hospital_name last_updated_on version hospital_location hospital_address license_number|CA "To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements Of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated." Northern Inyo Hospital 10/1/2024 2.2.0 Northern Inyo Hospital "150 Pioneer Lane, Bishop, CA 93514" 240000179 TRUE description code|1 code|1|type code|2 code|2|type code|3 code|3|type billing_class setting drug_unit_of_measurement drug_type_of_measurement modifiers standard_charge|gross standard_charge|discounted_cash payer_name plan_name standard_charge|negotiated_dollar standard_charge|negotiated_percentage standard_charge|negotiated_algorithm estimated_amount standard_charge|methodology standard_charge|min standard_charge|max additional_generic_notes "Naltrexone, depot form" 759 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 339.43 other 339.43 339.43 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 2 Type A ED Visits 5022 APC facility outpatient Blue Shield Anthem 89.4 491.9 percent of total billed charges 491.9 595.84 Level 2 Type A ED Visits 5022 APC facility outpatient United Healthcare All Commercial Plans 98 595.84 percent of total billed charges 491.9 595.84 Level 3 Type A ED Visits 5023 APC facility outpatient Blue Cross Anthem 99 886.73 percent of total billed charges 886.73 2092.64 Level 3 Type A ED Visits 5023 APC facility outpatient Blue Shield Anthem 89.4 1855.42 percent of total billed charges 886.73 2092.64 Level 3 Type A ED Visits 5023 APC facility outpatient Cigna All Commercial Plans 98.5 2092.64 percent of total billed charges 886.73 2092.64 Level 3 Type A ED Visits 5023 APC facility outpatient United Healthcare Advantage Medicare Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 1181.96 other 886.73 2092.64 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 4 Type A ED Visits 5024 APC facility outpatient Blue Cross Anthem 99 2591.04 percent of total billed charges 2591.04 5305.88 Level 4 Type A ED Visits 5024 APC facility outpatient Blue Shield Anthem 89.4 4073.08 percent of total billed charges 2591.04 5305.88 Level 4 Type A ED Visits 5024 APC facility outpatient Cigna All Commercial Plans 98.5 5305.88 percent of total billed charges 2591.04 5305.88 Level 4 Type A ED Visits 5024 APC facility outpatient Hometown Health Hmo/Ppo 99 3529.32 percent of total billed charges 2591.04 5305.88 Level 4 Type A ED Visits 5024 APC facility outpatient United Healthcare All Commercial Plans 98 2851.8 percent of total billed charges 2591.04 5305.88 Level 4 Type A ED Visits 5024 APC facility outpatient United Healthcare Advantage Medicare Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 3231.76 other 2591.04 5305.88 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 5 Type A ED Visits 5025 APC facility outpatient Blue Cross Anthem 99 1088.9 percent of total billed charges 300 7177.75 Level 5 Type A ED Visits 5025 APC facility outpatient Cigna All Commercial Plans 98.5 5118.9 percent of total billed charges 300 7177.75 Level 5 Type A ED Visits 5025 APC facility outpatient Health Net All Commercial Plans 99 300 percent of total billed charges 300 7177.75 Level 5 Type A ED Visits 5025 APC facility outpatient United Healthcare Advantage Medicare Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 7177.75 other 300 7177.75 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 1 Skin Procedures 5051 APC facility outpatient Blue Cross Anthem 99 858 percent of total billed charges 230.36 858 Level 1 Skin Procedures 5051 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 230.36 other 230.36 858 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 1 Skin Procedures 5051 APC facility outpatient Cigna All Commercial Plans 98.5 553.17 percent of total billed charges 230.36 858 Level 2 Skin Procedures 5052 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 253.1 other 253.1 253.1 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 1 Strapping and Cast Application 5101 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 241.59 other 241.59 241.59 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 2 Musculoskeletal Procedures 5112 APC facility outpatient United Healthcare Advantage Medicare Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 3794.62 other 3794.62 3794.62 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 1 Vascular Procedures 5181 APC facility outpatient United Healthcare Advantage Medicare Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 170.42 other 170.42 170.42 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 3 Vascular Procedures 5183 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 860.33 other 860.33 860.33 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 1 Lower GI Procedures 5311 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 23.66 other 23.66 23.66 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 1 Gynecologic Procedures 5411 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 111.78 other 111.78 2560.5 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 1 Gynecologic Procedures 5411 APC facility outpatient Hometown Health Hmo/Ppo 99 2560.5 percent of total billed charges 111.78 2560.5 Level 1 Nerve Injections 5441 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 158.78 other 158.78 158.78 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 2 Nerve Injections 5442 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 1005.99 other 1005.99 1005.99 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 1 Intraocular Procedures 5491 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 1012.47 other 1012.47 1012.47 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 1 Imaging without Contrast 5521 APC facility outpatient Bc Managed Care Medi-Cal Medicaid Managed Care Plan 84 18.14 percent of total billed charges 18.14 374.1 Level 1 Imaging without Contrast 5521 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 83.8 other 18.14 374.1 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 1 Imaging without Contrast 5521 APC facility outpatient Cigna All Commercial Plans 98.5 374.1 percent of total billed charges 18.14 374.1 Level 1 Imaging without Contrast 5521 APC facility outpatient United Healthcare Advantage Medicare Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 215.14 other 18.14 374.1 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 2 Imaging without Contrast 5522 APC facility outpatient Blue Cross Anthem 99 63.05 percent of total billed charges 63.05 1093.62 Level 2 Imaging without Contrast 5522 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 92.63 other 63.05 1093.62 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 2 Imaging without Contrast 5522 APC facility outpatient Cigna All Commercial Plans 98.5 483.02 percent of total billed charges 63.05 1093.62 Level 2 Imaging without Contrast 5522 APC facility outpatient United Healthcare Advantage Medicare Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 1093.62 other 63.05 1093.62 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 3 Imaging without Contrast 5523 APC facility outpatient Bc Managed Care Medi-Cal Medicaid Managed Care Plan 84 126.48 percent of total billed charges 126.48 11477.24 Level 3 Imaging without Contrast 5523 APC facility outpatient Blue Cross Anthem 99 3448.66 percent of total billed charges 126.48 11477.24 Level 3 Imaging without Contrast 5523 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 344.3 other 126.48 11477.24 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 3 Imaging without Contrast 5523 APC facility outpatient Cigna All Commercial Plans 98.5 2898.13 percent of total billed charges 126.48 11477.24 Level 3 Imaging without Contrast 5523 APC facility outpatient United Healthcare Advantage Medicare Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 11477.24 other 126.48 11477.24 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 4 Imaging without Contrast 5524 APC facility outpatient Blue Cross Anthem 99 2419 percent of total billed charges 299.7 2419 Level 4 Imaging without Contrast 5524 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 299.7 other 299.7 2419 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 4 Imaging without Contrast 5524 APC facility outpatient Geha All Commercial Plans 92 2370.62 percent of total billed charges 299.7 2419 Level 4 Imaging without Contrast 5524 APC facility outpatient United Healthcare Advantage Medicare Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 1350.9 other 299.7 2419 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 1 Imaging with Contrast 5571 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 208.61 other 208.61 208.61 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 2 Imaging with Contrast 5572 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 440.15 other 440.15 440.15 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 3 Imaging with Contrast 5573 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 312.36 other 312.36 312.36 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 1 Nuclear Medicine and Related Services 5591 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 9.44 other 9.44 1328.44 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 1 Nuclear Medicine and Related Services 5591 APC facility outpatient United Healthcare All Commercial Plans 98 1013.51 percent of total billed charges 9.44 1328.44 Level 1 Nuclear Medicine and Related Services 5591 APC facility outpatient United Healthcare Advantage Medicare Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 1328.44 other 9.44 1328.44 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 3 Nuclear Medicine and Related Services 5593 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 510.03 other 510.03 4726.45 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 3 Nuclear Medicine and Related Services 5593 APC facility outpatient United Healthcare Advantage Medicare Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 4726.45 other 510.03 4726.45 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 1 Pathology 5671 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 122.97 other 122.97 25310.3 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 1 Pathology 5671 APC facility outpatient Cigna All Commercial Plans 98.5 25310.3 percent of total billed charges 122.97 25310.3 Level 3 Pathology 5673 APC facility outpatient Blue Shield Anthem 89.4 20747.96 percent of total billed charges 371.26 20747.96 Level 3 Pathology 5673 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 371.26 other 371.26 20747.96 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 4 Pathology 5674 APC facility outpatient Blue Cross Anthem 99 15691.13 percent of total billed charges 15691.13 15691.13 Level 1 Drug Administration 5691 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 1180.35 other 1180.35 1180.35 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 2 Drug Administration 5692 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 98.49 other 98.49 98.49 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 3 Drug Administration 5693 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 358.52 other 358.52 358.52 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 2 Diagnostic Tests and Related Services 5722 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 134.59 other 134.59 1190.54 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 2 Diagnostic Tests and Related Services 5722 APC facility outpatient United Healthcare Advantage Medicare Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 1190.54 other 134.59 1190.54 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 1 Minor Procedures 5731 APC facility outpatient Blue Cross Anthem 99 5.38 percent of total billed charges 5.38 5.38 Level 2 Minor Procedures 5732 APC facility outpatient Bc Managed Care Medi-Cal Medicaid Managed Care Plan 84 136 percent of total billed charges 14.03 136 Level 2 Minor Procedures 5732 APC facility outpatient Blue Cross Anthem 99 14.03 percent of total billed charges 14.03 136 Level 2 Minor Procedures 5732 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 43.87 other 14.03 136 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 3 Minor Procedures 5733 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 116.75 other 116.75 145.32 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 3 Minor Procedures 5733 APC facility outpatient United Healthcare Advantage Medicare Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 145.32 other 116.75 145.32 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Level 4 Minor Procedures 5734 APC facility outpatient Bc Managed Care Medi-Cal Medicaid Managed Care Plan 84 202.78 percent of total billed charges 75.15 2206.98 Level 4 Minor Procedures 5734 APC facility outpatient Blue Cross Anthem 99 2206.98 percent of total billed charges 75.15 2206.98 Level 4 Minor Procedures 5734 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 75.15 other 75.15 2206.98 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." "Rabies vaccine, im" 9139 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 866.02 other 866.02 866.02 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Buprenorphine xr over 100 mg 9239 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 2262.8 other 2262.8 2262.8 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Clinical Diagnostic Lab Services N800 APC facility outpatient Aetna All Commercial Plans 85 212.12 percent of total billed charges 13.15 489.64 Clinical Diagnostic Lab Services N800 APC facility outpatient Blue Cross Anthem 99 13.15 percent of total billed charges 13.15 489.64 Clinical Diagnostic Lab Services N800 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 61.35 other 13.15 489.64 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Clinical Diagnostic Lab Services N800 APC facility outpatient Cigna All Commercial Plans 98.5 489.64 percent of total billed charges 13.15 489.64 Clinical Diagnostic Lab Services N800 APC facility outpatient Geha All Commercial Plans 92 20.62 percent of total billed charges 13.15 489.64 Clinical Diagnostic Lab Services N800 APC facility outpatient United Healthcare All Commercial Plans 98 486.08 percent of total billed charges 13.15 489.64 Clinical Diagnostic Lab Services N800 APC facility outpatient United Healthcare Advantage Medicare Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 180.52 other 13.15 489.64 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Therapy Services N801 APC facility outpatient Blue Shield Anthem 89.4 30 percent of total billed charges 30 121.4 Therapy Services N801 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 121.4 other 30 121.4 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Mammography Services N804 APC facility outpatient Blue Cross Anthem 99 501.93 percent of total billed charges 138.41 501.93 Mammography Services N804 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 138.41 other 138.41 501.93 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Mammography Services N804 APC facility outpatient United Healthcare All Commercial Plans 98 218.42 percent of total billed charges 138.41 501.93 Packaged Services N902 APC facility outpatient Chw Medicaid Managed Care Plan "Conditional payment logic at the claim level including numerous contracting methods, hierarchical applications, and service utilization requirements." 62 other 62 62 "Contracting method is an algorithm described in the 'standard_charges|algorithm' field. The estimated allowed amount provided accounts for the structural rates, conditions, and utilization elements inherent in the payer’s algorithm." Protein C-Functional LC #REF! CDM 305 RC facility both 9.49 9.49 Gross Charge Type: NIHD_Hosp_Profee_Price Protein C-Functional LC #REF! CDM 305 RC facility both 14.1 14.1 Gross Charge Type: NIHD_Hosp_Profee_Price 0141A IM ADMN SARSCOV2 BIVALENT 25 MCG/0.25 ML 1ST 0141A CDM 771 RC 0141A HCPCS facility both 96 96 Gross Charge Type: NIHD_RHC_Price 0141A IM ADMN SARSCOV2 BIVALENT 25 MCG/0.25 ML 1ST 0141A CDM 771 RC 0141A HCPCS facility both 101 101 Gross Charge Type: NIHD_Clinic_Price 0184T EXC RECTAL TUMOR/TRANSANAL ENDOSCOPIC 0184T CDM 982 RC 0184T HCPCS facility both 1685 1685 Gross Charge Type: NIHD_Hosp_Profee_Price 0184T EXC RECTAL TUMOR/TRANSANAL ENDOSCOPIC 0184T CDM 982 RC 0184T HCPCS facility both 1685 1685 Gross Charge Type: NIHD_Hosp_Profee_Price Xpress MVP (GeneXpert) 0352U CDM 306 RC 0352U HCPCS facility both 210 210 Gross Charge Type: NIHD_RHC_Price Xpress MVP (GeneXpert) 0352U CDM 306 RC 0352U HCPCS facility both 210 210 Gross Charge Type: NIHD_Clinic_Price Cepheid Multiplex Vaginal Panel (MVP) 0352U CDM 306 RC facility both 210 210 Gross Charge Type: NIHD_Hosp_Profee_Price Cepheid Multiplex Vaginal Panel (MVP) 0352U CDM 306 RC facility both 210 210 Gross Charge Type: NIHD_Hosp_Profee_Price "Vista Cervical Collar Set with Extra Replacement Pads, One Size Fits All" 1000072 CDM 272 RC facility both 116 116 Gross Charge Type: NIHD_Hosp_Profee_Price "Vista Cervical Collar Set with Extra Replacement Pads, One Size Fits All" 1000072 CDM 272 RC facility both 116 116 Gross Charge Type: NIHD_Hosp_Profee_Price US Biopsy Thyroid 100051 CDM 361 RC facility both TC 1068 1068 Gross Charge Type: NIHD_Hosp_Profee_Price US Biopsy Thyroid 100051 CDM 361 RC facility both TC 1068 1068 Gross Charge Type: NIHD_Hosp_Profee_Price US Biopsy Thyroid - Report 100052 CDM 975 RC 10005 HCPCS facility both 175 175 Gross Charge Type: NIHD_Hosp_Profee_Price US Biopsy Thyroid - Report 100052 CDM 975 RC 10005 HCPCS facility both 175 175 Gross Charge Type: NIHD_Hosp_Profee_Price NIHD US BIOPSY THYROID EACH ADDL LESION 10006 CDM 402 RC facility both TC 534 534 Gross Charge Type: NIHD_Hosp_Profee_Price NIHD US BIOPSY THYROID EACH ADDL LESION 10006 CDM 402 RC facility both TC 534 534 Gross Charge Type: NIHD_Hosp_Profee_Price 10007 FINE NDL ASPIRATION BX W/FLUOR GDN 1ST L CHARGE 10007 CDM 361 RC facility both 1225 1225 Gross Charge Type: NIHD_Hosp_Profee_Price 10007 FINE NDL ASPIRATION BX W/FLUOR GDN 1ST L CHARGE 10007 CDM 361 RC facility both 1225 1225 Gross Charge Type: NIHD_Hosp_Profee_Price 10008 FINE NDL ASPIRATION BX W/FLUOR GDN EA AD CHARGE 10008 CDM 361 RC facility both 613 613 Gross Charge Type: NIHD_Hosp_Profee_Price 10008 FINE NDL ASPIRATION BX W/FLUOR GDN EA AD CHARGE 10008 CDM 361 RC facility both 613 613 Gross Charge Type: NIHD_Hosp_Profee_Price "10021 Fine needle aspiration biopsy, w/o imaging guidance; 1st lesion" 10021 CDM 450 RC facility both 629 629 Gross Charge Type: NIHD_Hosp_Profee_Price "10021 Fine needle aspiration biopsy, w/o imaging guidance; 1st lesion" 10021 CDM 450 RC facility both 629 629 Gross Charge Type: NIHD_Hosp_Profee_Price 10021 Fine needle aspiration; without imaging guidance 100211 CDM 521 RC 10021 HCPCS facility both 356 356 Gross Charge Type: NIHD_RHC_Price 10021 Fine needle aspiration; without imaging guidance 100211 CDM 521 RC 10021 HCPCS facility both 398 398 Gross Charge Type: NIHD_Clinic_Price 10021 FINE NEEDLE ASPIRATION; WITHOUT IMAGING GUIDANCE ProFee 100212 CDM 982 RC 10021 HCPCS facility both 151 151 Gross Charge Type: NIHD_Hosp_Profee_Price 10021 FINE NEEDLE ASPIRATION; WITHOUT IMAGING GUIDANCE ProFee 100212 CDM 982 RC 10021 HCPCS facility both 151 151 Gross Charge Type: NIHD_Hosp_Profee_Price CT Drain Abscess or Cyst Soft Tissue 100301 CDM 761 RC facility both TC 2619 2619 Gross Charge Type: NIHD_Hosp_Profee_Price CT Drain Abscess or Cyst Soft Tissue 100301 CDM 761 RC facility both TC 2619 2619 Gross Charge Type: NIHD_Hosp_Profee_Price CT Drain Abscess or Cyst Soft Tissue - Report 100302 CDM 982 RC 10030 HCPCS facility both 26 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price CT Drain Abscess or Cyst Soft Tissue - Report 100302 CDM 982 RC 10030 HCPCS facility both 26 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price US Drain Abscess or Cyst Soft Tissue 100303 CDM 761 RC facility both TC 2619 2619 Gross Charge Type: NIHD_Hosp_Profee_Price US Drain Abscess or Cyst Soft Tissue 100303 CDM 761 RC facility both TC 2619 2619 Gross Charge Type: NIHD_Hosp_Profee_Price US Drain Abscess or Cyst Soft Tissue - Report 100304 CDM 982 RC 10030 HCPCS facility both 26 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price US Drain Abscess or Cyst Soft Tissue - Report 100304 CDM 982 RC 10030 HCPCS facility both 26 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price "10030 IMAGE-GUIDED FLUID COLLECTION DRAINAGE BY CATHETER (EG, ABSCESS, HEMATOMA, SEROMA, LYM ProFee" 100305 CDM 982 RC 10030 HCPCS facility both 26 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price "10030 IMAGE-GUIDED FLUID COLLECTION DRAINAGE BY CATHETER (EG, ABSCESS, HEMATOMA, SEROMA, LYM ProFee" 100305 CDM 982 RC 10030 HCPCS facility both 26 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price 10040 Acne Surgery 10040 CDM 521 RC 10040 HCPCS facility both 183 183 Gross Charge Type: NIHD_RHC_Price 10040 Acne Surgery 10040 CDM 521 RC 10040 HCPCS facility both 183 183 Gross Charge Type: NIHD_Clinic_Price physostigmine 1 mg/mL Inj Sol [INYO] 10046 CDM J3490 HCPCS 17478-0510-02 NDC facility both 2 ML 751.54 751.54 Gross Charge Type: Pharmacy 10060 Incision and drainage of abscess; simple or single 100601 CDM 521 RC 10060 HCPCS facility both 582 582 Gross Charge Type: NIHD_RHC_Price 10060 Incision and drainage of abscess; simple or single 100601 CDM 521 RC 10060 HCPCS facility both 250 250 Gross Charge Type: NIHD_Clinic_Price 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE TechFee 100602 CDM 450 RC facility both 649 649 Gross Charge Type: NIHD_Hosp_Profee_Price 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE TechFee 100602 CDM 450 RC facility both 649 649 Gross Charge Type: NIHD_Hosp_Profee_Price 10060 I&D ABSC; SMPL OR SINGLE CHARGE 100603 CDM 761 RC facility both 649 649 Gross Charge Type: NIHD_Hosp_Profee_Price 10060 I&D ABSC; SMPL OR SINGLE CHARGE 100603 CDM 761 RC facility both 649 649 Gross Charge Type: NIHD_Hosp_Profee_Price "10060 INCISION AND DRAINAGE OF ABSCESS (EG, CARBUNCLE, SUPPURATIVE HIDRADENITIS, CUTANEOUS O ProFee" 100604 CDM 982 RC 10060 HCPCS facility both 250 250 Gross Charge Type: NIHD_Hosp_Profee_Price "10060 INCISION AND DRAINAGE OF ABSCESS (EG, CARBUNCLE, SUPPURATIVE HIDRADENITIS, CUTANEOUS O ProFee" 100604 CDM 982 RC 10060 HCPCS facility both 250 250 Gross Charge Type: NIHD_Hosp_Profee_Price 10061 Incision and drainage of abscess; complicated or multiple 100611 CDM 521 RC 10061 HCPCS facility both 832 832 Gross Charge Type: NIHD_RHC_Price 10061 Incision and drainage of abscess; complicated or multiple 100611 CDM 521 RC 10061 HCPCS facility both 832 832 Gross Charge Type: NIHD_Clinic_Price 10061 INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE TechFee 100612 CDM 450 RC facility both 950 950 Gross Charge Type: NIHD_Hosp_Profee_Price 10061 INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE TechFee 100612 CDM 450 RC facility both 950 950 Gross Charge Type: NIHD_Hosp_Profee_Price 10061 I&D ABSC; COMPL/MULTI CHARGE 100613 CDM 761 RC facility both 950 950 Gross Charge Type: NIHD_Hosp_Profee_Price 10061 I&D ABSC; COMPL/MULTI CHARGE 100613 CDM 761 RC facility both 950 950 Gross Charge Type: NIHD_Hosp_Profee_Price "10061 INCISION AND DRAINAGE OF ABSCESS (EG, CARBUNCLE, SUPPURATIVE HIDRADENITIS, CUTANEOUS O ProFee" 100614 CDM 982 RC 10061 HCPCS facility both 438 438 Gross Charge Type: NIHD_Hosp_Profee_Price "10061 INCISION AND DRAINAGE OF ABSCESS (EG, CARBUNCLE, SUPPURATIVE HIDRADENITIS, CUTANEOUS O ProFee" 100614 CDM 982 RC 10061 HCPCS facility both 438 438 Gross Charge Type: NIHD_Hosp_Profee_Price 10080 INCISION & DRAINAGE PILONIDAL CYST SIMPLE TechFee 100801 CDM 450 RC facility both 663 663 Gross Charge Type: NIHD_Hosp_Profee_Price 10080 INCISION & DRAINAGE PILONIDAL CYST SIMPLE TechFee 100801 CDM 450 RC facility both 663 663 Gross Charge Type: NIHD_Hosp_Profee_Price 10080 I+D PILONIDAL CYST SIMPLE CHARGE 100802 CDM 761 RC facility both 663 663 Gross Charge Type: NIHD_Hosp_Profee_Price 10080 I+D PILONIDAL CYST SIMPLE CHARGE 100802 CDM 761 RC facility both 663 663 Gross Charge Type: NIHD_Hosp_Profee_Price 10080 INCISION AND DRAINAGE OF PILONIDAL CYST; SIMPLE ProFee 100803 CDM 982 RC 10080 HCPCS facility both 563 563 Gross Charge Type: NIHD_Hosp_Profee_Price 10080 INCISION AND DRAINAGE OF PILONIDAL CYST; SIMPLE ProFee 100803 CDM 982 RC 10080 HCPCS facility both 563 563 Gross Charge Type: NIHD_Hosp_Profee_Price 10080 Incision and drainage of pilonidal cyst; simple 100804 CDM 521 RC 10080 HCPCS facility both 411 411 Gross Charge Type: NIHD_RHC_Price 10080 Incision and drainage of pilonidal cyst; simple 100804 CDM 521 RC 10080 HCPCS facility both 411 411 Gross Charge Type: NIHD_Clinic_Price 10081-I&D Pilonidal Cyst Complicated 10081 CDM 450 RC facility both 1603 1603 Gross Charge Type: NIHD_Hosp_Profee_Price 10081-I&D Pilonidal Cyst Complicated 10081 CDM 450 RC facility both 1603 1603 Gross Charge Type: NIHD_Hosp_Profee_Price 10081 INCISION & DRAINAGE PILONIDAL CYST COMPLICATED TechFee 100811 CDM 450 RC facility both 1603 1603 Gross Charge Type: NIHD_Hosp_Profee_Price 10081 INCISION & DRAINAGE PILONIDAL CYST COMPLICATED TechFee 100811 CDM 450 RC facility both 1603 1603 Gross Charge Type: NIHD_Hosp_Profee_Price 10081 I+D PILONIDAL CYST COMPLICATED CHARGE 100812 CDM 761 RC facility both 1603 1603 Gross Charge Type: NIHD_Hosp_Profee_Price 10081 I+D PILONIDAL CYST COMPLICATED CHARGE 100812 CDM 761 RC facility both 1603 1603 Gross Charge Type: NIHD_Hosp_Profee_Price 10081 Incision and drainage of pilonidal cyst; complicated 100813 CDM 521 RC 10081 HCPCS facility both 552 552 Gross Charge Type: NIHD_RHC_Price 10081 Incision and drainage of pilonidal cyst; complicated 100813 CDM 521 RC 10081 HCPCS facility both 552 552 Gross Charge Type: NIHD_Clinic_Price "HCV RNA Diagnosis, NAA LC" 10085465 CDM 300 RC facility both 50 50 Gross Charge Type: NIHD_Hosp_Profee_Price "HCV RNA Diagnosis, NAA LC" 10085465 CDM 300 RC facility both 50 50 Gross Charge Type: NIHD_Hosp_Profee_Price BARD SOFT MESH 6 X 6 (15CM X 15 CM) RECTANGLE 10112720 CDM 272 RC facility both 660 660 Gross Charge Type: NIHD_Hosp_Profee_Price BARD SOFT MESH 6 X 6 (15CM X 15 CM) RECTANGLE 10112720 CDM 272 RC facility both 660 660 Gross Charge Type: NIHD_Hosp_Profee_Price 3D MAX MID ANATOMICAL MESH RIGHT LARGE 10116311 CDM 278 RC facility both 1187 1187 Gross Charge Type: NIHD_Hosp_Profee_Price 3D MAX MID ANATOMICAL MESH RIGHT LARGE 10116311 CDM 278 RC facility both 1187 1187 Gross Charge Type: NIHD_Hosp_Profee_Price 3D MAX MID ANATOMICAL MESH LG LEFT 10116312 CDM 278 RC facility both 1187 1187 Gross Charge Type: NIHD_Hosp_Profee_Price 3D MAX MID ANATOMICAL MESH LG LEFT 10116312 CDM 278 RC facility both 1187 1187 Gross Charge Type: NIHD_Hosp_Profee_Price 3D MAX MID ANATOMICAL MESH XTRA LARGE LT 10116313 CDM 278 RC facility both 1313 1313 Gross Charge Type: NIHD_Hosp_Profee_Price 3D MAX MID ANATOMICAL MESH XTRA LARGE LT 10116313 CDM 278 RC facility both 1313 1313 Gross Charge Type: NIHD_Hosp_Profee_Price 3D MAX MID ANATOMICAL MESH XTRA LARGE RT 10116322 CDM 278 RC facility both 1313 1313 Gross Charge Type: NIHD_Hosp_Profee_Price 3D MAX MID ANATOMICAL MESH XTRA LARGE RT 10116322 CDM 278 RC facility both 1313 1313 Gross Charge Type: NIHD_Hosp_Profee_Price Celiac Disease HLA DQ Assoc. LC 10116324 CDM 301 RC facility both 112.4 112.4 Gross Charge Type: NIHD_Hosp_Profee_Price Celiac Disease HLA DQ Assoc. LC 10116324 CDM 301 RC facility both 112.4 112.4 Gross Charge Type: NIHD_Hosp_Profee_Price Celiac Disease Ab Screen w/Rfx LC 10116341 CDM 301 RC facility both 4.32 4.32 Gross Charge Type: NIHD_Hosp_Profee_Price Celiac Disease Ab Screen w/Rfx LC 10116341 CDM 301 RC facility both 4.32 4.32 Gross Charge Type: NIHD_Hosp_Profee_Price "Ethyl Glucuronide, Ur LC" 10116354 CDM 301 RC facility both 21 21 Gross Charge Type: NIHD_Hosp_Profee_Price "Ethyl Glucuronide, Ur LC" 10116354 CDM 301 RC facility both 21 21 Gross Charge Type: NIHD_Hosp_Profee_Price "10120 Incision and removal of foreign body, subcutaneous tissues; simple" 101201 CDM 521 RC 10120 HCPCS facility both 501 501 Gross Charge Type: NIHD_RHC_Price "10120 Incision and removal of foreign body, subcutaneous tissues; simple" 101201 CDM 521 RC 10120 HCPCS facility both 501 501 Gross Charge Type: NIHD_Clinic_Price 10120 INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE TechFee 101202 CDM 450 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price 10120 INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE TechFee 101202 CDM 450 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price "10120 INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES; SIMPLE ProFee" 101203 CDM 982 RC 10120 HCPCS facility both 326 326 Gross Charge Type: NIHD_Hosp_Profee_Price "10120 INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES; SIMPLE ProFee" 101203 CDM 982 RC 10120 HCPCS facility both 326 326 Gross Charge Type: NIHD_Hosp_Profee_Price 10121 INCISION & REMOVAL FOREIGN BODY SUBQ TISS COMPL TechFee 101211 CDM 450 RC facility both 2832 2832 Gross Charge Type: NIHD_Hosp_Profee_Price 10121 INCISION & REMOVAL FOREIGN BODY SUBQ TISS COMPL TechFee 101211 CDM 450 RC facility both 2832 2832 Gross Charge Type: NIHD_Hosp_Profee_Price "10121 INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES; COMPLICATED ProFee" 101212 CDM 982 RC 10121 HCPCS facility both 326 326 Gross Charge Type: NIHD_Hosp_Profee_Price "10121 INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES; COMPLICATED ProFee" 101212 CDM 982 RC 10121 HCPCS facility both 326 326 Gross Charge Type: NIHD_Hosp_Profee_Price "10140 Incision and drainage of hematoma, seroma or fluid collection" 101401 CDM 521 RC 10140 HCPCS facility both 832 832 Gross Charge Type: NIHD_RHC_Price "10140 Incision and drainage of hematoma, seroma or fluid collection" 101401 CDM 521 RC 10140 HCPCS facility both 832 832 Gross Charge Type: NIHD_Clinic_Price 10140 I&D HEMATOMA SEROMA/FLUID COLLECTION TechFee 101402 CDM 450 RC facility both 2620 2620 Gross Charge Type: NIHD_Hosp_Profee_Price 10140 I&D HEMATOMA SEROMA/FLUID COLLECTION TechFee 101402 CDM 450 RC facility both 2620 2620 Gross Charge Type: NIHD_Hosp_Profee_Price I&D Hematoma Charge 101403 CDM 761 RC facility both 2620 2620 Gross Charge Type: NIHD_Hosp_Profee_Price I&D Hematoma Charge 101403 CDM 761 RC facility both 2620 2620 Gross Charge Type: NIHD_Hosp_Profee_Price "10140 INCISION AND DRAINAGE OF HEMATOMA, SEROMA OR FLUID COLLECTION ProFee" 101404 CDM 982 RC 10140 HCPCS facility both 237 237 Gross Charge Type: NIHD_Hosp_Profee_Price "10140 INCISION AND DRAINAGE OF HEMATOMA, SEROMA OR FLUID COLLECTION ProFee" 101404 CDM 982 RC 10140 HCPCS facility both 237 237 Gross Charge Type: NIHD_Hosp_Profee_Price "10160 Puncture aspiration of abscess, hematoma, bulla, or cyst" 101601 CDM 521 RC 10160 HCPCS facility both 234 234 Gross Charge Type: NIHD_RHC_Price "10160 Puncture aspiration of abscess, hematoma, bulla, or cyst" 101601 CDM 521 RC 10160 HCPCS facility both 234 234 Gross Charge Type: NIHD_Clinic_Price 10160 PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST TechFee 101602 CDM 450 RC facility both 201 201 Gross Charge Type: NIHD_Hosp_Profee_Price 10160 PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST TechFee 101602 CDM 450 RC facility both 201 201 Gross Charge Type: NIHD_Hosp_Profee_Price "10160 PUNCTURE ASPIRATION OF ABSCESS, HEMATOMA, BULLA, OR CYST ProFee" 101603 CDM 982 RC 10160 HCPCS facility both 195 195 Gross Charge Type: NIHD_Hosp_Profee_Price "10160 PUNCTURE ASPIRATION OF ABSCESS, HEMATOMA, BULLA, OR CYST ProFee" 101603 CDM 982 RC 10160 HCPCS facility both 195 195 Gross Charge Type: NIHD_Hosp_Profee_Price CT Aspiration Abscess/Hematoma/Cyst 101604 CDM 761 RC facility both TC 619 619 Gross Charge Type: NIHD_Hosp_Profee_Price CT Aspiration Abscess/Hematoma/Cyst 101604 CDM 761 RC facility both TC 619 619 Gross Charge Type: NIHD_Hosp_Profee_Price CT Aspiration Abscess/Hematoma/Cyst - Report 101605 CDM 972 RC 10160 HCPCS facility both 26 168 168 Gross Charge Type: NIHD_Hosp_Profee_Price CT Aspiration Abscess/Hematoma/Cyst - Report 101605 CDM 972 RC 10160 HCPCS facility both 26 168 168 Gross Charge Type: NIHD_Hosp_Profee_Price "10180 Incision and drainage, complex, postoperative wound infection" 101801 CDM 521 RC 10180 HCPCS facility both 775 775 Gross Charge Type: NIHD_RHC_Price "10180 Incision and drainage, complex, postoperative wound infection" 101801 CDM 521 RC 10180 HCPCS facility both 775 775 Gross Charge Type: NIHD_Clinic_Price "10180 INCISION AND DRAINAGE, COMPLEX, POSTOPERATIVE WOUND INFECTION ProFee" 101802 CDM 982 RC 10180 HCPCS facility both 512 512 Gross Charge Type: NIHD_Hosp_Profee_Price "10180 INCISION AND DRAINAGE, COMPLEX, POSTOPERATIVE WOUND INFECTION ProFee" 101802 CDM 982 RC 10180 HCPCS facility both 512 512 Gross Charge Type: NIHD_Hosp_Profee_Price "Viral Hepatitis Screening and Diagnosis (HBV, HCV) LC 144025" 10180711 CDM 301 RC facility both 18.24 18.24 Gross Charge Type: NIHD_Hosp_Profee_Price "Viral Hepatitis Screening and Diagnosis (HBV, HCV) LC 144025" 10180711 CDM 301 RC facility both 18.24 18.24 Gross Charge Type: NIHD_Hosp_Profee_Price Hearing Screen POC 1019764 CDM 521 RC 92551 HCPCS facility both 73 73 Gross Charge Type: NIHD_Clinic_Price "HAV, HBV Immunity LC" 10199499 CDM 301 RC facility both 2.82 2.82 Gross Charge Type: NIHD_Hosp_Profee_Price "HAV, HBV Immunity LC" 10199499 CDM 301 RC facility both 2.82 2.82 Gross Charge Type: NIHD_Hosp_Profee_Price HEYMAN DISPOSABLE DILATORS 10 THRU 24 FR STRAIGHT TIP 1021100 CDM 272 RC facility both 204 204 Gross Charge Type: NIHD_Hosp_Profee_Price HEYMAN DISPOSABLE DILATORS 10 THRU 24 FR STRAIGHT TIP 1021100 CDM 272 RC facility both 204 204 Gross Charge Type: NIHD_Hosp_Profee_Price sodium polystyrene sulfonate 15 g/60 mL Sus UD [INYO] 10215 CDM 46287-0006-60 NDC facility both 60 ML 109.63 109.63 Gross Charge Type: Pharmacy sodium polystyrene sulfonate 15 g/60 mL Sus UD [INYO] 10215 CDM 00574-2003-02 NDC facility both 60 ML 56.25 56.25 Gross Charge Type: Pharmacy 86037 Antineutrophil Cytoplasmic Antibody (ANCA) Profile LC 10230921 CDM 301 RC 86037 HCPCS facility both 6.73 6.73 Gross Charge Type: NIHD_Hosp_Profee_Price 86037 Antineutrophil Cytoplasmic Antibody (ANCA) Profile LC 10230921 CDM 301 RC 86037 HCPCS facility both 6.73 6.73 Gross Charge Type: NIHD_Hosp_Profee_Price Phosphatidylethanol (PEth) LC 10253576 CDM 301 RC facility both 100 100 Gross Charge Type: NIHD_Hosp_Profee_Price Phosphatidylethanol (PEth) LC 10253576 CDM 301 RC facility both 100 100 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER HEMATURIA 3 WAY 22FR 1025522 CDM 272 RC facility both 40 40 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER HEMATURIA 3 WAY 22FR 1025522 CDM 272 RC facility both 40 40 Gross Charge Type: NIHD_Hosp_Profee_Price 80307 Amphetamines 10257397 CDM 300 RC 80307 HCPCS facility both 24 24 Gross Charge Type: NIHD_Hosp_Profee_Price 80307 Amphetamines 10257397 CDM 300 RC 80307 HCPCS facility both 24 24 Gross Charge Type: NIHD_Hosp_Profee_Price 80307 Barbiturates 10257398 CDM 300 RC 80307 HCPCS facility both 24 24 Gross Charge Type: NIHD_Hosp_Profee_Price 80307 Barbiturates 10257398 CDM 300 RC 80307 HCPCS facility both 24 24 Gross Charge Type: NIHD_Hosp_Profee_Price 80307 Cannabinoids 10257399 CDM 300 RC 80307 HCPCS facility both 24 24 Gross Charge Type: NIHD_Hosp_Profee_Price 80307 Cannabinoids 10257399 CDM 300 RC 80307 HCPCS facility both 24 24 Gross Charge Type: NIHD_Hosp_Profee_Price 80307 Cocaines 10257400 CDM 300 RC 80307 HCPCS facility both 24 24 Gross Charge Type: NIHD_Hosp_Profee_Price 80307 Cocaines 10257400 CDM 300 RC 80307 HCPCS facility both 24 24 Gross Charge Type: NIHD_Hosp_Profee_Price 80307 Opiates 10257401 CDM 300 RC 80307 HCPCS facility both 24 24 Gross Charge Type: NIHD_Hosp_Profee_Price 80307 Opiates 10257401 CDM 300 RC 80307 HCPCS facility both 24 24 Gross Charge Type: NIHD_Hosp_Profee_Price 80307 Benzodiazepines 10258728 CDM 300 RC 80307 HCPCS facility both 24 24 Gross Charge Type: NIHD_Hosp_Profee_Price 80307 Benzodiazepines 10258728 CDM 300 RC 80307 HCPCS facility both 24 24 Gross Charge Type: NIHD_Hosp_Profee_Price 80307 Methadones 10258729 CDM 300 RC 80307 HCPCS facility both 24 24 Gross Charge Type: NIHD_Hosp_Profee_Price 80307 Methadones 10258729 CDM 300 RC 80307 HCPCS facility both 24 24 Gross Charge Type: NIHD_Hosp_Profee_Price 80307 PCP 10258730 CDM 300 RC 80307 HCPCS facility both 24 24 Gross Charge Type: NIHD_Hosp_Profee_Price 80307 PCP 10258730 CDM 300 RC 80307 HCPCS facility both 24 24 Gross Charge Type: NIHD_Hosp_Profee_Price 80307 Propoxyphene 10258731 CDM 300 RC 80307 HCPCS facility both 21 21 Gross Charge Type: NIHD_Hosp_Profee_Price 80307 Propoxyphene 10258731 CDM 300 RC 80307 HCPCS facility both 21 21 Gross Charge Type: NIHD_Hosp_Profee_Price NIFEdipine 30 mg ER Tab [INYO] 10268 CDM 68084-0597-01 NDC facility both 1 EA 10.73 10.73 Gross Charge Type: Pharmacy | NDC EA = 1 TAB NIFEdipine 30 mg ER Tab [INYO] 10268 CDM 50268-0597-15 NDC facility both 1 EA 7.87 7.87 Gross Charge Type: Pharmacy | NDC EA = 1 TAB niMODipine 30 mg Cap [INYO] 10271 CDM 68084-0912-32 NDC facility both 1 EA 93.53 93.53 Gross Charge Type: Pharmacy | NDC EA = 1 CAP niMODipine 30 mg Cap 10271 CDM 69452-0209-13 NDC facility both 1 EA 96.17 96.17 Gross Charge Type: Pharmacy | NDC EA = 1 CAP niMODipine 30 mg Cap [INYO] 10271 CDM 23155-0108-30 NDC facility both 1 EA 96.17 96.17 Gross Charge Type: Pharmacy | NDC EA = 1 CAP "Antigliadin Abs, IgG LC" 10312875 CDM 301 RC facility both 3.67 3.67 Gross Charge Type: NIHD_Hosp_Profee_Price "Antigliadin Abs, IgG LC" 10312875 CDM 301 RC facility both 3.67 3.67 Gross Charge Type: NIHD_Hosp_Profee_Price procainamide 500 mg/mL Inj Sol [INYO] 10342 CDM J2690 HCPCS 14789-0900-02 NDC facility both 2 ML 1520 1520 Gross Charge Type: Pharmacy procainamide 500 mg/mL Inj Sol [INYO] 10342 CDM J2690 HCPCS 00409-1903-41 NDC facility both 2 ML 1520 1520 Gross Charge Type: Pharmacy T001-IgE Maple/Box Elder LC 10359780 CDM 300 RC facility both 3.26 3.26 Gross Charge Type: NIHD_Hosp_Profee_Price T001-IgE Maple/Box Elder LC 10359780 CDM 300 RC facility both 3.26 3.26 Gross Charge Type: NIHD_Hosp_Profee_Price T070-IgE White Mulberry LC 10359794 CDM 300 RC facility both 3.26 3.26 Gross Charge Type: NIHD_Hosp_Profee_Price T070-IgE White Mulberry LC 10359794 CDM 300 RC facility both 3.26 3.26 Gross Charge Type: NIHD_Hosp_Profee_Price sodium bicarbonate 4.2% IV Sol 10 mL [INYO] 10382 CDM 00409-5534-14 NDC facility both 10 ML 235 235 Gross Charge Type: Pharmacy sodium bicarbonate 4.2% IV Sol 10 mL [INYO] 10382 CDM 00409-5534-34 NDC facility both 10 ML 235 235 Gross Charge Type: Pharmacy ARTIFICIAL TEARS 1.4% DROPS [INYO] 10403 CDM 00536-1084-94 NDC facility both 1 EA 36 36 Gross Charge Type: Pharmacy | NDC EA = 15 DROPS ARTIFICIAL TEARS 1.4% DROPS [INYO] 10403 CDM 17478-0060-12 NDC facility both 1 EA 38.46 38.46 Gross Charge Type: Pharmacy | NDC EA = 15 DROPS 83516-Antineutrophil Cytoplasmic Antibody (ANCA) Profile LC 10446871 CDM 301 RC 83516 HCPCS facility both 33.63 33.63 Gross Charge Type: NIHD_Hosp_Profee_Price 83516-Antineutrophil Cytoplasmic Antibody (ANCA) Profile LC 10446871 CDM 301 RC 83516 HCPCS facility both 33.63 33.63 Gross Charge Type: NIHD_Hosp_Profee_Price "84166 - IFE+Protein Electro, 24-Hr Ur LC" 10448874 CDM 301 RC 84166 HCPCS facility both 8.06 8.06 Gross Charge Type: NIHD_Hosp_Profee_Price "84166 - IFE+Protein Electro, 24-Hr Ur LC" 10448874 CDM 301 RC 84166 HCPCS facility both 8.06 8.06 Gross Charge Type: NIHD_Hosp_Profee_Price "86335 - IFE, Protein Electro, 24-Hr Ur LC 003467" 10448875 CDM 301 RC 86335 HCPCS facility both 8.06 8.06 Gross Charge Type: NIHD_Hosp_Profee_Price "86335 - IFE, Protein Electro, 24-Hr Ur LC 003467" 10448875 CDM 301 RC 86335 HCPCS facility both 8.06 8.06 Gross Charge Type: NIHD_Hosp_Profee_Price "Coccidioides Abs, IgG/IgM, EIA LC" 10453378 CDM 301 RC facility both 9.89 9.89 Gross Charge Type: NIHD_Hosp_Profee_Price "Coccidioides Abs, IgG/IgM, EIA LC" 10453378 CDM 301 RC facility both 9.89 9.89 Gross Charge Type: NIHD_Hosp_Profee_Price T-Helper (CD4 Lymph) LC 10453383 CDM 301 RC facility both 18.73 18.73 Gross Charge Type: NIHD_Hosp_Profee_Price T-Helper (CD4 Lymph) LC 10453383 CDM 301 RC facility both 18.73 18.73 Gross Charge Type: NIHD_Hosp_Profee_Price Hemoglobpathy+Fer w/A Thal Rfx LC 10453390 CDM 301 RC facility both 4.54 4.54 Gross Charge Type: NIHD_Hosp_Profee_Price Hemoglobpathy+Fer w/A Thal Rfx LC 10453390 CDM 301 RC facility both 4.54 4.54 Gross Charge Type: NIHD_Hosp_Profee_Price "Zinc, RBC LC" 10453396 CDM 301 RC facility both 25 25 Gross Charge Type: NIHD_Hosp_Profee_Price "Zinc, RBC LC" 10453396 CDM 301 RC facility both 25 25 Gross Charge Type: NIHD_Hosp_Profee_Price "Respiratory Pathogen Panel, LC 139845" 10465237 CDM 301 RC facility both 61.25 61.25 Gross Charge Type: NIHD_Hosp_Profee_Price "Respiratory Pathogen Panel, LC 139845" 10465237 CDM 301 RC facility both 61.25 61.25 Gross Charge Type: NIHD_Hosp_Profee_Price 87581 10465268 CDM 301 RC 87581 HCPCS facility both 64 64 Gross Charge Type: NIHD_Hosp_Profee_Price 87581 10465268 CDM 301 RC 87581 HCPCS facility both 64 64 Gross Charge Type: NIHD_Hosp_Profee_Price 87633 10465269 CDM 301 RC 87633 HCPCS facility both 64 64 Gross Charge Type: NIHD_Hosp_Profee_Price 87633 10465269 CDM 301 RC 87633 HCPCS facility both 64 64 Gross Charge Type: NIHD_Hosp_Profee_Price 87798 10465270 CDM 301 RC 87798 HCPCS facility both 64 64 Gross Charge Type: NIHD_Hosp_Profee_Price 87798 10465270 CDM 301 RC 87798 HCPCS facility both 64 64 Gross Charge Type: NIHD_Hosp_Profee_Price Thrombin Time 015230 LC 10481995 CDM 301 RC facility both 8 8 Gross Charge Type: NIHD_Hosp_Profee_Price Thrombin Time 015230 LC 10481995 CDM 301 RC facility both 8 8 Gross Charge Type: NIHD_Hosp_Profee_Price Prostatic Acid Phosphatase (PAP) 004747 LC 10481996 CDM 301 RC facility both 5.7 5.7 Gross Charge Type: NIHD_Hosp_Profee_Price Prostatic Acid Phosphatase (PAP) 004747 LC 10481996 CDM 301 RC facility both 5.7 5.7 Gross Charge Type: NIHD_Hosp_Profee_Price Reptilase Time 117180 LC 10483875 CDM 301 RC facility both 58.24 58.24 Gross Charge Type: NIHD_Hosp_Profee_Price Reptilase Time 117180 LC 10483875 CDM 301 RC facility both 58.24 58.24 Gross Charge Type: NIHD_Hosp_Profee_Price calcium chloride 1000 mg/10mL Inj Sol [INYO] 10535 CDM 00409-1631-10 NDC facility both 10 ML 235 235 Gross Charge Type: Pharmacy calcium chloride 1000 mg/10mL Inj Sol [INYO] 10535 CDM 00409-4928-34 NDC facility both 10 ML 235 235 Gross Charge Type: Pharmacy calcium chloride 1000 mg/10mL Inj Sol [INYO] 10535 CDM 76329-3304-01 NDC facility both 10 ML 235 235 Gross Charge Type: Pharmacy Dextrose 50% IV Sol 50 mL [INYO] 10536 CDM 76329-3302-01 NDC facility both 50 ML 235 235 Gross Charge Type: Pharmacy Dextrose 50% IV Sol 50 mL [INYO] 10536 CDM 00409-7517-16 NDC facility both 50 ML 235 235 Gross Charge Type: Pharmacy Dextrose 50% IV Sol 50 mL [INYO] 10536 CDM 76329-3301-01 NDC facility both 50 ML 235 235 Gross Charge Type: Pharmacy EPINEPHrine 0.1 mg/mL Inj 10 mL Sol [INYO] 10538 CDM J0171 HCPCS 76329-3318-01 NDC facility both 10 ML 235 235 Gross Charge Type: Pharmacy EPINEPHrine 0.1 mg/mL Inj 10 mL Sol [INYO] 10538 CDM J0171 HCPCS 00409-4921-34 NDC facility both 10 ML 235 235 Gross Charge Type: Pharmacy EPINEPHrine 0.1 mg/mL Sol [inyo] 10538 CDM J0171 HCPCS 00409-4933-01 NDC facility both 10 ML 235 235 Gross Charge Type: Pharmacy EPINEPHrine 0.1 mg/mL Inj 10 mL Sol [INYO] 10538 CDM J0171 HCPCS 76329-3316-01 NDC facility both 10 ML 235 235 Gross Charge Type: Pharmacy carbidopa-levodopa 50 mg-200 mg ER Tab [INYO] 10549 CDM 68084-0282-01 NDC facility both 1 EA 9.49 9.49 Gross Charge Type: Pharmacy | NDC EA = 1 TAB carbidopa-levodopa 50 mg-200 mg ER Tab [INYO] 10549 CDM 51079-0923-20 NDC facility both 1 EA 10.45 10.45 Gross Charge Type: Pharmacy | NDC EA = 1 TAB carbidopa-levodopa 50 mg-200 mg ER Tab [INYO] 10549 CDM 62756-0457-88 NDC facility both 1 EA 10.83 10.83 Gross Charge Type: Pharmacy | NDC EA = 1 TAB potassium chloride 10 mEq ER Tab [INYO] 10555 CDM 00904-7292-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB potassium chloride 10 mEq ER Tab [INYO] 10555 CDM 00904-7085-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB potassium chloride 10 mEq ER Tab [INYO] 10555 CDM 00245-5317-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB "TRANSTRACHEAL CATHETER, CHILD, 14 G," 1060221 CDM 272 RC facility both 293 293 Gross Charge