029240","STRAPPING SHOULDER","29240",71]
["10029540","STRAPPING/ANKLE","29540",70]
["10099308","SUBSEQ NURS FACILITY CARE(15 MIN/MORE)","99308",78]
["10099309","SUBSUQ  NURSING FACILITY CARE(30 MIN/MOR","99309",110]
["10199225","SUBSUQ NURSING FACILITY CARE 45 MIN/","99310",150]
["10002422","SUTURE REMOVAL","15850",0]
["10024250","SWB - SKILLED SUBSEQ (10 MIN/MORE)","99307",50]
["10099312","SWB INTERMEDIATE SUBSEQ (10 MIN/MORE)","99307",50]
["10011101","TANGENTIAL BIOPSY OF SKIN ADDITIONAL","11103",70]
["10011100","TANGENTIAL BIOPSY SKIN SINGLE LESION","11102",125]
["10028450","TARSAL BONE WITHOUT MANIPULATION","28450",360]
["10024276","TELEPHONE E&M 11-20 MINUTES","99442",80]
["10024279","TELEPHONE E&M 21-30 MINUTES","99443",115]
["10024275","TELEPHONE E&M 5-10 MINUTES","99441",60]
["10002431","TETANUS DIPTHERIA (TENIVAC) 0.5ML","90714",56.57]
["10096372","THER INJ ADMIN","96372",25]
["10032421","THORACENTESIS","32554",270]
["10199262","TRIGGER POINT INJ BOTOX MIGRAINE","64615",800]
["10012020","TX SUPERFICIAL DEHISCENCE  SIMPLE CLOSUR","12020",355]
["10002423","TX SUPERFICIAL WOUND DEHISCENCE W/PACKIN","12021",215]
["10081002","UA (CLINIC)","81002",6]
["10029580","UNNA BOOT APPLICATION","29580",80]
["10055250","VASECTOMY","55250",600]
["10024274","VIRTUAL CHECK IN","G2012",30]
["10002403","VITAMIN K PER MG","J3430",38.51]
["10199212","WEIGHT LOSS MANAGEMENT OFFICE VISIT",null,45]
["10002510","WYCILLIN 600000 UNITS","J2510",7]
["10002413","XOPENEX NEB 0.63MG",null,29.63]
["10000698","XYLO/EPI 1% 1:100000 PER ML",null,1.47]
["10099207","XYLOCAINE INJ 2%",null,1.2]
["10024228","ZOSTER(SHINGLES) VACCINE,LIVE SUBCUTANEO","90736",208.85]

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