Type: NIHD_Hosp_Profee_Price "TRANSTRACHEAL CATHETER, CHILD, 14 G," 1060221 CDM 272 RC facility both 293 293 Gross Charge Type: NIHD_Hosp_Profee_Price albuterol 0.5% Inh Sol [INYO] 10604 CDM J7611 HCPCS 50383-0741-20 NDC facility both 20 ML 260 260 Gross Charge Type: Pharmacy Polar Care Kodiak with Intelli-Flo Shoulder Pad Regular 1060600 CDM 272 RC facility both 270 270 Gross Charge Type: NIHD_Hosp_Profee_Price Polar Care Kodiak with Intelli-Flo Shoulder Pad Regular 1060600 CDM 272 RC facility both 270 270 Gross Charge Type: NIHD_Hosp_Profee_Price Ice Therapy 1060700 CDM 272 RC facility both 280 280 Gross Charge Type: NIHD_Hosp_Profee_Price Polar Care Kodiak with Intelli-Flo XL Shoulder 1060700_1 CDM 272 RC facility both 267 267 Gross Charge Type: NIHD_Hosp_Profee_Price Ice Therapy 1060700_2 CDM 272 RC facility both 280 280 Gross Charge Type: NIHD_Hosp_Profee_Price albuterol 0.083% Inh Sol 3 mL [INYO] 10610 CDM J7613 HCPCS 76204-0200-01 NDC facility both 3 ML 8.39 8.39 Gross Charge Type: Pharmacy albuterol 2.5 mg/3 mL (0.083%) Sol 10610 CDM J7613 HCPCS 76204-0200-30 NDC facility both 3 ML 7.99 7.99 Gross Charge Type: Pharmacy albuterol 0.083% Inh Sol 3 mL [INYO] 10610 CDM J7613 HCPCS 00487-9501-01 NDC facility both 3 ML 6 6 Gross Charge Type: Pharmacy silver sulfADIAZINE Top 1% Crm [INYO] 10611 CDM 67877-0124-05 NDC facility both 1 EA 75.6 75.6 Gross Charge Type: Pharmacy | NDC EA = 50 APP silver sulfADIAZINE topical 1% Cre 10611 CDM 67877-0124-50 NDC facility both 1 EA 75.6 75.6 Gross Charge Type: Pharmacy | NDC EA = 50 APP silver sulfADIAZINE topical 1% Cre 10611 CDM 61570-0131-55 NDC facility both 1 EA 74.1 74.1 Gross Charge Type: Pharmacy | NDC EA = 50 APP silver sulfADIAZINE Top 1% Crm [INYO] 10611 CDM 61570-0131-50 NDC facility both 1 EA 82.7 82.7 Gross Charge Type: Pharmacy | NDC EA = 50 APP isradipine 2.5 mg Cap [INYO] 10621 CDM 16252-0539-01 NDC facility both 1 EA 8.19 8.19 Gross Charge Type: Pharmacy | NDC EA = 1 CAP sodium chloride 0.9% 3mL Inhalation Sol UD [INYO] 10625 CDM 76204-0300-03 NDC facility both 3 ML 36 36 Gross Charge Type: Pharmacy methylPREDNISolone 16 mg Tab [INYO] 10636 CDM J7509 HCPCS 59746-0003-14 NDC facility both 1 EA 18.63 18.63 Gross Charge Type: Pharmacy | NDC EA = 1 TAB tobramycin 40 mg/mL Inj Sol [INYO] 10666 CDM J3260 HCPCS 67457-0473-22 NDC facility both 2 ML 235 235 Gross Charge Type: Pharmacy tobramycin 40 mg/mL Inj Sol [INYO] 10666 CDM J3260 HCPCS 63323-0306-02 NDC facility both 2 ML 235 235 Gross Charge Type: Pharmacy tobramycin 40 mg/mL Inj Sol [INYO] 10666 CDM J3260 HCPCS 36000-0244-25 NDC facility both 2 ML 235 235 Gross Charge Type: Pharmacy tobramycin 1.2 g Inj [INYO] 10672 CDM J3260 HCPCS 39822-0412-01 NDC facility both 1 EA 1520 1520 Gross Charge Type: Pharmacy dexamethasone-tobramycin Ophth 0.1%-0.3% Susp [INYO] 10673 CDM 00574-4031-05 NDC facility both 1 EA 365.04 365.04 Gross Charge Type: Pharmacy | NDC EA = 5 DROPS dexamethasone-tobramycin Ophth 0.1%-0.3% Susp [INYO] 10673 CDM 00065-0647-05 NDC facility both 1 EA 761.44 761.44 Gross Charge Type: Pharmacy | NDC EA = 5 DROPS dexamethasone-tobramycin Ophth 0.1%-0.3% Susp [INYO] 10673 CDM 24208-0295-05 NDC facility both 1 EA 486.72 486.72 Gross Charge Type: Pharmacy | NDC EA = 5 DROPS "NMO/AQP4 FACS, S LC" 10702520 CDM 301 RC facility both 651.4 651.4 Gross Charge Type: NIHD_Hosp_Profee_Price "NMO/AQP4 FACS, S LC" 10702520 CDM 301 RC facility both 651.4 651.4 Gross Charge Type: NIHD_Hosp_Profee_Price Anti-Sm Ab (RDL) LC 10714444 CDM 301 RC facility both 99 99 Gross Charge Type: NIHD_Hosp_Profee_Price Anti-Sm Ab (RDL) LC 10714444 CDM 301 RC facility both 99 99 Gross Charge Type: NIHD_Hosp_Profee_Price benzocaine/butamben/tetracaine Top Aer [INYO] 10715 CDM 10223-0201-03 NDC facility both 1 EA 330 330 Gross Charge Type: Pharmacy | NDC EA = 20 INH "Anti-Myelin Oligodendrocyte Glycoprotein (MOG), Serum LC" 10716927 CDM 301 RC facility both 550 550 Gross Charge Type: NIHD_Hosp_Profee_Price "Anti-Myelin Oligodendrocyte Glycoprotein (MOG), Serum LC" 10716927 CDM 301 RC facility both 550 550 Gross Charge Type: NIHD_Hosp_Profee_Price W010-IgE Lamb's Quarters LC 10721461 CDM 300 RC facility both 3.26 3.26 Gross Charge Type: NIHD_Hosp_Profee_Price W010-IgE Lamb's Quarters LC 10721461 CDM 300 RC facility both 3.26 3.26 Gross Charge Type: NIHD_Hosp_Profee_Price T011-IgE Maple Leaf Sycamore LC 10721505 CDM 300 RC facility both 3.26 3.26 Gross Charge Type: NIHD_Hosp_Profee_Price T011-IgE Maple Leaf Sycamore LC 10721505 CDM 300 RC facility both 3.26 3.26 Gross Charge Type: NIHD_Hosp_Profee_Price 83020 10735632 CDM 301 RC 83020 HCPCS facility both 5 5 Gross Charge Type: NIHD_Hosp_Profee_Price 83020 10735632 CDM 301 RC 83020 HCPCS facility both 5 5 Gross Charge Type: NIHD_Hosp_Profee_Price 85027 10735633 CDM 301 RC 85027 HCPCS facility both 5 5 Gross Charge Type: NIHD_Hosp_Profee_Price 85027 10735633 CDM 301 RC 85027 HCPCS facility both 5 5 Gross Charge Type: NIHD_Hosp_Profee_Price amoxicillin 250 mg/5 mL Oral Liq [INYO] 10755 CDM 00781-6041-55 NDC facility both 150 ML 42.36 42.36 Gross Charge Type: Pharmacy ceFAZolin 500 mg PWVL [INYO] 10762 CDM J0690 HCPCS 00143-9923-90 NDC facility both 1 EA 330 330 Gross Charge Type: Pharmacy dexAMETHasone 4 mg Tab [inyo] 10773 CDM J8540 HCPCS 00904-7266-61 NDC facility both 1 EA 7.52 7.52 Gross Charge Type: Pharmacy | NDC EA = 1 TAB dexamethasone 4 mg Tab [INYO] 10773 CDM J8540 HCPCS 00054-8175-25 NDC facility both 1 EA 7.23 7.23 Gross Charge Type: Pharmacy | NDC EA = 1 TAB dexAMETHasone 4 mg Tab 10773 CDM J8540 HCPCS 66993-0730-80 NDC facility both 1 EA 7.23 7.23 Gross Charge Type: Pharmacy | NDC EA = 1 TAB dexamethasone 4 mg Tab [INYO] 10773 CDM J8540 HCPCS 47781-0914-51 NDC facility both 1 EA 7.23 7.23 Gross Charge Type: Pharmacy | NDC EA = 1 TAB dexamethasone 4 mg Tab [INYO] 10773 CDM J8540 HCPCS 48102-0047-20 NDC facility both 1 EA 7.23 7.23 Gross Charge Type: Pharmacy | NDC EA = 1 TAB erythromycin 250 mg Oral EC Tab [INYO] 10778 CDM 24338-0122-13 NDC facility both 1 EA 52.98 52.98 Gross Charge Type: Pharmacy | NDC EA = 1 TAB "AChR Antibodies, Complete Profile LC" 10790990 CDM 301 RC facility both 30.34 30.34 Gross Charge Type: NIHD_Hosp_Profee_Price "AChR Antibodies, Complete Profile LC" 10790990 CDM 301 RC facility both 30.34 30.34 Gross Charge Type: NIHD_Hosp_Profee_Price ferrous gluconate 324 mg (37.5 mg elemental iron) Tab UD [INYO] 10792 CDM 00904-2137-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB ferrous gluconate 324 mg (37.5 mg elemental iron) Tab UD [INYO] 10792 CDM 20555-0019-00 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB diphenhydrAMINE 50 mg/mL Inj Sol [INYO] 10794 CDM J1200 HCPCS 63323-0664-01 NDC facility both 1 ML 235 235 Gross Charge Type: Pharmacy diphenhydrAMINE 50 mg/mL Inj Sol [INYO] 10794 CDM J1200 HCPCS 00641-0376-25 NDC facility both 1 ML 235 235 Gross Charge Type: Pharmacy acetaminophen 650 mg Supp [INYO] 10795 CDM 45802-0730-32 NDC facility both 1 EA 36 36 Gross Charge Type: Pharmacy | NDC EA = 1 SUPP acetaminophen 325 mg Tab [INYO] 10796 CDM 50580-0458-11 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB acetaminophen 325 mg Tab [INYO] 10796 CDM 00536-1327-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB acetaminophen 325 mg Tab [INYO] 10796 CDM 50580-0600-02 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB acetaminophen 325 mg Tab [INYO] 10796 CDM 00536-1327-06 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB acetaminophen 325 mg Tab [INYO] 10796 CDM 00904-6773-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB acetaminophen 325 mg Tab [INYO] 10796 CDM 50580-0501-10 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB meperidine 100 mg/mL Inj Sol [INYO] 10814 CDM J2175 HCPCS 00641-6054-25 NDC facility both 1 ML 170 170 Gross Charge Type: Pharmacy meperidine 100 mg/mL Inj Sol [INYO] 10814 CDM J2175 HCPCS 00409-1180-69 NDC facility both 1 ML 170 170 Gross Charge Type: Pharmacy nitroglycerin 0.4 mg/hr Transderm ER Film [INYO] 10817 CDM 49730-0112-30 NDC facility both 1 EA 15 15 Gross Charge Type: Pharmacy | NDC EA = 1 PATCHES nitroglycerin 0.3 mg/hr Transderm ER Film [INYO] 10818 CDM 00085-3315-35 NDC facility both 1 EA 31.5 31.5 Gross Charge Type: Pharmacy | NDC EA = 1 PATCHES nitroglycerin 0.2 mg/hr Transderm ER Film [INYO] 10819 CDM 49730-0111-30 NDC facility both 1 EA 15 15 Gross Charge Type: Pharmacy | NDC EA = 1 PATCHES nitroglycerin 0.2 mg/hr Transderm ER Film [INYO] 10819 CDM 00378-9104-93 NDC facility both 1 EA 15 15 Gross Charge Type: Pharmacy | NDC EA = 1 PATCHES nitroglycerin 0.1 mg/hr Transderm ER Film [INYO] 10820 CDM 00085-3305-30 NDC facility both 1 EA 27.66 27.66 Gross Charge Type: Pharmacy | NDC EA = 1 PATCHES nitroglycerin 0.1 mg/hr Transderm ER Film [INYO] 10820 CDM 00378-9102-93 NDC facility both 1 EA 15 15 Gross Charge Type: Pharmacy | NDC EA = 1 PATCHES nitroglycerin 50 mg/10 mL IV Sol [INYO] 10825 CDM J2305 HCPCS 00517-4810-25 NDC facility both 10 ML 265 265 Gross Charge Type: Pharmacy naproxen 250 mg Tab [INYO] 10827 CDM 50268-0594-15 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB naproxen 250 mg Tab [INYO] 10827 CDM 68462-0188-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB naloxone 4 mg/10 mL Son [INYO] 10828 CDM J2310 HCPCS 00409-1219-01 NDC facility both 10 ML 1139.9 1139.9 Gross Charge Type: Pharmacy naloxone 4 mg/10 mL Son [INYO] 10828 CDM J2310 HCPCS 55150-0328-10 NDC facility both 10 ML 1196 1196 Gross Charge Type: Pharmacy naloxone 4 mg/10 mL Son [INYO] 10828 CDM J2310 HCPCS 70069-0072-10 NDC facility both 10 ML 1135.34 1135.34 Gross Charge Type: Pharmacy nitroglycerin 50 mg/250 mL-D5W IV Sol [INYO] 10830 CDM J2305 HCPCS 00338-1049-02 NDC facility both 250 ML 265 265 Gross Charge Type: Pharmacy oxybutynin 5 mg Tab [INYO] 10835 CDM 00832-0038-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB oxybutynin 5 mg Tab [INYO] 10835 CDM 00904-2821-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB 86258 10835837 CDM 301 RC 86258 HCPCS facility both 5 5 Gross Charge Type: NIHD_Hosp_Profee_Price 86258 10835837 CDM 301 RC 86258 HCPCS facility both 5 5 Gross Charge Type: NIHD_Hosp_Profee_Price oxytocin 10 intl units/mL Inj Sol [INYO] 10836 CDM J2590 HCPCS 63323-0012-11 NDC facility both 1 ML 235 235 Gross Charge Type: Pharmacy oxytocin 10 intl units/mL Inj Sol [INYO] 10836 CDM J2590 HCPCS 42023-0116-25 NDC facility both 1 ML 235 235 Gross Charge Type: Pharmacy 86364 10838900 CDM 301 RC 86364 HCPCS facility both 5 5 Gross Charge Type: NIHD_Hosp_Profee_Price 86364 10838900 CDM 301 RC 86364 HCPCS facility both 5 5 Gross Charge Type: NIHD_Hosp_Profee_Price Fluoride LC 070060 10838929 CDM 301 RC facility both 16 16 Gross Charge Type: NIHD_Hosp_Profee_Price Fluoride LC 070060 10838929 CDM 301 RC facility both 16 16 Gross Charge Type: NIHD_Hosp_Profee_Price tuberculin purified protein derivative 5 TU/0.1 mL ID Sol [INYO] 10840 CDM 49281-0752-21 NDC facility both 1 ML 820.32 820.32 Gross Charge Type: Pharmacy tuberculin purified protein derivative 5 TU/0.1 mL ID Sol [INYO] 10840 CDM 42023-0104-01 NDC facility both 1 ML 852.8 852.8 Gross Charge Type: Pharmacy Penicillin V Potassium 250 mg Tab [INYO] 10842 CDM 65862-0175-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB Penicillin V Potassium 250 mg Tab [INYO] 10842 CDM 00781-1205-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB Amphetamines LC 10845757 CDM 301 RC 80307 HCPCS facility both 8 8 Gross Charge Type: NIHD_Hosp_Profee_Price Amphetamines LC 10845757 CDM 301 RC 80307 HCPCS facility both 8 8 Gross Charge Type: NIHD_Hosp_Profee_Price Penicillin V Potassium 250 mg/5 mL Pow [INYO] 10848 CDM 00093-4127-74 NDC facility both 200 ML 74 74 Gross Charge Type: Pharmacy SUMAtriptan 6 mg/0.5 mL SubQ Sol [INYO] 10867 CDM J3030 HCPCS 55150-0173-01 NDC facility both 0.5 ML 235 235 Gross Charge Type: Pharmacy 86357 10872071 CDM 301 RC 86357 HCPCS facility both 36 36 Gross Charge Type: NIHD_Hosp_Profee_Price 86357 10872071 CDM 301 RC 86357 HCPCS facility both 36 36 Gross Charge Type: NIHD_Hosp_Profee_Price Galectin-3 LC 004110 10872088 CDM 301 RC facility both 45 45 Gross Charge Type: NIHD_Hosp_Profee_Price Galectin-3 LC 004110 10872088 CDM 301 RC facility both 45 45 Gross Charge Type: NIHD_Hosp_Profee_Price "Fat Emul, 20% IV 250 mL [INYO]" 10886 CDM 00338-0519-09 NDC facility both 250 ML 395.1 395.1 Gross Charge Type: Pharmacy "Fat Emul, 20% IV 250 mL [INYO]" 10886 CDM 00264-4460-30 NDC facility both 250 ML 265 265 Gross Charge Type: Pharmacy amitriptyline 25 mg Tab [INYO] 10887 CDM 00904-0201-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB amitriptyline 25 mg Tab [INYO] 10887 CDM 60687-0433-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB amitriptyline 25 mg Tab [INYO] 10887 CDM 51079-0107-20 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB amLODIPine 5 mg Tab [INYO] 10888 CDM 00904-6370-61 NDC facility both 1 EA 9.86 9.86 Gross Charge Type: Pharmacy | NDC EA = 1 TAB propranolol 20 mg Tab [INYO] 10907 CDM 50268-0663-15 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB propranolol 20 mg Tab [INYO] 10907 CDM 00904-6705-06 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB propranolol 20 mg Tab [INYO] 10907 CDM 23155-0111-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB propranolol 20 mg Tab [INYO] 10907 CDM 50268-0701-15 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB "Human Herpesvirus 6 (HHV-6) Quantitation, DNA PCR LC 139310" 10936868 CDM 301 RC facility both 275 275 Gross Charge Type: NIHD_Hosp_Profee_Price "Human Herpesvirus 6 (HHV-6) Quantitation, DNA PCR LC 139310" 10936868 CDM 301 RC facility both 275 275 Gross Charge Type: NIHD_Hosp_Profee_Price 86706-Viral Hepatitis Immunity Profile (HAV and HBV) LC 028910 10961309 CDM 301 RC 86706 HCPCS facility both 2.82 2.82 Gross Charge Type: NIHD_Hosp_Profee_Price 86706-Viral Hepatitis Immunity Profile (HAV and HBV) LC 028910 10961309 CDM 301 RC 86706 HCPCS facility both 2.82 2.82 Gross Charge Type: NIHD_Hosp_Profee_Price 86708-Viral Hepatitis Immunity Profile (HAV and HBV) LC 028910 10961310 CDM 301 RC 86708 HCPCS facility both 2.82 2.82 Gross Charge Type: NIHD_Hosp_Profee_Price 86708-Viral Hepatitis Immunity Profile (HAV and HBV) LC 028910 10961310 CDM 301 RC 86708 HCPCS facility both 2.82 2.82 Gross Charge Type: NIHD_Hosp_Profee_Price "82533- Salivary Cortisol (Four Specimens), MS (Endocrine Sciences) LC 502124" 10961323 CDM 301 RC 82533 HCPCS facility both 123.8 123.8 Gross Charge Type: NIHD_Hosp_Profee_Price "82533- Salivary Cortisol (Four Specimens), MS (Endocrine Sciences) LC 502124" 10961323 CDM 301 RC 82533 HCPCS facility both 123.8 123.8 Gross Charge Type: NIHD_Hosp_Profee_Price 86317-Pneumococcal IM (14 Serotype) LC 816767 10966398 CDM 301 RC 86317 HCPCS facility both 23.1 23.1 Gross Charge Type: NIHD_Hosp_Profee_Price 86317-Pneumococcal IM (14 Serotype) LC 816767 10966398 CDM 301 RC 86317 HCPCS facility both 23.1 23.1 Gross Charge Type: NIHD_Hosp_Profee_Price "86635-Coccidioides immitis Antibodies, IgG and IgM, EIA LC 164798" 10974894 CDM 301 RC 86635 HCPCS facility both 9.89 9.89 Gross Charge Type: NIHD_Hosp_Profee_Price "86635-Coccidioides immitis Antibodies, IgG and IgM, EIA LC 164798" 10974894 CDM 301 RC 86635 HCPCS facility both 9.89 9.89 Gross Charge Type: NIHD_Hosp_Profee_Price "Prostaglandin D2, Serum LC 505530" 10974914 CDM 301 RC facility both 288.75 288.75 Gross Charge Type: NIHD_Hosp_Profee_Price "Prostaglandin D2, Serum LC 505530" 10974914 CDM 301 RC facility both 288.75 288.75 Gross Charge Type: NIHD_Hosp_Profee_Price sulfamethoxazole-trimethoprim 800 mg-160 mg Tab [INYO] 10980 CDM 00904-2725-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB sulfamethoxazole-trimethoprim 800 mg-160 mg Tab [INYO] 10980 CDM 65162-0272-10 NDC facility both 1 EA 8.41 8.41 Gross Charge Type: Pharmacy | NDC EA = 1 TAB sulfamethoxazole-trimethoprim 200 mg-40 mg/5 mL Oral Susp [INYO] 10981 CDM 70954-0258-10 NDC facility both 20 ML 15.61 15.61 Gross Charge Type: Pharmacy sulfamethoxazole-trimethoprim 200 mg-40 mg/5 mL Oral Susp [INYO] 10981 CDM 00121-0854-16 NDC facility both 20 ML 28.65 28.65 Gross Charge Type: Pharmacy sulfamethoxazole-trimethoprim 200 mg-40 mg/5 mL Oral Susp [INYO] 10981 CDM 50383-0824-16 NDC facility both 20 ML 54.65 54.65 Gross Charge Type: Pharmacy prednisoLONE-sodium sulfacetamide Ophth 0.2%-10% Susp [INYO] 10986 CDM 11980-0022-05 NDC facility both 1 EA 733.25 733.25 Gross Charge Type: Pharmacy | NDC EA = 5 DROPS benztropine 1 mg/mL Inj Sol [INYO] 10993 CDM J0515 HCPCS 17478-0012-02 NDC facility both 2 ML 476.72 476.72 Gross Charge Type: Pharmacy benztropine 1 mg/mL Inj Sol [INYO] 10993 CDM J0515 HCPCS 68382-0860-10 NDC facility both 2 ML 470 470 Gross Charge Type: Pharmacy 11000 Debridement of extensive eczematous or infected skin; up to 10% of body surface 110001 CDM 521 RC 11000 HCPCS facility both 118 118 Gross Charge Type: NIHD_RHC_Price 11000 Debridement of extensive eczematous or infected skin; up to 10% of body surface 110001 CDM 521 RC 11000 HCPCS facility both 116 116 Gross Charge Type: NIHD_Clinic_Price 11000 MD DEBRIDE UP TO 10 % BSA CHARGE 110002 CDM 761 RC facility both 563 563 Gross Charge Type: NIHD_Hosp_Profee_Price 11000 MD DEBRIDE UP TO 10 % BSA CHARGE 110002 CDM 761 RC facility both 563 563 Gross Charge Type: NIHD_Hosp_Profee_Price 11000 DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN; UP TO 10% OF BODY SURFACE ProFee 110003 CDM 982 RC 11000 HCPCS facility both 116 116 Gross Charge Type: NIHD_Hosp_Profee_Price 11000 DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN; UP TO 10% OF BODY SURFACE ProFee 110003 CDM 982 RC 11000 HCPCS facility both 116 116 Gross Charge Type: NIHD_Hosp_Profee_Price 11000 DBRDMT EXTENSV ECZEMA/INFECT SKN UP 10% BDY SURF TechFee 110004 CDM 450 RC facility both 807 807 Gross Charge Type: NIHD_Hosp_Profee_Price 11000 DBRDMT EXTENSV ECZEMA/INFECT SKN UP 10% BDY SURF TechFee 110004 CDM 450 RC facility both 807 807 Gross Charge Type: NIHD_Hosp_Profee_Price "Cortisol, ACTH Stim (3 Spec) LC 380910" 11000923 CDM 301 RC facility both 6.84 6.84 Gross Charge Type: NIHD_Hosp_Profee_Price "Cortisol, ACTH Stim (3 Spec) LC 380910" 11000923 CDM 301 RC facility both 6.84 6.84 Gross Charge Type: NIHD_Hosp_Profee_Price 82533 11000933 CDM 301 RC 82533 HCPCS facility both 7 7 Gross Charge Type: NIHD_Hosp_Profee_Price 82533 11000933 CDM 301 RC 82533 HCPCS facility both 7 7 Gross Charge Type: NIHD_Hosp_Profee_Price 11001 MD DEBRIDE ADD 10 % BSA CHARGE 11001 CDM 761 RC facility both 46 46 Gross Charge Type: NIHD_Hosp_Profee_Price 11001 MD DEBRIDE ADD 10 % BSA CHARGE 11001 CDM 761 RC facility both 46 46 Gross Charge Type: NIHD_Hosp_Profee_Price 82397 11004041 CDM 301 RC 82397 HCPCS facility both 290 290 Gross Charge Type: NIHD_Hosp_Profee_Price 82397 11004041 CDM 301 RC 82397 HCPCS facility both 290 290 Gross Charge Type: NIHD_Hosp_Profee_Price "11005 Debride of skin, subQ tissue, muscle/fascia for necrotizing soft tissue infection; abd wall" 110051 CDM 521 RC 11005 HCPCS facility both 1380 1380 Gross Charge Type: NIHD_Clinic_Price "11005 DEBRIDEMENT OF SKIN, SUBCUTANEOUS TISSUE, MUSCLE AND FASCIA FOR NECROTIZING SOFT TISSU ProFee" 110052 CDM 982 RC 11005 HCPCS facility both 1380 1380 Gross Charge Type: NIHD_Hosp_Profee_Price "11005 DEBRIDEMENT OF SKIN, SUBCUTANEOUS TISSUE, MUSCLE AND FASCIA FOR NECROTIZING SOFT TISSU ProFee" 110052 CDM 982 RC 11005 HCPCS facility both 1380 1380 Gross Charge Type: NIHD_Hosp_Profee_Price "11008 REMOVAL OF PROSTHETIC MATERIAL OR MESH, ABDOMINAL WALL FOR INFECTION (EG, FOR CHRONIC ProFee" 11008 CDM 982 RC 11008 HCPCS facility both 486 486 Gross Charge Type: NIHD_Hosp_Profee_Price "11008 REMOVAL OF PROSTHETIC MATERIAL OR MESH, ABDOMINAL WALL FOR INFECTION (EG, FOR CHRONIC ProFee" 11008 CDM 982 RC 11008 HCPCS facility both 486 486 Gross Charge Type: NIHD_Hosp_Profee_Price 11010 DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL AT THE SITE OF AN OPEN FRACTURE AND/ ProFee 11010 CDM 982 RC 11010 HCPCS facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price 11010 DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL AT THE SITE OF AN OPEN FRACTURE AND/ ProFee 11010 CDM 982 RC 11010 HCPCS facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price gentamicin Ophth 0.3% Sol [INYO] 11010 CDM 61314-0633-05 NDC facility both 1 EA 130.2 130.2 Gross Charge Type: Pharmacy | NDC EA = 5 DROPS gentamicin Ophth 0.3% Sol [INYO] 11010 CDM 24208-0580-60 NDC facility both 1 EA 257.1 257.1 Gross Charge Type: Pharmacy | NDC EA = 5 DROPS 11011 DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL AT THE SITE OF AN OPEN FRACTURE AND/ ProFee 11011 CDM 982 RC 11011 HCPCS facility both 1124 1124 Gross Charge Type: NIHD_Hosp_Profee_Price 11011 DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL AT THE SITE OF AN OPEN FRACTURE AND/ ProFee 11011 CDM 982 RC 11011 HCPCS facility both 1124 1124 Gross Charge Type: NIHD_Hosp_Profee_Price 11012 DBRDMT FX&/DISLC SUBQ T/M/F BONE TechFee 110121 CDM 450 RC facility both 851 851 Gross Charge Type: NIHD_Hosp_Profee_Price 11012 DBRDMT FX&/DISLC SUBQ T/M/F BONE TechFee 110121 CDM 450 RC facility both 851 851 Gross Charge Type: NIHD_Hosp_Profee_Price 11012 DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL AT THE SITE OF AN OPEN FRACTURE AND/ ProFee 110122 CDM 982 RC 11012 HCPCS facility both 1498 1498 Gross Charge Type: NIHD_Hosp_Profee_Price 11012 DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL AT THE SITE OF AN OPEN FRACTURE AND/ ProFee 110122 CDM 982 RC 11012 HCPCS facility both 1498 1498 Gross Charge Type: NIHD_Hosp_Profee_Price Dengue Virus IgG and IgM LC 819213 11020869 CDM 301 RC facility both 53.5 53.5 Gross Charge Type: NIHD_Hosp_Profee_Price Dengue Virus IgG and IgM LC 819213 11020869 CDM 301 RC facility both 53.5 53.5 Gross Charge Type: NIHD_Hosp_Profee_Price Coccidioidal Serology LC 825569 11020880 CDM 301 RC facility both 49 49 Gross Charge Type: NIHD_Hosp_Profee_Price Coccidioidal Serology LC 825569 11020880 CDM 301 RC facility both 49 49 Gross Charge Type: NIHD_Hosp_Profee_Price 86790 11025881 CDM 301 RC 86790 HCPCS facility both 56 56 Gross Charge Type: NIHD_Hosp_Profee_Price 86790 11025881 CDM 301 RC 86790 HCPCS facility both 56 56 Gross Charge Type: NIHD_Hosp_Profee_Price 86635 11025908 CDM 301 RC 86635 HCPCS facility both 51 51 Gross Charge Type: NIHD_Hosp_Profee_Price 86635 11025908 CDM 301 RC 86635 HCPCS facility both 51 51 Gross Charge Type: NIHD_Hosp_Profee_Price Anti-U1 RNP Ab (RDL) LC 520034 11028512 CDM 301 RC facility both 34 34 Gross Charge Type: NIHD_Hosp_Profee_Price Anti-U1 RNP Ab (RDL) LC 520034 11028512 CDM 301 RC facility both 34 34 Gross Charge Type: NIHD_Hosp_Profee_Price Anti-MDA-5 Ab (CADM-140) (RDL) LC 520002 11028522 CDM 301 RC facility both 30 30 Gross Charge Type: NIHD_Hosp_Profee_Price Anti-MDA-5 Ab (CADM-140) (RDL) LC 520002 11028522 CDM 301 RC facility both 30 30 Gross Charge Type: NIHD_Hosp_Profee_Price Anti-PM/Scl-100 Ab (RDL) LC 520007 11038013 CDM 301 RC facility both 34.43 34.43 Gross Charge Type: NIHD_Hosp_Profee_Price Anti-PM/Scl-100 Ab (RDL) LC 520007 11038013 CDM 301 RC facility both 34.43 34.43 Gross Charge Type: NIHD_Hosp_Profee_Price Anti-Mi-2 Ab (RDL) LC 520000 11038019 CDM 301 RC facility both 31.36 31.36 Gross Charge Type: NIHD_Hosp_Profee_Price Anti-Mi-2 Ab (RDL) LC 520000 11038019 CDM 301 RC facility both 31.36 31.36 Gross Charge Type: NIHD_Hosp_Profee_Price Magnesium Chloride w Calcium 112 mg-64 mg Tab [INYO] 11041 CDM 68585-0005-75 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB calcium carbonate-magnesium chloride 112 mg-64 mg Tab [inyo] 11041 CDM 10006-0700-13 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB mannitol 20% IV Sol 500 mL [INYO] 11042 CDM 00409-7715-03 NDC facility both 500 ML 265 265 Gross Charge Type: Pharmacy mannitol 20% IV Sol 500 mL [INYO] 11042 CDM 00990-7715-13 NDC facility both 500 ML 265 265 Gross Charge Type: Pharmacy "11042 Debridement, subcutaneous tissue; first 20 sq cm or less" 110421 CDM 521 RC 11042 HCPCS facility both 346 346 Gross Charge Type: NIHD_RHC_Price "11042 Debridement, subcutaneous tissue; first 20 sq cm or less" 110421 CDM 521 RC 11042 HCPCS facility both 347 347 Gross Charge Type: NIHD_Clinic_Price 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/< TechFee 110422 CDM 450 RC facility both 851 851 Gross Charge Type: NIHD_Hosp_Profee_Price 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/< TechFee 110422 CDM 450 RC facility both 851 851 Gross Charge Type: NIHD_Hosp_Profee_Price "11042 DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); FIRST ProFee" 110423 CDM 982 RC 11042 HCPCS facility both 512 512 Gross Charge Type: NIHD_Hosp_Profee_Price "11042 DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); FIRST ProFee" 110423 CDM 982 RC 11042 HCPCS facility both 512 512 Gross Charge Type: NIHD_Hosp_Profee_Price "11043 DEBRIDEMENT, MUSCLE AND/OR FASCIA (INCLUDES EPIDERMIS, DERMIS, AND SUBCUTANEOUS TISSUE ProFee" 11043 CDM 982 RC 11043 HCPCS facility both 488 488 Gross Charge Type: NIHD_Hosp_Profee_Price "11043 DEBRIDEMENT, MUSCLE AND/OR FASCIA (INCLUDES EPIDERMIS, DERMIS, AND SUBCUTANEOUS TISSUE ProFee" 11043 CDM 982 RC 11043 HCPCS facility both 488 488 Gross Charge Type: NIHD_Hosp_Profee_Price mannitol 25% IV Sol 50 mL [INYO] 11043 CDM J2150 HCPCS 00409-4031-01 NDC facility both 50 ML 235 235 Gross Charge Type: Pharmacy "11044 DEBRIDEMENT, BONE (INCLUDES EPIDERMIS, DERMIS, SUBCUTANEOUS TISSUE, MUSCLE AND/OR FASC ProFee" 11044 CDM 982 RC 11044 HCPCS facility both 476 476 Gross Charge Type: NIHD_Hosp_Profee_Price "11044 DEBRIDEMENT, BONE (INCLUDES EPIDERMIS, DERMIS, SUBCUTANEOUS TISSUE, MUSCLE AND/OR FASC ProFee" 11044 CDM 982 RC 11044 HCPCS facility both 476 476 Gross Charge Type: NIHD_Hosp_Profee_Price "11045 Debridement, subcutaneous tissue each additional 20 sq cm, or part thereof" 110451 CDM 521 RC 11045 HCPCS facility both 51 51 Gross Charge Type: NIHD_Clinic_Price "11045 DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); EACH A ProFee" 110452 CDM 982 RC 11045 HCPCS facility both 51 51 Gross Charge Type: NIHD_Hosp_Profee_Price "11045 DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); EACH A ProFee" 110452 CDM 982 RC 11045 HCPCS facility both 51 51 Gross Charge Type: NIHD_Hosp_Profee_Price "11046 Debridement, muscle and/or fascia; each additional 20 sq cm, or part thereof" 110461 CDM 521 RC 11046 HCPCS facility both 102 102 Gross Charge Type: NIHD_Clinic_Price "11046 DEBRIDEMENT, MUSCLE AND/OR FASCIA (INCLUDES EPIDERMIS, DERMIS, AND SUBCUTANEOUS TISSUE ProFee" 110462 CDM 982 RC 11046 HCPCS facility both 102 102 Gross Charge Type: NIHD_Hosp_Profee_Price "11046 DEBRIDEMENT, MUSCLE AND/OR FASCIA (INCLUDES EPIDERMIS, DERMIS, AND SUBCUTANEOUS TISSUE ProFee" 110462 CDM 982 RC 11046 HCPCS facility both 102 102 Gross Charge Type: NIHD_Hosp_Profee_Price "11047 DEBRIDEMENT, BONE (INCLUDES EPIDERMIS, DERMIS, SUBCUTANEOUS TISSUE, MUSCLE AND/OR FASC ProFee" 11047 CDM 982 RC 11047 HCPCS facility both 179 179 Gross Charge Type: NIHD_Hosp_Profee_Price "11047 DEBRIDEMENT, BONE (INCLUDES EPIDERMIS, DERMIS, SUBCUTANEOUS TISSUE, MUSCLE AND/OR FASC ProFee" 11047 CDM 982 RC 11047 HCPCS facility both 179 179 Gross Charge Type: NIHD_Hosp_Profee_Price 11055 Paring or cutting of benign hyperkeratotic lesion; single lesion 11055 CDM 521 RC 11055 HCPCS facility both 88 88 Gross Charge Type: NIHD_RHC_Price 11055 Paring or cutting of benign hyperkeratotic lesion; single lesion 11055 CDM 521 RC 11055 HCPCS facility both 88 88 Gross Charge Type: NIHD_Clinic_Price mupirocin Top 2% Oint [INYO] 11055 CDM 51672-1312-00 NDC facility both 1 EA 125 125 Gross Charge Type: Pharmacy | NDC EA = 22 APP mupirocin topical 2% Oin [inyo] 11055 CDM 68462-0180-22 NDC facility both 1 EA 213.75 213.75 Gross Charge Type: Pharmacy | NDC EA = 22 APP mupirocin Top 2% Oint [INYO] 11055 CDM 45802-0112-22 NDC facility both 1 EA 57.25 57.25 Gross Charge Type: Pharmacy | NDC EA = 22 APP "11055 PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); SINGLE LESION ProFee" 110551 CDM 982 RC 11055 HCPCS facility both 24 24 Gross Charge Type: NIHD_Hosp_Profee_Price "11055 PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); SINGLE LESION ProFee" 110551 CDM 982 RC 11055 HCPCS facility both 24 24 Gross Charge Type: NIHD_Hosp_Profee_Price 11055 PARING OF BENIGN LESION - SINGLE LESION CHARGE 110552 CDM 761 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price 11055 PARING OF BENIGN LESION - SINGLE LESION CHARGE 110552 CDM 761 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price 11056 Paring or cutting of benign hyperkeratotic lesion; 2 to 4 lesions 11056 CDM 521 RC 11056 HCPCS facility both 132 132 Gross Charge Type: NIHD_RHC_Price 11056 Paring or cutting of benign hyperkeratotic lesion; 2 to 4 lesions 11056 CDM 521 RC 11056 HCPCS facility both 132 132 Gross Charge Type: NIHD_Clinic_Price "11057 Paring or cutting of benign hyperkeratotic lesion (eg, corn" 11057 CDM 521 RC 11057 HCPCS facility both 159 159 Gross Charge Type: NIHD_RHC_Price "11057 Paring or cutting of benign hyperkeratotic lesion (eg, corn" 11057 CDM 521 RC 11057 HCPCS facility both 159 159 Gross Charge Type: NIHD_Clinic_Price Anti-Jo-1 Ab (RDL) LC 520032 11060555 CDM 301 RC facility both 14.66 14.66 Gross Charge Type: NIHD_Hosp_Profee_Price Anti-Jo-1 Ab (RDL) LC 520032 11060555 CDM 301 RC facility both 14.66 14.66 Gross Charge Type: NIHD_Hosp_Profee_Price tetracaine 1% Inj Sol 2 mL [INYO] 11070 CDM 17478-0045-32 NDC facility both 2 ML 729.03 729.03 Gross Charge Type: Pharmacy potassium phosphate 3 mmol/mL IV Sol [INYO] 11072 CDM 63323-0086-05 NDC facility both 5 ML 330 330 Gross Charge Type: Pharmacy neostigmine 1 mg/mL Sol [INYO] 11080 CDM J2710 HCPCS 70121-1479-07 NDC facility both 10 ML 249.6 249.6 Gross Charge Type: Pharmacy neostigmine 1 mg/mL Sol [INYO] 11080 CDM J2710 HCPCS 71839-0106-10 NDC facility both 10 ML 235 235 Gross Charge Type: Pharmacy neostigmine 1 mg/mL Sol [inyo] 11080 CDM J2710 HCPCS 42023-0189-10 NDC facility both 10 ML 415 415 Gross Charge Type: Pharmacy neostigmine 1 mg/mL [INYO] 11080 CDM J2710 HCPCS 00548-9602-00 NDC facility both 10 ML 235 235 Gross Charge Type: Pharmacy neostigmine 1 mg/mL [INYO] 11080 CDM J2710 HCPCS 70700-0172-23 NDC facility both 10 ML 235 235 Gross Charge Type: Pharmacy neostigmine 1 mg/mL [INYO] 11080 CDM J2710 HCPCS 76014-0003-10 NDC facility both 10 ML 235 235 Gross Charge Type: Pharmacy sodium acetate 2 mEq/mL IV Sol [INYO] 11094 CDM J3490 HCPCS 00409-7299-73 NDC facility both 20 ML 330 330 Gross Charge Type: Pharmacy "11102 Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); single lesion" 11102 CDM 521 RC 11102 HCPCS facility both 277 277 Gross Charge Type: NIHD_RHC_Price "11102 Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); single lesion" 11102 CDM 521 RC 11102 HCPCS facility both 277 277 Gross Charge Type: NIHD_Clinic_Price EPINEPHrine 1 mg/mL 1 mL Sol [INYO] 11102 CDM J0171 HCPCS 42023-0159-25 NDC facility both 1 ML 235 235 Gross Charge Type: Pharmacy "11102 Tangential Biopsy of Skin, 1 lesion" 111021 CDM 761 RC facility both 463 463 Gross Charge Type: NIHD_Hosp_Profee_Price "11102 Tangential Biopsy of Skin, 1 lesion" 111021 CDM 761 RC facility both 463 463 Gross Charge Type: NIHD_Hosp_Profee_Price 11102 TANGENTIAL BIOPSY OF SKIN ProFee 111022 CDM 982 RC 11102 HCPCS facility both 57 57 Gross Charge Type: NIHD_Hosp_Profee_Price 11102 TANGENTIAL BIOPSY OF SKIN ProFee 111022 CDM 982 RC 11102 HCPCS facility both 57 57 Gross Charge Type: NIHD_Hosp_Profee_Price "11103 Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); each separate/additional les" 11103 CDM 521 RC 11103 HCPCS facility both 88 88 Gross Charge Type: NIHD_RHC_Price "11103 Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); each separate/additional les" 11103 CDM 521 RC 11103 HCPCS facility both 88 88 Gross Charge Type: NIHD_Clinic_Price 11103 TANGENTIAL BIOPSY SKIN EA SEP/ADDITIONAL LESION ProFee 111031 CDM 982 RC 11103 HCPCS facility both 66 66 Gross Charge Type: NIHD_Hosp_Profee_Price 11103 TANGENTIAL BIOPSY SKIN EA SEP/ADDITIONAL LESION ProFee 111031 CDM 982 RC 11103 HCPCS facility both 66 66 Gross Charge Type: NIHD_Hosp_Profee_Price "11104 Punch biopsy of skin (including simple closure, when performed); single lesion" 11104 CDM 521 RC 11104 HCPCS facility both 277 277 Gross Charge Type: NIHD_RHC_Price "11104 Punch biopsy of skin (including simple closure, when performed); single lesion" 11104 CDM 521 RC 11104 HCPCS facility both 277 277 Gross Charge Type: NIHD_Clinic_Price "11104 Punch biopsy of skin (including simple closure, when performed); single lesion PIKE" 111041 CDM 761 RC facility both 580 580 Gross Charge Type: NIHD_Hosp_Profee_Price "11104 Punch biopsy of skin (including simple closure, when performed); single lesion PIKE" 111041 CDM 761 RC facility both 580 580 Gross Charge Type: NIHD_Hosp_Profee_Price "11100 BIOPSY OF SKIN, SUBCUTANEOUS TISSUE AND/OR MUCOUS MEMBRANE (INCLUDING SIMPLE CLOSURE), ProFee" 111042 CDM 982 RC 11104 HCPCS facility both 71 71 Gross Charge Type: NIHD_Hosp_Profee_Price "11100 BIOPSY OF SKIN, SUBCUTANEOUS TISSUE AND/OR MUCOUS MEMBRANE (INCLUDING SIMPLE CLOSURE), ProFee" 111042 CDM 982 RC 11104 HCPCS facility both 71 71 Gross Charge Type: NIHD_Hosp_Profee_Price "11105 Punch biopsy of skin (including simple closure, when performed); each separate/additional lesi" 11105 CDM 521 RC 11105 HCPCS facility both 88 88 Gross Charge Type: NIHD_RHC_Price "11105 Punch biopsy of skin (including simple closure, when performed); each separate/additional lesi" 11105 CDM 521 RC 11105 HCPCS facility both 88 88 Gross Charge Type: NIHD_Clinic_Price "11105 Punch Biopsy of Skin, each add lesion-WC Charge" 111051 CDM 761 RC facility both 293 293 Gross Charge Type: NIHD_Hosp_Profee_Price "11105 Punch Biopsy of Skin, each add lesion-WC Charge" 111051 CDM 761 RC facility both 293 293 Gross Charge Type: NIHD_Hosp_Profee_Price "11101 BIOPSY OF SKIN, SUBCUTANEOUS TISSUE AND/OR MUCOUS MEMBRANE (INCLUDING SIMPLE CLOSURE), ProFee" 111052 CDM 982 RC 11105 HCPCS facility both 42 42 Gross Charge Type: NIHD_Hosp_Profee_Price "11101 BIOPSY OF SKIN, SUBCUTANEOUS TISSUE AND/OR MUCOUS MEMBRANE (INCLUDING SIMPLE CLOSURE), ProFee" 111052 CDM 982 RC 11105 HCPCS facility both 42 42 Gross Charge Type: NIHD_Hosp_Profee_Price NIHD MG/US BIOPSY SKIN 11106 CDM 761 RC facility both TC 997 997 Gross Charge Type: NIHD_Hosp_Profee_Price NIHD MG/US BIOPSY SKIN 11106 CDM 761 RC facility both TC 997 997 Gross Charge Type: NIHD_Hosp_Profee_Price "11106 Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); single lesi" 111061 CDM 521 RC 11106 HCPCS facility both 277 277 Gross Charge Type: NIHD_RHC_Price "11106 Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); single lesi" 111061 CDM 521 RC 11106 HCPCS facility both 277 277 Gross Charge Type: NIHD_Clinic_Price 11106 INCISIONAL BIOPSY SKIN SINGLE LESION CHARGE 111062 CDM 761 RC facility both 1143 1143 Gross Charge Type: NIHD_Hosp_Profee_Price 11106 INCISIONAL BIOPSY SKIN SINGLE LESION CHARGE 111062 CDM 761 RC facility both 1143 1143 Gross Charge Type: NIHD_Hosp_Profee_Price "11107 Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); each separat" 111071 CDM 521 RC 11107 HCPCS facility both 88 88 Gross Charge Type: NIHD_RHC_Price "11107 Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); each separat" 111071 CDM 521 RC 11107 HCPCS facility both 88 88 Gross Charge Type: NIHD_Clinic_Price 11107 INCISIONAL BIOPSY SKIN EA SEP/ADDL LSN CHARGE 111072 CDM 761 RC facility both 604 604 Gross Charge Type: NIHD_Hosp_Profee_Price 11107 INCISIONAL BIOPSY SKIN EA SEP/ADDL LSN CHARGE 111072 CDM 761 RC facility both 604 604 Gross Charge Type: NIHD_Hosp_Profee_Price cyanocobalamin 1000 mcg/mL Inj Sol [INYO] 11118 CDM J3420 HCPCS 63323-0044-01 NDC facility both 1 ML 235 235 Gross Charge Type: Pharmacy cyanocobalamin 1000 mcg/mL Inj Sol [INYO] 11118 CDM J3420 HCPCS 70069-0005-10 NDC facility both 1 ML 235 235 Gross Charge Type: Pharmacy "11200 Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions" 111201 CDM 521 RC 11200 HCPCS facility both 501 501 Gross Charge Type: NIHD_RHC_Price "11200 Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions" 111201 CDM 521 RC 11200 HCPCS facility both 139 139 Gross Charge Type: NIHD_Clinic_Price "T-Cell Activation Profile, CD8 Subsets LC 505750" 11120101 CDM 301 RC facility both 50.5 50.5 Gross Charge Type: NIHD_Hosp_Profee_Price "T-Cell Activation Profile, CD8 Subsets LC 505750" 11120101 CDM 301 RC facility both 50.5 50.5 Gross Charge Type: NIHD_Hosp_Profee_Price 11200 REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15 TechFee 111202 CDM 450 RC facility both 233 233 Gross Charge Type: NIHD_Hosp_Profee_Price 11200 REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15 TechFee 111202 CDM 450 RC facility both 233 233 Gross Charge Type: NIHD_Hosp_Profee_Price "11200 REMOVAL OF SKIN TAGS, MULTIPLE FIBROCUTANEOUS TAGS, ANY AREA; UP TO AND INCLUDING 15 L ProFee" 111203 CDM 982 RC 11200 HCPCS facility both 139 139 Gross Charge Type: NIHD_Hosp_Profee_Price "11200 REMOVAL OF SKIN TAGS, MULTIPLE FIBROCUTANEOUS TAGS, ANY AREA; UP TO AND INCLUDING 15 L ProFee" 111203 CDM 982 RC 11200 HCPCS facility both 139 139 Gross Charge Type: NIHD_Hosp_Profee_Price "86356 T-Cell Activation Profile, CD8 Subsets LC 505750" 11120471 CDM 301 RC 86356 HCPCS facility both 50.5 50.5 Gross Charge Type: NIHD_Hosp_Profee_Price "86356 T-Cell Activation Profile, CD8 Subsets LC 505750" 11120471 CDM 301 RC 86356 HCPCS facility both 50.5 50.5 Gross Charge Type: NIHD_Hosp_Profee_Price "86360 T-Cell Activation Profile, CD8 Subsets LC 505750" 11129015 CDM 301 RC 86360 HCPCS facility both 50.5 50.5 Gross Charge Type: NIHD_Hosp_Profee_Price "86360 T-Cell Activation Profile, CD8 Subsets LC 505750" 11129015 CDM 301 RC 86360 HCPCS facility both 50.5 50.5 Gross Charge Type: NIHD_Hosp_Profee_Price sodium sulfacetamide Ophth 10% Sol [INYO] 11131 CDM 24208-0670-04 NDC facility both 1 EA 330 330 Gross Charge Type: Pharmacy | NDC EA = 15 DROPS HYDROmorphone 2 mg/mL Inj Sol vial [INYO] 11141 CDM J1170 HCPCS 00409-3365-10 NDC facility both 1 ML 170 170 Gross Charge Type: Pharmacy HYDROmorphone 2 mg/mL Inj Sol vial [INYO] 11141 CDM J1170 HCPCS 00641-0121-25 NDC facility both 1 ML 170 170 Gross Charge Type: Pharmacy HYDROmorphone 2 mg/mL Inj Sol vial [INYO] 11141 CDM J1170 HCPCS 00641-6151-25 NDC facility both 1 ML 170 170 Gross Charge Type: Pharmacy HYDROmorphone 2 mg/mL Inj Sol vial [INYO] 11141 CDM J1170 HCPCS 63323-0853-25 NDC facility both 1 ML 170 170 Gross Charge Type: Pharmacy HYDROmorphone 2 mg Tab [INYO] 11142 CDM 60687-0579-01 NDC facility both 1 EA 35 35 Gross Charge Type: Pharmacy | NDC EA = 1 TAB HYDROmorphone 2 mg Tab [INYO] 11142 CDM 00406-3243-01 NDC facility both 1 EA 35 35 Gross Charge Type: Pharmacy | NDC EA = 1 TAB HYDROmorphone 2 mg Tab [INYO] 11142 CDM 42858-0301-01 NDC facility both 1 EA 35 35 Gross Charge Type: Pharmacy | NDC EA = 1 TAB HYDROmorphone 2 mg Tab [INYO] 11142 CDM 68084-0423-01 NDC facility both 1 EA 35 35 Gross Charge Type: Pharmacy | NDC EA = 1 TAB hydroxypropyl methylcellulose Ophth 2.5% Sol [INYO] 11143 CDM 17478-0064-12 NDC facility both 1 EA 105.7 105.7 Gross Charge Type: Pharmacy | NDC EA = 15 DROPS "HSV 1 and 2 Ab, IgG LC" 11148936 CDM 301 RC facility both 20 20 Gross Charge Type: NIHD_Hosp_Profee_Price "HSV 1 and 2 Ab, IgG LC" 11148936 CDM 301 RC facility both 20 20 Gross Charge Type: NIHD_Hosp_Profee_Price 86602 Hypersensitivity Pneumonitis Profile LC 660670 11149648 CDM 300 RC 86602 HCPCS facility both 125 125 Gross Charge Type: NIHD_Hosp_Profee_Price 86602 Hypersensitivity Pneumonitis Profile LC 660670 11149648 CDM 300 RC 86602 HCPCS facility both 125 125 Gross Charge Type: NIHD_Hosp_Profee_Price 86606 Hypersensitivity Pneumonitis Profile LC 660670 11149650 CDM 300 RC 86606 HCPCS facility both 125 125 Gross Charge Type: NIHD_Hosp_Profee_Price 86606 Hypersensitivity Pneumonitis Profile LC 660670 11149650 CDM 300 RC 86606 HCPCS facility both 125 125 Gross Charge Type: NIHD_Hosp_Profee_Price 86671 Hypersensitivity Pneumonitis Profile LC 660670 11149651 CDM 300 RC 86671 HCPCS facility both 125 125 Gross Charge Type: NIHD_Hosp_Profee_Price 86671 Hypersensitivity Pneumonitis Profile LC 660670 11149651 CDM 300 RC 86671 HCPCS facility both 125 125 Gross Charge Type: NIHD_Hosp_Profee_Price hydrocortisone Top 2.5% Crm [INYO] 11150 CDM 00168-0080-31 NDC facility both 1 EA 55 55 Gross Charge Type: Pharmacy | NDC EA = 30 APP hydrocortisone Top 2.5% Crm [INYO] 11150 CDM 69315-0312-28 NDC facility both 1 EA 360 360 Gross Charge Type: Pharmacy | NDC EA = 30 APP hydrocortisone Top 2.5% Crm [INYO] 11150 CDM 00472-0337-30 NDC facility both 1 EA 55 55 Gross Charge Type: Pharmacy | NDC EA = 30 APP 86609 Hypersensitivity Pneumonitis Profile LC 660670 11151024 CDM 300 RC 86609 HCPCS facility both 125 125 Gross Charge Type: NIHD_Hosp_Profee_Price 86609 Hypersensitivity Pneumonitis Profile LC 660670 11151024 CDM 300 RC 86609 HCPCS facility both 125 125 Gross Charge Type: NIHD_Hosp_Profee_Price beclomethasone 40 mcg/inh Inh Aer w/Adapt [INYO] 11174 CDM 59310-0202-12 NDC facility both 1 EA 738.67 738.67 Gross Charge Type: Pharmacy | NDC EA = 8.7 INH beclomethasone Nasal 0.042 mg/inh Spry [INYO] 11175 CDM 00173-0388-79 NDC facility both 1 EA 1408.12 1408.12 Gross Charge Type: Pharmacy | NDC EA = 25 SPRAYS phenytoin 125 mg/5 mL Oral Susp [INYO] 11180 CDM 51672-4069-01 NDC facility both 237 ML 184.85 184.85 Gross Charge Type: Pharmacy 85598-Lupus Anticoagulant Panel LC 11180112 CDM 300 RC 85598 HCPCS facility both 19.56 19.56 Gross Charge Type: NIHD_Hosp_Profee_Price 85598-Lupus Anticoagulant Panel LC 11180112 CDM 300 RC 85598 HCPCS facility both 19.56 19.56 Gross Charge Type: NIHD_Hosp_Profee_Price 85610-Lupus Anticoagulant Panel LC 11180113 CDM 300 RC 85610 HCPCS facility both 19.56 19.56 Gross Charge Type: NIHD_Hosp_Profee_Price 85610-Lupus Anticoagulant Panel LC 11180113 CDM 300 RC 85610 HCPCS facility both 19.56 19.56 Gross Charge Type: NIHD_Hosp_Profee_Price 85613-Lupus Anticoagulant Panel LC 11180115 CDM 300 RC 85613 HCPCS facility both 19.56 19.56 Gross Charge Type: NIHD_Hosp_Profee_Price 85613-Lupus Anticoagulant Panel LC 11180115 CDM 300 RC 85613 HCPCS facility both 19.56 19.56 Gross Charge Type: NIHD_Hosp_Profee_Price 85730-Lupus Anticoagulant Panel LC 11180116 CDM 300 RC 85730 HCPCS facility both 19.56 19.56 Gross Charge Type: NIHD_Hosp_Profee_Price 85730-Lupus Anticoagulant Panel LC 11180116 CDM 300 RC 85730 HCPCS facility both 19.56 19.56 Gross Charge Type: NIHD_Hosp_Profee_Price 85732-Lupus Anticoagulant Panel LC 11180117 CDM 300 RC 85732 HCPCS facility both 19.56 19.56 Gross Charge Type: NIHD_Hosp_Profee_Price 85732-Lupus Anticoagulant Panel LC 11180117 CDM 300 RC 85732 HCPCS facility both 19.56 19.56 Gross Charge Type: NIHD_Hosp_Profee_Price 86147-Lupus Anticoagulant Panel LC 11180118 CDM 300 RC 86147 HCPCS facility both 19.56 19.56 Gross Charge Type: NIHD_Hosp_Profee_Price 86147-Lupus Anticoagulant Panel LC 11180118 CDM 300 RC 86147 HCPCS facility both 19.56 19.56 Gross Charge Type: NIHD_Hosp_Profee_Price phenytoin 100 mg ERCap [INYO] 11184 CDM 00904-6187-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 CAP gentamicin 20 mg/2 mL Inj Sol [INYO] 11185 CDM J1580 HCPCS 63323-0173-02 NDC facility both 2 ML 330 330 Gross Charge Type: Pharmacy 85670-Lupus Anticoagulant Panel LC 11185130 CDM 300 RC 85670 HCPCS facility both 19.56 19.56 Gross Charge Type: NIHD_Hosp_Profee_Price 85670-Lupus Anticoagulant Panel LC 11185130 CDM 300 RC 85670 HCPCS facility both 19.56 19.56 Gross Charge Type: NIHD_Hosp_Profee_Price 86146-Lupus Anticoagulant Panel LC 11185131 CDM 300 RC 86146 HCPCS facility both 19.56 19.56 Gross Charge Type: NIHD_Hosp_Profee_Price 86146-Lupus Anticoagulant Panel LC 11185131 CDM 300 RC 86146 HCPCS facility both 19.56 19.56 Gross Charge Type: NIHD_Hosp_Profee_Price phytonadione 1 mg/0.5 mL Inj Sol [INYO] 11189 CDM J3430 HCPCS 76329-1240-01 NDC facility both 0.5 ML 235 235 Gross Charge Type: Pharmacy Eosinophil Count LC 005298 11199444 CDM 300 RC facility both 2.93 2.93 Gross Charge Type: NIHD_Hosp_Profee_Price Eosinophil Count LC 005298 11199444 CDM 300 RC facility both 2.93 2.93 Gross Charge Type: NIHD_Hosp_Profee_Price "11201 Removal of skin tags, multiple fibrocutaneous tags, any area; each additional 10 lesions" 11201 CDM 521 RC 11201 HCPCS facility both 34 34 Gross Charge Type: NIHD_RHC_Price "11201 Removal of skin tags, multiple fibrocutaneous tags, any area; each additional 10 lesions" 11201 CDM 521 RC 11201 HCPCS facility both 34 34 Gross Charge Type: NIHD_Clinic_Price Monitor Screen 13 Drug Class Profile (MedWatch) LC 733690 11201493 CDM 300 RC facility both 90 90 Gross Charge Type: NIHD_Hosp_Profee_Price Monitor Screen 13 Drug Class Profile (MedWatch) LC 733690 11201493 CDM 300 RC facility both 90 90 Gross Charge Type: NIHD_Hosp_Profee_Price "Dockweed, Yellow LC 602974" 11211929 CDM 300 RC facility both 3.26 3.26 Gross Charge Type: NIHD_Hosp_Profee_Price "Dockweed, Yellow LC 602974" 11211929 CDM 300 RC facility both 3.26 3.26 Gross Charge Type: NIHD_Hosp_Profee_Price "Ash, White LC 602927" 11212849 CDM 300 RC facility both 3.26 3.26 Gross Charge Type: NIHD_Hosp_Profee_Price "Ash, White LC 602927" 11212849 CDM 300 RC facility both 3.26 3.26 Gross Charge Type: NIHD_Hosp_Profee_Price "83519-AChR Antibodies, Complete Profile LC" 11241636 CDM 301 RC 83519 HCPCS facility both 30.33 30.33 Gross Charge Type: NIHD_Hosp_Profee_Price "83519-AChR Antibodies, Complete Profile LC" 11241636 CDM 301 RC 83519 HCPCS facility both 30.33 30.33 Gross Charge Type: NIHD_Hosp_Profee_Price "Hemoglobin (Hb) A2, Quantitative LC 121060" 11241644 CDM 301 RC facility both 9.16 9.16 Gross Charge Type: NIHD_Hosp_Profee_Price "Hemoglobin (Hb) A2, Quantitative LC 121060" 11241644 CDM 301 RC facility both 9.16 9.16 Gross Charge Type: NIHD_Hosp_Profee_Price 86003 Aspergillus IgE Panel LC 819248 11243471 CDM 300 RC 86003 HCPCS facility both 25 25 Gross Charge Type: NIHD_Hosp_Profee_Price 86003 Aspergillus IgE Panel LC 819248 11243471 CDM 300 RC 86003 HCPCS facility both 25 25 Gross Charge Type: NIHD_Hosp_Profee_Price amantadine 100 mg Cap [INYO] 11247 CDM 00904-7042-06 NDC facility both 1 EA 10.1 10.1 Gross Charge Type: Pharmacy | NDC EA = 1 CAP amantadine 100 mg Cap [INYO] 11247 CDM 00904-6630-61 NDC facility both 1 EA 12.91 12.91 Gross Charge Type: Pharmacy | NDC EA = 1 CAP amantadine 100 mg Cap [INYO] 11247 CDM 00904-6630-06 NDC facility both 1 EA 10.1 10.1 Gross Charge Type: Pharmacy | NDC EA = 1 CAP amantadine 100 mg Cap [INYO] 11247 CDM 50268-0069-15 NDC facility both 1 EA 20.9 20.9 Gross Charge Type: Pharmacy | NDC EA = 1 CAP amantadine 100 mg Cap [INYO] 11247 CDM 68084-0611-01 NDC facility both 1 EA 12.7 12.7 Gross Charge Type: Pharmacy | NDC EA = 1 CAP Aspergillus IgE Panel LC 819248 11251238 CDM 300 RC facility both 25 25 Gross Charge Type: NIHD_Hosp_Profee_Price Aspergillus IgE Panel LC 819248 11251238 CDM 300 RC facility both 25 25 Gross Charge Type: NIHD_Hosp_Profee_Price "a-Thalassemia, DNA Analysis LC 511172" 11268164 CDM 300 RC facility both 285.08 285.08 Gross Charge Type: NIHD_Hosp_Profee_Price "a-Thalassemia, DNA Analysis LC 511172" 11268164 CDM 300 RC facility both 285.08 285.08 Gross Charge Type: NIHD_Hosp_Profee_Price "Buprenorphine, Screen Only, Urine LC 761160" 11268169 CDM 300 RC facility both 15 15 Gross Charge Type: NIHD_Hosp_Profee_Price "Buprenorphine, Screen Only, Urine LC 761160" 11268169 CDM 300 RC facility both 15 15 Gross Charge Type: NIHD_Hosp_Profee_Price "Allergen Profile With Total IgE, Respiratory Area 12 LC 603719" 11268171 CDM 300 RC facility both 3.06 3.06 Gross Charge Type: NIHD_Hosp_Profee_Price "Allergen Profile With Total IgE, Respiratory Area 12 LC 603719" 11268171 CDM 300 RC facility both 3.06 3.06 Gross Charge Type: NIHD_Hosp_Profee_Price "86003-Allergen Profile With Total IgE, Respiratory Area 12 LC 603719" 11268200 CDM 300 RC 86003 HCPCS facility both 3.17 3.17 Gross Charge Type: NIHD_Hosp_Profee_Price "86003-Allergen Profile With Total IgE, Respiratory Area 12 LC 603719" 11268200 CDM 300 RC 86003 HCPCS facility both 3.17 3.17 Gross Charge Type: NIHD_Hosp_Profee_Price Chaetomium Globosum LC 602917 11268391 CDM 300 RC facility both 3.26 3.26 Gross Charge Type: NIHD_Hosp_Profee_Price Chaetomium Globosum LC 602917 11268391 CDM 300 RC facility both 3.26 3.26 Gross Charge Type: NIHD_Hosp_Profee_Price Common Silver Birch LC 602936 11272600 CDM 300 RC facility both 3.26 3.26 Gross Charge Type: NIHD_Hosp_Profee_Price Common Silver Birch LC 602936 11272600 CDM 300 RC facility both 3.26 3.26 Gross Charge Type: NIHD_Hosp_Profee_Price "Plantain, English LC 602536" 11272605 CDM 300 RC facility both 3.26 3.26 Gross Charge Type: NIHD_Hosp_Profee_Price "Plantain, English LC 602536" 11272605 CDM 300 RC facility both 3.26 3.26 Gross Charge Type: NIHD_Hosp_Profee_Price Eucalyptus LC 602930 11282485 CDM 300 RC facility both 3.26 3.26 Gross Charge Type: NIHD_Hosp_Profee_Price Eucalyptus LC 602930 11282485 CDM 300 RC facility both 3.26 3.26 Gross Charge Type: NIHD_Hosp_Profee_Price Macroprolactin LC 11283420 CDM 301 RC 84146 HCPCS facility both 36.25 36.25 Gross Charge Type: NIHD_Hosp_Profee_Price Macroprolactin LC 11283420 CDM 301 RC 84146 HCPCS facility both 36.25 36.25 Gross Charge Type: NIHD_Hosp_Profee_Price Asparagus LC 11285328 CDM 301 RC facility both 3.26 3.26 Gross Charge Type: NIHD_Hosp_Profee_Price Asparagus LC 11285328 CDM 301 RC facility both 3.26 3.26 Gross Charge Type: NIHD_Hosp_Profee_Price 85014 11285517 CDM 301 RC 85014 HCPCS facility both 5 5 Gross Charge Type: NIHD_Hosp_Profee_Price 85014 11285517 CDM 301 RC 85014 HCPCS facility both 5 5 Gross Charge Type: NIHD_Hosp_Profee_Price "84165 Protein Electrophoresis with Interpretation, Serum with Reflex to IFE, Serum LC" 11288022 CDM 301 RC 84165 HCPCS facility both 3.98 3.98 Gross Charge Type: NIHD_Hosp_Profee_Price "84165 Protein Electrophoresis with Interpretation, Serum with Reflex to IFE, Serum LC" 11288022 CDM 301 RC 84165 HCPCS facility both 3.98 3.98 Gross Charge Type: NIHD_Hosp_Profee_Price GI Enteric Pathogen Panel LC 11288590 CDM 301 RC facility both 408.5 408.5 Gross Charge Type: NIHD_Hosp_Profee_Price GI Enteric Pathogen Panel LC 11288590 CDM 301 RC facility both 408.5 408.5 Gross Charge Type: NIHD_Hosp_Profee_Price lidocaine Top 4% Sol [INYO] 11292 CDM 00527-6004-80 NDC facility both 1 EA 260 260 Gross Charge Type: Pharmacy | NDC EA = 50 APP lidocaine Top 4% Sol [INYO] 11292 CDM 00054-3505-47 NDC facility both 1 EA 240 240 Gross Charge Type: Pharmacy | NDC EA = 50 APP lidocaine Top 4% Sol [INYO] 11292 CDM 60432-0465-51 NDC facility both 1 EA 240 240 Gross Charge Type: Pharmacy | NDC EA = 50 APP lidocaine Top 4% Sol [INYO] 11292 CDM 52565-0009-50 NDC facility both 1 EA 260 260 Gross Charge Type: Pharmacy | NDC EA = 50 APP polyethylene glycol 3350 with electrolytes - Pow [INYO] 11298 CDM 43386-0090-19 NDC facility both 4000 ML 105.6 105.6 Gross Charge Type: Pharmacy polyethylene glycol 3350 with electrolytes Oral Pwdr for Sol 4000 mL [INYO] 11298 CDM 52268-0100-01 NDC facility both 4000 ML 115 115 Gross Charge Type: Pharmacy "11300 Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion < 0.5cm" 11300 CDM 521 RC 11300 HCPCS facility both 367 367 Gross Charge Type: NIHD_RHC_Price "11300 Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion < 0.5cm" 11300 CDM 521 RC 11300 HCPCS facility both 367 367 Gross Charge Type: NIHD_Clinic_Price "11301 Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion 0.6 to 1.0cm" 11301 CDM 521 RC 11301 HCPCS facility both 467 467 Gross Charge Type: NIHD_RHC_Price "11301 Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion 0.6 to 1.0cm" 11301 CDM 521 RC 11301 HCPCS facility both 467 467 Gross Charge Type: NIHD_Clinic_Price "11302 Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion 1.1 to 2.0cm" 11302 CDM 521 RC 11302 HCPCS facility both 533 533 Gross Charge Type: NIHD_RHC_Price "11302 Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion 1.1 to 2.0cm" 11302 CDM 521 RC 11302 HCPCS facility both 533 533 Gross Charge Type: NIHD_Clinic_Price "11303 Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion >2.0cm" 11303 CDM 521 RC 11303 HCPCS facility both 582 582 Gross Charge Type: NIHD_RHC_Price "11303 Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion >2.0cm" 11303 CDM 521 RC 11303 HCPCS facility both 582 582 Gross Charge Type: NIHD_Clinic_Price "11305 Shaving of epidermal or dermal lesion; scalp, neck, hands, feet, genitalia; > 0.5cm" 11305 CDM 521 RC 11305 HCPCS facility both 367 367 Gross Charge Type: NIHD_RHC_Price clarithromycin 250 mg/5 mL Oral Liq [INYO] 11305 CDM 00781-6023-52 NDC facility both 50 ML 428.6 428.6 Gross Charge Type: Pharmacy "84403 - Testosterone, Free/Tot Equilib LC" 11305974 CDM 301 RC 84403 HCPCS facility both 26.78 26.78 Gross Charge Type: NIHD_Hosp_Profee_Price "84403 - Testosterone, Free/Tot Equilib LC" 11305974 CDM 301 RC 84403 HCPCS facility both 26.78 26.78 Gross Charge Type: NIHD_Hosp_Profee_Price "11306 Shaving of epidermal or dermal lesion; scalp, neck, hands, feet, genitalia; 0.6-1.0cm" 11306 CDM 521 RC 11306 HCPCS facility both 467 467 Gross Charge Type: NIHD_RHC_Price "11306 Shaving of epidermal or dermal lesion; scalp, neck, hands, feet, genitalia; 0.6-1.0cm" 11306 CDM 521 RC 11306 HCPCS facility both 467 467 Gross Charge Type: NIHD_Clinic_Price "11307 Shaving of epidermal or dermal lesion; scalp, neck, hands, feet, genitalia; 1.1-2.0cm" 11307 CDM 521 RC 11307 HCPCS facility both 533 533 Gross Charge Type: NIHD_RHC_Price "11307 Shaving of epidermal or dermal lesion; scalp, neck, hands, feet, genitalia; 1.1-2.0cm" 11307 CDM 521 RC 11307 HCPCS facility both 263 263 Gross Charge Type: NIHD_Clinic_Price clotrimazole Top 1% Crm [INYO] 11309 CDM 00536-1272-11 NDC facility both 1 EA 15 15 Gross Charge Type: Pharmacy | NDC EA = 15 APP clotrimazole Top 1% Crm [INYO] 11309 CDM 51672-1275-01 NDC facility both 1 EA 99.7 99.7 Gross Charge Type: Pharmacy | NDC EA = 15 APP clotrimazole Top 1% Crm [INYO] 11309 CDM 00904-7822-36 NDC facility both 1 EA 26.45 26.45 Gross Charge Type: Pharmacy | NDC EA = 15 APP "11310 Shaving of lesion; face, ears, eyelids, nose, lips, mucous membrane; < 0.5cm" 11310 CDM 521 RC 11310 HCPCS facility both 367 367 Gross Charge Type: NIHD_RHC_Price "11310 Shaving of lesion; face, ears, eyelids, nose, lips, mucous membrane; < 0.5cm" 11310 CDM 521 RC 11310 HCPCS facility both 352 352 Gross Charge Type: NIHD_Clinic_Price "11311 Shaving of lesion; face, ears, eyelids, nose, lips, mucous membrane; 0.6-1.0cm" 11311 CDM 521 RC 11311 HCPCS facility both 467 467 Gross Charge Type: NIHD_RHC_Price "11311 Shaving of lesion; face, ears, eyelids, nose, lips, mucous membrane; 0.6-1.0cm" 11311 CDM 521 RC 11311 HCPCS facility both 467 467 Gross Charge Type: NIHD_Clinic_Price "11312 Shaving of lesion; face, ears, eyelids, nose, lips, mucous membrane; 1.1-2.0cm" 11312 CDM 521 RC 11312 HCPCS facility both 533 533 Gross Charge Type: NIHD_RHC_Price "11312 Shaving of lesion; face, ears, eyelids, nose, lips, mucous membrane; 1.1-2.0cm" 11312 CDM 521 RC 11312 HCPCS facility both 533 533 Gross Charge Type: NIHD_Clinic_Price guaiFENesin 600 mg ER Tab [INYO] 11322 CDM 00904-6718-39 NDC facility both 1 EA 6.41 6.41 Gross Charge Type: Pharmacy | NDC EA = 1 TAB guaiFENesin 600 mg ER Tab [INYO] 11322 CDM 68084-0572-01 NDC facility both 1 EA 6.01 6.01 Gross Charge Type: Pharmacy | NDC EA = 1 TAB "83018 Chromium and Cobalt, Whole Blood LC" 11340037 CDM 301 RC 83018 HCPCS facility both 16 16 Gross Charge Type: NIHD_Hosp_Profee_Price "83018 Chromium and Cobalt, Whole Blood LC" 11340037 CDM 301 RC 83018 HCPCS facility both 16 16 Gross Charge Type: NIHD_Hosp_Profee_Price "Estrogens, Total Serum LC 504796" 11343292 CDM 301 RC facility both 21.95 21.95 Gross Charge Type: NIHD_Hosp_Profee_Price "Estrogens, Total Serum LC 504796" 11343292 CDM 301 RC facility both 21.95 21.95 Gross Charge Type: NIHD_Hosp_Profee_Price Inheritest 14-gene Panel LC 11345139 CDM 300 RC facility both 25.77 25.77 Gross Charge Type: NIHD_Hosp_Profee_Price 81200 Inheritest 14-gene Panel LC 11345139_81200 CDM 300 RC 81200 HCPCS facility both 25.77 25.77 Gross Charge Type: NIHD_Hosp_Profee_Price 81209 Inheritest 14-gene Panel LC 11345139_81209 CDM 300 RC 81209 HCPCS facility both 25.77 25.77 Gross Charge Type: NIHD_Hosp_Profee_Price 81220 Inheritest 14-gene Panel LC 11345139_81220 CDM 300 RC 81220 HCPCS facility both 25.77 25.77 Gross Charge Type: NIHD_Hosp_Profee_Price 81242 Inheritest 14-gene Panel LC 11345139_81242 CDM 300 RC 81242 HCPCS facility both 25.77 25.77 Gross Charge Type: NIHD_Hosp_Profee_Price 81243 Inheritest 14-gene Panel LC 11345139_81243 CDM 300 RC 81243 HCPCS facility both 25.77 25.77 Gross Charge Type: NIHD_Hosp_Profee_Price 81251 Inheritest 14-gene Panel LC 11345139_81251 CDM 300 RC 81251 HCPCS facility both 25.77 25.77 Gross Charge Type: NIHD_Hosp_Profee_Price 81255 Inheritest 14-gene Panel LC 11345139_81255 CDM 300 RC 81255 HCPCS facility both 25.77 25.77 Gross Charge Type: NIHD_Hosp_Profee_Price 81260 Inheritest 14-gene Panel LC 11345139_81260 CDM 300 RC 81260 HCPCS facility both 25.77 25.77 Gross Charge Type: NIHD_Hosp_Profee_Price 81290 Inheritest 14-gene Panel LC 11345139_81290 CDM 300 RC 81290 HCPCS facility both 25.77 25.77 Gross Charge Type: NIHD_Hosp_Profee_Price 81329 Inheritest 14-gene Panel LC 11345139_81329 CDM 300 RC 81329 HCPCS facility both 25.77 25.77 Gross Charge Type: NIHD_Hosp_Profee_Price 81330 Inheritest 14-gene Panel LC 11345139_81330 CDM 300 RC 81330 HCPCS facility both 25.77 25.77 Gross Charge Type: NIHD_Hosp_Profee_Price 81361 Inheritest 14-gene Panel LC 11345139_81361 CDM 300 RC 81361 HCPCS facility both 25.77 25.77 Gross Charge Type: NIHD_Hosp_Profee_Price 81363 Inheritest 14-gene Panel LC 11345139_81363 CDM 300 RC 81363 HCPCS facility both 25.76 25.76 Gross Charge Type: NIHD_Hosp_Profee_Price 81363 Inheritest 14-gene Panel LC 11345139_81363 CDM 300 RC 81363 HCPCS facility both 25.76 25.76 Gross Charge Type: NIHD_Hosp_Profee_Price RING PESSARY INCONTINENCE #2 1135112 CDM facility both 203 203 Gross Charge Type: NIHD_Hosp_Profee_Price RING PESSARY INCONTINENCE #2 1135112 CDM facility both 203 203 Gross Charge Type: NIHD_Hosp_Profee_Price "87206-M tuberculusis PCR, AFB Smear and Culture LC" 11375663 CDM 300 RC 87206 HCPCS facility both 91.32 91.32 Gross Charge Type: NIHD_Hosp_Profee_Price "87206-M tuberculusis PCR, AFB Smear and Culture LC" 11375663 CDM 300 RC 87206 HCPCS facility both 91.32 91.32 Gross Charge Type: NIHD_Hosp_Profee_Price "87556-M tuberculusis PCR, AFB Smear and Culture LC" 11375664 CDM 300 RC 87556 HCPCS facility both 91.38 91.38 Gross Charge Type: NIHD_Hosp_Profee_Price "87556-M tuberculusis PCR, AFB Smear and Culture LC" 11375664 CDM 300 RC 87556 HCPCS facility both 91.38 91.38 Gross Charge Type: NIHD_Hosp_Profee_Price "Ustekinumab and Anti-Ustekinumab Antibody, DoseASSURE UST LC 504594" 11387230 CDM 301 RC facility both 125 125 Gross Charge Type: NIHD_Hosp_Profee_Price "Ustekinumab and Anti-Ustekinumab Antibody, DoseASSURE UST LC 504594" 11387230 CDM 301 RC facility both 125 125 Gross Charge Type: NIHD_Hosp_Profee_Price "M tuberculosis PCR, AFB Smear and Culture LC" 11387314 CDM 300 RC facility both 91.32 91.32 Gross Charge Type: NIHD_Hosp_Profee_Price "M tuberculosis PCR, AFB Smear and Culture LC" 11387314 CDM 300 RC facility both 91.32 91.32 Gross Charge Type: NIHD_Hosp_Profee_Price "87798-M tuberculusis PCR, AFB Smear and Culture LC" 11387805 CDM 300 RC 87798 HCPCS facility both 91.32 91.32 Gross Charge Type: NIHD_Hosp_Profee_Price "87798-M tuberculusis PCR, AFB Smear and Culture LC" 11387805 CDM 300 RC 87798 HCPCS facility both 91.32 91.32 Gross Charge Type: NIHD_Hosp_Profee_Price azithromycin 250 mg Tab 11396 CDM 00904-7350-06 NDC facility both 1 EA 8.89 8.89 Gross Charge Type: Pharmacy | NDC EA = 1 TAB azithromycin 250 mg Tab [INYO] 11396 CDM 50268-0074-15 NDC facility both 1 EA 8.89 8.89 Gross Charge Type: Pharmacy | NDC EA = 1 TAB azithromycin 250 mg Tab [INYO] 11396 CDM 60687-0742-65 NDC facility both 1 EA 11.23 11.23 Gross Charge Type: Pharmacy | NDC EA = 1 TAB azithromycin 250 mg Tab [INYO] 11396 CDM 00904-6708-06 NDC facility both 1 EA 8.89 8.89 Gross Charge Type: Pharmacy | NDC EA = 1 TAB azithromycin 250 mg Tab [INYO] 11396 CDM 00904-6405-06 NDC facility both 1 EA 17.55 17.55 Gross Charge Type: Pharmacy | NDC EA = 1 TAB azithromycin 200 mg/5 mL Oral Liq [INYO] 11397 CDM Q0144 HCPCS 42806-0150-33 NDC facility both 22.5 ML 174.4 174.4 Gross Charge Type: Pharmacy azithromycin 200 mg/5 mL Oral Liq [INYO] 11397 CDM Q0144 HCPCS 00093-2026-94 NDC facility both 22.5 ML 174.4 174.4 Gross Charge Type: Pharmacy "11400 Excision, benign lesion including margins; trunk, arms or legs; < 0.5cm" 114001 CDM 521 RC 11400 HCPCS facility both 227 227 Gross Charge Type: NIHD_RHC_Price "11400 Excision, benign lesion including margins; trunk, arms or legs; < 0.5cm" 114001 CDM 521 RC 11400 HCPCS facility both 227 227 Gross Charge Type: NIHD_Clinic_Price "11400 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee" 114002 CDM 982 RC 11400 HCPCS facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price "11400 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee" 114002 CDM 982 RC 11400 HCPCS facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price "11401 Excision, benign lesion including margins; trunk, arms or legs; 0.6-1.0cm" 114011 CDM 521 RC 11401 HCPCS facility both 274 274 Gross Charge Type: NIHD_RHC_Price "11401 Excision, benign lesion including margins; trunk, arms or legs; 0.6-1.0cm" 114011 CDM 521 RC 11401 HCPCS facility both 274 274 Gross Charge Type: NIHD_Clinic_Price "11401 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee" 114012 CDM 982 RC 11401 HCPCS facility both 313 313 Gross Charge Type: NIHD_Hosp_Profee_Price "11401 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee" 114012 CDM 982 RC 11401 HCPCS facility both 313 313 Gross Charge Type: NIHD_Hosp_Profee_Price "Porphyrins, Total Serum LC" 11401257 CDM 301 RC facility both 46.85 46.85 Gross Charge Type: NIHD_Hosp_Profee_Price "Porphyrins, Total Serum LC" 11401257 CDM 301 RC facility both 46.85 46.85 Gross Charge Type: NIHD_Hosp_Profee_Price "11402 Excision, benign lesion including margins; trunk, arms or legs; 1.1-2.0cm" 114021 CDM 521 RC 11402 HCPCS facility both 304 304 Gross Charge Type: NIHD_RHC_Price "11402 Excision, benign lesion including margins; trunk, arms or legs; 1.1-2.0cm" 114021 CDM 521 RC 11402 HCPCS facility both 304 304 Gross Charge Type: NIHD_Clinic_Price "11402 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee" 114022 CDM 982 RC 11402 HCPCS facility both 330 330 Gross Charge Type: NIHD_Hosp_Profee_Price "11402 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee" 114022 CDM 982 RC 11402 HCPCS facility both 330 330 Gross Charge Type: NIHD_Hosp_Profee_Price "11403 Excision, benign lesion including margins; trunk, arms or legs; 2.1-3.0cm" 114031 CDM 521 RC 11403 HCPCS facility both 349 349 Gross Charge Type: NIHD_RHC_Price "11403 Excision, benign lesion including margins; trunk, arms or legs; 2.1-3.0cm" 114031 CDM 521 RC 11403 HCPCS facility both 624 624 Gross Charge Type: NIHD_Clinic_Price "11403 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee" 114032 CDM 982 RC 11403 HCPCS facility both 400 400 Gross Charge Type: NIHD_Hosp_Profee_Price "11403 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee" 114032 CDM 982 RC 11403 HCPCS facility both 400 400 Gross Charge Type: NIHD_Hosp_Profee_Price "11404 Excision, benign lesion including margins; trunk, arms or legs; 3.1-4.0cm" 114041 CDM 521 RC 11404 HCPCS facility both 396 396 Gross Charge Type: NIHD_RHC_Price "11404 Excision, benign lesion including margins; trunk, arms or legs; 3.1-4.0cm" 114041 CDM 521 RC 11404 HCPCS facility both 396 396 Gross Charge Type: NIHD_Clinic_Price "11404 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee" 114042 CDM 982 RC 11404 HCPCS facility both 338 338 Gross Charge Type: NIHD_Hosp_Profee_Price "11404 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee" 114042 CDM 982 RC 11404 HCPCS facility both 338 338 Gross Charge Type: NIHD_Hosp_Profee_Price "11406 Excision, benign lesion including margins; trunk, arms or legs; >4.0cm" 114061 CDM 521 RC 11406 HCPCS facility both 559 559 Gross Charge Type: NIHD_RHC_Price "11406 Excision, benign lesion including margins; trunk, arms or legs; >4.0cm" 114061 CDM 521 RC 11406 HCPCS facility both 559 559 Gross Charge Type: NIHD_Clinic_Price "11406 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee" 114062 CDM 982 RC 11406 HCPCS facility both 501 501 Gross Charge Type: NIHD_Hosp_Profee_Price "11406 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee" 114062 CDM 982 RC 11406 HCPCS facility both 501 501 Gross Charge Type: NIHD_Hosp_Profee_Price amphotericin B 50 mg IV Inj [INYO] 11412 CDM J0285 HCPCS 39822-1055-05 NDC facility both 1 EA 330 330 Gross Charge Type: Pharmacy EXC BNGN LES S/N/H/F/G 0.5 CM/< 114201 CDM 521 RC 11420 HCPCS facility both 229 229 Gross Charge Type: NIHD_RHC_Price EXC BNGN LES S/N/H/F/G 0.5 CM/< 114201 CDM 521 RC 11420 HCPCS facility both 229 229 Gross Charge Type: NIHD_Clinic_Price "11420 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee" 114202 CDM 982 RC 11420 HCPCS facility both 167 167 Gross Charge Type: NIHD_Hosp_Profee_Price "11420 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee" 114202 CDM 982 RC 11420 HCPCS facility both 167 167 Gross Charge Type: NIHD_Hosp_Profee_Price EXC BNGN LES S/N/H/F/G 0.6-1.0 114211 CDM 521 RC 11421 HCPCS facility both 286 286 Gross Charge Type: NIHD_RHC_Price EXC BNGN LES S/N/H/F/G 0.6-1.0 114211 CDM 521 RC 11421 HCPCS facility both 286 286 Gross Charge Type: NIHD_Clinic_Price "11421 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee" 114212 CDM 982 RC 11421 HCPCS facility both 326 326 Gross Charge Type: NIHD_Hosp_Profee_Price "11421 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee" 114212 CDM 982 RC 11421 HCPCS facility both 326 326 Gross Charge Type: NIHD_Hosp_Profee_Price "11422 Excision, benign lesion including margins; scalp, neck, hands, feet, genitalia; 1.1-2.0cm" 114221 CDM 521 RC 11422 HCPCS facility both 322 322 Gross Charge Type: NIHD_RHC_Price "11422 Excision, benign lesion including margins; scalp, neck, hands, feet, genitalia; 1.1-2.0cm" 114221 CDM 521 RC 11422 HCPCS facility both 322 322 Gross Charge Type: NIHD_Clinic_Price "11422 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee" 114222 CDM 982 RC 11422 HCPCS facility both 277 277 Gross Charge Type: NIHD_Hosp_Profee_Price "11422 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee" 114222 CDM 982 RC 11422 HCPCS facility both 277 277 Gross Charge Type: NIHD_Hosp_Profee_Price "11423 Excision, benign lesion including margins; scalp, neck, hands, feet, genitalia; 2.1-3.0cm" 114231 CDM 521 RC 11423 HCPCS facility both 363 363 Gross Charge Type: NIHD_RHC_Price "11423 Excision, benign lesion including margins; scalp, neck, hands, feet, genitalia; 2.1-3.0cm" 114231 CDM 521 RC 11423 HCPCS facility both 363 363 Gross Charge Type: NIHD_Clinic_Price "11423 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee" 114232 CDM 982 RC 11423 HCPCS facility both 326 326 Gross Charge Type: NIHD_Hosp_Profee_Price "11423 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee" 114232 CDM 982 RC 11423 HCPCS facility both 326 326 Gross Charge Type: NIHD_Hosp_Profee_Price "11424 Excision, benign lesion including margins; scalp, neck, hands, feet, genitalia; 3.1-4.0cm" 114241 CDM 521 RC 11424 HCPCS facility both 419 419 Gross Charge Type: NIHD_RHC_Price "11424 Excision, benign lesion including margins; scalp, neck, hands, feet, genitalia; 3.1-4.0cm" 114241 CDM 521 RC 11424 HCPCS facility both 419 419 Gross Charge Type: NIHD_Clinic_Price "11424 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee" 114242 CDM 982 RC 11424 HCPCS facility both 330 330 Gross Charge Type: NIHD_Hosp_Profee_Price "11424 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee" 114242 CDM 982 RC 11424 HCPCS facility both 330 330 Gross Charge Type: NIHD_Hosp_Profee_Price "11426 Excision, benign lesion including margins; scalp, neck, hands, feet, genitalia; > 4.0cm" 114261 CDM 521 RC 11426 HCPCS facility both 594 594 Gross Charge Type: NIHD_RHC_Price "11426 Excision, benign lesion including margins; scalp, neck, hands, feet, genitalia; > 4.0cm" 114261 CDM 521 RC 11426 HCPCS facility both 594 594 Gross Charge Type: NIHD_Clinic_Price "11426 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee" 114262 CDM 982 RC 11426 HCPCS facility both 687 687 Gross Charge Type: NIHD_Hosp_Profee_Price "11426 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), ProFee" 114262 CDM 982 RC 11426 HCPCS facility both 687 687 Gross Charge Type: NIHD_Hosp_Profee_Price IAA+GAD 65 LC 11433189 CDM 301 RC facility both 242.25 242.25 Gross Charge Type: NIHD_Hosp_Profee_Price IAA+GAD 65 LC 11433189 CDM 301 RC facility both 242.25 242.25 Gross Charge Type: NIHD_Hosp_Profee_Price cyclobenzaprine 10 mg Tab [INYO] 11439 CDM 69097-0846-07 NDC facility both 1 EA 6.95 6.95 Gross Charge Type: Pharmacy | NDC EA = 1 TAB cyclobenzaprine 10 mg Tab [INYO] 11439 CDM 60687-0558-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB cyclobenzaprine 10 mg Tab [INYO] 11439 CDM 51079-0644-20 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB "11440 Excision, benign lesion including margins; face, ears, eyelids, nose, lips; < 0.5cm" 114401 CDM 521 RC 11440 HCPCS facility both 251 251 Gross Charge Type: NIHD_RHC_Price "11440 Excision, benign lesion including margins; face, ears, eyelids, nose, lips; < 0.5cm" 114401 CDM 521 RC 11440 HCPCS facility both 251 251 Gross Charge Type: NIHD_Clinic_Price 11440 EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/< TechFee 114402 CDM 450 RC facility both 1818 1818 Gross Charge Type: NIHD_Hosp_Profee_Price 11440 EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/< TechFee 114402 CDM 450 RC facility both 1818 1818 Gross Charge Type: NIHD_Hosp_Profee_Price "11440 EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWH ProFee" 114403 CDM 982 RC 11440 HCPCS facility both 185 185 Gross Charge Type: NIHD_Hosp_Profee_Price "11440 EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWH ProFee" 114403 CDM 982 RC 11440 HCPCS facility both 185 185 Gross Charge Type: NIHD_Hosp_Profee_Price "11441 Excision, benign lesion including margins; face, ears, eyelids, nose, lips; 0.6-1.0cm" 114411 CDM 521 RC 11441 HCPCS facility both 308 308 Gross Charge Type: NIHD_RHC_Price "11441 Excision, benign lesion including margins; face, ears, eyelids, nose, lips; 0.6-1.0cm" 114411 CDM 521 RC 11441 HCPCS facility both 308 308 Gross Charge Type: NIHD_Clinic_Price "11441 EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWH ProFee" 114412 CDM 982 RC 11441 HCPCS facility both 250 250 Gross Charge Type: NIHD_Hosp_Profee_Price "11441 EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWH ProFee" 114412 CDM 982 RC 11441 HCPCS facility both 250 250 Gross Charge Type: NIHD_Hosp_Profee_Price EXC BNGN LES S/N/H/F/G 1.1-2.0 114421 CDM 521 RC 11442 HCPCS facility both 341 341 Gross Charge Type: NIHD_RHC_Price EXC BNGN LES S/N/H/F/G 1.1-2.0 114421 CDM 521 RC 11442 HCPCS facility both 341 341 Gross Charge Type: NIHD_Clinic_Price "11442 EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWH ProFee" 114422 CDM 982 RC 11442 HCPCS facility both 363 363 Gross Charge Type: NIHD_Hosp_Profee_Price "11442 EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWH ProFee" 114422 CDM 982 RC 11442 HCPCS facility both 363 363 Gross Charge Type: NIHD_Hosp_Profee_Price "11443 Excision, benign lesion including margins; face, ears, eyelids, nose, lips; 2.1-3.0cm" 114431 CDM 521 RC 11443 HCPCS facility both 403 403 Gross Charge Type: NIHD_RHC_Price "11443 Excision, benign lesion including margins; face, ears, eyelids, nose, lips; 2.1-3.0cm" 114431 CDM 521 RC 11443 HCPCS facility both 403 403 Gross Charge Type: NIHD_Clinic_Price "11443 EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWH ProFee" 114432 CDM 982 RC 11443 HCPCS facility both 363 363 Gross Charge Type: NIHD_Hosp_Profee_Price "11443 EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWH ProFee" 114432 CDM 982 RC 11443 HCPCS facility both 363 363 Gross Charge Type: NIHD_Hosp_Profee_Price "11444 Excision, benign lesion including margins; face, ears, eyelids, nose, lips; 3.1-4.0cm" 114441 CDM 521 RC 11444 HCPCS facility both 504 504 Gross Charge Type: NIHD_RHC_Price "11444 Excision, benign lesion including margins; face, ears, eyelids, nose, lips; 3.1-4.0cm" 114441 CDM 521 RC 11444 HCPCS facility both 504 504 Gross Charge Type: NIHD_Clinic_Price "11444 EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWH ProFee" 114442 CDM 982 RC 11444 HCPCS facility both 400 400 Gross Charge Type: NIHD_Hosp_Profee_Price "11444 EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWH ProFee" 114442 CDM 982 RC 11444 HCPCS facility both 400 400 Gross Charge Type: NIHD_Hosp_Profee_Price "11446 Excision, benign lesion including margins; face, ears, eyelids, nose, lips; > 4.0cm" 114461 CDM 521 RC 11446 HCPCS facility both 690 690 Gross Charge Type: NIHD_RHC_Price "11446 Excision, benign lesion including margins; face, ears, eyelids, nose, lips; > 4.0cm" 114461 CDM 521 RC 11446 HCPCS facility both 690 690 Gross Charge Type: NIHD_Clinic_Price "11446 EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWH ProFee" 114462 CDM 982 RC 11446 HCPCS facility both 569 569 Gross Charge Type: NIHD_Hosp_Profee_Price "11446 EXCISION, OTHER BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN TAG (UNLESS LISTED ELSEWH ProFee" 114462 CDM 982 RC 11446 HCPCS facility both 569 569 Gross Charge Type: NIHD_Hosp_Profee_Price UA w Micro if Ind 1148022 CDM 307 RC facility both 48 48 Gross Charge Type: NIHD_Hosp_Profee_Price UA w Micro if Ind 1148022 CDM 307 RC facility both 48 48 Gross Charge Type: NIHD_Hosp_Profee_Price "2019 Novel Coronavirus (COVID-19), NAA using Saliva Collection LC 139945" 11527584 CDM 301 RC facility both 100 100 Gross Charge Type: NIHD_Hosp_Profee_Price "2019 Novel Coronavirus (COVID-19), NAA using Saliva Collection LC 139945" 11527584 CDM 301 RC facility both 100 100 Gross Charge Type: NIHD_Hosp_Profee_Price Adenovirus (Type 40/41)/Rotavirus. Direct Detection EIA LC 11530235 CDM 301 RC facility both 22.4 22.4 Gross Charge Type: NIHD_Hosp_Profee_Price Adenovirus (Type 40/41)/Rotavirus. Direct Detection EIA LC 11530235 CDM 301 RC facility both 22.4 22.4 Gross Charge Type: NIHD_Hosp_Profee_Price Microsporidia Stain LC 11530296 CDM 301 RC facility both 50 50 Gross Charge Type: NIHD_Hosp_Profee_Price Microsporidia Stain LC 11530296 CDM 301 RC facility both 50 50 Gross Charge Type: NIHD_Hosp_Profee_Price "Mesh: 3DMax Mesh, Left, Size XL, 5"" x 7""" 115312 CDM 278 RC facility both 1044 1044 Gross Charge Type: NIHD_Hosp_Profee_Price "Mesh: 3DMax Mesh, Left, Size XL, 5"" x 7""" 115312 CDM 278 RC facility both 1044 1044 Gross Charge Type: NIHD_Hosp_Profee_Price lovastatin 20 mg Tab [INYO] 11554 CDM 68180-0468-01 NDC facility both 1 EA 14.24 14.24 Gross Charge Type: Pharmacy | NDC EA = 1 TAB lovastatin 20 mg Tab [INYO] 11554 CDM 63739-0281-10 NDC facility both 1 EA 17.43 17.43 Gross Charge Type: Pharmacy | NDC EA = 1 TAB LORazepam 1 mg Tab [INYO] 11555 CDM 00904-6008-61 NDC facility both 1 EA 35 35 Gross Charge Type: Pharmacy | NDC EA = 1 TAB LORazepam 1 mg Tab [INYO] 11555 CDM 60687-0638-01 NDC facility both 1 EA 35 35 Gross Charge Type: Pharmacy | NDC EA = 1 TAB LORazepam 1 mg Tab [INYO] 11555 CDM 51079-0386-20 NDC facility both 1 EA 35 35 Gross Charge Type: Pharmacy | NDC EA = 1 TAB LORazepam 1 mg Tab [INYO] 11555 CDM 63739-0500-10 NDC facility both 1 EA 35 35 Gross Charge Type: Pharmacy | NDC EA = 1 TAB LORazepam 1 mg Tab [INYO] 11555 CDM 69315-0905-01 NDC facility both 1 EA 35 35 Gross Charge Type: Pharmacy | NDC EA = 1 TAB loperamide 2 mg Cap [INYO] 11557 CDM 60687-0229-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 CAP loperamide 2 mg Cap [INYO] 11557 CDM 51079-0690-20 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 CAP APAP-codeine 120 mg-12 mg/5 mL Oral Liq 5 mL [INYO] 11576 CDM 00121-0504-05 NDC facility both 5 ML 35 35 Gross Charge Type: Pharmacy amikacin 250 mg/mL [INYO] 11592 CDM J0278 HCPCS 00703-9032-03 NDC facility both 2 ML 330 330 Gross Charge Type: Pharmacy amikacin 250 mg/mL [INYO] 11592 CDM J0278 HCPCS 23155-0290-41 NDC facility both 2 ML 330 330 Gross Charge Type: Pharmacy "11600 Excision, malignant lesion including margins, trunk, arms, or legs; < 0.5cm" 116001 CDM 521 RC 11600 HCPCS facility both 354 354 Gross Charge Type: NIHD_RHC_Price "11600 Excision, malignant lesion including margins, trunk, arms, or legs; < 0.5cm" 116001 CDM 521 RC 11600 HCPCS facility both 354 354 Gross Charge Type: NIHD_Clinic_Price "11600 EXCISION, MALIGNANT LESION INCLUDING MARGINS, TRUNK, ARMS, OR LEGS; EXCISED DIAMETER 0 ProFee" 116002 CDM 982 RC 11600 HCPCS facility both 215 215 Gross Charge Type: NIHD_Hosp_Profee_Price "11600 EXCISION, MALIGNANT LESION INCLUDING MARGINS, TRUNK, ARMS, OR LEGS; EXCISED DIAMETER 0 ProFee" 116002 CDM 982 RC 11600 HCPCS facility both 215 215 Gross Charge Type: NIHD_Hosp_Profee_Price "11601 Excision, malignant lesion including margins, trunk, arms, or legs; 0.6-1.0cm" 116011 CDM 521 RC 11601 HCPCS facility both 410 410 Gross Charge Type: NIHD_RHC_Price "11601 Excision, malignant lesion including margins, trunk, arms, or legs; 0.6-1.0cm" 116011 CDM 521 RC 11601 HCPCS facility both 410 410 Gross Charge Type: NIHD_Clinic_Price "11601 EXCISION, MALIGNANT LESION INCLUDING MARGINS, TRUNK, ARMS, OR LEGS; EXCISED DIAMETER 0 ProFee" 116012 CDM 982 RC 11601 HCPCS facility both 263 263 Gross Charge Type: NIHD_Hosp_Profee_Price "11601 EXCISION, MALIGNANT LESION INCLUDING MARGINS, TRUNK, ARMS, OR LEGS; EXCISED DIAMETER 0 ProFee" 116012 CDM 982 RC 11601 HCPCS facility both 263 263 Gross Charge Type: NIHD_Hosp_Profee_Price "11602 Excision, malignant lesion including margins, trunk, arms, or legs; 1.1-2.0cm" 116021 CDM 521 RC 11602 HCPCS facility both 442 442 Gross Charge Type: NIHD_RHC_Price "11602 Excision, malignant lesion including margins, trunk, arms, or legs; 1.1-2.0cm" 116021 CDM 521 RC 11602 HCPCS facility both 442 442 Gross Charge Type: NIHD_Clinic_Price "11602 EXCISION, MALIGNANT LESION INCLUDING MARGINS, TRUNK, ARMS, OR LEGS; EXCISED DIAMETER 1 ProFee" 116022 CDM 982 RC 11602 HCPCS facility both 288 288 Gross Charge Type: NIHD_Hosp_Profee_Price "11602 EXCISION, MALIGNANT LESION INCLUDING MARGINS, TRUNK, ARMS, OR LEGS; EXCISED DIAMETER 1 ProFee" 116022 CDM 982 RC 11602 HCPCS facility both 288 288 Gross Charge Type: NIHD_Hosp_Profee_Price "11603 Excision, malignant lesion including margins, trunk, arms, or legs; 2.1-3.0cm" 116031 CDM 521 RC 11603 HCPCS facility both 503 503 Gross Charge Type: NIHD_RHC_Price "11603 Excision, malignant lesion including margins, trunk, arms, or legs; 2.1-3.0cm" 116031 CDM 521 RC 11603 HCPCS facility both 503 503 Gross Charge Type: NIHD_Clinic_Price "11603 EXCISION, MALIGNANT LESION INCLUDING MARGINS, TRUNK, ARMS, OR LEGS; EXCISED DIAMETER 2 ProFee" 116032 CDM 982 RC 11603 HCPCS facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price "11603 EXCISION, MALIGNANT LESION INCLUDING MARGINS, TRUNK, ARMS, OR LEGS; EXCISED DIAMETER 2 ProFee" 116032 CDM 982 RC 11603 HCPCS facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price "11604 Excision, malignant lesion including margins, trunk, arms, or legs; 3.1-4.0cm" 116041 CDM 521 RC 11604 HCPCS facility both 558 558 Gross Charge Type: NIHD_RHC_Price "11604 Excision, malignant lesion including margins, trunk, arms, or legs; 3.1-4.0cm" 116041 CDM 521 RC 11604 HCPCS facility both 558 558 Gross Charge Type: NIHD_Clinic_Price "11604 EXCISION, MALIGNANT LESION INCLUDING MARGINS, TRUNK, ARMS, OR LEGS; EXCISED DIAMETER 3 ProFee" 116042 CDM 982 RC 11604 HCPCS facility both 376 376 Gross Charge Type: NIHD_Hosp_Profee_Price "11604 EXCISION, MALIGNANT LESION INCLUDING MARGINS, TRUNK, ARMS, OR LEGS; EXCISED DIAMETER 3 ProFee" 116042 CDM 982 RC 11604 HCPCS facility both 376 376 Gross Charge Type: NIHD_Hosp_Profee_Price "11606 Excision, malignant lesion including margins, trunk, arms, or legs; >4.0cm" 116061 CDM 521 RC 11606 HCPCS facility both 794 794 Gross Charge Type: NIHD_RHC_Price "11606 Excision, malignant lesion including margins, trunk, arms, or legs; >4.0cm" 116061 CDM 521 RC 11606 HCPCS facility both 794 794 Gross Charge Type: NIHD_Clinic_Price "11606 EXCISION, MALIGNANT LESION INCLUDING MARGINS, TRUNK, ARMS, OR LEGS; EXCISED DIAMETER O ProFee" 116062 CDM 982 RC 11606 HCPCS facility both 936 936 Gross Charge Type: NIHD_Hosp_Profee_Price "11606 EXCISION, MALIGNANT LESION INCLUDING MARGINS, TRUNK, ARMS, OR LEGS; EXCISED DIAMETER O ProFee" 116062 CDM 982 RC 11606 HCPCS facility both 936 936 Gross Charge Type: NIHD_Hosp_Profee_Price "11620 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; < 0.5cm" 116201 CDM 521 RC 11620 HCPCS facility both 356 356 Gross Charge Type: NIHD_RHC_Price "11620 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; < 0.5cm" 116201 CDM 521 RC 11620 HCPCS facility both 356 356 Gross Charge Type: NIHD_Clinic_Price "11620 EXCISION, MALIGNANT LESION INCLUDING MARGINS, SCALP, NECK, HANDS, FEET, GENITALIA; EXC ProFee" 116202 CDM 982 RC 11620 HCPCS facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price "11620 EXCISION, MALIGNANT LESION INCLUDING MARGINS, SCALP, NECK, HANDS, FEET, GENITALIA; EXC ProFee" 116202 CDM 982 RC 11620 HCPCS facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price "11621 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; 0.6-1.0cm" 116211 CDM 521 RC 11621 HCPCS facility both 413 413 Gross Charge Type: NIHD_RHC_Price "11621 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; 0.6-1.0cm" 116211 CDM 521 RC 11621 HCPCS facility both 413 413 Gross Charge Type: NIHD_Clinic_Price "11621 EXCISION, MALIGNANT LESION INCLUDING MARGINS, SCALP, NECK, HANDS, FEET, GENITALIA; EXC ProFee" 116212 CDM 982 RC 11621 HCPCS facility both 265 265 Gross Charge Type: NIHD_Hosp_Profee_Price "11621 EXCISION, MALIGNANT LESION INCLUDING MARGINS, SCALP, NECK, HANDS, FEET, GENITALIA; EXC ProFee" 116212 CDM 982 RC 11621 HCPCS facility both 265 265 Gross Charge Type: NIHD_Hosp_Profee_Price "11622 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; 1.1-2.0cm" 116221 CDM 521 RC 11622 HCPCS facility both 457 457 Gross Charge Type: NIHD_RHC_Price "11622 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; 1.1-2.0cm" 116221 CDM 521 RC 11622 HCPCS facility both 457 457 Gross Charge Type: NIHD_Clinic_Price "11622 EXCISION, MALIGNANT LESION INCLUDING MARGINS, SCALP, NECK, HANDS, FEET, GENITALIA; EXC ProFee" 116222 CDM 982 RC 11622 HCPCS facility both 301 301 Gross Charge Type: NIHD_Hosp_Profee_Price "11622 EXCISION, MALIGNANT LESION INCLUDING MARGINS, SCALP, NECK, HANDS, FEET, GENITALIA; EXC ProFee" 116222 CDM 982 RC 11622 HCPCS facility both 301 301 Gross Charge Type: NIHD_Hosp_Profee_Price "11623 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; 2.1-3.0cm" 116231 CDM 521 RC 11623 HCPCS facility both 534 534 Gross Charge Type: NIHD_RHC_Price "11623 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; 2.1-3.0cm" 116231 CDM 521 RC 11623 HCPCS facility both 534 534 Gross Charge Type: NIHD_Clinic_Price "11623 EXCISION, MALIGNANT LESION INCLUDING MARGINS, SCALP, NECK, HANDS, FEET, GENITALIA; EXC ProFee" 116232 CDM 982 RC 11623 HCPCS facility both 372 372 Gross Charge Type: NIHD_Hosp_Profee_Price "11623 EXCISION, MALIGNANT LESION INCLUDING MARGINS, SCALP, NECK, HANDS, FEET, GENITALIA; EXC ProFee" 116232 CDM 982 RC 11623 HCPCS facility both 372 372 Gross Charge Type: NIHD_Hosp_Profee_Price "11624 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; 3.1-4.0cm" 116241 CDM 521 RC 11624 HCPCS facility both 602 602 Gross Charge Type: NIHD_RHC_Price "11624 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; 3.1-4.0cm" 116241 CDM 521 RC 11624 HCPCS facility both 602 602 Gross Charge Type: NIHD_Clinic_Price "11624 EXCISION, MALIGNANT LESION INCLUDING MARGINS, SCALP, NECK, HANDS, FEET, GENITALIA; EXC ProFee" 116242 CDM 982 RC 11624 HCPCS facility both 438 438 Gross Charge Type: NIHD_Hosp_Profee_Price "11624 EXCISION, MALIGNANT LESION INCLUDING MARGINS, SCALP, NECK, HANDS, FEET, GENITALIA; EXC ProFee" 116242 CDM 982 RC 11624 HCPCS facility both 438 438 Gross Charge Type: NIHD_Hosp_Profee_Price "11626 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; >4.0cm" 116261 CDM 521 RC 11626 HCPCS facility both 723 723 Gross Charge Type: NIHD_RHC_Price "11626 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; >4.0cm" 116261 CDM 521 RC 11626 HCPCS facility both 723 723 Gross Charge Type: NIHD_Clinic_Price "11626 EXCISION, MALIGNANT LESION INCLUDING MARGINS, SCALP, NECK, HANDS, FEET, GENITALIA; EXC ProFee" 116262 CDM 982 RC 11626 HCPCS facility both 837 837 Gross Charge Type: NIHD_Hosp_Profee_Price "11626 EXCISION, MALIGNANT LESION INCLUDING MARGINS, SCALP, NECK, HANDS, FEET, GENITALIA; EXC ProFee" 116262 CDM 982 RC 11626 HCPCS facility both 837 837 Gross Charge Type: NIHD_Hosp_Profee_Price "11640 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; < 0.5 cm" 116401 CDM 521 RC 11640 HCPCS facility both 365 365 Gross Charge Type: NIHD_RHC_Price "11640 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; < 0.5 cm" 116401 CDM 521 RC 11640 HCPCS facility both 365 365 Gross Charge Type: NIHD_Clinic_Price "11640 EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE, LIPS; EXCISED ProFee" 116402 CDM 982 RC 11640 HCPCS facility both 222 222 Gross Charge Type: NIHD_Hosp_Profee_Price "11640 EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE, LIPS; EXCISED ProFee" 116402 CDM 982 RC 11640 HCPCS facility both 222 222 Gross Charge Type: NIHD_Hosp_Profee_Price "11641 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; 0.6-1.0cm" 116411 CDM 521 RC 11641 HCPCS facility both 426 426 Gross Charge Type: NIHD_RHC_Price "11641 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; 0.6-1.0cm" 116411 CDM 521 RC 11641 HCPCS facility both 426 426 Gross Charge Type: NIHD_Clinic_Price "11641 EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE, LIPS; EXCISED ProFee" 116412 CDM 982 RC 11641 HCPCS facility both 277 277 Gross Charge Type: NIHD_Hosp_Profee_Price "11641 EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE, LIPS; EXCISED ProFee" 116412 CDM 982 RC 11641 HCPCS facility both 277 277 Gross Charge Type: NIHD_Hosp_Profee_Price "11642 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; 1.1-2.0cm" 116421 CDM 521 RC 11642 HCPCS facility both 484 484 Gross Charge Type: NIHD_RHC_Price "11642 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; 1.1-2.0cm" 116421 CDM 521 RC 11642 HCPCS facility both 484 484 Gross Charge Type: NIHD_Clinic_Price "11642 EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE, LIPS; EXCISED ProFee" 116422 CDM 982 RC 11642 HCPCS facility both 351 351 Gross Charge Type: NIHD_Hosp_Profee_Price "11642 EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE, LIPS; EXCISED ProFee" 116422 CDM 982 RC 11642 HCPCS facility both 351 351 Gross Charge Type: NIHD_Hosp_Profee_Price "11643 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; 2.1-3.0cm" 116431 CDM 521 RC 11643 HCPCS facility both 566 566 Gross Charge Type: NIHD_RHC_Price "11643 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; 2.1-3.0cm" 116431 CDM 521 RC 11643 HCPCS facility both 566 566 Gross Charge Type: NIHD_Clinic_Price "11643 EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE, LIPS; EXCISED ProFee" 116432 CDM 982 RC 11643 HCPCS facility both 438 438 Gross Charge Type: NIHD_Hosp_Profee_Price "11643 EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE, LIPS; EXCISED ProFee" 116432 CDM 982 RC 11643 HCPCS facility both 438 438 Gross Charge Type: NIHD_Hosp_Profee_Price "11644 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; 3.1-4.0cm" 116441 CDM 521 RC 11644 HCPCS facility both 696 696 Gross Charge Type: NIHD_RHC_Price "11644 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; 3.1-4.0cm" 116441 CDM 521 RC 11644 HCPCS facility both 696 696 Gross Charge Type: NIHD_Clinic_Price "11644 EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE, LIPS; EXCISED ProFee" 116442 CDM 982 RC 11644 HCPCS facility both 500 500 Gross Charge Type: NIHD_Hosp_Profee_Price "11644 EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE, LIPS; EXCISED ProFee" 116442 CDM 982 RC 11644 HCPCS facility both 500 500 Gross Charge Type: NIHD_Hosp_Profee_Price "11646 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; < 4.0 cm" 116461 CDM 521 RC 11646 HCPCS facility both 902 902 Gross Charge Type: NIHD_RHC_Price "11646 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; < 4.0 cm" 116461 CDM 521 RC 11646 HCPCS facility both 902 902 Gross Charge Type: NIHD_Clinic_Price "11646 EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE, LIPS; EXCISED ProFee" 116462 CDM 982 RC 11646 HCPCS facility both 688 688 Gross Charge Type: NIHD_Hosp_Profee_Price "11646 EXCISION, MALIGNANT LESION INCLUDING MARGINS, FACE, EARS, EYELIDS, NOSE, LIPS; EXCISED ProFee" 116462 CDM 982 RC 11646 HCPCS facility both 688 688 Gross Charge Type: NIHD_Hosp_Profee_Price benzocaine-menthol topical 6 mg-10 mg Loz [INYO] 11671 CDM 78112-0011-06 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 LOZENGES "Ophth irrigation, extraocular Sol [INYO]" 11703 CDM 00065-0530-04 NDC facility both 1 EA 201.6 201.6 Gross Charge Type: Pharmacy | NDC EA = 120 DROPS "Ophth irrigation, extraocular Sol [INYO]" 11703 CDM 00536-1224-97 NDC facility both 1 EA 36 36 Gross Charge Type: Pharmacy | NDC EA = 120 DROPS "Ophth irrigation, extraocular Sol [INYO]" 11703 CDM 10119-0002-52 NDC facility both 1 EA 36 36 Gross Charge Type: Pharmacy | NDC EA = 120 DROPS propofol 200 mg/20 mL IV Emul [INYO] 11705 CDM J2704 HCPCS 63323-0269-29 NDC facility both 20 ML 235 235 Gross Charge Type: Pharmacy propofol 200 mg/20 mL IV Emul [INYO] 11705 CDM J2704 HCPCS 00409-4699-30 NDC facility both 20 ML 235 235 Gross Charge Type: Pharmacy propofol 200 mg/20mL IV Emul [INYO] 11705 CDM J2704 HCPCS 00069-0209-10 NDC facility both 20 ML 235 235 Gross Charge Type: Pharmacy propofol 200 mg/20 mL IV Emul [INYO] 11705 CDM J2704 HCPCS 63323-0269-70 NDC facility both 20 ML 235 235 Gross Charge Type: Pharmacy propofol 200 mg/20 mL IV Emul [INYO] 11705 CDM J2704 HCPCS 25021-0608-20 NDC facility both 20 ML 235 235 Gross Charge Type: Pharmacy propofol 500 mg/50 mL IV Emul 50 mL [INYO] 11707 CDM J2704 HCPCS 63323-0269-50 NDC facility both 50 ML 235 235 Gross Charge Type: Pharmacy propofol 500 mg/50 mL IV Emul 50 mL [INYO] 11707 CDM J2704 HCPCS 00409-4699-33 NDC facility both 50 ML 235 235 Gross Charge Type: Pharmacy propofol 500 mg/50 mL IV Emul 50 mL [INYO] 11707 CDM J2704 HCPCS 63323-0269-77 NDC facility both 50 ML 235 235 Gross Charge Type: Pharmacy propofol 500 mg/50 mL IV Emul 50 mL [INYO] 11707 CDM J2704 HCPCS 43598-0548-21 NDC facility both 50 ML 235 235 Gross Charge Type: Pharmacy propofol 500 mg/50 mL IV Emul 50 mL [INYO] 11707 CDM J2704 HCPCS 25021-0608-50 NDC facility both 50 ML 235 235 Gross Charge Type: Pharmacy TRIM NONDYSTRPHC NAIL ANY NMBR 11719 CDM 521 RC 11719 HCPCS facility both 66 66 Gross Charge Type: NIHD_RHC_Price TRIM NONDYSTRPHC NAIL ANY NMBR 11719 CDM 521 RC 11719 HCPCS facility both 66 66 Gross Charge Type: NIHD_Clinic_Price 11720 Debridement of nail(s) by any method(s); 1 to 5 11720 CDM 521 RC 11720 HCPCS facility both 60 60 Gross Charge Type: NIHD_RHC_Price 11720 Debridement of nail(s) by any method(s); 1 to 5 11720 CDM 521 RC 11720 HCPCS facility both 60 60 Gross Charge Type: NIHD_Clinic_Price 11720 DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); 1 TO 5 ProFee 11720 CDM 982 RC 11720 HCPCS facility both 89 89 Gross Charge Type: NIHD_Hosp_Profee_Price 11720 DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); 1 TO 5 ProFee 11720 CDM 982 RC 11720 HCPCS facility both 89 89 Gross Charge Type: NIHD_Hosp_Profee_Price 11720 DEBRIDEMENT NAIL ANY METHOD 1-5 TechFee 117202 CDM 450 RC facility both 166 166 Gross Charge Type: NIHD_Hosp_Profee_Price 11720 DEBRIDEMENT NAIL ANY METHOD 1-5 TechFee 117202 CDM 450 RC facility both 166 166 Gross Charge Type: NIHD_Hosp_Profee_Price 11721 Debridement of nail(s) by any method(s); 6 or more 11721 CDM 521 RC 11721 HCPCS facility both 80 80 Gross Charge Type: NIHD_RHC_Price 11721 Debridement of nail(s) by any method(s); 6 or more 11721 CDM 521 RC 11721 HCPCS facility both 80 80 Gross Charge Type: NIHD_Clinic_Price "11730 Avulsion of nail plate, partial or complete, simple; single" 117301 CDM 521 RC 11730 HCPCS facility both 291 291 Gross Charge Type: NIHD_RHC_Price "11730 Avulsion of nail plate, partial or complete, simple; single" 117301 CDM 521 RC 11730 HCPCS facility both 282 282 Gross Charge Type: NIHD_Clinic_Price 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1 TechFee 117302 CDM 450 RC facility both 512 512 Gross Charge Type: NIHD_Hosp_Profee_Price 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1 TechFee 117302 CDM 450 RC facility both 512 512 Gross Charge Type: NIHD_Hosp_Profee_Price "11730 AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; SINGLE ProFee" 117303 CDM 982 RC 11730 HCPCS facility both 338 338 Gross Charge Type: NIHD_Hosp_Profee_Price "11730 AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; SINGLE ProFee" 117303 CDM 982 RC 11730 HCPCS facility both 338 338 Gross Charge Type: NIHD_Hosp_Profee_Price "11732 AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; EACH AD TechFee" 11732 CDM 450 RC facility both 152 152 Gross Charge Type: NIHD_Hosp_Profee_Price "11732 AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; EACH AD TechFee" 11732 CDM 450 RC facility both 152 152 Gross Charge Type: NIHD_Hosp_Profee_Price "11732 AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; EACH AD ProFee" 117321 CDM 11732 HCPCS facility both 26 26 Gross Charge Type: NIHD_Hosp_Profee_Price "11732 AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE, SIMPLE; EACH AD ProFee" 117321 CDM 11732 HCPCS facility both 26 26 Gross Charge Type: NIHD_Hosp_Profee_Price "11732 Avulsion of nail plate, partial or complete, simple; each additional nail plate" 117322 CDM 521 RC 11732 HCPCS facility both 52 52 Gross Charge Type: NIHD_RHC_Price "11732 Avulsion of nail plate, partial or complete, simple; each additional nail plate" 117322 CDM 521 RC 11732 HCPCS facility both 52 52 Gross Charge Type: NIHD_Clinic_Price 11740 Evacuation of subungual hematoma 117401 CDM 521 RC 11740 HCPCS facility both 123 123 Gross Charge Type: NIHD_RHC_Price 11740 Evacuation of subungual hematoma 117401 CDM 521 RC 11740 HCPCS facility both 123 123 Gross Charge Type: NIHD_Clinic_Price 11740 EVACUATION SUBUNGUAL HEMATOMA TechFee 117402 CDM 450 RC facility both 250 250 Gross Charge Type: NIHD_Hosp_Profee_Price 11740 EVACUATION SUBUNGUAL HEMATOMA TechFee 117402 CDM 450 RC facility both 250 250 Gross Charge Type: NIHD_Hosp_Profee_Price Drainage Nail Bed Charge 117403 CDM 761 RC facility both 250 250 Gross Charge Type: NIHD_Hosp_Profee_Price Drainage Nail Bed Charge 117403 CDM 761 RC facility both 250 250 Gross Charge Type: NIHD_Hosp_Profee_Price 11740 EVACUATION OF SUBUNGUAL HEMATOMA ProFee 117404 CDM 982 RC 11740 HCPCS facility both 227 227 Gross Charge Type: NIHD_Hosp_Profee_Price 11740 EVACUATION OF SUBUNGUAL HEMATOMA ProFee 117404 CDM 982 RC 11740 HCPCS facility both 227 227 Gross Charge Type: NIHD_Hosp_Profee_Price EXC NAIL MTRIX PERM RMVL 117501 CDM 521 RC 11750 HCPCS facility both 998 998 Gross Charge Type: NIHD_RHC_Price 11750 EXCISION NAIL MATRIX PERMANENT REMOVAL TechFee 117502 CDM 450 RC facility both 851 851 Gross Charge Type: NIHD_Hosp_Profee_Price 11750 EXCISION NAIL MATRIX PERMANENT REMOVAL TechFee 117502 CDM 450 RC facility both 851 851 Gross Charge Type: NIHD_Hosp_Profee_Price "11750 EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPLETE (EG, INGROWN OR DEFORMED NAIL), ProFee" 117503 CDM 982 RC 11750 HCPCS facility both 288 288 Gross Charge Type: NIHD_Hosp_Profee_Price "11750 EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPLETE (EG, INGROWN OR DEFORMED NAIL), ProFee" 117503 CDM 982 RC 11750 HCPCS facility both 288 288 Gross Charge Type: NIHD_Hosp_Profee_Price CF Full-gene Carrier Screen LC 11751683 CDM 301 RC facility both 126 126 Gross Charge Type: NIHD_Hosp_Profee_Price CF Full-gene Carrier Screen LC 11751683 CDM 301 RC facility both 126 126 Gross Charge Type: NIHD_Hosp_Profee_Price 11760 REPAIR NAIL BED TechFee 117601 CDM 450 RC facility both 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price 11760 REPAIR NAIL BED TechFee 117601 CDM 450 RC facility both 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price 11760 REPAIR OF NAIL BED ProFee 117602 CDM 982 RC 11760 HCPCS facility both 233 233 Gross Charge Type: NIHD_Hosp_Profee_Price 11760 REPAIR OF NAIL BED ProFee 117602 CDM 982 RC 11760 HCPCS facility both 233 233 Gross Charge Type: NIHD_Hosp_Profee_Price 11765 WEDGE EXCISION SKIN NAIL FOLD TechFee 117651 CDM 450 RC facility both 233 233 Gross Charge Type: NIHD_Hosp_Profee_Price 11765 WEDGE EXCISION SKIN NAIL FOLD TechFee 117651 CDM 450 RC facility both 233 233 Gross Charge Type: NIHD_Hosp_Profee_Price "11765 WEDGE EXCISION OF SKIN OF NAIL FOLD (EG, FOR INGROWN TOENAIL) ProFee" 117652 CDM 982 RC 11765 HCPCS facility both 551 551 Gross Charge Type: NIHD_Hosp_Profee_Price "11765 WEDGE EXCISION OF SKIN OF NAIL FOLD (EG, FOR INGROWN TOENAIL) ProFee" 117652 CDM 982 RC 11765 HCPCS facility both 551 551 Gross Charge Type: NIHD_Hosp_Profee_Price ATN Profile LC 11768897 CDM 301 RC facility both 134.5 134.5 Gross Charge Type: NIHD_Hosp_Profee_Price ATN Profile LC 11768897 CDM 301 RC facility both 134.5 134.5 Gross Charge Type: NIHD_Hosp_Profee_Price 83520-ATN Profile LC 11769773 CDM 301 RC 83520 HCPCS facility both 134.5 134.5 Gross Charge Type: NIHD_Hosp_Profee_Price 83520-ATN Profile LC 11769773 CDM 301 RC 83520 HCPCS facility both 134.5 134.5 Gross Charge Type: NIHD_Hosp_Profee_Price 11770 Excision of pilonidal cyst or sinus; simple 117701 CDM 521 RC 11770 HCPCS facility both 375 375 Gross Charge Type: NIHD_Clinic_Price 11770 EXCISION OF PILONIDAL CYST OR SINUS; SIMPLE ProFee 117702 CDM 982 RC 11770 HCPCS facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price 11770 EXCISION OF PILONIDAL CYST OR SINUS; SIMPLE ProFee 117702 CDM 982 RC 11770 HCPCS facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price 11771 Excision of pilonidal cyst or sinus; extensive 117711 CDM 521 RC 11771 HCPCS facility both 201 201 Gross Charge Type: NIHD_Clinic_Price 11771 EXCISION OF PILONIDAL CYST OR SINUS; EXTENSIVE ProFee 117712 CDM 982 RC 11771 HCPCS facility both 799 799 Gross Charge Type: NIHD_Hosp_Profee_Price 11771 EXCISION OF PILONIDAL CYST OR SINUS; EXTENSIVE ProFee 117712 CDM 982 RC 11771 HCPCS facility both 799 799 Gross Charge Type: NIHD_Hosp_Profee_Price 11772 Excision of pilonidal cyst or sinus; complicated 117721 CDM 521 RC 11772 HCPCS facility both 1061 1061 Gross Charge Type: NIHD_Clinic_Price 11772 EXCISION OF PILONIDAL CYST OR SINUS; COMPLICATED ProFee 117722 CDM 982 RC 11772 HCPCS facility both 1061 1061 Gross Charge Type: NIHD_Hosp_Profee_Price 11772 EXCISION OF PILONIDAL CYST OR SINUS; COMPLICATED ProFee 117722 CDM 982 RC 11772 HCPCS facility both 1061 1061 Gross Charge Type: NIHD_Hosp_Profee_Price hyaluronidase human recombinant 150 units/mL [INYO] 11793 CDM J3473 HCPCS 18657-0117-04 NDC facility both 1 EA 535.68 535.68 Gross Charge Type: Pharmacy conjugated estrogens 0.625 mg Tab [INYO] 11797 CDM 00046-1102-81 NDC facility both 1 EA 42.51 42.51 Gross Charge Type: Pharmacy | NDC EA = 1 TAB dilTIAZem 30 mg Tab [INYO] 11799 CDM 60687-0717-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB diltiazem 30 mg Tab [INYO] 11799 CDM 00093-0318-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB diltiazem 30 mg Tab [INYO] 11799 CDM 60687-0562-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB docusate sodium 100 mg Cap [INYO] 11801 CDM 63739-0478-02 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 CAP docusate sodium 100 mg Cap [INYO] 11801 CDM 00904-7183-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 CAP docusate sodium 100 mg Cap [INYO] 11801 CDM 00904-6455-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 CAP docusate sodium 100 mg Cap [INYO] 11801 CDM 63739-0478-10 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 CAP fentaNYL 50 mcg/hr Fil [INYO] 11804 CDM 47781-0426-47 NDC facility both 1 EA 194.41 194.41 Gross Charge Type: Pharmacy | NDC EA = 1 PATCHES fentaNYL 50 mcg/hr Transderm ER Film [INYO] 11804 CDM 00406-9050-76 NDC facility both 1 EA 131.8 131.8 Gross Charge Type: Pharmacy | NDC EA = 1 PATCHES fentaNYL 50 mcg/hr Transderm ER Film [INYO] 11804 CDM 60505-7082-02 NDC facility both 1 EA 194.41 194.41 Gross Charge Type: Pharmacy | NDC EA = 1 PATCHES fentaNYL 25 mcg/hr Transderm ER Film [INYO] 11805 CDM 00406-9025-76 NDC facility both 1 EA 72.1 72.1 Gross Charge Type: Pharmacy | NDC EA = 1 PATCHES fentaNYL 25 mcg/hr Fil 11805 CDM 47781-0424-47 NDC facility both 1 EA 106.33 106.33 Gross Charge Type: Pharmacy | NDC EA = 1 PATCHES fentaNYL 25 mcg/hr Transderm ER Film [INYO] 11805 CDM 60505-7081-02 NDC facility both 1 EA 106.33 106.33 Gross Charge Type: Pharmacy | NDC EA = 1 PATCHES fentaNYL 25 mcg/hr Transderm ER Film [INYO] 11805 CDM 00406-9125-76 NDC facility both 1 EA 72.1 72.1 Gross Charge Type: Pharmacy | NDC EA = 1 PATCHES pilocarpine Ophth 1% Sol [INYO] 11810 CDM 61314-0203-15 NDC facility both 1 EA 394.24 394.24 Gross Charge Type: Pharmacy | NDC EA = 15 DROPS predniSONE 1 mg Tab [INYO] 11812 CDM J7512 HCPCS 00054-8739-25 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB predniSONE 1 mg Tab [inyo] 11812 CDM J7512 HCPCS 59746-0171-06 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB predniSONE 5 mg Tab [INYO] 11813 CDM J7512 HCPCS 60687-0122-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB predniSONE 5 mg Tab [INYO] 11813 CDM J7512 HCPCS 00054-8724-25 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB predniSONE 20 mg Tab [INYO] 11814 CDM J7512 HCPCS 60687-0145-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB predniSONE 20 mg Tab [INYO] 11814 CDM J7512 HCPCS 00904-7127-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB predniSONE 20 mg Tab [INYO] 11814 CDM J7512 HCPCS 00054-0018-20 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB aspirin 300 mg Supp [INYO] 11815 CDM 00574-7034-12 NDC facility both 1 EA 36 36 Gross Charge Type: Pharmacy | NDC EA = 1 SUPP aspirin 81 mg Chew Tab [INYO] 11817 CDM 66553-0002-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB aspirin 325 mg Oral EC Tab [INYO] 11818 CDM 57896-0921-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB aspirin 325 mg Oral EC Tab [INYO] 11818 CDM 00904-2013-60 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB atenolol 25 mg Tab [INYO] 11819 CDM 51079-0759-20 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB atenolol 25 mg Tab [inyo] 11819 CDM 00904-7187-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB bethanechol 10 mg Tab [INYO] 11820 CDM 00832-0511-01 NDC facility both 1 EA 12.01 12.01 Gross Charge Type: Pharmacy | NDC EA = 1 TAB captopril 12.5 mg Tab [INYO] 11821 CDM 60687-0304-21 NDC facility both 1 EA 10.19 10.19 Gross Charge Type: Pharmacy | NDC EA = 1 TAB captopril 12.5 mg Tab [INYO] 11821 CDM 51079-0863-20 NDC facility both 1 EA 10.3 10.3 Gross Charge Type: Pharmacy | NDC EA = 1 TAB cloNIDine 0.1 mg/24 hr Transderm ER Film [INYO] 11829 CDM 00555-1009-16 NDC facility both 1 EA 165.79 165.79 Gross Charge Type: Pharmacy | NDC EA = 1 PATCHES cloNIDine 0.1 mg/24 hr Transderm ER Film [INYO] 11829 CDM 00378-0871-99 NDC facility both 1 EA 165.61 165.61 Gross Charge Type: Pharmacy | NDC EA = 1 PATCHES digoxin 125 mcg (0.125 mg) Tab [INYO] 11837 CDM 00904-5921-61 NDC facility both 1 EA 10.11 10.11 Gross Charge Type: Pharmacy | NDC EA = 1 TAB digoxin 125 mcg (0.125 mg) Tab [INYO] 11837 CDM 24987-0242-56 NDC facility both 1 EA 17.28 17.28 Gross Charge Type: Pharmacy | NDC EA = 1 TAB APAP-codeine 300 mg-30 mg Tab [INYO] 11839 CDM 00406-0484-62 NDC facility both 1 EA 35 35 Gross Charge Type: Pharmacy | NDC EA = 1 TAB acetaminophen 120 mg Supp [INYO] 11841 CDM 45802-0732-30 NDC facility both 1 EA 36 36 Gross Charge Type: Pharmacy | NDC EA = 1 SUPP acetaminophen 120 mg Supp [INYO] 11841 CDM 00713-0118-12 NDC facility both 1 EA 36 36 Gross Charge Type: Pharmacy | NDC EA = 1 SUPP acetaminophen 325 mg Supp [INYO] 11842 CDM 51672-2116-02 NDC facility both 1 EA 36 36 Gross Charge Type: Pharmacy | NDC EA = 1 SUPP acetaminophen 325 mg Supp [INYO] 11842 CDM 00713-0164-12 NDC facility both 1 EA 36 36 Gross Charge Type: Pharmacy | NDC EA = 1 SUPP charcoal-sorbitol 25 g Oral Susp 120 mL [INYO] 11843 CDM 00574-0520-74 NDC facility both 120 ML 83.5 83.5 Gross Charge Type: Pharmacy charcoal-sorbitol 25 g Oral Susp 120 mL [INYO] 11843 CDM 00574-0120-74 NDC facility both 120 ML 83.5 83.5 Gross Charge Type: Pharmacy allopurinol 100 mg Tab [INYO] 11845 CDM 00904-6571-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB allopurinol 100 mg Tab [INYO] 11845 CDM 00904-7041-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB allopurinol 100 mg Tab [INYO] 11845 CDM 51079-0205-20 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB amitriptyline 10 mg Tab [INYO] 11847 CDM 70756-0201-11 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB amitriptyline 10 mg Tab [INYO] 11847 CDM 51079-0131-20 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB amitriptyline 10 mg Tab [INYO] 11847 CDM 16729-0171-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB amoxicillin 250 mg Cap [INYO] 11848 CDM 00781-2020-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 CAP ampicillin 1 g Inj [INYO] 11850 CDM J0290 HCPCS 55150-0113-10 NDC facility both 1 EA 235 235 Gross Charge Type: Pharmacy ampicillin 500 mg Inj [INYO] 11851 CDM J0290 HCPCS 00781-3407-95 NDC facility both 1 EA 330 330 Gross Charge Type: Pharmacy ampicillin 500 mg Inj [INYO] 11851 CDM J0290 HCPCS 25021-0135-10 NDC facility both 1 EA 330 330 Gross Charge Type: Pharmacy ampicillin 500 mg Inj [INYO] 11851 CDM J0290 HCPCS 65219-0016-10 NDC facility both 1 EA 330 330 Gross Charge Type: Pharmacy ampicillin 500 mg Inj [INYO] 11851 CDM J0290 HCPCS 55150-0112-10 NDC facility both 1 EA 330 330 Gross Charge Type: Pharmacy ampicillin 250 mg Inj [INYO] 11852 CDM J0290 HCPCS 25021-0134-10 NDC facility both 1 EA 330 330 Gross Charge Type: Pharmacy ampicillin 250 mg Inj [INYO] 11852 CDM J0290 HCPCS 00781-3402-95 NDC facility both 1 EA 330 330 Gross Charge Type: Pharmacy ampicillin 250 mg Inj [INYO] 11852 CDM J0290 HCPCS 00409-3719-01 NDC facility both 1 EA 330 330 Gross Charge Type: Pharmacy ampicillin 250 mg Inj [INYO] 11852 CDM J0290 HCPCS 55150-0111-10 NDC facility both 1 EA 330 330 Gross Charge Type: Pharmacy levothyroxine 100 mcg (0.1 mg) Tab [INYO] 11853 CDM 00904-6953-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB levothyroxine 100 mcg (0.1 mg) Tab [inyo] 11853 CDM 60687-0497-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB levothyroxine 100 mcg (0.1 mg) Tab [INYO] 11853 CDM 51079-0442-20 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB levothyroxine 25 mcg (0.025 mg) Tab [INYO] 11856 CDM 51079-0444-20 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB levothyroxine 25 mcg (0.025 mg) Tab 11856 CDM 00904-6949-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB levothyroxine 25 mcg (0.025 mg) Tab [INYO] 11856 CDM 60687-0453-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB hydrocortisone 25 mg Supp [INYO] 11857 CDM 00713-0503-12 NDC facility both 1 EA 135.88 135.88 Gross Charge Type: Pharmacy | NDC EA = 1 SUPP hydrocortisone 25 mg Supp [INYO] 11857 CDM 00574-7090-12 NDC facility both 1 EA 86.55 86.55 Gross Charge Type: Pharmacy | NDC EA = 1 SUPP glipiZIDE 5 mg Tab [INYO] 11858 CDM 00904-6637-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB hydrOXYzine hydrochloride 10 mg Tab [INYO] 11860 CDM 60687-0664-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB hydrOXYzine hydrochloride 10 mg Tab [INYO] 11860 CDM 67405-0575-10 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB hydrOXYzine hydrochloride 10 mg Tab [INYO] 11860 CDM 63739-0483-10 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB hydrOXYzine hydrochloride 10 mg Tab [INYO] 11860 CDM 68084-0253-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB ibuprofen 600 mg Tab [INYO] 11861 CDM 00904-5854-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB ibuprofen 600 mg Tab [INYO] 11861 CDM 60687-0457-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB ibuprofen 600 mg Tab [INYO] 11861 CDM 67877-0320-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB insulin isophane-insulin regular human recombinant 70 units-30 units/mL Sus [INYO] 11862 CDM J1815 HCPCS 00002-8715-01 NDC facility both 10 ML 428.26 428.26 Gross Charge Type: Pharmacy isosorbide dinitrate 10 mg Tab [INYO] 11867 CDM 00904-6619-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB isosorbide dinitrate 10 mg Tab [inyo] 11867 CDM 50268-0448-15 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB isosorbide mononitrate 30 mg ER Tab [INYO] 11870 CDM 00904-6449-61 NDC facility both 1 EA 9.96 9.96 Gross Charge Type: Pharmacy | NDC EA = 1 TAB isosorbide mononitrate 30 mg ER Tab [INYO] 11870 CDM 50268-0451-15 NDC facility both 1 EA 9.86 9.86 Gross Charge Type: Pharmacy | NDC EA = 1 TAB LORazepam 0.5 mg Tab [INYO] 11872 CDM 00904-6007-61 NDC facility both 1 EA 35 35 Gross Charge Type: Pharmacy | NDC EA = 1 TAB LORazepam 0.5 mg Tab [INYO] 11872 CDM 00591-0240-10 NDC facility both 1 EA 35 35 Gross Charge Type: Pharmacy | NDC EA = 1 TAB LORazepam 0.5 mg Tab [INYO] 11872 CDM 69315-0904-01 NDC facility both 1 EA 35 35 Gross Charge Type: Pharmacy | NDC EA = 1 TAB LORazepam 0.5 mg Tab [INYO] 11872 CDM 51079-0417-20 NDC facility both 1 EA 35 35 Gross Charge Type: Pharmacy | NDC EA = 1 TAB medroxyPROGESTERone 5 mg Tab [INYO] 11873 CDM 00555-0873-02 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB medroxyPROGESTERone 5 mg Tab [INYO] 11873 CDM 00009-0286-03 NDC facility both 1 EA 25.82 25.82 Gross Charge Type: Pharmacy | NDC EA = 1 TAB methocarbamol 500 mg Tab [INYO] 11875 CDM 00904-7057-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB methocarbamol 500 mg Tab [INYO] 11875 CDM 60687-0559-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB methocarbamol 500 mg Tab [INYO] 11875 CDM 63739-0166-10 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB methocarbamol 500 mg Tab [INYO] 11875 CDM 70010-0754-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB metOLazone 2.5 mg Tab UD [INYO] 11876 CDM 51079-0023-20 NDC facility both 1 EA 19.71 19.71 Gross Charge Type: Pharmacy | NDC EA = 1 TAB metOLazone 2.5 mg Tab UD(INYO) 11876 CDM 00904-6916-61 NDC facility both 1 EA 22.52 22.52 Gross Charge Type: Pharmacy | NDC EA = 1 TAB metOLazone 2.5 mg Tab UD(INYO) 11876 CDM 00185-5050-01 NDC facility both 1 EA 12.44 12.44 Gross Charge Type: Pharmacy | NDC EA = 1 TAB morphine 0.5 mg/mL preservative-free Inj Sol [INYO] 11879 CDM J2274 HCPCS 00641-6020-10 NDC facility both 10 ML 278.01 278.01 Gross Charge Type: Pharmacy nalbuphine 10 mg/mL Inj Sol [INYO] 11881 CDM J2300 HCPCS 00409-1463-01 NDC facility both 1 ML 235 235 Gross Charge Type: Pharmacy nicotine 14 mg/24 hr Transderm ER Film [INYO] 11883 CDM 00536-5895-53 NDC facility both 1 EA 15 15 Gross Charge Type: Pharmacy | NDC EA = 1 PATCHES nicotine 14 mg/24 hr Transderm ER Film [INYO] 11883 CDM 00536-5895-88 NDC facility both 1 EA 15 15 Gross Charge Type: Pharmacy | NDC EA = 1 PATCHES nicotine 7 mg/24 hr Transderm ER Film [INYO] 11884 CDM 00536-5894-88 NDC facility both 1 EA 15 15 Gross Charge Type: Pharmacy | NDC EA = 1 PATCHES oxymetazoline Nasal 0.05% Spry [INYO] 11885 CDM 00904-7006-35 NDC facility both 1 EA 36 36 Gross Charge Type: Pharmacy | NDC EA = 15 SPRAYS oxymetazoline Nasal 0.05% Spry [INYO] 11885 CDM 50024-0431-00 NDC facility both 1 EA 36 36 Gross Charge Type: Pharmacy | NDC EA = 15 SPRAYS oxymetazoline Nasal 0.05% Spry [INYO] 11885 CDM 37000-0803-01 NDC facility both 1 EA 36 36 Gross Charge Type: Pharmacy | NDC EA = 15 SPRAYS oxymetazoline Nasal 0.05% Spry [INYO] 11885 CDM 00904-5711-35 NDC facility both 1 EA 36 36 Gross Charge Type: Pharmacy | NDC EA = 15 SPRAYS oxymetazoline Nasal 0.05% Spry [INYO] 11885 CDM 41100-0811-23 NDC facility both 1 EA 36 36 Gross Charge Type: Pharmacy | NDC EA = 15 SPRAYS promethazine 25 mg Supp [INYO] 11890 CDM 00713-0526-12 NDC facility both 1 EA 106.23 106.23 Gross Charge Type: Pharmacy | NDC EA = 1 SUPP promethazine 12.5 mg Supp [INYO] 11891 CDM 00713-0536-12 NDC facility both 1 EA 106.23 106.23 Gross Charge Type: Pharmacy | NDC EA = 1 SUPP pseudoephedrine 30 mg Tab [INYO] 11892 CDM 00904-5053-24 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB pseudoephedrine 30 mg Tab 11892 CDM 00904-6990-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB pseudoephedrine 30 mg Tab [INYO] 11892 CDM 00904-5053-59 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB sertraline 50 mg Tab [INYO] 11893 CDM 00904-6925-61 NDC facility both 1 EA 28.94 28.94 Gross Charge Type: Pharmacy | NDC EA = 1 TAB sertraline 50 mg Tab [INYO] 11893 CDM 60687-0242-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB sertraline 50 mg Tab [INYO] 11893 CDM 59762-4900-03 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB carbidopa-levodopa 25 mg-250 mg Tab [INYO] 11894 CDM 00904-6238-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB carbidopa-levodopa 25 mg-100 mg Tab 11895 CDM 00904-7257-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB carbidopa-levodopa 25 mg-100 mg Tab [INYO] 11895 CDM 00904-6237-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB carbidopa-levodopa 25 mg-100 mg Tab [INYO] 11895 CDM 00228-2539-10 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB carbidopa-levodopa 25 mg-100 mg Tab [INYO] 11895 CDM 63739-0047-10 NDC facility both 1 EA 7.6 7.6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB carbidopa-levodopa 10 mg-100 mg Tab [INYO] 11896 CDM 63739-0107-10 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB carbidopa-levodopa 10 mg-100 mg Tab [inyo] 11896 CDM 50228-0457-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB carbidopa-levodopa 10 mg-100 mg Tab [INYO] 11896 CDM 62756-0517-88 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB carbidopa-levodopa 10 mg-100 mg Tab [INYO] 11896 CDM 00228-2538-10 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB terazosin 5 mg Cap [INYO] 11898 CDM 50268-0766-15 NDC facility both 1 EA 9.63 9.63 Gross Charge Type: Pharmacy | NDC EA = 1 CAP terazosin 5 mg Cap [INYO] 11898 CDM 00904-6128-61 NDC facility both 1 EA 8.67 8.67 Gross Charge Type: Pharmacy | NDC EA = 1 CAP "Phospholipase A2 Receptor Autoantibodies, IgG LC" 11898621 CDM 301 RC facility both 105 105 Gross Charge Type: NIHD_Hosp_Profee_Price "Phospholipase A2 Receptor Autoantibodies, IgG LC" 11898621 CDM 301 RC facility both 105 105 Gross Charge Type: NIHD_Hosp_Profee_Price terbutaline 2.5 mg Tab [INYO] 11899 CDM 10135-0579-01 NDC facility both 1 EA 68.64 68.64 Gross Charge Type: Pharmacy | NDC EA = 1 TAB terbutaline 2.5 mg Tab [INYO] 11899 CDM 00115-2611-01 NDC facility both 1 EA 32.65 32.65 Gross Charge Type: Pharmacy | NDC EA = 1 TAB "11900 Injection, intralesional; up to and including 7 lesions" 11900 CDM 521 RC 11900 HCPCS facility both 102 102 Gross Charge Type: NIHD_RHC_Price "11900 Injection, intralesional; up to and including 7 lesions" 11900 CDM 521 RC 11900 HCPCS facility both 102 102 Gross Charge Type: NIHD_Clinic_Price theophylline 200 mg ER Tab [INYO] 11900 CDM 00904-5888-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB "11901 Injection, intralesional; more than 7 lesions" 11901 CDM 521 RC 11901 HCPCS facility both 199 199 Gross Charge Type: NIHD_RHC_Price "11901 Injection, intralesional; more than 7 lesions" 11901 CDM 521 RC 11901 HCPCS facility both 199 199 Gross Charge Type: NIHD_Clinic_Price thyroid desiccated 30 mg Tab [INYO] 11904 CDM 00456-0458-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB ofloxacin Ophth 0.3% Sol [INYO] 11905 CDM 64980-0515-01 NDC facility both 1 EA 542.64 542.64 Gross Charge Type: Pharmacy | NDC EA = 10 DROPS ofloxacin Ophth 0.3% Sol [INYO] 11905 CDM 17478-0713-10 NDC facility both 1 EA 251.28 251.28 Gross Charge Type: Pharmacy | NDC EA = 10 DROPS sodium chloride Nasal 0.65% Spry [INYO] 11906 CDM 56184-0120-11 NDC facility both 1 EA 36 36 Gross Charge Type: Pharmacy | NDC EA = 30 SPRAYS sodium chloride Nasal 0.65% Spry [INYO] 11906 CDM 00904-3865-75 NDC facility both 1 EA 36 36 Gross Charge Type: Pharmacy | NDC EA = 30 SPRAYS "nystatin Top 100,000 units/g Crm [INYO]" 11907 CDM 45802-0059-35 NDC facility both 1 EA 87.5 87.5 Gross Charge Type: Pharmacy | NDC EA = 15 APP "nystatin Top 100,000 units/g Crm [INYO]" 11907 CDM 00603-7818-74 NDC facility both 1 EA 87.5 87.5 Gross Charge Type: Pharmacy | NDC EA = 15 APP timolol Ophth 0.25% Sol [INYO] 11913 CDM 61314-0226-05 NDC facility both 1 EA 90 90 Gross Charge Type: Pharmacy | NDC EA = 5 DROPS timolol Ophth 0.25% Sol [INYO] 11913 CDM 64980-0513-05 NDC facility both 1 EA 90 90 Gross Charge Type: Pharmacy | NDC EA = 5 DROPS timolol Ophth 0.25% Sol [INYO] 11913 CDM 60758-0802-05 NDC facility both 1 EA 36 36 Gross Charge Type: Pharmacy | NDC EA = 5 DROPS warfarin 10 mg Tab [INYO] 11915 CDM 00056-0174-75 NDC facility both 1 EA 23.03 23.03 Gross Charge Type: Pharmacy | NDC EA = 1 TAB warfarin 2.5 mg Tab [INYO] 11916 CDM 00832-1213-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB warfarin 2.5 mg Tab [INYO] 11916 CDM 68084-0027-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB warfarin 2.5 mg Tab [INYO] 11916 CDM 00056-0176-75 NDC facility both 1 EA 15.98 15.98 Gross Charge Type: Pharmacy | NDC EA = 1 TAB warfarin 2 mg Tab [INYO] 11917 CDM 00832-1212-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB warfarin 2 mg Tab [INYO] 11917 CDM 62584-0984-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB warfarin 2 mg Tab [INYO] 11917 CDM 00056-0170-75 NDC facility both 1 EA 15.49 15.49 Gross Charge Type: Pharmacy | NDC EA = 1 TAB ketorolac 15 mg/mL Inj Sol [INYO] 11918 CDM J1885 HCPCS 72266-0234-25 NDC facility both 1 ML 235 235 Gross Charge Type: Pharmacy ketorolac 15 mg/mL Inj Sol [INYO] 11918 CDM J1885 HCPCS 63323-0161-01 NDC facility both 1 ML 235 235 Gross Charge Type: Pharmacy ketorolac 15 mg/mL Inj Sol [INYO] 11918 CDM J1885 HCPCS 00409-3793-01 NDC facility both 1 ML 235 235 Gross Charge Type: Pharmacy ketorolac 15 mg/mL Inj Sol [INYO] 11918 CDM J1885 HCPCS 72611-0719-25 NDC facility both 1 ML 235 235 Gross Charge Type: Pharmacy gentamicin Ophth 0.3% Oint [INYO] 11919 CDM 17478-0284-35 NDC facility both 1 EA 212.64 212.64 Gross Charge Type: Pharmacy | NDC EA = 3.5 APP Penicillin V Potassium 125 mg/5 mL Pow [INYO] 11921 CDM 00093-4125-74 NDC facility both 200 ML 67 67 Gross Charge Type: Pharmacy warfarin 1 mg Tab [INYO] 11923 CDM 00056-0169-75 NDC facility both 1 EA 14.85 14.85 Gross Charge Type: Pharmacy | NDC EA = 1 TAB warfarin 1 mg Tab [INYO] 11923 CDM 00832-1211-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB promethazine 50 mg Supp [INYO] 11962 CDM 00713-0132-12 NDC facility both 1 EA 214.59 214.59 Gross Charge Type: Pharmacy | NDC EA = 1 SUPP PHENobarbital 65 mg/mL Sol [INYO] 11967 CDM J2560 HCPCS 42494-0415-25 NDC facility both 1 ML 209.47 209.47 Gross Charge Type: Pharmacy PHENobarbital 65 mg/mL Inj Sol [INYO] 11967 CDM J2560 HCPCS 00641-0476-25 NDC facility both 1 ML 230.21 230.21 Gross Charge Type: Pharmacy "11976 Removal, implantable contraceptive capsules" 11976 CDM 521 RC 11976 HCPCS facility both 713 713 Gross Charge Type: NIHD_RHC_Price ADAPTIC DRESSING 3X3 (50EA) 11980 CDM 272 RC facility both 19 19 Gross Charge Type: NIHD_Hosp_Profee_Price ADAPTIC DRESSING 3X3 (50EA) 11980 CDM 272 RC facility both 19 19 Gross Charge Type: NIHD_Hosp_Profee_Price "11981 Insertion, non-biodegradable drug delivery implant" 119811 CDM 521 RC 11981 HCPCS facility both 355 355 Gross Charge Type: NIHD_Clinic_Price "11981 INSERTION, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT ProFee" 119812 CDM 982 RC 11981 HCPCS facility both 355 355 Gross Charge Type: NIHD_Hosp_Profee_Price "11981 INSERTION, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT ProFee" 119812 CDM 982 RC 11981 HCPCS facility both 355 355 Gross Charge Type: NIHD_Hosp_Profee_Price "11982 Removal, non-biodegradable drug delivery implant" 11982 CDM 975 RC 11982 HCPCS facility both 130 130 Gross Charge Type: NIHD_Hosp_Profee_Price "11982 Removal, non-biodegradable drug delivery implant" 11982 CDM 975 RC 11982 HCPCS facility both 130 130 Gross Charge Type: NIHD_Hosp_Profee_Price "11982 Removal, non-biodegradable drug delivery implant" 119821 CDM 521 RC 11982 HCPCS facility both 301 301 Gross Charge Type: NIHD_Clinic_Price "11982 REMOVAL, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT ProFee" 119822 CDM 975 RC 11982 HCPCS facility both 132 132 Gross Charge Type: NIHD_Hosp_Profee_Price "11982 REMOVAL, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT ProFee" 119822 CDM 975 RC 11982 HCPCS facility both 132 132 Gross Charge Type: NIHD_Hosp_Profee_Price "11983 Removal with reinsertion, non-biodegradable drug delivery implant" 11983 CDM 521 RC 11983 HCPCS facility both 330 330 Gross Charge Type: NIHD_Clinic_Price predniSONE 10 mg Tab [INYO] 11990 CDM J7512 HCPCS 00904-6923-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB predniSONE 10 mg Tab [INYO] 11990 CDM J7512 HCPCS 60687-0134-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB predniSONE 10 mg Tab [INYO] 11990 CDM J7512 HCPCS 00054-0017-20 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB "12001 Simple repair of wounds; scalp, neck, axillae, genitalia, trunk, extremeties; <2.5cm" 120011 CDM 521 RC 12001 HCPCS facility both 350 350 Gross Charge Type: NIHD_RHC_Price "12001 Simple repair of wounds; scalp, neck, axillae, genitalia, trunk, extremeties; <2.5cm" 120011 CDM 521 RC 12001 HCPCS facility both 528 528 Gross Charge Type: NIHD_Clinic_Price 12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/< TechFee 120012 CDM 450 RC facility both 501 501 Gross Charge Type: NIHD_Hosp_Profee_Price 12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/< TechFee 120012 CDM 450 RC facility both 501 501 Gross Charge Type: NIHD_Hosp_Profee_Price "12001 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK ProFee" 120013 CDM 982 RC 12001 HCPCS facility both 188 188 Gross Charge Type: NIHD_Hosp_Profee_Price "12001 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK ProFee" 120013 CDM 982 RC 12001 HCPCS facility both 188 188 Gross Charge Type: NIHD_Hosp_Profee_Price "12002 Simple repair of wounds; scalp, neck, axillae, genitalia, trunk, extremeties; 2.6-7.5cm" 120021 CDM 521 RC 12002 HCPCS facility both 506 506 Gross Charge Type: NIHD_RHC_Price "12002 Simple repair of wounds; scalp, neck, axillae, genitalia, trunk, extremeties; 2.6-7.5cm" 120021 CDM 521 RC 12002 HCPCS facility both 506 506 Gross Charge Type: NIHD_Clinic_Price 12002 SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM TechFee 120022 CDM 450 RC facility both 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price 12002 SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM TechFee 120022 CDM 450 RC facility both 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price "12002 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK ProFee" 120023 CDM 982 RC 12002 HCPCS facility both 227 227 Gross Charge Type: NIHD_Hosp_Profee_Price "12002 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK ProFee" 120023 CDM 982 RC 12002 HCPCS facility both 227 227 Gross Charge Type: NIHD_Hosp_Profee_Price "12004 Simple repair of wounds; scalp, neck, axillae, genitalia, trunk, extremeties; 7.6-12.5cm" 120041 CDM 521 RC 12004 HCPCS facility both 662 662 Gross Charge Type: NIHD_RHC_Price 12004 SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM TechFee 120042 CDM 450 RC facility both 700 700 Gross Charge Type: NIHD_Hosp_Profee_Price 12004 SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM TechFee 120042 CDM 450 RC facility both 700 700 Gross Charge Type: NIHD_Hosp_Profee_Price "12004 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK ProFee" 120043 CDM 982 RC 12004 HCPCS facility both 265 265 Gross Charge Type: NIHD_Hosp_Profee_Price "12004 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK ProFee" 120043 CDM 982 RC 12004 HCPCS facility both 265 265 Gross Charge Type: NIHD_Hosp_Profee_Price 12005 SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM TechFee 120051 CDM 450 RC facility both 799 799 Gross Charge Type: NIHD_Hosp_Profee_Price 12005 SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM TechFee 120051 CDM 450 RC facility both 799 799 Gross Charge Type: NIHD_Hosp_Profee_Price "12005 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK ProFee" 120052 CDM 982 RC 12005 HCPCS facility both 332 332 Gross Charge Type: NIHD_Hosp_Profee_Price "12005 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK ProFee" 120052 CDM 982 RC 12005 HCPCS facility both 332 332 Gross Charge Type: NIHD_Hosp_Profee_Price 12006 SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 20.1-30.0CM TechFee 120061 CDM 450 RC facility both 900 900 Gross Charge Type: NIHD_Hosp_Profee_Price 12006 SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 20.1-30.0CM TechFee 120061 CDM 450 RC facility both 900 900 Gross Charge Type: NIHD_Hosp_Profee_Price "12006 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK ProFee" 120062 CDM 982 RC 12006 HCPCS facility both 400 400 Gross Charge Type: NIHD_Hosp_Profee_Price "12006 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK ProFee" 120062 CDM 982 RC 12006 HCPCS facility both 400 400 Gross Charge Type: NIHD_Hosp_Profee_Price 12007 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM TechFee 120071 CDM 450 RC facility both 999 999 Gross Charge Type: NIHD_Hosp_Profee_Price 12007 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM TechFee 120071 CDM 450 RC facility both 999 999 Gross Charge Type: NIHD_Hosp_Profee_Price "12007 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK ProFee" 120072 CDM 982 RC 12007 HCPCS facility both 1373 1373 Gross Charge Type: NIHD_Hosp_Profee_Price "12007 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK ProFee" 120072 CDM 982 RC 12007 HCPCS facility both 1373 1373 Gross Charge Type: NIHD_Hosp_Profee_Price "12011 Simple repair of wounds of face, ears, eyelids, nose, lips, mucous membra; <2.5cm" 120111 CDM 521 RC 12011 HCPCS facility both 467 467 Gross Charge Type: NIHD_RHC_Price "12011 Simple repair of wounds of face, ears, eyelids, nose, lips, mucous membra; <2.5cm" 120111 CDM 521 RC 12011 HCPCS facility both 639 639 Gross Charge Type: NIHD_Clinic_Price 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< TechFee 120112 CDM 450 RC facility both 501 501 Gross Charge Type: NIHD_Hosp_Profee_Price 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< TechFee 120112 CDM 450 RC facility both 501 501 Gross Charge Type: NIHD_Hosp_Profee_Price "12011 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS M ProFee" 120113 CDM 982 RC 12011 HCPCS facility both 726 726 Gross Charge Type: NIHD_Hosp_Profee_Price "12011 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS M ProFee" 120113 CDM 982 RC 12011 HCPCS facility both 726 726 Gross Charge Type: NIHD_Hosp_Profee_Price "12013 Simple repair of wounds of face, ears, eyelids, nose, lips, mucous membra; 2.6-5.0cm" 120131 CDM 521 RC 12013 HCPCS facility both 720 720 Gross Charge Type: NIHD_RHC_Price "12013 Simple repair of wounds of face, ears, eyelids, nose, lips, mucous membra; 2.6-5.0cm" 120131 CDM 521 RC 12013 HCPCS facility both 720 720 Gross Charge Type: NIHD_Clinic_Price 12013 SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM TechFee 120132 CDM 450 RC facility both 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price 12013 SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM TechFee 120132 CDM 450 RC facility both 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price "12013 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS M ProFee" 120133 CDM 982 RC 12013 HCPCS facility both 825 825 Gross Charge Type: NIHD_Hosp_Profee_Price "12013 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS M ProFee" 120133 CDM 982 RC 12013 HCPCS facility both 825 825 Gross Charge Type: NIHD_Hosp_Profee_Price 12014 SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM TechFee 120141 CDM 450 RC facility both 700 700 Gross Charge Type: NIHD_Hosp_Profee_Price 12014 SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM TechFee 120141 CDM 450 RC facility both 700 700 Gross Charge Type: NIHD_Hosp_Profee_Price "12014 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS M ProFee" 120142 CDM 982 RC 12014 HCPCS facility both 874 874 Gross Charge Type: NIHD_Hosp_Profee_Price "12014 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS M ProFee" 120142 CDM 982 RC 12014 HCPCS facility both 874 874 Gross Charge Type: NIHD_Hosp_Profee_Price 12015 SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM TechFee 120151 CDM 450 RC facility both 799 799 Gross Charge Type: NIHD_Hosp_Profee_Price 12015 SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM TechFee 120151 CDM 450 RC facility both 799 799 Gross Charge Type: NIHD_Hosp_Profee_Price "12015 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS M ProFee" 120152 CDM 982 RC 12015 HCPCS facility both 1124 1124 Gross Charge Type: NIHD_Hosp_Profee_Price "12015 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS M ProFee" 120152 CDM 982 RC 12015 HCPCS facility both 1124 1124 Gross Charge Type: NIHD_Hosp_Profee_Price 12016 SIMPLE REPAIR F/E/E/N/L/M 12.6CM-20.0 CM TechFee 120161 CDM 450 RC facility both 900 900 Gross Charge Type: NIHD_Hosp_Profee_Price 12016 SIMPLE REPAIR F/E/E/N/L/M 12.6CM-20.0 CM TechFee 120161 CDM 450 RC facility both 900 900 Gross Charge Type: NIHD_Hosp_Profee_Price "12016 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS M ProFee" 120162 CDM 982 RC 12016 HCPCS facility both 1560 1560 Gross Charge Type: NIHD_Hosp_Profee_Price "12016 SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS M ProFee" 120162 CDM 982 RC 12016 HCPCS facility both 1560 1560 Gross Charge Type: NIHD_Hosp_Profee_Price 12020 Treatment of superficial wound dehiscence; simple closure 120201 CDM 521 RC 12020 HCPCS facility both 338 338 Gross Charge Type: NIHD_Clinic_Price 12020 TREATMENT OF SUPERFICIAL WOUND DEHISCENCE; SIMPLE CLOSURE ProFee 120202 CDM 982 RC 12020 HCPCS facility both 338 338 Gross Charge Type: NIHD_Hosp_Profee_Price 12020 TREATMENT OF SUPERFICIAL WOUND DEHISCENCE; SIMPLE CLOSURE ProFee 120202 CDM 982 RC 12020 HCPCS facility both 338 338 Gross Charge Type: NIHD_Hosp_Profee_Price 12020 TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE TechFee 120203 CDM 450 RC facility both 2112 2112 Gross Charge Type: NIHD_Hosp_Profee_Price 12020 TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE TechFee 120203 CDM 450 RC facility both 2112 2112 Gross Charge Type: NIHD_Hosp_Profee_Price 12021 Treatment of superficial wound dehiscence; with packing 120211 CDM 521 RC 12021 HCPCS facility both 661 661 Gross Charge Type: NIHD_RHC_Price 12021 Treatment of superficial wound dehiscence; with packing 120211 CDM 521 RC 12021 HCPCS facility both 617 617 Gross Charge Type: NIHD_Clinic_Price 12021 TX SUPERFICIAL WOUND DEHISCENCE W/PACKING TechFee 120212 CDM 450 RC facility both 512 512 Gross Charge Type: NIHD_Hosp_Profee_Price 12021 TX SUPERFICIAL WOUND DEHISCENCE W/PACKING TechFee 120212 CDM 450 RC facility both 512 512 Gross Charge Type: NIHD_Hosp_Profee_Price 12021 TREATMENT OF SUPERFICIAL WOUND DEHISCENCE; WITH PACKING ProFee 120213 CDM 982 RC 12021 HCPCS facility both 950 950 Gross Charge Type: NIHD_Hosp_Profee_Price 12021 TREATMENT OF SUPERFICIAL WOUND DEHISCENCE; WITH PACKING ProFee 120213 CDM 982 RC 12021 HCPCS facility both 950 950 Gross Charge Type: NIHD_Hosp_Profee_Price "12031 Repair, intermediate; wounds of scalp, axillae, trunk, extremities; <2.5cm" 120311 CDM 521 RC 12031 HCPCS facility both 546 546 Gross Charge Type: NIHD_RHC_Price "12031 Repair, intermediate; wounds of scalp, axillae, trunk, extremities; <2.5cm" 120311 CDM 521 RC 12031 HCPCS facility both 501 501 Gross Charge Type: NIHD_Clinic_Price 12031 REPAIR INTERMEDIATE S/A/T/E 2.5 CM/< TechFee 120312 CDM 450 RC facility both 624 624 Gross Charge Type: NIHD_Hosp_Profee_Price 12031 REPAIR INTERMEDIATE S/A/T/E 2.5 CM/< TechFee 120312 CDM 450 RC facility both 624 624 Gross Charge Type: NIHD_Hosp_Profee_Price "12031 REPAIR, INTERMEDIATE, WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HA ProFee" 120313 CDM 982 RC 12031 HCPCS facility both 501 501 Gross Charge Type: NIHD_Hosp_Profee_Price "12031 REPAIR, INTERMEDIATE, WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HA ProFee" 120313 CDM 982 RC 12031 HCPCS facility both 501 501 Gross Charge Type: NIHD_Hosp_Profee_Price "12032 Repair, intermediate; wounds of scalp, axillae, trunk, extremities; 2.6-7.5cm" 120321 CDM 521 RC 12032 HCPCS facility both 698 698 Gross Charge Type: NIHD_RHC_Price "12032 Repair, intermediate; wounds of scalp, axillae, trunk, extremities; 2.6-7.5cm" 120321 CDM 521 RC 12032 HCPCS facility both 632 632 Gross Charge Type: NIHD_Clinic_Price 12032 REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM TechFee 120322 CDM 450 RC facility both 624 624 Gross Charge Type: NIHD_Hosp_Profee_Price 12032 REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM TechFee 120322 CDM 450 RC facility both 624 624 Gross Charge Type: NIHD_Hosp_Profee_Price "12032 REPAIR, INTERMEDIATE, WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HA ProFee" 120323 CDM 982 RC 12032 HCPCS facility both 638 638 Gross Charge Type: NIHD_Hosp_Profee_Price "12032 REPAIR, INTERMEDIATE, WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HA ProFee" 120323 CDM 982 RC 12032 HCPCS facility both 638 638 Gross Charge Type: NIHD_Hosp_Profee_Price 12034 REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM TechFee 120341 CDM 450 RC facility both 736 736 Gross Charge Type: NIHD_Hosp_Profee_Price 12034 REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM TechFee 120341 CDM 450 RC facility both 736 736 Gross Charge Type: NIHD_Hosp_Profee_Price "12034 REPAIR, INTERMEDIATE, WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HA ProFee" 120342 CDM 982 RC 12034 HCPCS facility both 649 649 Gross Charge Type: NIHD_Hosp_Profee_Price "12034 REPAIR, INTERMEDIATE, WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HA ProFee" 120342 CDM 982 RC 12034 HCPCS facility both 649 649 Gross Charge Type: NIHD_Hosp_Profee_Price "12034 LAYER CLOSURE OF WOUND(S),SCALP,7.6-12.5CM" 120343 CDM 521 RC 12034 HCPCS facility both 526 526 Gross Charge Type: NIHD_RHC_Price "12034 LAYER CLOSURE OF WOUND(S),SCALP,7.6-12.5CM" 120343 CDM 521 RC 12034 HCPCS facility both 526 526 Gross Charge Type: NIHD_Clinic_Price 12035 REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM TechFee 120351 CDM 450 RC facility both 851 851 Gross Charge Type: NIHD_Hosp_Profee_Price 12035 REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM TechFee 120351 CDM 450 RC facility both 851 851 Gross Charge Type: NIHD_Hosp_Profee_Price "12035 REPAIR, INTERMEDIATE, WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HA ProFee" 120352 CDM 982 RC 12035 HCPCS facility both 799 799 Gross Charge Type: NIHD_Hosp_Profee_Price "12035 REPAIR, INTERMEDIATE, WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HA ProFee" 120352 CDM 982 RC 12035 HCPCS facility both 799 799 Gross Charge Type: NIHD_Hosp_Profee_Price 12036 REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM TechFee 120361 CDM 450 RC facility both 963 963 Gross Charge Type: NIHD_Hosp_Profee_Price 12036 REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM TechFee 120361 CDM 450 RC facility both 963 963 Gross Charge Type: NIHD_Hosp_Profee_Price "12036 REPAIR, INTERMEDIATE, WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HA ProFee" 120362 CDM 982 RC 12036 HCPCS facility both 874 874 Gross Charge Type: NIHD_Hosp_Profee_Price "12036 REPAIR, INTERMEDIATE, WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HA ProFee" 120362 CDM 982 RC 12036 HCPCS facility both 874 874 Gross Charge Type: NIHD_Hosp_Profee_Price "12037 REPAIR, INTERMEDIATE, WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HA ProFee" 12037 CDM 975 RC 12037 HCPCS facility both 563 563 Gross Charge Type: NIHD_Hosp_Profee_Price "12037 REPAIR, INTERMEDIATE, WOUNDS OF SCALP, AXILLAE, TRUNK AND/OR EXTREMITIES (EXCLUDING HA ProFee" 12037 CDM 975 RC 12037 HCPCS facility both 563 563 Gross Charge Type: NIHD_Hosp_Profee_Price "12041 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; <2.5cm" 120411 CDM 521 RC 12041 HCPCS facility both 288 288 Gross Charge Type: NIHD_Clinic_Price 12041 REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM/< TechFee 120412 CDM 450 RC facility both 624 624 Gross Charge Type: NIHD_Hosp_Profee_Price 12041 REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM/< TechFee 120412 CDM 450 RC facility both 624 624 Gross Charge Type: NIHD_Hosp_Profee_Price "12041 REPAIR, INTERMEDIATE, WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; 2.5 CM OR ProFee" 120413 CDM 982 RC 12041 HCPCS facility both 288 288 Gross Charge Type: NIHD_Hosp_Profee_Price "12041 REPAIR, INTERMEDIATE, WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; 2.5 CM OR ProFee" 120413 CDM 982 RC 12041 HCPCS facility both 288 288 Gross Charge Type: NIHD_Hosp_Profee_Price "12042 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.6-7.5cm" 120421 CDM 521 RC 12042 HCPCS facility both 370 370 Gross Charge Type: NIHD_Clinic_Price 12042 REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM TechFee 120422 CDM 450 RC facility both 736 736 Gross Charge Type: NIHD_Hosp_Profee_Price 12042 REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM TechFee 120422 CDM 450 RC facility both 736 736 Gross Charge Type: NIHD_Hosp_Profee_Price "12042 REPAIR, INTERMEDIATE, WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; 2.6 CM TO ProFee" 120423 CDM 982 RC 12042 HCPCS facility both 370 370 Gross Charge Type: NIHD_Hosp_Profee_Price "12042 REPAIR, INTERMEDIATE, WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; 2.6 CM TO ProFee" 120423 CDM 982 RC 12042 HCPCS facility both 370 370 Gross Charge Type: NIHD_Hosp_Profee_Price "12044 REPAIR, INTERMEDIATE, WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; 7.6 CM TO ProFee" 12044 CDM 982 RC 12044 HCPCS facility both 652 652 Gross Charge Type: NIHD_Hosp_Profee_Price "12044 REPAIR, INTERMEDIATE, WOUNDS OF NECK, HANDS, FEET AND/OR EXTERNAL GENITALIA; 7.6 CM TO ProFee" 12044 CDM 982 RC 12044 HCPCS facility both 652 652 Gross Charge Type: NIHD_Hosp_Profee_Price "12051 Intermed repair of wounds; face, ears, eyelids, nose, lips, mucous membra; <2.5cm" 120511 CDM 521 RC 12051 HCPCS facility both 351 351 Gross Charge Type: NIHD_Clinic_Price 12051 REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.5 CM/< TechFee 120512 CDM 450 RC facility both 624 624 Gross Charge Type: NIHD_Hosp_Profee_Price 12051 REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.5 CM/< TechFee 120512 CDM 450 RC facility both 624 624 Gross Charge Type: NIHD_Hosp_Profee_Price "12051 REPAIR, INTERMEDIATE, WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANE ProFee" 120513 CDM 982 RC 12051 HCPCS facility both 351 351 Gross Charge Type: NIHD_Hosp_Profee_Price "12051 REPAIR, INTERMEDIATE, WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANE ProFee" 120513 CDM 982 RC 12051 HCPCS facility both 351 351 Gross Charge Type: NIHD_Hosp_Profee_Price 12052 REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM TechFee 120521 CDM 450 RC facility both 736 736 Gross Charge Type: NIHD_Hosp_Profee_Price 12052 REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM TechFee 120521 CDM 450 RC facility both 736 736 Gross Charge Type: NIHD_Hosp_Profee_Price "12052 REPAIR, INTERMEDIATE, WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANE ProFee" 120522 CDM 982 RC 12052 HCPCS facility both 874 874 Gross Charge Type: NIHD_Hosp_Profee_Price "12052 REPAIR, INTERMEDIATE, WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANE ProFee" 120522 CDM 982 RC 12052 HCPCS facility both 874 874 Gross Charge Type: NIHD_Hosp_Profee_Price "12052 Intermed repair of wounds; face, ears, eyelids, nose, lips, mucous membra; 2.6-5.0cm" 120523 CDM 521 RC 12052 HCPCS facility both 497 497 Gross Charge Type: NIHD_RHC_Price "12052 Intermed repair of wounds; face, ears, eyelids, nose, lips, mucous membra; 2.6-5.0cm" 120523 CDM 521 RC 12052 HCPCS facility both 497 497 Gross Charge Type: NIHD_Clinic_Price 12053 REPAIR INTERMEDIATE F/E/E/N/L&/MUC 5.1-7.5 CM TechFee 120531 CDM 450 RC facility both 851 851 Gross Charge Type: NIHD_Hosp_Profee_Price 12053 REPAIR INTERMEDIATE F/E/E/N/L&/MUC 5.1-7.5 CM TechFee 120531 CDM 450 RC facility both 851 851 Gross Charge Type: NIHD_Hosp_Profee_Price "12053 REPAIR, INTERMEDIATE, WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANE ProFee" 120532 CDM 982 RC 12053 HCPCS facility both 1124 1124 Gross Charge Type: NIHD_Hosp_Profee_Price "12053 REPAIR, INTERMEDIATE, WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANE ProFee" 120532 CDM 982 RC 12053 HCPCS facility both 1124 1124 Gross Charge Type: NIHD_Hosp_Profee_Price "12053 Intermed repair of wounds; face, ears, eyelids, nose, lips, mucous membra; 5.1-7.5cm" 120533 CDM 521 RC 12053 HCPCS facility both 574 574 Gross Charge Type: NIHD_RHC_Price "12053 Intermed repair of wounds; face, ears, eyelids, nose, lips, mucous membra; 5.1-7.5cm" 120533 CDM 521 RC 12053 HCPCS facility both 574 574 Gross Charge Type: NIHD_Clinic_Price 12054 REPAIR INTERMEDIATE F/E/E/N/L&/MUC 7.6-12.5 CM TechFee 120541 CDM 450 RC facility both 963 963 Gross Charge Type: NIHD_Hosp_Profee_Price 12054 REPAIR INTERMEDIATE F/E/E/N/L&/MUC 7.6-12.5 CM TechFee 120541 CDM 450 RC facility both 963 963 Gross Charge Type: NIHD_Hosp_Profee_Price "12054 REPAIR, INTERMEDIATE, WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANE ProFee" 120542 CDM 982 RC 12054 HCPCS facility both 1424 1424 Gross Charge Type: NIHD_Hosp_Profee_Price "12054 REPAIR, INTERMEDIATE, WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANE ProFee" 120542 CDM 982 RC 12054 HCPCS facility both 1424 1424 Gross Charge Type: NIHD_Hosp_Profee_Price "12055 REPAIR, INTERMEDIATE, WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANE ProFee" 12055 CDM 982 RC 12055 HCPCS facility both 555 555 Gross Charge Type: NIHD_Hosp_Profee_Price "12055 REPAIR, INTERMEDIATE, WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANE ProFee" 12055 CDM 982 RC 12055 HCPCS facility both 555 555 Gross Charge Type: NIHD_Hosp_Profee_Price terazosin 1 mg Cap [INYO] 12066 CDM 50268-0764-15 NDC facility both 1 EA 9.63 9.63 Gross Charge Type: Pharmacy | NDC EA = 1 CAP terazosin 1 mg Cap [INYO] 12066 CDM 00904-6126-61 NDC facility both 1 EA 8.67 8.67 Gross Charge Type: Pharmacy | NDC EA = 1 CAP terbutaline 1 mg/mL Inj Sol [INYO] 12068 CDM J3105 HCPCS 00143-9746-10 NDC facility both 1 ML 235 235 Gross Charge Type: Pharmacy terbutaline 1 mg/mL Inj Sol [INYO] 12068 CDM J3105 HCPCS 63323-0665-01 NDC facility both 1 ML 235 235 Gross Charge Type: Pharmacy warfarin 5 mg Tab [INYO] 12108 CDM 62584-0994-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB warfarin 5 mg Tab [INYO] 12108 CDM 00832-1216-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB warfarin 5 mg Tab [INYO] 12108 CDM 00056-0172-75 NDC facility both 1 EA 16.66 16.66 Gross Charge Type: Pharmacy | NDC EA = 1 TAB prochlorperazine 25 mg Supp [INYO] 12125 CDM 00713-0135-12 NDC facility both 1 EA 73.55 73.55 Gross Charge Type: Pharmacy | NDC EA = 1 SUPP prochlorperazine 25 mg Sup [inyo] 12125 CDM 00574-7226-12 NDC facility both 1 EA 75.5 75.5 Gross Charge Type: Pharmacy | NDC EA = 1 SUPP Intact N-Terminal Propeptide of Type 1 Procollagen LC 140850 12134072 CDM 301 RC facility both 65 65 Gross Charge Type: NIHD_Hosp_Profee_Price Intact N-Terminal Propeptide of Type 1 Procollagen LC 140850 12134072 CDM 301 RC facility both 65 65 Gross Charge Type: NIHD_Hosp_Profee_Price XEROFORM GAUZE 5X9 12159 CDM 272 RC facility both 19 19 Gross Charge Type: NIHD_Hosp_Profee_Price XEROFORM GAUZE 5X9 12159 CDM 272 RC facility both 19 19 Gross Charge Type: NIHD_Hosp_Profee_Price Amino Acids 10% (Aminosyn II Sulfite-Free) IV Sol 500 mL [INYO] 12170 CDM 00409-4164-03 NDC facility both 500 ML 330 330 Gross Charge Type: Pharmacy lactulose 20 g/30 mL Oral Syrup [INYO] 12201 CDM 00121-1154-40 NDC facility both 30 ML 6 6 Gross Charge Type: Pharmacy lactulose 20 g/30 mL Oral Syrup [INYO] 12201 CDM 00121-4577-30 NDC facility both 30 ML 6 6 Gross Charge Type: Pharmacy lactulose 20 g/30 mL Oral Syrup [INYO] 12201 CDM 50383-0779-31 NDC facility both 30 ML 17.88 17.88 Gross Charge Type: Pharmacy lactulose 20 g/30 mL Oral Syrup [INYO] 12201 CDM 66689-0038-50 NDC facility both 30 ML 10.04 10.04 Gross Charge Type: Pharmacy t-Transglutaminase (tTG) IgA LC 12205872 CDM 301 RC facility both 30 30 Gross Charge Type: NIHD_Hosp_Profee_Price t-Transglutaminase (tTG) IgA LC 12205872 CDM 301 RC facility both 30 30 Gross Charge Type: NIHD_Hosp_Profee_Price "Deamidated Gliadin Abs, IgG LC" 12205873 CDM 301 RC facility both 30 30 Gross Charge Type: NIHD_Hosp_Profee_Price "Deamidated Gliadin Abs, IgG LC" 12205873 CDM 301 RC facility both 30 30 Gross Charge Type: NIHD_Hosp_Profee_Price vancomycin 500 mg IV inj [INYO] 12209 CDM J3370 HCPCS 70594-0122-02 NDC facility both 1 EA 330 330 Gross Charge Type: Pharmacy vancomycin 500 mg IV Inj [INYO] 12209 CDM J3370 HCPCS 67457-0339-50 NDC facility both 1 EA 330 330 Gross Charge Type: Pharmacy vancomycin 500 mg IV Inj [INYO] 12209 CDM J3370 HCPCS 47781-0598-91 NDC facility both 1 EA 330 330 Gross Charge Type: Pharmacy vancomycin 500 mg IV Inj [INYO] 12209 CDM J3370 HCPCS 72611-0761-10 NDC facility both 1 EA 330 330 Gross Charge Type: Pharmacy vancomycin 500 mg IV Inj [INYO] 12209 CDM J3370 HCPCS 00409-4332-01 NDC facility both 1 EA 330 330 Gross Charge Type: Pharmacy sulfamethoxazole-trimethoprim 80 mg-16 mg/mL IV Sol 10 mL [INYO] 12214 CDM J3490 HCPCS 00703-9514-03 NDC facility both 10 ML 330 330 Gross Charge Type: Pharmacy prazosin 1 mg Cap [INYO] 12238 CDM 00378-1101-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 CAP prazosin 1 mg Cap [INYO] 12238 CDM 00904-7020-61 NDC facility both 1 EA 9.71 9.71 Gross Charge Type: Pharmacy | NDC EA = 1 CAP prazosin 1 mg Cap [INYO] 12238 CDM 68084-0996-01 NDC facility both 1 EA 10.71 10.71 Gross Charge Type: Pharmacy | NDC EA = 1 CAP sodium hypochlorite Top 0.25% Sol [INYO] 12285 CDM 39328-0063-25 NDC facility both 1 EA 63.75 63.75 Gross Charge Type: Pharmacy | NDC EA = 473 APP metoprolol 50 mg Tab [inyo] 12291 CDM 00904-7118-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB metoprolol TARTrate 50 mg Tab [INYO] 12291 CDM 51079-0801-20 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB metoprolol TARTrate 50 mg Tab [INYO] 12291 CDM 00904-6341-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB metoprolol 5 mg/5 mL Inj Sol [INYO] 12293 CDM 36000-0033-10 NDC facility both 5 ML 235 235 Gross Charge Type: Pharmacy metoprolol 5 mg/5 mL Inj Sol [INYO] 12293 CDM 63323-0660-05 NDC facility both 5 ML 235 235 Gross Charge Type: Pharmacy metoprolol 5 mg/5 mL Inj Sol [INYO] 12293 CDM 00409-2285-05 NDC facility both 5 ML 235 235 Gross Charge Type: Pharmacy timolol Ophth 0.5% Sol 5mL [INYO] 12325 CDM 61314-0227-05 NDC facility both 1 EA 102 102 Gross Charge Type: Pharmacy | NDC EA = 5 DROPS timolol Ophth 0.5% Sol 5mL [INYO] 12325 CDM 64980-0514-05 NDC facility both 1 EA 102 102 Gross Charge Type: Pharmacy | NDC EA = 5 DROPS benztropine 1 mg Tab [INYO] 12379 CDM 00904-7289-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB benztropine 1 mg Tab [INYO] 12379 CDM 00904-6790-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB benztropine 1 mg Tab [INYO] 12379 CDM 00904-6540-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB atropine/hyoscyamine/PB/scopolamine Oral Elix 118 mL [INYO] 12399 CDM 75826-0127-04 NDC facility both 10 ML 135.61 135.61 Gross Charge Type: Pharmacy atropine/hyoscyamine/PB/scopolamine Oral Elix 118 mL [INYO] 12399 CDM 59212-0423-04 NDC facility both 10 ML 197.8 197.8 Gross Charge Type: Pharmacy enalapril 1.25 mg/mL IV Sol [INYO] 12404 CDM J3490 HCPCS 00143-9787-10 NDC facility both 1 ML 235 235 Gross Charge Type: Pharmacy enalapril 1.25 mg/mL 2 mL Sol [INYO] 12420 CDM 00143-9786-10 NDC facility both 2 ML 235 235 Gross Charge Type: Pharmacy Multiple Vitamins IV Sol 5 mL [INYO] 12436 CDM 54643-5649-01 NDC facility both 5 ML 235 235 Gross Charge Type: Pharmacy bismuth subsalicylate 262 mg Chew Tab [INYO] 12445 CDM 37000-0477-12 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB bismuth subsalicylate 262 mg Tab [inyo] 12445 CDM 00904-7205-46 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB bismuth subsalicylate 262 mg Chew Tab [INYO] 12445 CDM 00904-1315-46 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB bismuth subsalicylate 236 mL Oral Susp [INYO] 12446 CDM 00904-1313-09 NDC facility both 236 ML 18.78 18.78 Gross Charge Type: Pharmacy bismuth subsalicylate 236 mL Oral Susp [INYO] 12446 CDM 01490-0039-08 NDC facility both 236 ML 17.76 17.76 Gross Charge Type: Pharmacy bismuth subsalicylate 236 mL Oral Susp [INYO] 12446 CDM 37000-0032-02 NDC facility both 236 ML 27.02 27.02 Gross Charge Type: Pharmacy PHENobarbital 32.4 mg Tab [INYO] 12449 CDM 00904-6575-61 NDC facility both 1 EA 35 35 Gross Charge Type: Pharmacy | NDC EA = 1 TAB PHENobarbital 32.4 mg Tab [INYO] 12449 CDM 00603-5166-21 NDC facility both 1 EA 35 35 Gross Charge Type: Pharmacy | NDC EA = 1 TAB phenylephrine Nasal 0.5% Spry [INYO] 12456 CDM 00225-0805-47 NDC facility both 1 EA 36 36 Gross Charge Type: Pharmacy | NDC EA = 15 SPRAYS phenylephrine Nasal 0.5% Spry [INYO] 12456 CDM 69536-0050-15 NDC facility both 1 EA 36 36 Gross Charge Type: Pharmacy | NDC EA = 15 SPRAYS phenylephrine Nasal 0.5% Spry [INYO] 12456 CDM 50323-0060-03 NDC facility both 1 EA 36 36 Gross Charge Type: Pharmacy | NDC EA = 15 SPRAYS phenytoin 50 mg Chew Tab [INYO] 12458 CDM 00071-0007-40 NDC facility both 1 EA 13.02 13.02 Gross Charge Type: Pharmacy | NDC EA = 1 TAB triamcinolone Top 0.1% Crm [INYO] 12477 CDM 67877-0251-15 NDC facility both 1 EA 29.15 29.15 Gross Charge Type: Pharmacy | NDC EA = 15 APP clindamycin 900 mg/6 mL Sol [INYO] 12478 CDM J0736 HCPCS 00009-0902-18 NDC facility both 6 ML 235 235 Gross Charge Type: Pharmacy cholecalciferol 400 intl units Cap [INYO] 12487 CDM 11845-0118-31 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 CAP CENTRALIZER DISTAL VERSYS 15MM 125 CDM facility both 151 151 Gross Charge Type: NIHD_Hosp_Profee_Price CENTRALIZER DISTAL VERSYS 15MM 125 CDM facility both 151 151 Gross Charge Type: NIHD_Hosp_Profee_Price cefOXitin 1 g Pow [INYO] 12511 CDM J0694 HCPCS 25021-0109-10 NDC facility both 1 EA 235 235 Gross Charge Type: Pharmacy cefOXitin 1 g Pow [INYO] 12511 CDM J0694 HCPCS 44567-0245-25 NDC facility both 1 EA 235 235 Gross Charge Type: Pharmacy metoclopramide 10 mg Tab [INYO] 12519 CDM 60687-0631-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB metoclopramide 10 mg Tab [INYO] 12519 CDM 68084-0676-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB metoclopramide 10 mg Tab [INYO] 12519 CDM 51079-0888-20 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB metoclopramide 10 mg/2 mL Inj Sol [INYO] 12522 CDM J2765 HCPCS 00409-3414-01 NDC facility both 2 ML 235 235 Gross Charge Type: Pharmacy metoclopramide 5 mg/mL Sol [inyo] 12522 CDM J2765 HCPCS 23155-0240-41 NDC facility both 2 ML 235 235 Gross Charge Type: Pharmacy metoclopramide 5 mg/5 mL Oral Syrup [INYO] 12523 CDM 00121-0576-16 NDC facility both 473 ML 184.4 184.4 Gross Charge Type: Pharmacy metoclopramide 5 mg/5 mL Oral Syrup [INYO] 12523 CDM 62559-0190-16 NDC facility both 473 ML 402.81 402.81 Gross Charge Type: Pharmacy NEEDLE BONE BIOPSY 11G OSTEO-SITE M2 1301800 CDM facility both 196 196 Gross Charge Type: NIHD_Hosp_Profee_Price NEEDLE BONE BIOPSY 11G OSTEO-SITE M2 1301800 CDM facility both 196 196 Gross Charge Type: NIHD_Hosp_Profee_Price "13100 Repair, complex, trunk; 1.1 cm to 2.5 cm" 131001 CDM 521 RC 13100 HCPCS facility both 613 613 Gross Charge Type: NIHD_RHC_Price "13100 Repair, complex, trunk; 1.1 cm to 2.5 cm" 131001 CDM 521 RC 13100 HCPCS facility both 613 613 Gross Charge Type: NIHD_Clinic_Price 13100 REPAIR COMPLEX TRUNK 1.1-2.5 CM TechFee 131002 CDM 450 RC facility both 963 963 Gross Charge Type: NIHD_Hosp_Profee_Price 13100 REPAIR COMPLEX TRUNK 1.1-2.5 CM TechFee 131002 CDM 450 RC facility both 963 963 Gross Charge Type: NIHD_Hosp_Profee_Price "13100 REPAIR, COMPLEX, TRUNK; 1.1 CM TO 2.5 CM ProFee" 131003 CDM 982 RC 13100 HCPCS facility both 358 358 Gross Charge Type: NIHD_Hosp_Profee_Price "13100 REPAIR, COMPLEX, TRUNK; 1.1 CM TO 2.5 CM ProFee" 131003 CDM 982 RC 13100 HCPCS facility both 358 358 Gross Charge Type: NIHD_Hosp_Profee_Price "13101 Repair, complex, trunk; 2.6 cm to 7.5 cm" 131011 CDM 521 RC 13101 HCPCS facility both 719 719 Gross Charge Type: NIHD_RHC_Price "13101 Repair, complex, trunk; 2.6 cm to 7.5 cm" 131011 CDM 521 RC 13101 HCPCS facility both 719 719 Gross Charge Type: NIHD_Clinic_Price 13101 REPAIR COMPLEX TRUNK 2.6-7.5 CM TechFee 131012 CDM 450 RC facility both 1148 1148 Gross Charge Type: NIHD_Hosp_Profee_Price 13101 REPAIR COMPLEX TRUNK 2.6-7.5 CM TechFee 131012 CDM 450 RC facility both 1148 1148 Gross Charge Type: NIHD_Hosp_Profee_Price "13101 REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM ProFee" 131013 CDM 982 RC 13101 HCPCS facility both 512 512 Gross Charge Type: NIHD_Hosp_Profee_Price "13101 REPAIR, COMPLEX, TRUNK; 2.6 CM TO 7.5 CM ProFee" 131013 CDM 982 RC 13101 HCPCS facility both 512 512 Gross Charge Type: NIHD_Hosp_Profee_Price "13102 Repair, complex, trunk; each additional 5 cm or less" 131021 CDM 521 RC 13102 HCPCS facility both 215 215 Gross Charge Type: NIHD_RHC_Price "13102 Repair, complex, trunk; each additional 5 cm or less" 131021 CDM 521 RC 13102 HCPCS facility both 215 215 Gross Charge Type: NIHD_Clinic_Price 13102 REPAIR COMPLEX TRUNK EACH ADDITIONAL 5 CM/< TechFee 131022 CDM 450 RC facility both 900 900 Gross Charge Type: NIHD_Hosp_Profee_Price 13102 REPAIR COMPLEX TRUNK EACH ADDITIONAL 5 CM/< TechFee 131022 CDM 450 RC facility both 900 900 Gross Charge Type: NIHD_Hosp_Profee_Price "13102 REPAIR, COMPLEX, TRUNK; EACH ADDITIONAL 5 CM OR LESS (LIST SEPARATELY IN ADDITION TO C ProFee" 131023 CDM 982 RC 13102 HCPCS facility both 188 188 Gross Charge Type: NIHD_Hosp_Profee_Price "13102 REPAIR, COMPLEX, TRUNK; EACH ADDITIONAL 5 CM OR LESS (LIST SEPARATELY IN ADDITION TO C ProFee" 131023 CDM 982 RC 13102 HCPCS facility both 188 188 Gross Charge Type: NIHD_Hosp_Profee_Price "13120 Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm" 131201 CDM 521 RC 13120 HCPCS facility both 638 638 Gross Charge Type: NIHD_RHC_Price "13120 Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm" 131201 CDM 521 RC 13120 HCPCS facility both 638 638 Gross Charge Type: NIHD_Clinic_Price "13120 REPAIR, COMPLEX, SCALP, ARMS, AND/OR LEGS; 1.1 CM TO 2.5 CM ProFee" 131202 CDM 982 RC 13120 HCPCS facility both 436 436 Gross Charge Type: NIHD_Hosp_Profee_Price "13120 REPAIR, COMPLEX, SCALP, ARMS, AND/OR LEGS; 1.1 CM TO 2.5 CM ProFee" 131202 CDM 982 RC 13120 HCPCS facility both 436 436 Gross Charge Type: NIHD_Hosp_Profee_Price "13121 Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm" 131211 CDM 521 RC 13121 HCPCS facility both 771 771 Gross Charge Type: NIHD_RHC_Price "13121 Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm" 131211 CDM 521 RC 13121 HCPCS facility both 771 771 Gross Charge Type: NIHD_Clinic_Price 13121 REPAIR COMPLEX SCALP/ARM/LEG 2.6-7.5 CM TechFee 131212 CDM 450 RC facility both 1733 1733 Gross Charge Type: NIHD_Hosp_Profee_Price 13121 REPAIR COMPLEX SCALP/ARM/LEG 2.6-7.5 CM TechFee 131212 CDM 450 RC facility both 1733 1733 Gross Charge Type: NIHD_Hosp_Profee_Price "13121 REPAIR, COMPLEX, SCALP, ARMS, AND/OR LEGS; 2.6 CM TO 7.5 CM ProFee" 131213 CDM 982 RC 13121 HCPCS facility both 538 538 Gross Charge Type: NIHD_Hosp_Profee_Price "13121 REPAIR, COMPLEX, SCALP, ARMS, AND/OR LEGS; 2.6 CM TO 7.5 CM ProFee" 131213 CDM 982 RC 13121 HCPCS facility both 538 538 Gross Charge Type: NIHD_Hosp_Profee_Price "13122 Repair, complex, scalp, arms, and/or legs; each additional 5 cm or less" 131221 CDM 521 RC 13122 HCPCS facility both 234 234 Gross Charge Type: NIHD_RHC_Price "13122 Repair, complex, scalp, arms, and/or legs; each additional 5 cm or less" 131221 CDM 521 RC 13122 HCPCS facility both 234 234 Gross Charge Type: NIHD_Clinic_Price 13122 REPAIR COMPLEX SCALP/ARM/LEG EA ADDL 5 CM/< TechFee 131222 CDM 450 RC facility both 1106 1106 Gross Charge Type: NIHD_Hosp_Profee_Price 13122 REPAIR COMPLEX SCALP/ARM/LEG EA ADDL 5 CM/< TechFee 131222 CDM 450 RC facility both 1106 1106 Gross Charge Type: NIHD_Hosp_Profee_Price "13122 REPAIR, COMPLEX, SCALP, ARMS, AND/OR LEGS; EACH ADDITIONAL 5 CM OR LESS (LIST SEPARATE ProFee" 131223 CDM 982 RC 13122 HCPCS facility both 164 164 Gross Charge Type: NIHD_Hosp_Profee_Price "13122 REPAIR, COMPLEX, SCALP, ARMS, AND/OR LEGS; EACH ADDITIONAL 5 CM OR LESS (LIST SEPARATE ProFee" 131223 CDM 982 RC 13122 HCPCS facility both 164 164 Gross Charge Type: NIHD_Hosp_Profee_Price "13131 Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands; 1.1-2.5cm" 131311 CDM 521 RC 13131 HCPCS facility both 698 698 Gross Charge Type: NIHD_RHC_Price "13131 Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands; 1.1-2.5cm" 131311 CDM 521 RC 13131 HCPCS facility both 698 698 Gross Charge Type: NIHD_Clinic_Price "13131 REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR ProFee" 131312 CDM 982 RC 13131 HCPCS facility both 435 435 Gross Charge Type: NIHD_Hosp_Profee_Price "13131 REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR ProFee" 131312 CDM 982 RC 13131 HCPCS facility both 435 435 Gross Charge Type: NIHD_Hosp_Profee_Price 13131 REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 1.1-2.5 CM TechFee 131313 CDM 450 RC facility both 1207 1207 Gross Charge Type: NIHD_Hosp_Profee_Price 13131 REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 1.1-2.5 CM TechFee 131313 CDM 450 RC facility both 1207 1207 Gross Charge Type: NIHD_Hosp_Profee_Price "13132 Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands; 2.6-7.5cm" 131321 CDM 521 RC 13132 HCPCS facility both 854 854 Gross Charge Type: NIHD_RHC_Price "13132 Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands; 2.6-7.5cm" 131321 CDM 521 RC 13132 HCPCS facility both 854 854 Gross Charge Type: NIHD_Clinic_Price "13132 REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR ProFee" 131322 CDM 982 RC 13132 HCPCS facility both 573 573 Gross Charge Type: NIHD_Hosp_Profee_Price "13132 REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR ProFee" 131322 CDM 982 RC 13132 HCPCS facility both 573 573 Gross Charge Type: NIHD_Hosp_Profee_Price 13132 REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM TechFee 131323 CDM 450 RC facility both 1727 1727 Gross Charge Type: NIHD_Hosp_Profee_Price 13132 REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM TechFee 131323 CDM 450 RC facility both 1727 1727 Gross Charge Type: NIHD_Hosp_Profee_Price "13133 Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands; addl 5cm" 131331 CDM 521 RC 13133 HCPCS facility both 309 309 Gross Charge Type: NIHD_RHC_Price "13133 Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands; addl 5cm" 131331 CDM 521 RC 13133 HCPCS facility both 309 309 Gross Charge Type: NIHD_Clinic_Price "13133 REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR ProFee" 131332 CDM 982 RC 13133 HCPCS facility both 227 227 Gross Charge Type: NIHD_Hosp_Profee_Price "13133 REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR ProFee" 131332 CDM 982 RC 13133 HCPCS facility both 227 227 Gross Charge Type: NIHD_Hosp_Profee_Price "13151 Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm" 131511 CDM 521 RC 13151 HCPCS facility both 760 760 Gross Charge Type: NIHD_RHC_Price "13151 Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm" 131511 CDM 521 RC 13151 HCPCS facility both 760 760 Gross Charge Type: NIHD_Clinic_Price "13151 REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; 1.1 CM TO 2.5 CM ProFee" 131512 CDM 982 RC 13151 HCPCS facility both 500 500 Gross Charge Type: NIHD_Hosp_Profee_Price "13151 REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; 1.1 CM TO 2.5 CM ProFee" 131512 CDM 982 RC 13151 HCPCS facility both 500 500 Gross Charge Type: NIHD_Hosp_Profee_Price "13152 Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm" 131521 CDM 521 RC 13152 HCPCS facility both 901 901 Gross Charge Type: NIHD_RHC_Price "13152 Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm" 131521 CDM 521 RC 13152 HCPCS facility both 901 901 Gross Charge Type: NIHD_Clinic_Price "13152 REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; 2.6 CM TO 7.5 CM ProFee" 131522 CDM 982 RC 13152 HCPCS facility both 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price "13152 REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; 2.6 CM TO 7.5 CM ProFee" 131522 CDM 982 RC 13152 HCPCS facility both 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price "13153 Repair, complex, eyelids, nose, ears and/or lips; each additional 5 cm or less" 131531 CDM 521 RC 13153 HCPCS facility both 338 338 Gross Charge Type: NIHD_RHC_Price "13153 Repair, complex, eyelids, nose, ears and/or lips; each additional 5 cm or less" 131531 CDM 521 RC 13153 HCPCS facility both 338 338 Gross Charge Type: NIHD_Clinic_Price "13153 REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM OR LESS (LIST S ProFee" 131532 CDM 982 RC 13153 HCPCS facility both 245 245 Gross Charge Type: NIHD_Hosp_Profee_Price "13153 REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM OR LESS (LIST S ProFee" 131532 CDM 982 RC 13153 HCPCS facility both 245 245 Gross Charge Type: NIHD_Hosp_Profee_Price "13160 SECONDARY CLOSURE OF SURGICAL WOUND OR DEHISCENCE, EXTENSIVE OR COMPLICATED ProFee" 13160 CDM 982 RC 13160 HCPCS facility both 1585 1585 Gross Charge Type: NIHD_Hosp_Profee_Price "13160 SECONDARY CLOSURE OF SURGICAL WOUND OR DEHISCENCE, EXTENSIVE OR COMPLICATED ProFee" 13160 CDM 982 RC 13160 HCPCS facility both 1585 1585 Gross Charge Type: NIHD_Hosp_Profee_Price "BB-TAK, MTP, THREADED" 1322700 CDM 278 RC facility both 255 255 Gross Charge Type: NIHD_Hosp_Profee_Price "BB-TAK, MTP, THREADED" 1322700 CDM 278 RC facility both 255 255 Gross Charge Type: NIHD_Hosp_Profee_Price Major Additional 15 Min 1378482 CDM 360 RC facility both 3185 3185 Gross Charge Type: NIHD_Hosp_Profee_Price Major Additional 15 Min 1378482 CDM 360 RC facility both 3185 3185 Gross Charge Type: NIHD_Hosp_Profee_Price Echocardiogram Transesophageal 1378485 CDM 360 RC facility both 1973 1973 Gross Charge Type: NIHD_Hosp_Profee_Price Echocardiogram Transesophageal 1378485 CDM 360 RC facility both 1973 1973 Gross Charge Type: NIHD_Hosp_Profee_Price "14000 Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less" 140001 CDM 521 RC 14000 HCPCS facility both 1112 1112 Gross Charge Type: NIHD_RHC_Price "14000 Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less" 140001 CDM 521 RC 14000 HCPCS facility both 1112 1112 Gross Charge Type: NIHD_Clinic_Price "14000 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK; DEFECT 10 SQ CM OR LESS ProFee" 140002 CDM 982 RC 14000 HCPCS facility both 1023 1023 Gross Charge Type: NIHD_Hosp_Profee_Price "14000 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK; DEFECT 10 SQ CM OR LESS ProFee" 140002 CDM 982 RC 14000 HCPCS facility both 1023 1023 Gross Charge Type: NIHD_Hosp_Profee_Price "14001 Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm" 140011 CDM 521 RC 14001 HCPCS facility both 1413 1413 Gross Charge Type: NIHD_RHC_Price "14001 Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm" 140011 CDM 521 RC 14001 HCPCS facility both 1413 1413 Gross Charge Type: NIHD_Clinic_Price "14001 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK; DEFECT 10.1 SQ CM TO 30.0 SQ CM ProFee" 140012 CDM 982 RC 14001 HCPCS facility both 1135 1135 Gross Charge Type: NIHD_Hosp_Profee_Price "14001 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK; DEFECT 10.1 SQ CM TO 30.0 SQ CM ProFee" 140012 CDM 982 RC 14001 HCPCS facility both 1135 1135 Gross Charge Type: NIHD_Hosp_Profee_Price "14020 Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect < 10 sq cm" 140201 CDM 521 RC 14020 HCPCS facility both 1238 1238 Gross Charge Type: NIHD_RHC_Price "14020 Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect < 10 sq cm" 140201 CDM 521 RC 14020 HCPCS facility both 12367 12367 Gross Charge Type: NIHD_Clinic_Price "14020 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, SCALP, ARMS AND/OR LEGS; DEFECT 10 SQ CM OR ProFee" 140202 CDM 982 RC 14020 HCPCS facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "14020 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, SCALP, ARMS AND/OR LEGS; DEFECT 10 SQ CM OR ProFee" 140202 CDM 982 RC 14020 HCPCS facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "14021 Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 sq cm to 30.0" 140211 CDM 521 RC 14021 HCPCS facility both 1534 1534 Gross Charge Type: NIHD_RHC_Price "14021 Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 sq cm to 30.0" 140211 CDM 521 RC 14021 HCPCS facility both 1534 1534 Gross Charge Type: NIHD_Clinic_Price "14021 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, SCALP, ARMS AND/OR LEGS; DEFECT 10.1 SQ CM ProFee" 140212 CDM 982 RC 14021 HCPCS facility both 1254 1254 Gross Charge Type: NIHD_Hosp_Profee_Price "14021 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, SCALP, ARMS AND/OR LEGS; DEFECT 10.1 SQ CM ProFee" 140212 CDM 982 RC 14021 HCPCS facility both 1254 1254 Gross Charge Type: NIHD_Hosp_Profee_Price "14040 Adjacent tissue transfer; forehead, cheeks, chin, mouth, neck, axillae, hands; < 10 sq cm" 140401 CDM 521 RC 14040 HCPCS facility both 1345 1345 Gross Charge Type: NIHD_RHC_Price "14040 Adjacent tissue transfer; forehead, cheeks, chin, mouth, neck, axillae, hands; < 10 sq cm" 140401 CDM 521 RC 14040 HCPCS facility both 1345 1345 Gross Charge Type: NIHD_Clinic_Price "14040 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLA ProFee" 140402 CDM 982 RC 14040 HCPCS facility both 1103 1103 Gross Charge Type: NIHD_Hosp_Profee_Price "14040 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLA ProFee" 140402 CDM 982 RC 14040 HCPCS facility both 1103 1103 Gross Charge Type: NIHD_Hosp_Profee_Price "14041 Adjacent tissue transfer; forehead, cheeks, chin, mouth, neck, axillae, hands; 10.1-30.0 sq cm" 140411 CDM 521 RC 14041 HCPCS facility both 1644 1644 Gross Charge Type: NIHD_RHC_Price "14041 Adjacent tissue transfer; forehead, cheeks, chin, mouth, neck, axillae, hands; 10.1-30.0 sq cm" 140411 CDM 521 RC 14041 HCPCS facility both 1644 1644 Gross Charge Type: NIHD_Clinic_Price "14041 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLA ProFee" 140412 CDM 982 RC 14041 HCPCS facility both 1351 1351 Gross Charge Type: NIHD_Hosp_Profee_Price "14041 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLA ProFee" 140412 CDM 982 RC 14041 HCPCS facility both 1351 1351 Gross Charge Type: NIHD_Hosp_Profee_Price "14060 Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; <10 sq cm" 140601 CDM 521 RC 14060 HCPCS facility both 1365 1365 Gross Charge Type: NIHD_RHC_Price "14060 Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; <10 sq cm" 140601 CDM 521 RC 14060 HCPCS facility both 1365 1365 Gross Charge Type: NIHD_Clinic_Price "14060 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS, NOSE, EARS AND/OR LIPS; DEFECT 10 ProFee" 140602 CDM 982 RC 14060 HCPCS facility both 1176 1176 Gross Charge Type: NIHD_Hosp_Profee_Price "14060 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS, NOSE, EARS AND/OR LIPS; DEFECT 10 ProFee" 140602 CDM 982 RC 14060 HCPCS facility both 1176 1176 Gross Charge Type: NIHD_Hosp_Profee_Price "14061 Adj tissue transfer/rearrangement, eyelids/nose/ears and/or lips; defect 10.1 to 30.0 sq cm" 140611 CDM 521 RC 14061 HCPCS facility both 1770 1770 Gross Charge Type: NIHD_RHC_Price "14061 Adj tissue transfer/rearrangement, eyelids/nose/ears and/or lips; defect 10.1 to 30.0 sq cm" 140611 CDM 521 RC 14061 HCPCS facility both 1770 1770 Gross Charge Type: NIHD_Clinic_Price "14061 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS, NOSE, EARS AND/OR LIPS; DEFECT 10. ProFee" 140612 CDM 982 RC 14061 HCPCS facility both 1449 1449 Gross Charge Type: NIHD_Hosp_Profee_Price "14061 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS, NOSE, EARS AND/OR LIPS; DEFECT 10. ProFee" 140612 CDM 982 RC 14061 HCPCS facility both 1449 1449 Gross Charge Type: NIHD_Hosp_Profee_Price "14301 Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm" 143011 CDM 521 RC 14301 HCPCS facility both 1912 1912 Gross Charge Type: NIHD_RHC_Price "14301 Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm" 143011 CDM 521 RC 14301 HCPCS facility both 1912 1912 Gross Charge Type: NIHD_Clinic_Price "14301 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, ANY AREA; DEFECT 30.1 SQ CM TO 60.0 SQ CM ProFee" 143012 CDM 982 RC 14301 HCPCS facility both 1532 1532 Gross Charge Type: NIHD_Hosp_Profee_Price "14301 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, ANY AREA; DEFECT 30.1 SQ CM TO 60.0 SQ CM ProFee" 143012 CDM 982 RC 14301 HCPCS facility both 1532 1532 Gross Charge Type: NIHD_Hosp_Profee_Price "14302 Adjacent tissue transfer or rearrangement, any area; each addtnl 30.0 sq cm, or part thereof" 143021 CDM 521 RC 14302 HCPCS facility both 381 381 Gross Charge Type: NIHD_RHC_Price "14302 Adjacent tissue transfer or rearrangement, any area; each addtnl 30.0 sq cm, or part thereof" 143021 CDM 521 RC 14302 HCPCS facility both 381 381 Gross Charge Type: NIHD_Clinic_Price "14302 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, ANY AREA; EACH ADDITIONAL 30.0 SQ CM, OR PA ProFee" 143022 CDM 982 RC 14302 HCPCS facility both 381 381 Gross Charge Type: NIHD_Hosp_Profee_Price "14302 ADJACENT TISSUE TRANSFER OR REARRANGEMENT, ANY AREA; EACH ADDITIONAL 30.0 SQ CM, OR PA ProFee" 143022 CDM 982 RC 14302 HCPCS facility both 381 381 Gross Charge Type: NIHD_Hosp_Profee_Price "15100 SPLIT-THICKNESS AUTOGRAFT, TRUNK, ARMS, LEGS; FIRST 100 SQ CM OR LESS, OR 1% OF BODY A ProFee" 15100 CDM 982 RC 15100 HCPCS facility both 1435 1435 Gross Charge Type: NIHD_Hosp_Profee_Price "15100 SPLIT-THICKNESS AUTOGRAFT, TRUNK, ARMS, LEGS; FIRST 100 SQ CM OR LESS, OR 1% OF BODY A ProFee" 15100 CDM 982 RC 15100 HCPCS facility both 1435 1435 Gross Charge Type: NIHD_Hosp_Profee_Price MESH PARIETENE 15X10CM 1510252 CDM 278 RC facility both 559 559 Gross Charge Type: NIHD_Hosp_Profee_Price MESH PARIETENE 15X10CM 1510252 CDM 278 RC facility both 559 559 Gross Charge Type: NIHD_Hosp_Profee_Price "15200 Full thickness graft, free, including direct closure of donor site, trunk; 20 sq cm or less" 152001 CDM 521 RC 15200 HCPCS facility both 1483 1483 Gross Charge Type: NIHD_RHC_Price "15200 Full thickness graft, free, including direct closure of donor site, trunk; 20 sq cm or less" 152001 CDM 521 RC 15200 HCPCS facility both 1483 1483 Gross Charge Type: NIHD_Clinic_Price "15200 FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, TRUNK; 20 SQ CM OR ProFee" 152002 CDM 982 RC 15200 HCPCS facility both 1182 1182 Gross Charge Type: NIHD_Hosp_Profee_Price "15200 FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, TRUNK; 20 SQ CM OR ProFee" 152002 CDM 982 RC 15200 HCPCS facility both 1182 1182 Gross Charge Type: NIHD_Hosp_Profee_Price "15201 Full thickness graft, free, including direct closure of donor site, trunk; ea addtnl 20 sq cm" 152011 CDM 521 RC 15201 HCPCS facility both 263 263 Gross Charge Type: NIHD_RHC_Price "15201 Full thickness graft, free, including direct closure of donor site, trunk; ea addtnl 20 sq cm" 152011 CDM 521 RC 15201 HCPCS facility both 263 263 Gross Charge Type: NIHD_Clinic_Price "15201 FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, TRUNK; EACH ADDITI ProFee" 152012 CDM 982 RC 15201 HCPCS facility both 136 136 Gross Charge Type: NIHD_Hosp_Profee_Price "15201 FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, TRUNK; EACH ADDITI ProFee" 152012 CDM 982 RC 15201 HCPCS facility both 136 136 Gross Charge Type: NIHD_Hosp_Profee_Price "15220 Full thickness graft, free, including direct closure of donor site, scalp/arms/legs; <20 sq cm" 152201 CDM 521 RC 15220 HCPCS facility both 1370 1370 Gross Charge Type: NIHD_RHC_Price "15220 Full thickness graft, free, including direct closure of donor site, scalp/arms/legs; <20 sq cm" 152201 CDM 521 RC 15220 HCPCS facility both 1370 1370 Gross Charge Type: NIHD_Clinic_Price "15220 FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, SCALP, ARMS, AND/O ProFee" 152202 CDM 982 RC 15220 HCPCS facility both 1034 1034 Gross Charge Type: NIHD_Hosp_Profee_Price "15220 FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, SCALP, ARMS, AND/O ProFee" 152202 CDM 982 RC 15220 HCPCS facility both 1034 1034 Gross Charge Type: NIHD_Hosp_Profee_Price "15221 Full thickness graft, free, including closure of donor site, scalp/arms/legs; ea addl 20 sq cm" 152211 CDM 521 RC 15221 HCPCS facility both 243 243 Gross Charge Type: NIHD_RHC_Price "15221 Full thickness graft, free, including closure of donor site, scalp/arms/legs; ea addl 20 sq cm" 152211 CDM 521 RC 15221 HCPCS facility both 243 243 Gross Charge Type: NIHD_Clinic_Price "15221 FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, SCALP, ARMS, AND/O ProFee" 152212 CDM 982 RC 15221 HCPCS facility both 124 124 Gross Charge Type: NIHD_Hosp_Profee_Price "15221 FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, SCALP, ARMS, AND/O ProFee" 152212 CDM 982 RC 15221 HCPCS facility both 124 124 Gross Charge Type: NIHD_Hosp_Profee_Price "15240 Full thickness graft, free; forehead, cheeks, chin, mouth, neck, axillae, hands; <20 sq cm" 152401 CDM 521 RC 15240 HCPCS facility both 1653 1653 Gross Charge Type: NIHD_RHC_Price "15240 Full thickness graft, free; forehead, cheeks, chin, mouth, neck, axillae, hands; <20 sq cm" 152401 CDM 521 RC 15240 HCPCS facility both 1653 1653 Gross Charge Type: NIHD_Clinic_Price "15240 FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, FOREHEAD, CHEEKS, ProFee" 152402 CDM 982 RC 15240 HCPCS facility both 1407 1407 Gross Charge Type: NIHD_Hosp_Profee_Price "15240 FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, FOREHEAD, CHEEKS, ProFee" 152402 CDM 982 RC 15240 HCPCS facility both 1407 1407 Gross Charge Type: NIHD_Hosp_Profee_Price 15241 Full thickness graft; forehead/cheeks/chin/mouth/neck/axil/gen/hands/feet; ea add 20 sq cm 152411 CDM 521 RC 15241 HCPCS facility both 322 322 Gross Charge Type: NIHD_RHC_Price 15241 Full thickness graft; forehead/cheeks/chin/mouth/neck/axil/gen/hands/feet; ea add 20 sq cm 152411 CDM 521 RC 15241 HCPCS facility both 322 322 Gross Charge Type: NIHD_Clinic_Price "15241 FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, FOREHEAD, CHEEKS, ProFee" 152412 CDM 982 RC 15241 HCPCS facility both 192 192 Gross Charge Type: NIHD_Hosp_Profee_Price "15241 FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, FOREHEAD, CHEEKS, ProFee" 152412 CDM 982 RC 15241 HCPCS facility both 192 192 Gross Charge Type: NIHD_Hosp_Profee_Price "15260 Full thickness graft, free, direct closure of donor site, nose/ears/eyelids/lips; <20 sq cm" 152601 CDM 521 RC 15260 HCPCS facility both 1780 1780 Gross Charge Type: NIHD_RHC_Price "15260 Full thickness graft, free, direct closure of donor site, nose/ears/eyelids/lips; <20 sq cm" 152601 CDM 521 RC 15260 HCPCS facility both 1780 1780 Gross Charge Type: NIHD_Clinic_Price "15260 FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, NOSE, EARS, EYELID ProFee" 152602 CDM 982 RC 15260 HCPCS facility both 1499 1499 Gross Charge Type: NIHD_Hosp_Profee_Price "15260 FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, NOSE, EARS, EYELID ProFee" 152602 CDM 982 RC 15260 HCPCS facility both 1499 1499 Gross Charge Type: NIHD_Hosp_Profee_Price "15261 Full thickness graft, free, closure of donor site, nose/ears/eyelids/lips; ea add 20 sq cm" 152611 CDM 521 RC 15261 HCPCS facility both 374 374 Gross Charge Type: NIHD_RHC_Price "15261 Full thickness graft, free, closure of donor site, nose/ears/eyelids/lips; ea add 20 sq cm" 152611 CDM 521 RC 15261 HCPCS facility both 374 374 Gross Charge Type: NIHD_Clinic_Price "15261 FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, NOSE, EARS, EYELID ProFee" 152612 CDM 982 RC 15261 HCPCS facility both 243 243 Gross Charge Type: NIHD_Hosp_Profee_Price "15261 FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, NOSE, EARS, EYELID ProFee" 152612 CDM 982 RC 15261 HCPCS facility both 243 243 Gross Charge Type: NIHD_Hosp_Profee_Price 15271 APP SKN SUB GRFT T/A/L AREA/100SQ CM /<1 CHARGE 15271 CDM 761 RC facility both 2863 2863 Gross Charge Type: NIHD_Hosp_Profee_Price 15271 APP SKN SUB GRFT T/A/L AREA/100SQ CM /<1 CHARGE 15271 CDM 761 RC facility both 2863 2863 Gross Charge Type: NIHD_Hosp_Profee_Price "15271 Application of skin graft to trunk/arms/legs, up to 100 sq cm; first 25 sq cm" 152711 CDM 521 RC 15271 HCPCS facility both 176 176 Gross Charge Type: NIHD_Clinic_Price "15271 APPLICATION OF SKIN SUBSTITUTE GRAFT TO TRUNK, ARMS, LEGS, TOTAL WOUND SURFACE AREA UP ProFee" 152712 CDM 982 RC 15271 HCPCS facility both 176 176 Gross Charge Type: NIHD_Hosp_Profee_Price "15271 APPLICATION OF SKIN SUBSTITUTE GRAFT TO TRUNK, ARMS, LEGS, TOTAL WOUND SURFACE AREA UP ProFee" 152712 CDM 982 RC 15271 HCPCS facility both 176 176 Gross Charge Type: NIHD_Hosp_Profee_Price "15272 Application of skin graft to trunk,arms,legs, up to 100 sq cm; ea add 25 sq cm" 15272 CDM 361 RC facility both 2329 2329 Gross Charge Type: NIHD_Hosp_Profee_Price "15272 Application of skin graft to trunk,arms,legs, up to 100 sq cm; ea add 25 sq cm" 15272 CDM 361 RC facility both 2329 2329 Gross Charge Type: NIHD_Hosp_Profee_Price "15272 Application of skin graft to trunk/arms/legs, up to 100 sq cm; ea add 25 sq cm" 152721 CDM 521 RC 15272 HCPCS facility both 114 114 Gross Charge Type: NIHD_Clinic_Price "15272 APPLICATION OF SKIN SUBSTITUTE GRAFT TO TRUNK, ARMS, LEGS, TOTAL WOUND SURFACE AREA UP ProFee" 152722 CDM 982 RC 15272 HCPCS facility both 114 114 Gross Charge Type: NIHD_Hosp_Profee_Price "15272 APPLICATION OF SKIN SUBSTITUTE GRAFT TO TRUNK, ARMS, LEGS, TOTAL WOUND SURFACE AREA UP ProFee" 152722 CDM 982 RC 15272 HCPCS facility both 114 114 Gross Charge Type: NIHD_Hosp_Profee_Price 15273 APP SKN SUBGRFT T/A/L AREA/100SQ CM 1ST CHARGE 15273 CDM 761 RC facility both 4032 4032 Gross Charge Type: NIHD_Hosp_Profee_Price 15273 APP SKN SUBGRFT T/A/L AREA/100SQ CM 1ST CHARGE 15273 CDM 761 RC facility both 4032 4032 Gross Charge Type: NIHD_Hosp_Profee_Price "15273 — Application of skin substitute graft, first 100 sq cm wound surface area" 152732 CDM 982 RC 15273 HCPCS facility both 589 589 Gross Charge Type: NIHD_Hosp_Profee_Price "15273 — Application of skin substitute graft, first 100 sq cm wound surface area" 152732 CDM 982 RC 15273 HCPCS facility both 589 589 Gross Charge Type: NIHD_Hosp_Profee_Price "15274 Application of skin substiture graft, trunk, arms, legs, total wound surface area, ea add'l 10" 15274 CDM 761 RC facility both 1892 1892 Gross Charge Type: NIHD_Hosp_Profee_Price "15274 Application of skin substiture graft, trunk, arms, legs, total wound surface area, ea add'l 10" 15274 CDM 761 RC facility both 1892 1892 Gross Charge Type: NIHD_Hosp_Profee_Price "15274 — Each additional 100 sq cm wound surface area, or part thereof (list separately in addition t" 152742 CDM 982 RC 15274 HCPCS facility both 133 133 Gross Charge Type: NIHD_Hosp_Profee_Price "15274 — Each additional 100 sq cm wound surface area, or part thereof (list separately in addition t" 152742 CDM 982 RC 15274 HCPCS facility both 133 133 Gross Charge Type: NIHD_Hosp_Profee_Price 15275 APP SKN SUB GRFT F/S/N/H/F/G/M/D <100SQ CHARGE 15275 CDM 361 RC facility both 3198 3198 Gross Charge Type: NIHD_Hosp_Profee_Price 15275 APP SKN SUB GRFT F/S/N/H/F/G/M/D <100SQ CHARGE 15275 CDM 361 RC facility both 3198 3198 Gross Charge Type: NIHD_Hosp_Profee_Price "15275 APPLICATION OF SKIN SUBSTITUTE GRAFT TO FACE,SCALP,EYELIDS,MOUTH,NECK,EARS,ORBITS,GENIT ProFee" 152751 CDM 982 RC 15275 HCPCS facility both 141 141 Gross Charge Type: NIHD_Hosp_Profee_Price "15275 APPLICATION OF SKIN SUBSTITUTE GRAFT TO FACE,SCALP,EYELIDS,MOUTH,NECK,EARS,ORBITS,GENIT ProFee" 152751 CDM 982 RC 15275 HCPCS facility both 141 141 Gross Charge Type: NIHD_Hosp_Profee_Price "15276 APPLY SKIN SUB - FEET, EACH ADD 25 SQ CM Wound" 15276 CDM 361 RC facility both 1411 1411 Gross Charge Type: NIHD_Hosp_Profee_Price "15276 APPLY SKIN SUB - FEET, EACH ADD 25 SQ CM Wound" 15276 CDM 361 RC facility both 1411 1411 Gross Charge Type: NIHD_Hosp_Profee_Price "15276 APPLICATION OF SKIN SUBSTITUTE GRAFT TO FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBIT ProFee" 152761 CDM 982 RC 15276 HCPCS facility both 38 38 Gross Charge Type: NIHD_Hosp_Profee_Price "15276 APPLICATION OF SKIN SUBSTITUTE GRAFT TO FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBIT ProFee" 152761 CDM 982 RC 15276 HCPCS facility both 38 38 Gross Charge Type: NIHD_Hosp_Profee_Price "15277 Application of skin substitute graft, face, scalp, eyelids, mouth, neck, ears, orbits, genital" 15277 CDM 761 RC facility both 3388 3388 Gross Charge Type: NIHD_Hosp_Profee_Price "15277 Application of skin substitute graft, face, scalp, eyelids, mouth, neck, ears, orbits, genital" 15277 CDM 761 RC facility both 3388 3388 Gross Charge Type: NIHD_Hosp_Profee_Price "15277 — Application of skin substitute graft, first 100 sq cm wound surface area" 152771 CDM 982 RC 15277 HCPCS facility both 671 671 Gross Charge Type: NIHD_Hosp_Profee_Price "15277 — Application of skin substitute graft, first 100 sq cm wound surface area" 152771 CDM 982 RC 15277 HCPCS facility both 671 671 Gross Charge Type: NIHD_Hosp_Profee_Price "15278 Application of skin substitute graft, face, scalp, eyelids, mouth, neck, ears, orbits, genital" 15278 CDM 761 RC facility both 3992 3992 Gross Charge Type: NIHD_Hosp_Profee_Price "15278 Application of skin substitute graft, face, scalp, eyelids, mouth, neck, ears, orbits, genital" 15278 CDM 761 RC facility both 3992 3992 Gross Charge Type: NIHD_Hosp_Profee_Price "15278 — Each additional 100 sq cm wound surface area, or part thereof (list separately in addition t" 152781 CDM 982 RC 15278 HCPCS facility both 167 167 Gross Charge Type: NIHD_Hosp_Profee_Price "15278 — Each additional 100 sq cm wound surface area, or part thereof (list separately in addition t" 152781 CDM 982 RC 15278 HCPCS facility both 167 167 Gross Charge Type: NIHD_Hosp_Profee_Price "15630 Delay of flap or sectioning of flap (division and inset); at eyelids, nose, ears, or lips" 156301 CDM 521 RC 15630 HCPCS facility both 820 820 Gross Charge Type: NIHD_RHC_Price "15630 Delay of flap or sectioning of flap (division and inset); at eyelids, nose, ears, or lips" 156301 CDM 521 RC 15630 HCPCS facility both 820 820 Gross Charge Type: NIHD_Clinic_Price "15630 DELAY OF FLAP OR SECTIONING OF FLAP (DIVISION AND INSET); AT EYELIDS, NOSE, EARS, OR L ProFee" 156302 CDM 982 RC 15630 HCPCS facility both 608 608 Gross Charge Type: NIHD_Hosp_Profee_Price "15630 DELAY OF FLAP OR SECTIONING OF FLAP (DIVISION AND INSET); AT EYELIDS, NOSE, EARS, OR L ProFee" 156302 CDM 982 RC 15630 HCPCS facility both 608 608 Gross Charge Type: NIHD_Hosp_Profee_Price 15731 Forehead flap with preservation of vascular pedicle 157311 CDM 521 RC 15731 HCPCS facility both 1980 1980 Gross Charge Type: NIHD_RHC_Price 15731 Forehead flap with preservation of vascular pedicle 157311 CDM 521 RC 15731 HCPCS facility both 1980 1980 Gross Charge Type: NIHD_Clinic_Price "15731 FOREHEAD FLAP WITH PRESERVATION OF VASCULAR PEDICLE (EG, AXIAL PATTERN FLAP, PARAMEDIA ProFee" 157312 CDM 982 RC 15731 HCPCS facility both 1758 1758 Gross Charge Type: NIHD_Hosp_Profee_Price "15731 FOREHEAD FLAP WITH PRESERVATION OF VASCULAR PEDICLE (EG, AXIAL PATTERN FLAP, PARAMEDIA ProFee" 157312 CDM 982 RC 15731 HCPCS facility both 1758 1758 Gross Charge Type: NIHD_Hosp_Profee_Price "15738 MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP; LOWER EXTREMITY ProFee" 15738 CDM 982 RC 15738 HCPCS facility both 2278 2278 Gross Charge Type: NIHD_Hosp_Profee_Price "15738 MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP; LOWER EXTREMITY ProFee" 15738 CDM 982 RC 15738 HCPCS facility both 2278 2278 Gross Charge Type: NIHD_Hosp_Profee_Price "15777 IMPLANTATION OF BIOLOGIC IMPLANT (EG, ACELLULAR DERMAL MATRIX) FOR SOFT TISSUE REINFOR ProFee" 15777 CDM 982 RC 15777 HCPCS facility both 391 391 Gross Charge Type: NIHD_Hosp_Profee_Price "15777 IMPLANTATION OF BIOLOGIC IMPLANT (EG, ACELLULAR DERMAL MATRIX) FOR SOFT TISSUE REINFOR ProFee" 15777 CDM 982 RC 15777 HCPCS facility both 391 391 Gross Charge Type: NIHD_Hosp_Profee_Price "15822 BLEPHAROPLASTY, UPPER EYELID; ProFee" 15822 CDM 09820981 RC 15822 HCPCS facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price "15822 BLEPHAROPLASTY, UPPER EYELID; ProFee" 15822 CDM 09820981 RC 15822 HCPCS facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price "15830 EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDES LIPECTOMY); ABDOMEN, INFRAU ProFee" 15830 CDM 982 RC 15830 HCPCS facility both 2060 2060 Gross Charge Type: NIHD_Hosp_Profee_Price "15830 EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDES LIPECTOMY); ABDOMEN, INFRAU ProFee" 15830 CDM 982 RC 15830 HCPCS facility both 2060 2060 Gross Charge Type: NIHD_Hosp_Profee_Price "15839 EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDES LIPECTOMY); OTHER AREA ProFee" 15839 CDM 982 RC 15839 HCPCS facility both 1293 1293 Gross Charge Type: NIHD_Hosp_Profee_Price "15839 EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDES LIPECTOMY); OTHER AREA ProFee" 15839 CDM 982 RC 15839 HCPCS facility both 1293 1293 Gross Charge Type: NIHD_Hosp_Profee_Price "15851 REMOVAL OF SUTURES UNDER ANESTHESIA (OTHER THAN LOCAL), OTHER SURGEON ProFee" 15851 CDM 982 RC 15851 HCPCS facility both 170 170 Gross Charge Type: NIHD_Hosp_Profee_Price "15851 REMOVAL OF SUTURES UNDER ANESTHESIA (OTHER THAN LOCAL), OTHER SURGEON ProFee" 15851 CDM 982 RC 15851 HCPCS facility both 170 170 Gross Charge Type: NIHD_Hosp_Profee_Price 15852 DRESSING CHANGE (FOR OTHER THAN BURNS) UNDER ANESTHESIA (OTHER THAN LOCAL) ProFee 15852 CDM 982 RC 15852 HCPCS facility both 85 85 Gross Charge Type: NIHD_Hosp_Profee_Price 15852 DRESSING CHANGE (FOR OTHER THAN BURNS) UNDER ANESTHESIA (OTHER THAN LOCAL) ProFee 15852 CDM 982 RC 15852 HCPCS facility both 85 85 Gross Charge Type: NIHD_Hosp_Profee_Price "15853, Removal of sutures or staples not requiring anesthesia" 15853 CDM 521 RC 15853 HCPCS facility both 19 19 Gross Charge Type: NIHD_RHC_Price "15853, Removal of sutures or staples not requiring anesthesia" 15853 CDM 521 RC 15853 HCPCS facility both 19 19 Gross Charge Type: NIHD_Clinic_Price 16000 INITIAL TX 1ST DEGREE BURN LOCAL TX ProFee 16000 CDM 982 RC 16000 HCPCS facility both 67 67 Gross Charge Type: NIHD_Hosp_Profee_Price 16000 INITIAL TX 1ST DEGREE BURN LOCAL TX ProFee 16000 CDM 982 RC 16000 HCPCS facility both 67 67 Gross Charge Type: NIHD_Hosp_Profee_Price 16000 INITIAL TX 1ST DEGREE BURN LOCAL TX TechFee 160001 CDM 450 RC facility both 391 391 Gross Charge Type: NIHD_Hosp_Profee_Price 16000 INITIAL TX 1ST DEGREE BURN LOCAL TX TechFee 160001 CDM 450 RC facility both 391 391 Gross Charge Type: NIHD_Hosp_Profee_Price 16000 BURN CARE 1ST DEGREE CHARGE 160002 CDM 761 RC facility both 391 391 Gross Charge Type: NIHD_Hosp_Profee_Price 16000 BURN CARE 1ST DEGREE CHARGE 160002 CDM 761 RC facility both 391 391 Gross Charge Type: NIHD_Hosp_Profee_Price "16020 Dressings and/or debridement of partial-thickness burns, initial or subsequent; small" 160201 CDM 521 RC 16020 HCPCS facility both 205 205 Gross Charge Type: NIHD_RHC_Price "16020 Dressings and/or debridement of partial-thickness burns, initial or subsequent; small" 160201 CDM 521 RC 16020 HCPCS facility both 284 284 Gross Charge Type: NIHD_Clinic_Price 16020 DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL TechFee 160202 CDM 450 RC facility both 501 501 Gross Charge Type: NIHD_Hosp_Profee_Price 16020 DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL TechFee 160202 CDM 450 RC facility both 501 501 Gross Charge Type: NIHD_Hosp_Profee_Price "16020 DRESSINGS AND/OR DEBRIDEMENT OF PARTIAL-THICKNESS BURNS, INITIAL OR SUBSEQUENT; SMALL ProFee" 160203 CDM 982 RC 16020 HCPCS facility both 288 288 Gross Charge Type: NIHD_Hosp_Profee_Price "16020 DRESSINGS AND/OR DEBRIDEMENT OF PARTIAL-THICKNESS BURNS, INITIAL OR SUBSEQUENT; SMALL ProFee" 160203 CDM 982 RC 16020 HCPCS facility both 288 288 Gross Charge Type: NIHD_Hosp_Profee_Price 16020 BURN CARE SMALL <5% CHARGE 160204 CDM 761 RC facility both 501 501 Gross Charge Type: NIHD_Hosp_Profee_Price 16020 BURN CARE SMALL <5% CHARGE 160204 CDM 761 RC facility both 501 501 Gross Charge Type: NIHD_Hosp_Profee_Price "16025 DRESSINGS AND/OR DEBRIDEMENT OF PARTIAL-THICKNESS BURNS, INITIAL OR SUBSEQUENT; MEDIUM ProFee" 16025 CDM 982 RC 16025 HCPCS facility both 558 558 Gross Charge Type: NIHD_Hosp_Profee_Price "16025 DRESSINGS AND/OR DEBRIDEMENT OF PARTIAL-THICKNESS BURNS, INITIAL OR SUBSEQUENT; MEDIUM ProFee" 16025 CDM 982 RC 16025 HCPCS facility both 558 558 Gross Charge Type: NIHD_Hosp_Profee_Price 16025 BURN CARE 5-10% TBSA CHARGE 160251 CDM 761 RC facility both 644 644 Gross Charge Type: NIHD_Hosp_Profee_Price 16025 BURN CARE 5-10% TBSA CHARGE 160251 CDM 761 RC facility both 644 644 Gross Charge Type: NIHD_Hosp_Profee_Price "16030 DRESSINGS AND/OR DEBRIDEMENT OF PARTIAL-THICKNESS BURNS, INITIAL OR SUBSEQUENT; LARGE ProFee" 16030 CDM 982 RC 16030 HCPCS facility both 794 794 Gross Charge Type: NIHD_Hosp_Profee_Price "16030 DRESSINGS AND/OR DEBRIDEMENT OF PARTIAL-THICKNESS BURNS, INITIAL OR SUBSEQUENT; LARGE ProFee" 16030 CDM 982 RC 16030 HCPCS facility both 794 794 Gross Charge Type: NIHD_Hosp_Profee_Price "16030 Debride/dressing partial thickness burn,large-WC Charge" 160301 CDM 761 RC facility both 787 787 Gross Charge Type: NIHD_Hosp_Profee_Price "16030 Debride/dressing partial thickness burn,large-WC Charge" 160301 CDM 761 RC facility both 787 787 Gross Charge Type: NIHD_Hosp_Profee_Price 16035 Escharotomy; initial incision 160351 CDM 521 RC 16035 HCPCS facility both 389 389 Gross Charge Type: NIHD_Clinic_Price 16035 ESCHAROTOMY; INITIAL INCISION ProFee 160352 CDM 982 RC 16035 HCPCS facility both 389 389 Gross Charge Type: NIHD_Hosp_Profee_Price 16035 ESCHAROTOMY; INITIAL INCISION ProFee 160352 CDM 982 RC 16035 HCPCS facility both 389 389 Gross Charge Type: NIHD_Hosp_Profee_Price 16035 ESCHAROTOMY FIRST INCISION 160353 CDM 761 RC facility both 548 548 Gross Charge Type: NIHD_Hosp_Profee_Price 16035 ESCHAROTOMY FIRST INCISION 160353 CDM 761 RC facility both 548 548 Gross Charge Type: NIHD_Hosp_Profee_Price Rheumatoid Arthritis Profile LC 164065 CDM 300 RC facility both 12.16 12.16 Gross Charge Type: NIHD_Hosp_Profee_Price Rheumatoid Arthritis Profile LC 164065 CDM 300 RC facility both 12.16 12.16 Gross Charge Type: NIHD_Hosp_Profee_Price SPLINT KNEE UNIVERSAL 24 INCH 1668329 CDM 274 RC facility both 51 51 Gross Charge Type: NIHD_Hosp_Profee_Price SPLINT KNEE UNIVERSAL 24 INCH 1668329 CDM 274 RC facility both 51 51 Gross Charge Type: NIHD_Hosp_Profee_Price SPLINT KNEE UNIVERSAL 20 INCH 1668339 CDM 274 RC facility both 37 37 Gross Charge Type: NIHD_Hosp_Profee_Price SPLINT KNEE UNIVERSAL 20 INCH 1668339 CDM 274 RC facility both 37 37 Gross Charge Type: NIHD_Hosp_Profee_Price SPLINT UNIVERSAL KNEE 16 INCH 1668349 CDM 271 RC facility both 52 52 Gross Charge Type: NIHD_Hosp_Profee_Price SPLINT UNIVERSAL KNEE 16 INCH 1668349 CDM 271 RC facility both 52 52 Gross Charge Type: NIHD_Hosp_Profee_Price "17000 Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettemen" 17000 CDM 521 RC 17000 HCPCS facility both 217 217 Gross Charge Type: NIHD_RHC_Price "17000 Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettemen" 17000 CDM 521 RC 17000 HCPCS facility both 157 157 Gross Charge Type: NIHD_Clinic_Price "17003 Destruction, premalignant lesions; second through 14 lesions, each" 17003 CDM 521 RC 17003 HCPCS facility both 50 50 Gross Charge Type: NIHD_RHC_Price "17003 Destruction, premalignant lesions; second through 14 lesions, each" 17003 CDM 521 RC 17003 HCPCS facility both 56 56 Gross Charge Type: NIHD_Clinic_Price "17004 Destruction, premalignant lesions, 15 or more lesions" 17004 CDM 521 RC 17004 HCPCS facility both 998 998 Gross Charge Type: NIHD_RHC_Price "17004 Destruction, premalignant lesions, 15 or more lesions" 17004 CDM 521 RC 17004 HCPCS facility both 998 998 Gross Charge Type: NIHD_Clinic_Price DESTRCT BNGN LESIONS UP TO 14 17110 CDM 521 RC 17110 HCPCS facility both 198 198 Gross Charge Type: NIHD_RHC_Price DESTRCT BNGN LESIONS UP TO 14 17110 CDM 521 RC 17110 HCPCS facility both 194 194 Gross Charge Type: NIHD_Clinic_Price 17110 DESTROY BENIGN LESION 1-14 CHARGE 171101 CDM 761 RC facility both 241 241 Gross Charge Type: NIHD_Hosp_Profee_Price 17110 DESTROY BENIGN LESION 1-14 CHARGE 171101 CDM 761 RC facility both 241 241 Gross Charge Type: NIHD_Hosp_Profee_Price "17110 Destruction, benign lesions other than skin tags, up to 14 lesions" 171102 CDM 982 RC 17110 HCPCS facility both 222 222 Gross Charge Type: NIHD_Hosp_Profee_Price "17110 Destruction, benign lesions other than skin tags, up to 14 lesions" 171102 CDM 982 RC 17110 HCPCS facility both 222 222 Gross Charge Type: NIHD_Hosp_Profee_Price 17111 Destruction of benign lesions; 15 + lesions 17111 CDM 521 RC 17111 HCPCS facility both 202 202 Gross Charge Type: NIHD_RHC_Price 17111 Destruction of benign lesions; 15 + lesions 17111 CDM 521 RC 17111 HCPCS facility both 203 203 Gross Charge Type: NIHD_Clinic_Price "17250 Chemical cauterization of granulation tissue (proud flesh, sinus or fistula)" 172501 CDM 521 RC 17250 HCPCS facility both 68 68 Gross Charge Type: NIHD_RHC_Price "17250 Chemical cauterization of granulation tissue (proud flesh, sinus or fistula)" 172501 CDM 521 RC 17250 HCPCS facility both 69 69 Gross Charge Type: NIHD_Clinic_Price "17250 CHEMICAL CAUTERIZATION OF GRANULATION TISSUE (PROUD FLESH, SINUS OR FISTULA) ProFee" 172502 CDM 982 RC 17250 HCPCS facility both 71 71 Gross Charge Type: NIHD_Hosp_Profee_Price "17250 CHEMICAL CAUTERIZATION OF GRANULATION TISSUE (PROUD FLESH, SINUS OR FISTULA) ProFee" 172502 CDM 982 RC 17250 HCPCS facility both 71 71 Gross Charge Type: NIHD_Hosp_Profee_Price 17250 CHEMICAL CAUTERY GRANULATION TISSUE CHARGE 172503 CDM 761 RC facility both 493 493 Gross Charge Type: NIHD_Hosp_Profee_Price 17250 CHEMICAL CAUTERY GRANULATION TISSUE CHARGE 172503 CDM 761 RC facility both 493 493 Gross Charge Type: NIHD_Hosp_Profee_Price "17260 Destruction malignant lesion trunk, arms, legs; lesion diameter 0.5cm or less" 17260 CDM 521 RC 17260 HCPCS facility both 179 179 Gross Charge Type: NIHD_RHC_Price "17260 Destruction malignant lesion trunk, arms, legs; lesion diameter 0.5cm or less" 17260 CDM 521 RC 17260 HCPCS facility both 179 179 Gross Charge Type: NIHD_Clinic_Price "17261 Destruction, malignant lesion, trunk, arms or legs; lesion diameter 0.6 to 1.0 cm" 17261 CDM 521 RC 17261 HCPCS facility both 267 267 Gross Charge Type: NIHD_RHC_Price "17261 Destruction, malignant lesion, trunk, arms or legs; lesion diameter 0.6 to 1.0 cm" 17261 CDM 521 RC 17261 HCPCS facility both 267 267 Gross Charge Type: NIHD_Clinic_Price 17262 Lesion diameter 1.1 to 2.0cm 17262 CDM 521 RC 17262 HCPCS facility both 319 319 Gross Charge Type: NIHD_RHC_Price 17262 Lesion diameter 1.1 to 2.0cm 17262 CDM 521 RC 17262 HCPCS facility both 319 319 Gross Charge Type: NIHD_Clinic_Price "17263 Destruction, malignant lesion, trunk, arms or legs; lesion diameter 2.1 to 3.0 cm" 17263 CDM 521 RC 17263 HCPCS facility both 347 347 Gross Charge Type: NIHD_RHC_Price "17263 Destruction, malignant lesion, trunk, arms or legs; lesion diameter 2.1 to 3.0 cm" 17263 CDM 521 RC 17263 HCPCS facility both 347 347 Gross Charge Type: NIHD_Clinic_Price "17264 Destruction, malignant lesion, trunk, arms or legs; lesion diameter 3.1 to 4.0 cm" 17264 CDM 521 RC 17264 HCPCS facility both 371 371 Gross Charge Type: NIHD_RHC_Price "17264 Destruction, malignant lesion, trunk, arms or legs; lesion diameter 3.1 to 4.0 cm" 17264 CDM 521 RC 17264 HCPCS facility both 371 371 Gross Charge Type: NIHD_Clinic_Price "17280 Destruction, malignant lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion dm 0.5" 17280 CDM 521 RC 17280 HCPCS facility both 442 442 Gross Charge Type: NIHD_RHC_Price "17283 Destruction, malignant lesion, face, ears, eyelids, nose, lips, mucous; lesion diameter 2.1-3" 17283 CDM 521 RC 17283 HCPCS facility both 291 291 Gross Charge Type: NIHD_RHC_Price "17283 Destruction, malignant lesion, face, ears, eyelids, nose, lips, mucous; lesion diameter 2.1-3" 17283 CDM 521 RC 17283 HCPCS facility both 291 291 Gross Charge Type: NIHD_Clinic_Price 17999 Unlisted procedure skin MM & SQ tissue 17999 CDM 521 RC 17999 HCPCS facility both 1310 1310 Gross Charge Type: NIHD_RHC_Price 17999 Unlisted procedure skin MM & SQ tissue 17999 CDM 521 RC 17999 HCPCS facility both 1310 1310 Gross Charge Type: NIHD_Clinic_Price "17999 UNLISTED PROCEDURE, SKIN, MUCOUS MEMBRANE AND SUBCUTANEOUS TISSUE ProFee" 179991 CDM 982 RC 17999 HCPCS facility both 615 615 Gross Charge Type: NIHD_Hosp_Profee_Price "17999 UNLISTED PROCEDURE, SKIN, MUCOUS MEMBRANE AND SUBCUTANEOUS TISSUE ProFee" 179991 CDM 982 RC 17999 HCPCS facility both 615 615 Gross Charge Type: NIHD_Hosp_Profee_Price levothyroxine 100 mcg (0.1 mg) Pow [INYO] 18539 CDM 63323-0649-07 NDC facility both 1 EA 1013.6 1013.6 Gross Charge Type: Pharmacy levothyroxine 100 mcg (0.1 mg) Pow [inyo] 18539 CDM 42023-0201-01 NDC facility both 1 EA 1013.6 1013.6 Gross Charge Type: Pharmacy levothyroxine 100 mcg (0.1 mg) Pow [INYO] 18539 CDM 70860-0451-10 NDC facility both 1 EA 907.2 907.2 Gross Charge Type: Pharmacy 19000 Puncture aspiration of cyst of breast 190001 CDM 521 RC 19000 HCPCS facility both 541 541 Gross Charge Type: NIHD_RHC_Price 19000 Puncture aspiration of cyst of breast 190001 CDM 521 RC 19000 HCPCS facility both 541 541 Gross Charge Type: NIHD_Clinic_Price 19000 PUNCTURE ASPIRATION OF CYST OF BREAST; ProFee 190002 CDM 982 RC 19000 HCPCS facility both 250 250 Gross Charge Type: NIHD_Hosp_Profee_Price 19000 PUNCTURE ASPIRATION OF CYST OF BREAST; ProFee 190002 CDM 982 RC 19000 HCPCS facility both 250 250 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Cyst Aspiration Left 190003 CDM 320 RC facility both TCLT 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Cyst Aspiration Left 190003 CDM 320 RC facility both TCLT 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Cyst Aspiration Left - Report 190004 CDM 972 RC 19000 HCPCS facility both 26LT 63 63 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Cyst Aspiration Left - Report 190004 CDM 972 RC 19000 HCPCS facility both 26LT 63 63 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Cyst Aspiration Right 190005 CDM 320 RC facility both TCRT 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Cyst Aspiration Right 190005 CDM 320 RC facility both TCRT 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Cyst Aspiration Right - Report 190006 CDM 972 RC 19000 HCPCS facility both 26RT 63 63 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Cyst Aspiration Right - Report 190006 CDM 972 RC 19000 HCPCS facility both 26RT 63 63 Gross Charge Type: NIHD_Hosp_Profee_Price 19000 US ASP BREAST CYST 190007 CDM 320 RC facility both TC50 1143 1143 Gross Charge Type: NIHD_Hosp_Profee_Price 19000 US ASP BREAST CYST 190007 CDM 320 RC facility both TC50 1143 1143 Gross Charge Type: NIHD_Hosp_Profee_Price "19020 Mastotomy with exploration or drainage of abscess, deep" 190201 CDM 521 RC 19020 HCPCS facility both 999 999 Gross Charge Type: NIHD_Clinic_Price "19020 MASTOTOMY WITH EXPLORATION OR DRAINAGE OF ABSCESS, DEEP ProFee" 190202 CDM 982 RC 19020 HCPCS facility both 999 999 Gross Charge Type: NIHD_Hosp_Profee_Price "19020 MASTOTOMY WITH EXPLORATION OR DRAINAGE OF ABSCESS, DEEP ProFee" 190202 CDM 982 RC 19020 HCPCS facility both 999 999 Gross Charge Type: NIHD_Hosp_Profee_Price MG Breast Biopsy w/ Stereo Guide Right. 19081 CDM 320 RC facility both TCRT 3562 3562 Gross Charge Type: NIHD_Hosp_Profee_Price MG Breast Biopsy w/ Stereo Guide Right. 19081 CDM 320 RC facility both TCRT 3562 3562 Gross Charge Type: NIHD_Hosp_Profee_Price MG Breast Biopsy w/ Stereo Guide Left 190811 CDM 320 RC facility both TCLT 3562 3562 Gross Charge Type: NIHD_Hosp_Profee_Price MG Breast Biopsy w/ Stereo Guide Left 190811 CDM 320 RC facility both TCLT 3562 3562 Gross Charge Type: NIHD_Hosp_Profee_Price MG Breast Biopsy w/ Stereo Guide Left - Report 190812 CDM 972 RC 19081 HCPCS facility both 26LT 325 325 Gross Charge Type: NIHD_Hosp_Profee_Price MG Breast Biopsy w/ Stereo Guide Left - Report 190812 CDM 972 RC 19081 HCPCS facility both 26LT 325 325 Gross Charge Type: NIHD_Hosp_Profee_Price MG Breast Biopsy w/ Stereo Guide Right 190813 CDM 320 RC facility both TCRT 3562 3562 Gross Charge Type: NIHD_Hosp_Profee_Price MG Breast Biopsy w/ Stereo Guide Right 190813 CDM 320 RC facility both TCRT 3562 3562 Gross Charge Type: NIHD_Hosp_Profee_Price MG Breast Biopsy w/ Stereo Guide Right - Report 190814 CDM 972 RC 19081 HCPCS facility both RT 325 325 Gross Charge Type: NIHD_Hosp_Profee_Price MG Breast Biopsy w/ Stereo Guide Right - Report 190814 CDM 972 RC 19081 HCPCS facility both RT 325 325 Gross Charge Type: NIHD_Hosp_Profee_Price MG Breast Biopsy w/ Stereo Guide Left. 190815 CDM 320 RC facility both TCLT 3562 3562 Gross Charge Type: NIHD_Hosp_Profee_Price MG Breast Biopsy w/ Stereo Guide Left. 190815 CDM 320 RC facility both TCLT 3562 3562 Gross Charge Type: NIHD_Hosp_Profee_Price MG Breast Biopsy w/ Stereo Guide Left. - Report 190816 CDM 972 RC 19081 HCPCS facility both 26LT 325 325 Gross Charge Type: NIHD_Hosp_Profee_Price MG Breast Biopsy w/ Stereo Guide Left. - Report 190816 CDM 972 RC 19081 HCPCS facility both 26LT 325 325 Gross Charge Type: NIHD_Hosp_Profee_Price MG Breast Biopsy w/ Stereo Guide Bilat 190817 CDM 320 RC facility both TC 3562 3562 Gross Charge Type: NIHD_Hosp_Profee_Price MG Breast Biopsy w/ Stereo Guide Bilat 190817 CDM 320 RC facility both TC 3562 3562 Gross Charge Type: NIHD_Hosp_Profee_Price MG Breast Biopsy w/ Stereo Guide Right. - Report 190818 CDM 972 RC 19081 HCPCS facility both 26RT 325 325 Gross Charge Type: NIHD_Hosp_Profee_Price MG Breast Biopsy w/ Stereo Guide Right. - Report 190818 CDM 972 RC 19081 HCPCS facility both 26RT 325 325 Gross Charge Type: NIHD_Hosp_Profee_Price MG Breast Biopsy w/ Stereo Guide Bilat - Report 190819 CDM 972 RC 19081 HCPCS facility both 2650 325 325 Gross Charge Type: NIHD_Hosp_Profee_Price MG Breast Biopsy w/ Stereo Guide Bilat - Report 190819 CDM 972 RC 19081 HCPCS facility both 2650 325 325 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Biopsy Left 190831 CDM 402 RC facility both TCLT 4452 4452 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Biopsy Left 190831 CDM 402 RC facility both TCLT 4452 4452 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Biopsy Left - Report 190832 CDM 972 RC 19083 HCPCS facility both LT 1536 1536 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Biopsy Left - Report 190832 CDM 972 RC 19083 HCPCS facility both LT 1536 1536 Gross Charge Type: NIHD_Hosp_Profee_Price US Guided Breast Biopsy Core Left 190833 CDM 402 RC facility both TCLT 4452 4452 Gross Charge Type: NIHD_Hosp_Profee_Price US Guided Breast Biopsy Core Left 190833 CDM 402 RC facility both TCLT 4452 4452 Gross Charge Type: NIHD_Hosp_Profee_Price US Guided Breast Biopsy Core Right 190835 CDM 402 RC facility both TCRT 4452 4452 Gross Charge Type: NIHD_Hosp_Profee_Price US Guided Breast Biopsy Core Right 190835 CDM 402 RC facility both TCRT 4452 4452 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Biopsy Right 190837 CDM 402 RC facility both RT 4452 4452 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Biopsy Right 190837 CDM 402 RC facility both RT 4452 4452 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Biopsy Right - Report 190838 CDM 972 RC 19083 HCPCS facility both RT 1536 1536 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Biopsy Right - Report 190838 CDM 972 RC 19083 HCPCS facility both RT 1536 1536 Gross Charge Type: NIHD_Hosp_Profee_Price NIHD US BREAST BIPOSY EA ADDL LESION 19084 CDM 402 RC facility both 2612 2612 Gross Charge Type: NIHD_Hosp_Profee_Price NIHD US BREAST BIPOSY EA ADDL LESION 19084 CDM 402 RC facility both 2612 2612 Gross Charge Type: NIHD_Hosp_Profee_Price 19084 NIHD US BREAST BIPOSY EA ADDL LESION 190841 CDM 402 RC facility both 2736 2736 Gross Charge Type: NIHD_Hosp_Profee_Price 19084 NIHD US BREAST BIPOSY EA ADDL LESION 190841 CDM 402 RC facility both 2736 2736 Gross Charge Type: NIHD_Hosp_Profee_Price MRI Breast Biopsy w/ MRI Guide Left. 190851 CDM 320 RC facility both TCLT 5501 5501 Gross Charge Type: NIHD_Hosp_Profee_Price MRI Breast Biopsy w/ MRI Guide Left. 190851 CDM 320 RC facility both TCLT 5501 5501 Gross Charge Type: NIHD_Hosp_Profee_Price MRI Breast Biopsy w/ MRI Guide Right. 190853 CDM 320 RC facility both TCRT 5501 5501 Gross Charge Type: NIHD_Hosp_Profee_Price MRI Breast Biopsy w/ MRI Guide Right. 190853 CDM 320 RC facility both TCRT 5501 5501 Gross Charge Type: NIHD_Hosp_Profee_Price "19101 BIOPSY OF BREAST; OPEN, INCISIONAL ProFee" 19101 CDM 982 RC 19101 HCPCS facility both 712 712 Gross Charge Type: NIHD_Hosp_Profee_Price "19101 BIOPSY OF BREAST; OPEN, INCISIONAL ProFee" 19101 CDM 982 RC 19101 HCPCS facility both 712 712 Gross Charge Type: NIHD_Hosp_Profee_Price "19110 NIPPLE EXPLORATION, WITH OR WITHOUT EXCISION OF A SOLITARY LACTIFEROUS DUCT OR A PAPIL ProFee" 19110 CDM 982 RC 19110 HCPCS facility both 673 673 Gross Charge Type: NIHD_Hosp_Profee_Price "19110 NIPPLE EXPLORATION, WITH OR WITHOUT EXCISION OF A SOLITARY LACTIFEROUS DUCT OR A PAPIL ProFee" 19110 CDM 982 RC 19110 HCPCS facility both 673 673 Gross Charge Type: NIHD_Hosp_Profee_Price "19120 Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue" 191202 CDM 521 RC 19120 HCPCS facility both 812 812 Gross Charge Type: NIHD_Clinic_Price "19120 EXCISION OF CYST, FIBROADENOMA, OR OTHER BENIGN OR MALIGNANT TUMOR, ABERRANT BREAST TI ProFee" 191203 CDM 982 RC 19120 HCPCS facility both 812 812 Gross Charge Type: NIHD_Hosp_Profee_Price "19120 EXCISION OF CYST, FIBROADENOMA, OR OTHER BENIGN OR MALIGNANT TUMOR, ABERRANT BREAST TI ProFee" 191203 CDM 982 RC 19120 HCPCS facility both 812 812 Gross Charge Type: NIHD_Hosp_Profee_Price "19125 EXCISION OF BREAST LESION IDENTIFIED BY PREOPERATIVE PLACEMENT OF RADIOLOGICAL MARKER, ProFee" 19125 CDM 982 RC 19125 HCPCS facility both 900 900 Gross Charge Type: NIHD_Hosp_Profee_Price "19125 EXCISION OF BREAST LESION IDENTIFIED BY PREOPERATIVE PLACEMENT OF RADIOLOGICAL MARKER, ProFee" 19125 CDM 982 RC 19125 HCPCS facility both 900 900 Gross Charge Type: NIHD_Hosp_Profee_Price "19281 Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactiv" 192811 CDM 521 RC 19281 HCPCS facility both 207 207 Gross Charge Type: NIHD_Clinic_Price MG Device Plcmnt w/ Mammo Guide Right 1928110 CDM 320 RC facility both TCRT 2933 2933 Gross Charge Type: NIHD_Hosp_Profee_Price MG Device Plcmnt w/ Mammo Guide Right 1928110 CDM 320 RC facility both TCRT 2933 2933 Gross Charge Type: NIHD_Hosp_Profee_Price MG Device Plcmnt w/ Mammo Guide Bilat 1928111 CDM 320 RC facility both TC 2933 2933 Gross Charge Type: NIHD_Hosp_Profee_Price MG Device Plcmnt w/ Mammo Guide Bilat 1928111 CDM 320 RC facility both TC 2933 2933 Gross Charge Type: NIHD_Hosp_Profee_Price MG Device Plcmnt w/ Mammo Guide Bilat - Report 1928112 CDM 972 RC 19281 HCPCS facility both 2650 1020 1020 Gross Charge Type: NIHD_Hosp_Profee_Price MG Device Plcmnt w/ Mammo Guide Bilat - Report 1928112 CDM 972 RC 19281 HCPCS facility both 2650 1020 1020 Gross Charge Type: NIHD_Hosp_Profee_Price "19281 PLACEMENT OF BREAST LOCALIZATION DEVICE(S) (EG, CLIP, METALLIC PELLET, WIRE/NEEDLE, RA ProFee" 192812 CDM 982 RC 19281 HCPCS facility both 207 207 Gross Charge Type: NIHD_Hosp_Profee_Price "19281 PLACEMENT OF BREAST LOCALIZATION DEVICE(S) (EG, CLIP, METALLIC PELLET, WIRE/NEEDLE, RA ProFee" 192812 CDM 982 RC 19281 HCPCS facility both 207 207 Gross Charge Type: NIHD_Hosp_Profee_Price MG Device Plcmnt w/ Mammo Guide Left - Report 192817 CDM 972 RC 19281 HCPCS facility both 26LT 1020 1020 Gross Charge Type: NIHD_Hosp_Profee_Price MG Device Plcmnt w/ Mammo Guide Left - Report 192817 CDM 972 RC 19281 HCPCS facility both 26LT 1020 1020 Gross Charge Type: NIHD_Hosp_Profee_Price MG Device Plcmnt w/ Mammo Guide Right - Report 192818 CDM 972 RC 19281 HCPCS facility both 26RT 1020 1020 Gross Charge Type: NIHD_Hosp_Profee_Price MG Device Plcmnt w/ Mammo Guide Right - Report 192818 CDM 972 RC 19281 HCPCS facility both 26RT 1020 1020 Gross Charge Type: NIHD_Hosp_Profee_Price MG Device Plcmnt w/ Mammo Guide Left 192819 CDM 320 RC facility both TCLT 2933 2933 Gross Charge Type: NIHD_Hosp_Profee_Price MG Device Plcmnt w/ Mammo Guide Left 192819 CDM 320 RC facility both TCLT 2933 2933 Gross Charge Type: NIHD_Hosp_Profee_Price NIHD MG BREAST WIRE LOC ADDL LESION 19284 CDM 320 RC facility both TC 3053 3053 Gross Charge Type: NIHD_Hosp_Profee_Price NIHD MG BREAST WIRE LOC ADDL LESION 19284 CDM 320 RC facility both TC 3053 3053 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Device Plcmnt w/US Guide Left 192851 CDM 402 RC facility both TCLT 2409 2409 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Device Plcmnt w/US Guide Left 192851 CDM 402 RC facility both TCLT 2409 2409 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Device Plcmnt w/US Guide Left - Report 192852 CDM 972 RC 19285 HCPCS facility both 26LT 877 877 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Device Plcmnt w/US Guide Left - Report 192852 CDM 972 RC 19285 HCPCS facility both 26LT 877 877 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Device Plcmnt w/US Guide Right 192853 CDM 402 RC facility both TCRT 2409 2409 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Device Plcmnt w/US Guide Right 192853 CDM 402 RC facility both TCRT 2409 2409 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Device Plcmnt w/US Guide Right - Report 192854 CDM 972 RC 19285 HCPCS facility both 26RT 877 877 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Device Plcmnt w/US Guide Right - Report 192854 CDM 972 RC 19285 HCPCS facility both 26RT 877 877 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Device Plcmnt w/US Guide Bilat 192855 CDM 402 RC facility both TC 2409 2409 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Device Plcmnt w/US Guide Bilat 192855 CDM 402 RC facility both TC 2409 2409 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Device Plcmnt w/US Guide Bilat - Report 192856 CDM 972 RC 19285 HCPCS facility both 2650 877 877 Gross Charge Type: NIHD_Hosp_Profee_Price US Breast Device Plcmnt w/US Guide Bilat - Report 192856 CDM 972 RC 19285 HCPCS facility both 2650 877 877 Gross Charge Type: NIHD_Hosp_Profee_Price 19286 US Breast Needle Loc Unilateral Ea Addl 192863 CDM 761 RC facility both TC 1393 1393 Gross Charge Type: NIHD_Hosp_Profee_Price 19286 US Breast Needle Loc Unilateral Ea Addl 192863 CDM 761 RC facility both TC 1393 1393 Gross Charge Type: NIHD_Hosp_Profee_Price 19286 US Breast Needle Loc Unilateral Ea Addl PROFEE 192864 CDM 972 RC 19286 HCPCS facility both 26 75 75 Gross Charge Type: NIHD_Hosp_Profee_Price 19286 US Breast Needle Loc Unilateral Ea Addl PROFEE 192864 CDM 972 RC 19286 HCPCS facility both 26 75 75 Gross Charge Type: NIHD_Hosp_Profee_Price 19300 MASTECTOMY FOR GYNECOMASTIA ProFee 19300 CDM 19300 HCPCS facility both 659 659 Gross Charge Type: NIHD_Hosp_Profee_Price 19300 MASTECTOMY FOR GYNECOMASTIA ProFee 19300 CDM 19300 HCPCS facility both 659 659 Gross Charge Type: NIHD_Hosp_Profee_Price "19301 MASTECTOMY, PARTIAL (EG, LUMPECTOMY, TYLECTOMY, QUADRANTECTOMY, SEGMENTECTOMY); ProFee" 19301 CDM 982 RC 19301 HCPCS facility both 1274 1274 Gross Charge Type: NIHD_Hosp_Profee_Price "19301 MASTECTOMY, PARTIAL (EG, LUMPECTOMY, TYLECTOMY, QUADRANTECTOMY, SEGMENTECTOMY); ProFee" 19301 CDM 982 RC 19301 HCPCS facility both 1274 1274 Gross Charge Type: NIHD_Hosp_Profee_Price "19302 MASTECTOMY, PARTIAL (EG, LUMPECTOMY, TYLECTOMY, QUADRANTECTOMY, SEGMENTECTOMY); WITH A ProFee" 19302 CDM 982 RC 19302 HCPCS facility both 1809 1809 Gross Charge Type: NIHD_Hosp_Profee_Price "19302 MASTECTOMY, PARTIAL (EG, LUMPECTOMY, TYLECTOMY, QUADRANTECTOMY, SEGMENTECTOMY); WITH A ProFee" 19302 CDM 982 RC 19302 HCPCS facility both 1809 1809 Gross Charge Type: NIHD_Hosp_Profee_Price "19303 MASTECTOMY, SIMPLE, COMPLETE ProFee" 19303 CDM 982 RC 19303 HCPCS facility both 1997 1997 Gross Charge Type: NIHD_Hosp_Profee_Price "19303 MASTECTOMY, SIMPLE, COMPLETE ProFee" 19303 CDM 982 RC 19303 HCPCS facility both 1997 1997 Gross Charge Type: NIHD_Hosp_Profee_Price 19305 ASST MAST RADICAL 19305 CDM 982 RC 19305 HCPCS facility both 563 563 Gross Charge Type: NIHD_Hosp_Profee_Price 19305 ASST MAST RADICAL 19305 CDM 982 RC 19305 HCPCS facility both 563 563 Gross Charge Type: NIHD_Hosp_Profee_Price "19307 MASTECTOMY, MODIFIED RADICAL, INCLUDING AXILLARY LYMPH NODES, WITH OR WITHOUT PECTORAL ProFee" 19307 CDM 982 RC 19307 HCPCS facility both 2372 2372 Gross Charge Type: NIHD_Hosp_Profee_Price "19307 MASTECTOMY, MODIFIED RADICAL, INCLUDING AXILLARY LYMPH NODES, WITH OR WITHOUT PECTORAL ProFee" 19307 CDM 982 RC 19307 HCPCS facility both 2372 2372 Gross Charge Type: NIHD_Hosp_Profee_Price 19316 ASST SUSPENSION OF BREAST 19316 CDM 982 RC 19316 HCPCS facility both 389 389 Gross Charge Type: NIHD_Hosp_Profee_Price 19316 ASST SUSPENSION OF BREAST 19316 CDM 982 RC 19316 HCPCS facility both 389 389 Gross Charge Type: NIHD_Hosp_Profee_Price 19318 REDUCTION MAMMAPLASTY ProFee 19318 CDM 982 RC 19318 HCPCS facility both 1928 1928 Gross Charge Type: NIHD_Hosp_Profee_Price 19318 REDUCTION MAMMAPLASTY ProFee 19318 CDM 982 RC 19318 HCPCS facility both 1928 1928 Gross Charge Type: NIHD_Hosp_Profee_Price "19340 IMMEDIATE INSERTION OF BREAST PROSTHESIS FOLLOWING MASTOPEXY, MASTECTOMY OR IN RECONST ProFee" 19340 CDM 982 RC 19340 HCPCS facility both 1738 1738 Gross Charge Type: NIHD_Hosp_Profee_Price "19340 IMMEDIATE INSERTION OF BREAST PROSTHESIS FOLLOWING MASTOPEXY, MASTECTOMY OR IN RECONST ProFee" 19340 CDM 982 RC 19340 HCPCS facility both 1738 1738 Gross Charge Type: NIHD_Hosp_Profee_Price 19350 NIPPLE/AREOLA RECONSTRUCTION ProFee 19350 CDM 982 RC 19350 HCPCS facility both 1373 1373 Gross Charge Type: NIHD_Hosp_Profee_Price 19350 NIPPLE/AREOLA RECONSTRUCTION ProFee 19350 CDM 982 RC 19350 HCPCS facility both 1373 1373 Gross Charge Type: NIHD_Hosp_Profee_Price "19357 BREAST RECONSTRUCTION, IMMEDIATE OR DELAYED, WITH TISSUE EXPANDER, INCLUDING SUBSEQUEN ProFee" 19357 CDM 982 RC 19357 HCPCS facility both 2665 2665 Gross Charge Type: NIHD_Hosp_Profee_Price "19357 BREAST RECONSTRUCTION, IMMEDIATE OR DELAYED, WITH TISSUE EXPANDER, INCLUDING SUBSEQUEN ProFee" 19357 CDM 982 RC 19357 HCPCS facility both 2665 2665 Gross Charge Type: NIHD_Hosp_Profee_Price "19367 BREAST RECONSTRUCTION WITH TRANSVERSE RECTUS ABDOMINIS MYOCUTANEOUS FLAP (TRAM), SINGL ProFee" 19367 CDM 982 RC 19367 HCPCS facility both 3306 3306 Gross Charge Type: NIHD_Hosp_Profee_Price "19367 BREAST RECONSTRUCTION WITH TRANSVERSE RECTUS ABDOMINIS MYOCUTANEOUS FLAP (TRAM), SINGL ProFee" 19367 CDM 982 RC 19367 HCPCS facility both 3306 3306 Gross Charge Type: NIHD_Hosp_Profee_Price "19371 PERIPROSTHETIC CAPSULECTOMY, BREAST ProFee" 19371 CDM 982 RC 19371 HCPCS facility both 1560 1560 Gross Charge Type: NIHD_Hosp_Profee_Price "19371 PERIPROSTHETIC CAPSULECTOMY, BREAST ProFee" 19371 CDM 982 RC 19371 HCPCS facility both 1560 1560 Gross Charge Type: NIHD_Hosp_Profee_Price 19380 REVISION OF RECONSTRUCTED BREAST ProFee 19380 CDM 982 RC 19380 HCPCS facility both 1365 1365 Gross Charge Type: NIHD_Hosp_Profee_Price 19380 REVISION OF RECONSTRUCTED BREAST ProFee 19380 CDM 982 RC 19380 HCPCS facility both 1365 1365 Gross Charge Type: NIHD_Hosp_Profee_Price 20102 EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE); ABDOMEN/FLANK/BACK ProFee 20102 CDM 975 RC 20102 HCPCS facility both 444 444 Gross Charge Type: NIHD_Hosp_Profee_Price 20102 EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE); ABDOMEN/FLANK/BACK ProFee 20102 CDM 975 RC 20102 HCPCS facility both 444 444 Gross Charge Type: NIHD_Hosp_Profee_Price 20103 EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE); EXTREMITY ProFee 20103 CDM 982 RC 20103 HCPCS facility both 1225 1225 Gross Charge Type: NIHD_Hosp_Profee_Price 20103 EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE); EXTREMITY ProFee 20103 CDM 982 RC 20103 HCPCS facility both 1225 1225 Gross Charge Type: NIHD_Hosp_Profee_Price pyridoxine 50 mg Tab [INYO] 20162 CDM 50268-0858-15 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB pyridoxine 50 mg Tab [INYO] 20162 CDM 11845-0570-01 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB pyridoxine 100 mg/mL Inj Sol [INYO] 20170 CDM J3415 HCPCS 63323-0180-01 NDC facility both 1 ML 235 235 Gross Charge Type: Pharmacy CT Biopsy Muscle 202061 CDM 761 RC facility both TC 1414 1414 Gross Charge Type: NIHD_Hosp_Profee_Price CT Biopsy Muscle 202061 CDM 761 RC facility both TC 1414 1414 Gross Charge Type: NIHD_Hosp_Profee_Price CT Biopsy Muscle - Report 202062 CDM 972 RC 20206 HCPCS facility both 26 492 492 Gross Charge Type: NIHD_Hosp_Profee_Price CT Biopsy Muscle - Report 202062 CDM 972 RC 20206 HCPCS facility both 26 492 492 Gross Charge Type: NIHD_Hosp_Profee_Price US Biopsy Muscle 202063 CDM 761 RC facility both TC 1414 1414 Gross Charge Type: NIHD_Hosp_Profee_Price US Biopsy Muscle 202063 CDM 761 RC facility both TC 1414 1414 Gross Charge Type: NIHD_Hosp_Profee_Price US Biopsy Muscle - Report 202064 CDM 972 RC 20206 HCPCS facility both 26 492 492 Gross Charge Type: NIHD_Hosp_Profee_Price US Biopsy Muscle - Report 202064 CDM 972 RC 20206 HCPCS facility both 26 492 492 Gross Charge Type: NIHD_Hosp_Profee_Price CT Biopsy Bone Superficial 202202 CDM 761 RC facility both TC 2242 2242 Gross Charge Type: NIHD_Hosp_Profee_Price CT Biopsy Bone Superficial 202202 CDM 761 RC facility both TC 2242 2242 Gross Charge Type: NIHD_Hosp_Profee_Price "20225 BIOPSY, BONE, TROCAR, OR NEEDLE; DEEP (EG, VERTEBRAL BODY, FEMUR) ProFee" 202251 CDM 982 RC 20225 HCPCS facility both 229 229 Gross Charge Type: NIHD_Hosp_Profee_Price "20225 BIOPSY, BONE, TROCAR, OR NEEDLE; DEEP (EG, VERTEBRAL BODY, FEMUR) ProFee" 202251 CDM 982 RC 20225 HCPCS facility both 229 229 Gross Charge Type: NIHD_Hosp_Profee_Price US Biopsy Bone Deep - Report 202252 CDM 972 RC 20225 HCPCS facility both 26 1124 1124 Gross Charge Type: NIHD_Hosp_Profee_Price US Biopsy Bone Deep - Report 202252 CDM 972 RC 20225 HCPCS facility both 26 1124 1124 Gross Charge Type: NIHD_Hosp_Profee_Price US Biopsy Bone Deep 202253 CDM 761 RC facility both TC 2095 2095 Gross Charge Type: NIHD_Hosp_Profee_Price US Biopsy Bone Deep 202253 CDM 761 RC facility both TC 2095 2095 Gross Charge Type: NIHD_Hosp_Profee_Price "20240 BIOPSY, BONE, OPEN; SUPERFICIAL (EG, STERNUM, SPINOUS PROCESS, RIB, PATELLA, OLECRANON ProFee" 20240 CDM 982 RC 20240 HCPCS facility both 282 282 Gross Charge Type: NIHD_Hosp_Profee_Price "20240 BIOPSY, BONE, OPEN; SUPERFICIAL (EG, STERNUM, SPINOUS PROCESS, RIB, PATELLA, OLECRANON ProFee" 20240 CDM 982 RC 20240 HCPCS facility both 282 282 Gross Charge Type: NIHD_Hosp_Profee_Price "20245 BIOPSY, BONE, OPEN; DEEP (EG, HUMERAL SHAFT, ISCHIUM, FEMORAL SHAFT) ProFee" 20245 CDM 982 RC 20245 HCPCS facility both 1046 1046 Gross Charge Type: NIHD_Hosp_Profee_Price "20245 BIOPSY, BONE, OPEN; DEEP (EG, HUMERAL SHAFT, ISCHIUM, FEMORAL SHAFT) ProFee" 20245 CDM 982 RC 20245 HCPCS facility both 1046 1046 Gross Charge Type: NIHD_Hosp_Profee_Price "5.0X180MM - DRILL, AO, STERILE" 2025001 CDM 272 RC facility both 396 396 Gross Charge Type: NIHD_Hosp_Profee_Price "5.0X180MM - DRILL, AO, STERILE" 2025001 CDM 272 RC facility both 396 396 Gross Charge Type: NIHD_Hosp_Profee_Price FLEXIBLE NAIL PRE-CURVED 1.50X300 MM 2025002 CDM 278 RC facility both 947 947 Gross Charge Type: NIHD_Hosp_Profee_Price FLEXIBLE NAIL PRE-CURVED 1.50X300 MM 2025002 CDM 278 RC facility both 947 947 Gross Charge Type: NIHD_Hosp_Profee_Price FLEXIBLE NAIL PRE-CURVED 1.75X300 MM 2025003 CDM 278 RC facility both 974 974 Gross Charge Type: NIHD_Hosp_Profee_Price FLEXIBLE NAIL PRE-CURVED 1.75X300 MM 2025003 CDM 278 RC facility both 974 974 Gross Charge Type: NIHD_Hosp_Profee_Price FLEXIBLE NAIL PRE-CURVED 2.0X300 MM 2025004 CDM 278 RC facility both 1008 1008 Gross Charge Type: NIHD_Hosp_Profee_Price FLEXIBLE NAIL PRE-CURVED 2.0X300 MM 2025004 CDM 278 RC facility both 1008 1008 Gross Charge Type: NIHD_Hosp_Profee_Price FLEXIBLE NAIL PRE-CURVED 2.25X300 MM 2025005 CDM 278 RC facility both 1042 1042 Gross Charge Type: NIHD_Hosp_Profee_Price FLEXIBLE NAIL PRE-CURVED 2.25X300 MM 2025005 CDM 278 RC facility both 1042 1042 Gross Charge Type: NIHD_Hosp_Profee_Price FLEXIBLE NAIL PRE-CURVED 2.5X450 MM 2025006 CDM 278 RC facility both 1107 1107 Gross Charge Type: NIHD_Hosp_Profee_Price FLEXIBLE NAIL PRE-CURVED 2.5X450 MM 2025006 CDM 278 RC facility both 1107 1107 Gross Charge Type: NIHD_Hosp_Profee_Price FLEXIBLE NAIL PRE-CURVED 3.0X450 MM 2025007 CDM 278 RC facility both 1139 1139 Gross Charge Type: NIHD_Hosp_Profee_Price FLEXIBLE NAIL PRE-CURVED 3.0X450 MM 2025007 CDM 278 RC facility both 1139 1139 Gross Charge Type: NIHD_Hosp_Profee_Price FLEXIBLE NAIL PRE-CURVED 3.5X450 MM 2025008 CDM 278 RC facility both 1172 1172 Gross Charge Type: NIHD_Hosp_Profee_Price FLEXIBLE NAIL PRE-CURVED 3.5X450 MM 2025008 CDM 278 RC facility both 1172 1172 Gross Charge Type: NIHD_Hosp_Profee_Price FLEXIBLE NAIL PRE-CURVED 4.0X450 2025009 CDM 278 RC facility both 1206 1206 Gross Charge Type: NIHD_Hosp_Profee_Price FLEXIBLE NAIL PRE-CURVED 4.0X450 2025009 CDM 278 RC facility both 1206 1206 Gross Charge Type: NIHD_Hosp_Profee_Price STERILE MODIFIED HALL MODULAR SHAFT 450M 2025013 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price STERILE MODIFIED HALL MODULAR SHAFT 450M 2025013 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "REAMER SHAFT, MODIFIED TRINKLE, 8X510MM" 2025014 CDM 278 RC facility both 1026 1026 Gross Charge Type: NIHD_Hosp_Profee_Price "REAMER SHAFT, MODIFIED TRINKLE, 8X510MM" 2025014 CDM 278 RC facility both 1026 1026 Gross Charge Type: NIHD_Hosp_Profee_Price 0.045IN.(1.143MM)K-WIRE W/LENGTH MARKING 2025015 CDM 278 RC facility both 95 95 Gross Charge Type: NIHD_Hosp_Profee_Price 0.045IN.(1.143MM)K-WIRE W/LENGTH MARKING 2025015 CDM 278 RC facility both 95 95 Gross Charge Type: NIHD_Hosp_Profee_Price R HEAD NECK PLATE 2025016 CDM 278 RC facility both 3410 3410 Gross Charge Type: NIHD_Hosp_Profee_Price R HEAD NECK PLATE 2025016 CDM 278 RC facility both 3410 3410 Gross Charge Type: NIHD_Hosp_Profee_Price R HEAD SMALL RIM PLATE 2025017 CDM 278 RC facility both 3410 3410 Gross Charge Type: NIHD_Hosp_Profee_Price R HEAD SMALL RIM PLATE 2025017 CDM 278 RC facility both 3410 3410 Gross Charge Type: NIHD_Hosp_Profee_Price R HEAD STANDARD RIM PLATE 2025018 CDM 278 RC facility both 3410 3410 Gross Charge Type: NIHD_Hosp_Profee_Price R HEAD STANDARD RIM PLATE 2025018 CDM 278 RC facility both 3410 3410 Gross Charge Type: NIHD_Hosp_Profee_Price R HEAD LONG STANDARD RIM PLATE 2025019 CDM 278 RC facility both 3410 3410 Gross Charge Type: NIHD_Hosp_Profee_Price R HEAD LONG STANDARD RIM PLATE 2025019 CDM 278 RC facility both 3410 3410 Gross Charge Type: NIHD_Hosp_Profee_Price K-WIRE 3.2X450MM (STERILE) 2025020 CDM 272 RC facility both 291 291 Gross Charge Type: NIHD_Hosp_Profee_Price K-WIRE 3.2X450MM (STERILE) 2025020 CDM 272 RC facility both 291 291 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL 4.2X300MM AO SMALL STERILE 2025022 CDM 272 RC facility both 421 421 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL 4.2X300MM AO SMALL STERILE 2025022 CDM 272 RC facility both 421 421 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 10MM 2025023 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 10MM 2025023 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 11MM 2025024 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 11MM 2025024 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 12MM 2025025 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 12MM 2025025 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 13MM 2025026 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 13MM 2025026 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 14MM 2025027 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 14MM 2025027 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 15MM 2025028 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 15MM 2025028 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 16MM 2025029 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 16MM 2025029 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 17MM 2025030 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 17MM 2025030 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 18MM 2025031 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 18MM 2025031 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 19MM 2025032 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 19MM 2025032 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 20MM 2025033 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 20MM 2025033 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 21MM 2025034 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 21MM 2025034 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 22MM 2025035 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 22MM 2025035 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 23MM 2025036 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 23MM 2025036 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 24MM 2025037 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 24MM 2025037 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 25MM 2025038 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 25MM 2025038 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 26MM 2025039 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 26MM 2025039 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 27MM 2025040 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 27MM 2025040 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 28MM 2025041 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 28MM 2025041 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 29MM 2025042 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 29MM 2025042 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 30MM 2025043 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.0 X 30MM 2025043 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 10MM 2025044 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 10MM 2025044 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 11MM 2025045 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 11MM 2025045 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 12MM 2025046 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 12MM 2025046 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 13MM 2025047 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 13MM 2025047 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 14MM 2025048 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 14MM 2025048 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 15MM 2025049 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 15MM 2025049 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 16MM 2025050 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 16MM 2025050 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 17MM 2025051 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 17MM 2025051 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 18MM 2025052 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 18MM 2025052 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 19MM 2025053 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 19MM 2025053 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 20MM 2025054 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 20MM 2025054 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 21MM 2025055 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 21MM 2025055 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 22MM 2025056 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 22MM 2025056 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 23MM 2025057 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 23MM 2025057 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 24MM 2025058 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 24MM 2025058 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 25MM 2025059 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 25MM 2025059 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 26MM 2025060 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 26MM 2025060 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 27MM 2025061 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 27MM 2025061 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 28MM 2025062 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 28MM 2025062 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 29MM 2025063 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 29MM 2025063 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 30MM 2025064 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 30MM 2025064 CDM 278 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price CORTEX SCREW SELF-TAPP MOD T7 DR 2.4 X 8 2025065 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTEX SCREW SELF-TAPP MOD T7 DR 2.4 X 8 2025065 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTEX SCREW SELF-TAPP MOD T7 DR 2.4X10 2025066 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTEX SCREW SELF-TAPP MOD T7 DR 2.4X10 2025066 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTEX SCREW SELF-TAPP MOD T7 DR 2.4X12 2025067 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTEX SCREW SELF-TAPP MOD T7 DR 2.4X12 2025067 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTEX SCREW SELF-TAPP MOD T7 DR 2.4X14 2025068 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTEX SCREW SELF-TAPP MOD T7 DR 2.4X14 2025068 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTEX SCREW SELF-TAPP MOD T7 DR 2.4X16 2025069 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTEX SCREW SELF-TAPP MOD T7 DR 2.4X16 2025069 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTEX SCREW SELF-TAPP MOD T7 DR 2.4X18 2025070 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTEX SCREW SELF-TAPP MOD T7 DR 2.4X18 2025070 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTEX SCREW SELF-TAPP MOD T7 DR 2.4X20 2025071 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTEX SCREW SELF-TAPP MOD T7 DR 2.4X20 2025071 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTEX SCREW SELF-TAPP MOD T7 DR 2.4X22 2025072 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTEX SCREW SELF-TAPP MOD T7 DR 2.4X22 2025072 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTEX SCREW SELF-TAPP MOD T7 DR 2.4X24 2025073 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTEX SCREW SELF-TAPP MOD T7 DR 2.4X24 2025073 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTEX SCREW SELF-TAPP MOD T7 DR 2.4X26 2025074 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTEX SCREW SELF-TAPP MOD T7 DR 2.4X26 2025074 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTEX SCREW SELF-TAPP MOD T7 DR 2.4X28 2025075 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTEX SCREW SELF-TAPP MOD T7 DR 2.4X28 2025075 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTICAL SCREW (MOD T7 DR) 2.7MM X 8MM 2025076 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTICAL SCREW (MOD T7 DR) 2.7MM X 8MM 2025076 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTICAL SCREW (MOD T7 DR) 2.7MM X 10MM 2025077 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTICAL SCREW (MOD T7 DR) 2.7MM X 10MM 2025077 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTICAL SCREW (MOD T7 DR) 2.7MM X 12MM 2025078 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTICAL SCREW (MOD T7 DR) 2.7MM X 12MM 2025078 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTICAL SCREW (MOD T7 DR) 2.7MM X 14MM 2025079 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTICAL SCREW (MOD T7 DR) 2.7MM X 14MM 2025079 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTICAL SCREW (MOD T7 DR) 2.7MM X 16MM 2025080 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTICAL SCREW (MOD T7 DR) 2.7MM X 16MM 2025080 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTICAL SCREW (MOD T7 DR) 2.7MM X 18MM 2025081 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTICAL SCREW (MOD T7 DR) 2.7MM X 18MM 2025081 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTICAL SCREW (MOD T7 DR) 2.7MM X 20MM 2025082 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTICAL SCREW (MOD T7 DR) 2.7MM X 20MM 2025082 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTICAL SCREW (MOD T7 DR) 2.7MM X 22MM 2025083 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTICAL SCREW (MOD T7 DR) 2.7MM X 22MM 2025083 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTICAL SCREW (MOD T7 DR) 2.7MM X 24MM 2025084 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTICAL SCREW (MOD T7 DR) 2.7MM X 24MM 2025084 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTICAL SCREW (MOD T7 DR) 2.7MM X 26MM 2025085 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTICAL SCREW (MOD T7 DR) 2.7MM X 26MM 2025085 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTICAL SCREW (MOD T7 DR) 2.7MM X 28MM 2025086 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price CORTICAL SCREW (MOD T7 DR) 2.7MM X 28MM 2025086 CDM 278 RC facility both 223 223 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.4MM X 8MM 2025087 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.4MM X 8MM 2025087 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.4MM X 10MM 2025088 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.4MM X 10MM 2025088 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.4MM X 12MM 2025089 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.4MM X 12MM 2025089 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.4MM X 14MM 2025090 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.4MM X 14MM 2025090 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.4MM X 16MM 2025091 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.4MM X 16MM 2025091 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.4MM X 18MM 2025092 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.4MM X 18MM 2025092 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.4MM X 20MM 2025093 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.4MM X 20MM 2025093 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.4MM X 22MM 2025094 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.4MM X 22MM 2025094 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.4MM X 24MM 2025095 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.4MM X 24MM 2025095 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.4MM X 26MM 2025096 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.4MM X 26MM 2025096 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.4MM X 28MM 2025097 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.4MM X 28MM 2025097 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.7MM X 8MM 2025098 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.7MM X 8MM 2025098 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.7MM X 10MM 2025099 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.7MM X 10MM 2025099 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.7MM X 12MM 2025101 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.7MM X 12MM 2025101 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.7MM X 14MM 2025102 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price FIXED ANGLE LOCKING SCREW 2.7MM X 14MM 2025102 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW SS 2.7 X 16MM 2025103 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW SS 2.7 X 16MM 2025103 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW SS 2.7 X 18MM 2025104 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW SS 2.7 X 18MM 2025104 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW SS 2.7 X 20MM 2025105 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW SS 2.7 X 20MM 2025105 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW SS 2.7 X 22MM 2025106 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW SS 2.7 X 22MM 2025106 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW SS 2.7 X 24MM 2025107 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW SS 2.7 X 24MM 2025107 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW SS 2.7 X 26MM 2025108 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW SS 2.7 X 26MM 2025108 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW SS 2.7 X 28MM 2025109 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW SS 2.7 X 28MM 2025109 CDM 278 RC facility both 378 378 Gross Charge Type: NIHD_Hosp_Profee_Price GUIDE WIRE BALL TIP 3.0X800MM STERILE 2025110 CDM 272 RC facility both 423 423 Gross Charge Type: NIHD_Hosp_Profee_Price GUIDE WIRE BALL TIP 3.0X800MM STERILE 2025110 CDM 272 RC facility both 423 423 Gross Charge Type: NIHD_Hosp_Profee_Price GUIDE WIRE BALL TIP 3X1000 STERILE 2025112 CDM 272 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price GUIDE WIRE BALL TIP 3X1000 STERILE 2025112 CDM 272 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price COUNTERSINK 1806-2016 2025114 CDM 272 RC facility both 720 720 Gross Charge Type: NIHD_Hosp_Profee_Price COUNTERSINK 1806-2016 2025114 CDM 272 RC facility both 720 720 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 4.2X340MM AO STERILE 2025115 CDM 272 RC facility both 401 401 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 4.2X340MM AO STERILE 2025115 CDM 272 RC facility both 401 401 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL 4.2X180MM AO SMALL STERILE 2025117 CDM 272 RC facility both 429 429 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL 4.2X180MM AO SMALL STERILE 2025117 CDM 272 RC facility both 429 429 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 4.2X130MM AO STERILE 2025118 CDM 272 RC facility both 401 401 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 4.2X130MM AO STERILE 2025118 CDM 272 RC facility both 401 401 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL 4.2X230MM AO SMALL STERILE 2025119 CDM 272 RC facility both 432 432 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL 4.2X230MM AO SMALL STERILE 2025119 CDM 272 RC facility both 432 432 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 5.0X230MM AO STERILE 2025120 CDM 272 RC facility both 709 709 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 5.0X230MM AO STERILE 2025120 CDM 272 RC facility both 709 709 Gross Charge Type: NIHD_Hosp_Profee_Price T2 ADV COMP SCREW TIBIA 2025121 CDM 278 RC facility both 750 750 Gross Charge Type: NIHD_Hosp_Profee_Price T2 ADV COMP SCREW TIBIA 2025121 CDM 278 RC facility both 750 750 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STANDARD END CAP - 8MM 2025122 CDM 278 RC facility both 434 434 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STANDARD END CAP - 8MM 2025122 CDM 278 RC facility both 434 434 Gross Charge Type: NIHD_Hosp_Profee_Price T2 +5MM END CAP 2025123 CDM 278 RC facility both 434 434 Gross Charge Type: NIHD_Hosp_Profee_Price T2 +5MM END CAP 2025123 CDM 278 RC facility both 434 434 Gross Charge Type: NIHD_Hosp_Profee_Price T2 +10MM END CAP 2025124 CDM 278 RC facility both 730 730 Gross Charge Type: NIHD_Hosp_Profee_Price T2 +10MM END CAP 2025124 CDM 278 RC facility both 730 730 Gross Charge Type: NIHD_Hosp_Profee_Price T2 +15MM END CAP 2025125 CDM 278 RC facility both 434 434 Gross Charge Type: NIHD_Hosp_Profee_Price T2 +15MM END CAP 2025125 CDM 278 RC facility both 434 434 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 9MMX270MM 2025126 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 9MMX270MM 2025126 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 9MMX285MM 2025127 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 9MMX285MM 2025127 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 9MMX300MM 2025128 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 9MMX300MM 2025128 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 9MMX315MM 2025129 CDM 278 RC facility both 3528 3528 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 9MMX315MM 2025129 CDM 278 RC facility both 3528 3528 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 9MMX330MM 2025130 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 9MMX330MM 2025130 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 9MMX345MM 2025131 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 9MMX345MM 2025131 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 9MMX360MM 2025132 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 9MMX360MM 2025132 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 9MMX375MM 2025133 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 9MMX375MM 2025133 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 9MMX390MM 2025134 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 9MMX390MM 2025134 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 9MMX405MM 2025135 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 9MMX405MM 2025135 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 10MMX270MM 2025136 CDM 278 RC facility both 3528 3528 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 10MMX270MM 2025136 CDM 278 RC facility both 3528 3528 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 10MMX285MM 2025137 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 10MMX285MM 2025137 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 10MMX300MM 2025138 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 10MMX300MM 2025138 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 10MMX315MM 2025139 CDM 278 RC facility both 3528 3528 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 10MMX315MM 2025139 CDM 278 RC facility both 3528 3528 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 10MMX330MM 2025140 CDM 278 RC facility both 3528 3528 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 10MMX330MM 2025140 CDM 278 RC facility both 3528 3528 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 10MMX345MM 2025141 CDM 278 RC facility both 3528 3528 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 10MMX345MM 2025141 CDM 278 RC facility both 3528 3528 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 10MMX360MM 2025142 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 10MMX360MM 2025142 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 10MMX375MM 2025143 CDM 278 RC facility both 3528 3528 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 10MMX375MM 2025143 CDM 278 RC facility both 3528 3528 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 10MMX390MM 2025144 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 10MMX390MM 2025144 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 10MMX405MM 2025145 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 10MMX405MM 2025145 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 11MMX270MM 2025146 CDM 278 RC facility both 7925 7925 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 11MMX270MM 2025146 CDM 278 RC facility both 7925 7925 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 11MMX285MM 2025147 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 11MMX285MM 2025147 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 11MMX300MM 2025148 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 11MMX300MM 2025148 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 11MMX315MM 2025149 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 11MMX315MM 2025149 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 11MMX330MM 2025150 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 11MMX330MM 2025150 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 11MMX345MM 2025151 CDM 278 RC facility both 3528 3528 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 11MMX345MM 2025151 CDM 278 RC facility both 3528 3528 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 11MMX360MM 2025152 CDM 278 RC facility both 3528 3528 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 11MMX360MM 2025152 CDM 278 RC facility both 3528 3528 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 11MMX375MM 2025153 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 11MMX375MM 2025153 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 11MMX390MM 2025154 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 11MMX390MM 2025154 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 11MMX405MM 2025155 CDM 278 RC facility both 3528 3528 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 11MMX405MM 2025155 CDM 278 RC facility both 3528 3528 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 12MMX270MM 2025156 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 12MMX270MM 2025156 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 12MMX285MM 2025157 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 12MMX285MM 2025157 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 12MMX300MM 2025158 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 12MMX300MM 2025158 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 12MMX315MM 2025159 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 12MMX315MM 2025159 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 12MMX330MM 2025160 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 12MMX330MM 2025160 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 12MMX345MM 2025161 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 12MMX345MM 2025161 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 12MMX360MM 2025162 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 12MMX360MM 2025162 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 12MMX375MM 2025163 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 12MMX375MM 2025163 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 12MMX390MM 2025164 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 12MMX390MM 2025164 CDM 278 RC facility both 5941 5941 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 12MMX405MM 2025165 CDM 278 RC facility both 3528 3528 Gross Charge Type: NIHD_Hosp_Profee_Price T2 STD. TIBIAL NAIL 12MMX405MM 2025165 CDM 278 RC facility both 3528 3528 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SCN FULLY THREADED END CAP 2025166 CDM 278 RC facility both 450 450 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SCN FULLY THREADED END CAP 2025166 CDM 278 RC facility both 450 450 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 10X170MM 2025168 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 10X170MM 2025168 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 10X200MM 2025169 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 10X200MM 2025169 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 10X300MM 2025170 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 10X300MM 2025170 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 10X320MM 2025171 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 10X320MM 2025171 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 10X340MM 2025172 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 10X340MM 2025172 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 10X360MM 2025173 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 10X360MM 2025173 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 10X380MM 2025174 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 10X380MM 2025174 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 10X400MM 2025175 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 10X400MM 2025175 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 10X420MM 2025176 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 10X420MM 2025176 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 11X170MM 2025177 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 11X170MM 2025177 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 11X200MM 2025178 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 11X200MM 2025178 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 11X300MM 2025179 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 11X300MM 2025179 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 11X320MM 2025180 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 11X320MM 2025180 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 11X340MM 2025181 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 11X340MM 2025181 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 11X360MM 2025182 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 11X360MM 2025182 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 11X380MM 2025183 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 11X380MM 2025183 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 11X400MM 2025184 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 11X400MM 2025184 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 11X420MM 2025185 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 11X420MM 2025185 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 12X170MM 2025186 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 12X170MM 2025186 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 12X200MM 2025187 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 12X200MM 2025187 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 12X300MM 2025188 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 12X300MM 2025188 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 12X320MM 2025189 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 12X320MM 2025189 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 12X340MM 2025190 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 12X340MM 2025190 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 12X360MM 2025191 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 12X360MM 2025191 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 12X380MM 2025192 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 12X380MM 2025192 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 12X400MM 2025193 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 12X400MM 2025193 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 12X420MM 2025194 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 12X420MM 2025194 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 13X170MM 2025195 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 13X170MM 2025195 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 13X200MM 2025196 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 13X200MM 2025196 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 13X300MM 2025197 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 13X300MM 2025197 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 13X320MM 2025198 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 13X320MM 2025198 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 13X340MM 2025199 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 13X340MM 2025199 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 13X360MM 2025200 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 13X360MM 2025200 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 13X380MM 2025201 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 13X380MM 2025201 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 13X400MM 2025202 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 13X400MM 2025202 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 13X420MM 2025203 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 13X420MM 2025203 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 14X170MM 2025204 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 14X170MM 2025204 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 14X200MM 2025205 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 14X200MM 2025205 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 14X300MM 2025206 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 14X300MM 2025206 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 14X320MM 2025207 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 14X320MM 2025207 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 14X340MM 2025208 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 14X340MM 2025208 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 14X360MM 2025209 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 14X360MM 2025209 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 14X380MM 2025210 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 14X380MM 2025210 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 14X400MM 2025211 CDM 278 RC facility both 6813 6813 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 14X400MM 2025211 CDM 278 RC facility both 6813 6813 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 14X420MM 2025212 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 SUPRACONDYLAR NAIL 14X420MM 2025212 CDM 278 RC facility both 7802 7802 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX25MM 2025214 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX25MM 2025214 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX27.5MM 2025215 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX27.5MM 2025215 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX30MM 2025217 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX30MM 2025217 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX32.5MM 2025219 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX32.5MM 2025219 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX40MM 2025225 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX40MM 2025225 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX42.5MM 2025227 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX42.5MM 2025227 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX45MM 2025229 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX45MM 2025229 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX47.5MM 2025231 CDM 278 RC facility both 730 730 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX47.5MM 2025231 CDM 278 RC facility both 730 730 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX50MM 2025232 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX50MM 2025232 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX52.5MM 2025233 CDM 278 RC facility both 730 730 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX52.5MM 2025233 CDM 278 RC facility both 730 730 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX55MM 2025234 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX55MM 2025234 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX57.5MM 2025235 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX57.5MM 2025235 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX60MM 2025236 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX60MM 2025236 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX65MM 2025237 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX65MM 2025237 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX70MM 2025238 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX70MM 2025238 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX75MM 2025239 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX75MM 2025239 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX80MM 2025240 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX80MM 2025240 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX85MM 2025241 CDM 278 RC facility both 730 730 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX85MM 2025241 CDM 278 RC facility both 730 730 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX90MM 2025242 CDM 278 RC facility both 730 730 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX90MM 2025242 CDM 278 RC facility both 730 730 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX95MM 2025243 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX95MM 2025243 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX100MM 2025244 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX100MM 2025244 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX105MM 2025245 CDM 278 RC facility both 730 730 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX105MM 2025245 CDM 278 RC facility both 730 730 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX110MM 2025246 CDM 278 RC facility both 730 730 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX110MM 2025246 CDM 278 RC facility both 730 730 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX115MM 2025247 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX115MM 2025247 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX120MM 2025248 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price T2 F/T LOCKING SCREW 5MMX120MM 2025248 CDM 278 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW TI SET 8X17.5MM 2025249 CDM 278 RC facility both 497 497 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW TI SET 8X17.5MM 2025249 CDM 278 RC facility both 497 497 Gross Charge Type: NIHD_Hosp_Profee_Price TI END CAP STANDARD 0MM 2025250 CDM 278 RC facility both 497 497 Gross Charge Type: NIHD_Hosp_Profee_Price TI END CAP STANDARD 0MM 2025250 CDM 278 RC facility both 497 497 Gross Charge Type: NIHD_Hosp_Profee_Price TI END CAP 5MM +5 2025251 CDM 278 RC facility both 789 789 Gross Charge Type: NIHD_Hosp_Profee_Price TI END CAP 5MM +5 2025251 CDM 278 RC facility both 789 789 Gross Charge Type: NIHD_Hosp_Profee_Price TI END CAP 10MM +10 2025252 CDM 278 RC facility both 497 497 Gross Charge Type: NIHD_Hosp_Profee_Price TI END CAP 10MM +10 2025252 CDM 278 RC facility both 497 497 Gross Charge Type: NIHD_Hosp_Profee_Price TI LAG SCREW 10.5X75MM 2025253 CDM 278 RC facility both 2198 2198 Gross Charge Type: NIHD_Hosp_Profee_Price TI LAG SCREW 10.5X75MM 2025253 CDM 278 RC facility both 2198 2198 Gross Charge Type: NIHD_Hosp_Profee_Price TI LAG SCREW 10.5X80MM 2025254 CDM 278 RC facility both 1386 1386 Gross Charge Type: NIHD_Hosp_Profee_Price TI LAG SCREW 10.5X80MM 2025254 CDM 278 RC facility both 1386 1386 Gross Charge Type: NIHD_Hosp_Profee_Price TI LAG SCREW 10.5X85MM 2025255 CDM 278 RC facility both 1386 1386 Gross Charge Type: NIHD_Hosp_Profee_Price TI LAG SCREW 10.5X85MM 2025255 CDM 278 RC facility both 1386 1386 Gross Charge Type: NIHD_Hosp_Profee_Price TI LAG SCREW 10.5X90MM 2025256 CDM 278 RC facility both 1386 1386 Gross Charge Type: NIHD_Hosp_Profee_Price TI LAG SCREW 10.5X90MM 2025256 CDM 278 RC facility both 1386 1386 Gross Charge Type: NIHD_Hosp_Profee_Price TI LAG SCREW 10.5X95MM 2025257 CDM 278 RC facility both 1386 1386 Gross Charge Type: NIHD_Hosp_Profee_Price TI LAG SCREW 10.5X95MM 2025257 CDM 278 RC facility both 1386 1386 Gross Charge Type: NIHD_Hosp_Profee_Price TI LAG SCREW 10.5X100MM 2025258 CDM 278 RC facility both 1386 1386 Gross Charge Type: NIHD_Hosp_Profee_Price TI LAG SCREW 10.5X100MM 2025258 CDM 278 RC facility both 1386 1386 Gross Charge Type: NIHD_Hosp_Profee_Price TI LAG SCREW 10.5X105MM 2025259 CDM 278 RC facility both 1386 1386 Gross Charge Type: NIHD_Hosp_Profee_Price TI LAG SCREW 10.5X105MM 2025259 CDM 278 RC facility both 1386 1386 Gross Charge Type: NIHD_Hosp_Profee_Price TI LAG SCREW 10.5X110MM 2025260 CDM 278 RC facility both 1386 1386 Gross Charge Type: NIHD_Hosp_Profee_Price TI LAG SCREW 10.5X110MM 2025260 CDM 278 RC facility both 1386 1386 Gross Charge Type: NIHD_Hosp_Profee_Price TI LAG SCREW 10.5X115MM 2025261 CDM 278 RC facility both 2198 2198 Gross Charge Type: NIHD_Hosp_Profee_Price TI LAG SCREW 10.5X115MM 2025261 CDM 278 RC facility both 2198 2198 Gross Charge Type: NIHD_Hosp_Profee_Price TI LAG SCREW 10.5X120MM 2025262 CDM 278 RC facility both 1386 1386 Gross Charge Type: NIHD_Hosp_Profee_Price TI LAG SCREW 10.5X120MM 2025262 CDM 278 RC facility both 1386 1386 Gross Charge Type: NIHD_Hosp_Profee_Price GAMMA 3 TI.LAGSCREW 10.5X125MM 2025263 CDM 278 RC facility both 2198 2198 Gross Charge Type: NIHD_Hosp_Profee_Price GAMMA 3 TI.LAGSCREW 10.5X125MM 2025263 CDM 278 RC facility both 2198 2198 Gross Charge Type: NIHD_Hosp_Profee_Price GAMMA 3 TI.LAGSCREW 10.5X130MM 2025264 CDM 278 RC facility both 2198 2198 Gross Charge Type: NIHD_Hosp_Profee_Price GAMMA 3 TI.LAGSCREW 10.5X130MM 2025264 CDM 278 RC facility both 2198 2198 Gross Charge Type: NIHD_Hosp_Profee_Price TI TROCHANTERIC NAIL KIT 11X180MM X 125 2025292 CDM 278 RC facility both 3522 3522 Gross Charge Type: NIHD_Hosp_Profee_Price TI TROCHANTERIC NAIL KIT 11X180MM X 125 2025292 CDM 278 RC facility both 3522 3522 Gross Charge Type: NIHD_Hosp_Profee_Price TI TROCHANTERIC NAIL KIT 11X180MM X 130 2025293 CDM 278 RC facility both 3522 3522 Gross Charge Type: NIHD_Hosp_Profee_Price TI TROCHANTERIC NAIL KIT 11X180MM X 130 2025293 CDM 278 RC facility both 3522 3522 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X14MM 2025294 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X14MM 2025294 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X16MM 2025295 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X16MM 2025295 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X18MM 2025296 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X18MM 2025296 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X20MM 2025297 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X20MM 2025297 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X22MM 2025298 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X22MM 2025298 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X24MM 2025299 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X24MM 2025299 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X26MM 2025301 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X26MM 2025301 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X28MM 2025302 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X28MM 2025302 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X30MM 2025303 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X30MM 2025303 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X32MM 2025304 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X32MM 2025304 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X34MM 2025305 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X34MM 2025305 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X36MM 2025306 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X36MM 2025306 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X38MM 2025307 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X38MM 2025307 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X40MM 2025308 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X40MM 2025308 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X42MM 2025309 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X42MM 2025309 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X44MM 2025310 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X44MM 2025310 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X46MM 2025311 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X46MM 2025311 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X48MM 2025312 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X48MM 2025312 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X50MM 2025313 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X50MM 2025313 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X55MM 2025314 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X55MM 2025314 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X60MM 2025315 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III SS CAN SCR 4X60MM 2025315 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 50MM 2025316 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 50MM 2025316 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 55MM 2025317 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 55MM 2025317 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 60MM 2025318 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 60MM 2025318 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 65MM 2025319 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 65MM 2025319 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 70MM 2025320 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 70MM 2025320 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 75MM 2025321 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 75MM 2025321 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 80MM 2025322 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 80MM 2025322 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 85MM 2025323 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 85MM 2025323 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 90MM 2025324 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 90MM 2025324 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 95MM 2025325 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 95MM 2025325 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 100MM 2025326 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 100MM 2025326 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 105MM 2025327 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 105MM 2025327 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 110MM 2025328 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 110MM 2025328 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 115MM 2025329 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 115MM 2025329 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 120MM 2025330 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 120MM 2025330 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 125MM 2025331 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 125MM 2025331 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 130MM 2025332 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA PLUS LAG SCREW 130MM 2025332 CDM 278 RC facility both 1249 1249 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X10MM 2025333 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X10MM 2025333 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X12MM 2025334 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X12MM 2025334 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X14MM 2025335 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X14MM 2025335 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X16MM 2025336 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X16MM 2025336 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X18MM 2025337 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X18MM 2025337 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X20MM 2025338 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X20MM 2025338 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X22MM 2025339 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X22MM 2025339 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X24MM 2025340 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X24MM 2025340 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X26MM 2025341 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X26MM 2025341 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X28MM 2025342 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X28MM 2025342 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X30MM 2025343 CDM 278 RC facility both 79 79 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X30MM 2025343 CDM 278 RC facility both 79 79 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X32MM 2025344 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X32MM 2025344 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X34MM 2025345 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X34MM 2025345 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X36MM 2025346 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X36MM 2025346 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X38MM 2025347 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X38MM 2025347 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X40MM 2025348 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X40MM 2025348 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X42MM 2025349 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X42MM 2025349 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X44MM 2025350 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X44MM 2025350 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X46MM 2025351 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X46MM 2025351 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X48MM 2025352 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X48MM 2025352 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X50MM 2025353 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X50MM 2025353 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X55MM 2025354 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X55MM 2025354 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X60MM 2025355 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 3.5X60MM 2025355 CDM 278 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X14MM 2025356 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X14MM 2025356 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X16MM 2025357 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X16MM 2025357 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X18MM 2025358 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X18MM 2025358 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X20MM 2025359 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X20MM 2025359 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X22MM 2025360 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X22MM 2025360 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X24MM 2025361 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X24MM 2025361 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X26MM 2025362 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X26MM 2025362 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X28MM 2025363 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X28MM 2025363 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X30MM 2025365 CDM 278 RC facility both 87 87 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X30MM 2025365 CDM 278 RC facility both 87 87 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X32MM 2025366 CDM 278 RC facility both 87 87 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X32MM 2025366 CDM 278 RC facility both 87 87 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X34MM 2025369 CDM 278 RC facility both 87 87 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X34MM 2025369 CDM 278 RC facility both 87 87 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X36MM 2025371 CDM 278 RC facility both 87 87 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X36MM 2025371 CDM 278 RC facility both 87 87 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X38MM 2025373 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X38MM 2025373 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X40MM 2025375 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X40MM 2025375 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X42MM 2025377 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X42MM 2025377 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X44MM 2025378 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X44MM 2025378 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X46MM 2025379 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X46MM 2025379 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X48MM 2025380 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X48MM 2025380 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X50MM 2025381 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X50MM 2025381 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X52MM 2025382 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X52MM 2025382 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X54MM 2025384 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X54MM 2025384 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X56MM 2025386 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X56MM 2025386 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X58MM 2025387 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X58MM 2025387 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X60MM 2025388 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X60MM 2025388 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X62MM 2025389 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X62MM 2025389 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X64MM 2025390 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X64MM 2025390 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X66MM 2025391 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X66MM 2025391 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X68MM 2025392 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X68MM 2025392 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X70MM 2025393 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW 4.5X70MM 2025393 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price 6.5X75MM CANCELLOUS SCREW 32MM T/L 2025414 CDM 278 RC facility both 162 162 Gross Charge Type: NIHD_Hosp_Profee_Price 6.5X75MM CANCELLOUS SCREW 32MM T/L 2025414 CDM 278 RC facility both 162 162 Gross Charge Type: NIHD_Hosp_Profee_Price 6.5X80MM CANCELLOUS SCREW 32MM T/L 2025415 CDM 278 RC facility both 162 162 Gross Charge Type: NIHD_Hosp_Profee_Price 6.5X80MM CANCELLOUS SCREW 32MM T/L 2025415 CDM 278 RC facility both 162 162 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI RIGHT 11X300MMX125 2025419 CDM 278 RC facility both 5824 5824 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI RIGHT 11X300MMX125 2025419 CDM 278 RC facility both 5824 5824 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI RIGHT 11X320MMX125 2025420 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI RIGHT 11X320MMX125 2025420 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI RIGHT 11X340MMX125 2025421 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI RIGHT 11X340MMX125 2025421 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price GAMMA3 NAIL 11X360MMX125 RT 2025422 CDM 278 RC facility both 11267 11267 Gross Charge Type: NIHD_Hosp_Profee_Price GAMMA3 NAIL 11X360MMX125 RT 2025422 CDM 278 RC facility both 11267 11267 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI RIGHT 11X380MMX125 2025423 CDM 278 RC facility both 5824 5824 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI RIGHT 11X380MMX125 2025423 CDM 278 RC facility both 5824 5824 Gross Charge Type: NIHD_Hosp_Profee_Price GAMMA3 NAIL 11X400MMX125 RT 2025424 CDM 278 RC facility both 11267 11267 Gross Charge Type: NIHD_Hosp_Profee_Price GAMMA3 NAIL 11X400MMX125 RT 2025424 CDM 278 RC facility both 11267 11267 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI RIGHT 11X420MMX125 2025425 CDM 278 RC facility both 5824 5824 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI RIGHT 11X420MMX125 2025425 CDM 278 RC facility both 5824 5824 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI RIGHT 11X440MMX125 2025426 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI RIGHT 11X440MMX125 2025426 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI RIGHT 11X300MMX130 2025427 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI RIGHT 11X300MMX130 2025427 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI RIGHT 11X320MMX130 2025428 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI RIGHT 11X320MMX130 2025428 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI RIGHT 11X340MMX130 2025429 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI RIGHT 11X340MMX130 2025429 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI RIGHT 11X360MMX130 2025430 CDM 278 RC facility both 5824 5824 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI RIGHT 11X360MMX130 2025430 CDM 278 RC facility both 5824 5824 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI RIGHT 11X380MMX130 2025431 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI RIGHT 11X380MMX130 2025431 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI RIGHT 11X400MMX130 2025432 CDM 278 RC facility both 5824 5824 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI RIGHT 11X400MMX130 2025432 CDM 278 RC facility both 5824 5824 Gross Charge Type: NIHD_Hosp_Profee_Price GAMMA3 NAIL 11X420MMX130 RT 2025433 CDM 278 RC facility both 10120 10120 Gross Charge Type: NIHD_Hosp_Profee_Price GAMMA3 NAIL 11X420MMX130 RT 2025433 CDM 278 RC facility both 10120 10120 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI RIGHT 11X440MMX130 2025434 CDM 278 RC facility both 5824 5824 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI RIGHT 11X440MMX130 2025434 CDM 278 RC facility both 5824 5824 Gross Charge Type: NIHD_Hosp_Profee_Price 6.5X20MM CANCELLOUS SCREW F/T 2025435 CDM 278 RC facility both 162 162 Gross Charge Type: NIHD_Hosp_Profee_Price 6.5X20MM CANCELLOUS SCREW F/T 2025435 CDM 278 RC facility both 162 162 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345410 2025448 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345410 2025448 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345412 2025449 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345412 2025449 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345414 2025450 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345414 2025450 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345416 2025451 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345416 2025451 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345418 2025452 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345418 2025452 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345420 2025453 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345420 2025453 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345422 2025454 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345422 2025454 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345424 2025455 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345424 2025455 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345426 2025456 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345426 2025456 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345428 2025457 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345428 2025457 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 2025458 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 2025458 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345432 2025459 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345432 2025459 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345434 2025460 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345434 2025460 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345436 2025461 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345436 2025461 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345438 2025462 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345438 2025462 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345440 2025463 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345440 2025463 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345445 2025464 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345445 2025464 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345450 2025465 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345450 2025465 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345455 2025466 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345455 2025466 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345460 2025467 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345460 2025467 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345510 2025468 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345510 2025468 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345512 2025469 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345512 2025469 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345514 2025470 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345514 2025470 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345516 2025471 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345516 2025471 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345518 2025472 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345518 2025472 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345520 2025473 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345520 2025473 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345522 2025474 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345522 2025474 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345524 2025475 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345524 2025475 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345526 2025476 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345526 2025476 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345528 2025477 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345528 2025477 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345530 2025478 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345530 2025478 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345532 2025479 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345532 2025479 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345534 2025480 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345534 2025480 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345536 2025481 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345536 2025481 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345538 2025482 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345538 2025482 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345540 2025483 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345540 2025483 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345545 2025484 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345545 2025484 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345550 2025485 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345550 2025485 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345555 2025486 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345555 2025486 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345560 2025487 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS SCREW 4.0 SS 345560 2025487 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW SS 349620 2025494 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price SELF TAP CORTICAL SCREW SS 349620 2025494 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X300MMX125 2025500 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X300MMX125 2025500 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X320MMX125 2025501 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X320MMX125 2025501 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X340MMX125 2025502 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X340MMX125 2025502 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X360MMX125 2025503 CDM 278 RC facility both 5824 5824 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X360MMX125 2025503 CDM 278 RC facility both 5824 5824 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X400MMX125 2025505 CDM 278 RC facility both 5824 5824 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X400MMX125 2025505 CDM 278 RC facility both 5824 5824 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X420MMX125 2025506 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X420MMX125 2025506 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X440MMX125 2025507 CDM 278 RC facility both 5824 5824 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X440MMX125 2025507 CDM 278 RC facility both 5824 5824 Gross Charge Type: NIHD_Hosp_Profee_Price GAMMA3 NAIL 11X300MMX130 LT 2025508 CDM 278 RC facility both 11267 11267 Gross Charge Type: NIHD_Hosp_Profee_Price GAMMA3 NAIL 11X300MMX130 LT 2025508 CDM 278 RC facility both 11267 11267 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X320MMX130 2025509 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X320MMX130 2025509 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X340MMX130 2025510 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X340MMX130 2025510 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X360MMX130 2025511 CDM 278 RC facility both 5824 5824 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X360MMX130 2025511 CDM 278 RC facility both 5824 5824 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X380MMX130 2025512 CDM 278 RC facility both 5824 5824 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X380MMX130 2025512 CDM 278 RC facility both 5824 5824 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X400MMX130 2025513 CDM 278 RC facility both 5824 5824 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X400MMX130 2025513 CDM 278 RC facility both 5824 5824 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X420MMX130 2025514 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X420MMX130 2025514 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X440MMX130 2025515 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price LONG NAIL KIT R1/5 TI LEFT 11X440MMX130 2025515 CDM 278 RC facility both 9243 9243 Gross Charge Type: NIHD_Hosp_Profee_Price 3.0 LOCKING INSERT 2025516 CDM 278 RC facility both 193 193 Gross Charge Type: NIHD_Hosp_Profee_Price 3.0 LOCKING INSERT 2025516 CDM 278 RC facility both 193 193 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0 LOCKING INSERT 2025517 CDM 278 RC facility both 211 211 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0 LOCKING INSERT 2025517 CDM 278 RC facility both 211 211 Gross Charge Type: NIHD_Hosp_Profee_Price 5.0 LOCKING INSERT 2025518 CDM 272 RC facility both 170 170 Gross Charge Type: NIHD_Hosp_Profee_Price 5.0 LOCKING INSERT 2025518 CDM 272 RC facility both 170 170 Gross Charge Type: NIHD_Hosp_Profee_Price 5.0 CABLE PLUG 2025520 CDM 278 RC facility both 275 275 Gross Charge Type: NIHD_Hosp_Profee_Price 5.0 CABLE PLUG 2025520 CDM 278 RC facility both 275 275 Gross Charge Type: NIHD_Hosp_Profee_Price 5.0X10MM PERIPROSTH. SCREW 2025521 CDM 278 RC facility both 699 699 Gross Charge Type: NIHD_Hosp_Profee_Price 5.0X10MM PERIPROSTH. SCREW 2025521 CDM 278 RC facility both 699 699 Gross Charge Type: NIHD_Hosp_Profee_Price 5.0X12MM PERIPROSTH. SCREW 2025522 CDM 278 RC facility both 699 699 Gross Charge Type: NIHD_Hosp_Profee_Price 5.0X12MM PERIPROSTH. SCREW 2025522 CDM 278 RC facility both 699 699 Gross Charge Type: NIHD_Hosp_Profee_Price 5.0X14MM PERIPROSTH. SCREW 2025523 CDM 278 RC facility both 699 699 Gross Charge Type: NIHD_Hosp_Profee_Price 5.0X14MM PERIPROSTH. SCREW 2025523 CDM 278 RC facility both 699 699 Gross Charge Type: NIHD_Hosp_Profee_Price 5.0X16MM PERIPROSTH. SCREW 2025524 CDM 278 RC facility both 699 699 Gross Charge Type: NIHD_Hosp_Profee_Price 5.0X16MM PERIPROSTH. SCREW 2025524 CDM 278 RC facility both 699 699 Gross Charge Type: NIHD_Hosp_Profee_Price 5.0X18MM PERIPROSTH. SCREW 2025525 CDM 278 RC facility both 699 699 Gross Charge Type: NIHD_Hosp_Profee_Price 5.0X18MM PERIPROSTH. SCREW 2025525 CDM 278 RC facility both 699 699 Gross Charge Type: NIHD_Hosp_Profee_Price 5.0X20MM PERIPROSTH. SCREW 2025526 CDM 278 RC facility both 699 699 Gross Charge Type: NIHD_Hosp_Profee_Price 5.0X20MM PERIPROSTH. SCREW 2025526 CDM 278 RC facility both 699 699 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 3.0MM / L8MM 2025527 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 3.0MM / L8MM 2025527 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 3.0MM / L10MM 2025528 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 3.0MM / L10MM 2025528 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 3.0MM / L12MM 2025529 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 3.0MM / L12MM 2025529 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 3.0MM / L14MM 2025530 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 3.0MM / L14MM 2025530 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 3.0MM / L16MM 2025531 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 3.0MM / L16MM 2025531 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 3.0MM / L18MM 2025532 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 3.0MM / L18MM 2025532 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 3.0MM / L20MM 2025533 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 3.0MM / L20MM 2025533 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 3.0MM / L22MM 2025534 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 3.0MM / L22MM 2025534 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 3.0MM / L24MM 2025535 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 3.0MM / L24MM 2025535 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 3.0MM / L26MM 2025536 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 3.0MM / L26MM 2025536 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 3.0MM / L28MM 2025537 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 3.0MM / L28MM 2025537 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 3.0MM / L30MM 2025538 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 3.0MM / L30MM 2025538 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L14MM 2025562 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L14MM 2025562 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L16MM 2025563 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L16MM 2025563 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L18MM 2025564 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L18MM 2025564 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L20MM 2025565 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L20MM 2025565 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L22MM 2025566 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L22MM 2025566 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L24MM 2025567 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L24MM 2025567 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L26MM 2025568 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L26MM 2025568 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L28MM 2025569 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L28MM 2025569 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L30MM 2025570 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L30MM 2025570 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L32MM 2025571 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L32MM 2025571 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L34MM 2025572 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L34MM 2025572 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L36MM 2025573 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L36MM 2025573 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L38MM 2025574 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L38MM 2025574 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L40MM 2025575 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L40MM 2025575 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L42MM 2025576 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L42MM 2025576 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L44MM 2025577 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L44MM 2025577 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L46MM 2025578 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L46MM 2025578 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L48MM 2025579 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L48MM 2025579 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L50MM 2025580 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L50MM 2025580 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L55MM 2025581 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L55MM 2025581 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L60MM 2025582 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW AXSOS 4.0MM / L60MM 2025582 CDM 278 RC facility both 554 554 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III WASHER FOR 6.5/8.0MM SCREWS SS 2025584 CDM 278 RC facility both 131 131 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III WASHER FOR 6.5/8.0MM SCREWS SS 2025584 CDM 278 RC facility both 131 131 Gross Charge Type: NIHD_Hosp_Profee_Price CANNULATED SCREW WASHER SS 2025586 CDM 278 RC facility both 138 138 Gross Charge Type: NIHD_Hosp_Profee_Price CANNULATED SCREW WASHER SS 2025586 CDM 278 RC facility both 138 138 Gross Charge Type: NIHD_Hosp_Profee_Price K-WIRE 1.0 STRYKER 2025587 CDM 272 RC facility both 360 360 Gross Charge Type: NIHD_Hosp_Profee_Price K-WIRE 1.0 STRYKER 2025587 CDM 272 RC facility both 360 360 Gross Charge Type: NIHD_Hosp_Profee_Price K-WIRE 1.6X150MM SS 2025589 CDM 278 RC facility both 37 37 Gross Charge Type: NIHD_Hosp_Profee_Price K-WIRE 1.6X150MM SS 2025589 CDM 278 RC facility both 37 37 Gross Charge Type: NIHD_Hosp_Profee_Price K-WIRE 2.0MM STRYKER 2025590 CDM 272 RC facility both 58 58 Gross Charge Type: NIHD_Hosp_Profee_Price K-WIRE 2.0MM STRYKER 2025590 CDM 272 RC facility both 58 58 Gross Charge Type: NIHD_Hosp_Profee_Price CALCANEUS STANDARD PLATE SMALL 2025594 CDM 278 RC facility both 3105 3105 Gross Charge Type: NIHD_Hosp_Profee_Price CALCANEUS STANDARD PLATE SMALL 2025594 CDM 278 RC facility both 3105 3105 Gross Charge Type: NIHD_Hosp_Profee_Price CALCANEUS STANDARD PLATE MEDIUM 2025595 CDM 278 RC facility both 3105 3105 Gross Charge Type: NIHD_Hosp_Profee_Price CALCANEUS STANDARD PLATE MEDIUM 2025595 CDM 278 RC facility both 3105 3105 Gross Charge Type: NIHD_Hosp_Profee_Price CALCANEUS STANDARD PLATE LARGE 2025596 CDM 278 RC facility both 3105 3105 Gross Charge Type: NIHD_Hosp_Profee_Price CALCANEUS STANDARD PLATE LARGE 2025596 CDM 278 RC facility both 3105 3105 Gross Charge Type: NIHD_Hosp_Profee_Price CURVED PLATE 4 HOLES 2025597 CDM 278 RC facility both 2025 2025 Gross Charge Type: NIHD_Hosp_Profee_Price CURVED PLATE 4 HOLES 2025597 CDM 278 RC facility both 2025 2025 Gross Charge Type: NIHD_Hosp_Profee_Price BROAD STRAIGHT PLATE LONG 2025609 CDM 278 RC facility both 2564 2564 Gross Charge Type: NIHD_Hosp_Profee_Price BROAD STRAIGHT PLATE LONG 2025609 CDM 278 RC facility both 2564 2564 Gross Charge Type: NIHD_Hosp_Profee_Price T-PLATE 2025614 CDM 278 RC facility both 1668 1668 Gross Charge Type: NIHD_Hosp_Profee_Price T-PLATE 2025614 CDM 278 RC facility both 1668 1668 Gross Charge Type: NIHD_Hosp_Profee_Price VARIAX STRAIGHT PLATE 2 HOLE 2025617 CDM 278 RC facility both 1123 1123 Gross Charge Type: NIHD_Hosp_Profee_Price VARIAX STRAIGHT PLATE 2 HOLE 2025617 CDM 278 RC facility both 1123 1123 Gross Charge Type: NIHD_Hosp_Profee_Price VARIAX STRAIGHT PLATE 3 HOLE 2025618 CDM 278 RC facility both 1672 1672 Gross Charge Type: NIHD_Hosp_Profee_Price VARIAX STRAIGHT PLATE 3 HOLE 2025618 CDM 278 RC facility both 1672 1672 Gross Charge Type: NIHD_Hosp_Profee_Price STRAIGHT PLATE VARIAX FIBULA 4HOLE L60MM 2025619 CDM 278 RC facility both 1600 1600 Gross Charge Type: NIHD_Hosp_Profee_Price STRAIGHT PLATE VARIAX FIBULA 4HOLE L60MM 2025619 CDM 278 RC facility both 1600 1600 Gross Charge Type: NIHD_Hosp_Profee_Price "VARIAX STRAIGHT PLATE, 5 HOLE" 2025620 CDM 278 RC facility both 1672 1672 Gross Charge Type: NIHD_Hosp_Profee_Price "VARIAX STRAIGHT PLATE, 5 HOLE" 2025620 CDM 278 RC facility both 1672 1672 Gross Charge Type: NIHD_Hosp_Profee_Price "VARIAX STRAIGHT PLATE, 6 HOLE" 2025621 CDM 278 RC facility both 1672 1672 Gross Charge Type: NIHD_Hosp_Profee_Price "VARIAX STRAIGHT PLATE, 6 HOLE" 2025621 CDM 278 RC facility both 1672 1672 Gross Charge Type: NIHD_Hosp_Profee_Price "VARIAX STRAIGHT PLATE, 7 HOLE" 2025622 CDM 278 RC facility both 1672 1672 Gross Charge Type: NIHD_Hosp_Profee_Price "VARIAX STRAIGHT PLATE, 7 HOLE" 2025622 CDM 278 RC facility both 1672 1672 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL LATERAL FIBULA PLATE 3 HOLE 2025623 CDM 278 RC facility both 1646 1646 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL LATERAL FIBULA PLATE 3 HOLE 2025623 CDM 278 RC facility both 1646 1646 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL LATERAL FIBULA PLATE 4 HOLE 2025624 CDM 278 RC facility both 1646 1646 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL LATERAL FIBULA PLATE 4 HOLE 2025624 CDM 278 RC facility both 1646 1646 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL LATERAL FIBULA PLATE 5 HOLE 2025625 CDM 278 RC facility both 1646 1646 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL LATERAL FIBULA PLATE 5 HOLE 2025625 CDM 278 RC facility both 1646 1646 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL LATERAL FIBULA PLATE 6 HOLE 2025626 CDM 278 RC facility both 2542 2542 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL LATERAL FIBULA PLATE 6 HOLE 2025626 CDM 278 RC facility both 2542 2542 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL LATERAL FIBULA PLATE 7 HOLE 2025627 CDM 278 RC facility both 2760 2760 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL LATERAL FIBULA PLATE 7 HOLE 2025627 CDM 278 RC facility both 2760 2760 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL LATERAL FIBULA PLATE 8 HOLE 2025628 CDM 278 RC facility both 2760 2760 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL LATERAL FIBULA PLATE 8 HOLE 2025628 CDM 278 RC facility both 2760 2760 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL LATERAL FIBULA PLATE 9 HOLE 2025629 CDM 278 RC facility both 2760 2760 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL LATERAL FIBULA PLATE 9 HOLE 2025629 CDM 278 RC facility both 2760 2760 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X8MM 2025630 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X8MM 2025630 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X10MM 2025631 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X10MM 2025631 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X12MM 40-27012 2025632 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X12MM 40-27012 2025632 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X14MM 40-27014 2025633 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X14MM 40-27014 2025633 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X16MM 40-27016 2025634 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X16MM 40-27016 2025634 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE NONLOCKING SCREW T7 2.7X18MM 2025635 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE NONLOCKING SCREW T7 2.7X18MM 2025635 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X20MM 40-27020 2025636 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X20MM 40-27020 2025636 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X22MM 40-27022 2025637 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X22MM 40-27022 2025637 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X24MM 40-27024 2025638 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X24MM 40-27024 2025638 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X26MM 40-27026 2025639 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X26MM 40-27026 2025639 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X28MM 2025640 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X28MM 2025640 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X30MM 2025641 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X30MM 2025641 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X32MM 2025642 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X32MM 2025642 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X34MM 2025643 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X34MM 2025643 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X36MM 2025644 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X36MM 2025644 CDM 278 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X38MM 2025645 CDM 272 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X38MM 2025645 CDM 272 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X40MM 2025646 CDM 272 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X40MM 2025646 CDM 272 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X45MM 2025647 CDM 272 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X45MM 2025647 CDM 272 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X50MM 2025648 CDM 272 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X50MM 2025648 CDM 272 RC facility both 295 295 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X8MM 2025649 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X8MM 2025649 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X10MM 2025650 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X10MM 2025650 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X12MM 2025651 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X12MM 2025651 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X14MM 2025652 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X14MM 2025652 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X16MM 2025653 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X16MM 2025653 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X18MM 2025654 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X18MM 2025654 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X20MM 2025655 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X20MM 2025655 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X22MM 2025656 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X22MM 2025656 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X24MM 2025657 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X24MM 2025657 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X26MM 2025658 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X26MM 2025658 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X28MM 2025659 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X28MM 2025659 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X30MM 2025660 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X30MM 2025660 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X32MM 2025661 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X32MM 2025661 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X34MM 2025662 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X34MM 2025662 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X36MM 2025663 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X36MM 2025663 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X38MM 2025664 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X38MM 2025664 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X40MM 2025665 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X40MM 2025665 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X45MM 2025666 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X45MM 2025666 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X50MM 2025667 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T7 2.7X50MM 2025667 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X10MM 2025668 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X10MM 2025668 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X12MM 2025669 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X12MM 2025669 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW BONE T10 3.5X14MM 2025670 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW BONE T10 3.5X14MM 2025670 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X16MM 2025671 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X16MM 2025671 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X18MM 2025672 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X18MM 2025672 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X20MM 2025673 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X20MM 2025673 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X22MM 2025674 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X22MM 2025674 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X24MM 2025675 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X24MM 2025675 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X26MM 2025676 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X26MM 2025676 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X28MM 2025677 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X28MM 2025677 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X30MM 2025678 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X30MM 2025678 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X32MM 2025679 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X32MM 2025679 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X34MM 2025680 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X34MM 2025680 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X36MM 2025681 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X36MM 2025681 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X38MM 2025682 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X38MM 2025682 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X40MM 2025683 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X40MM 2025683 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X42MM 2025684 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X42MM 2025684 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X44MM 2025685 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X44MM 2025685 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X46MM 2025686 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X46MM 2025686 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X48MM 2025687 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X48MM 2025687 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X50MM 2025688 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X50MM 2025688 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X55MM 2025689 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X55MM 2025689 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X60MM 2025690 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X60MM 2025690 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X65MM 2025691 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X65MM 2025691 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X70MM 2025692 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 3.5X70MM 2025692 CDM 278 RC facility both 327 327 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X10MM 2025693 CDM 278 RC facility both 361 361 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X10MM 2025693 CDM 278 RC facility both 361 361 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW FOOT LOCKING T10 3.5X12MM 2025694 CDM 278 RC facility both 361 361 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW FOOT LOCKING T10 3.5X12MM 2025694 CDM 278 RC facility both 361 361 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW LOCKING FOOT T10 3.5X14MM 2025695 CDM 278 RC facility both 361 361 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW LOCKING FOOT T10 3.5X14MM 2025695 CDM 278 RC facility both 361 361 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X16MM 2025696 CDM 278 RC facility both 361 361 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X16MM 2025696 CDM 278 RC facility both 361 361 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW FOOT LOCKING T10 3.5X18MM 2025697 CDM 278 RC facility both 361 361 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW FOOT LOCKING T10 3.5X18MM 2025697 CDM 278 RC facility both 361 361 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW LOCKING FOOT T10 3.5X20MM 2025698 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW LOCKING FOOT T10 3.5X20MM 2025698 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X22MM 2025699 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X22MM 2025699 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X24MM 2025700 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X24MM 2025700 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X26MM 2025701 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X26MM 2025701 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X28MM 2025702 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X28MM 2025702 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X30MM 2025703 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X30MM 2025703 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X32MM 2025704 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X32MM 2025704 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X34MM 2025705 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X34MM 2025705 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X38MM 2025706 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X38MM 2025706 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X40MM 2025707 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X40MM 2025707 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X42MM 2025708 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X42MM 2025708 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X44MM 2025709 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X44MM 2025709 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X46MM 2025710 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X46MM 2025710 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X48MM 2025711 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X48MM 2025711 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X50MM 2025712 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X50MM 2025712 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X55MM 2025713 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X55MM 2025713 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X60MM 2025714 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X60MM 2025714 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X65MM 2025715 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X65MM 2025715 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X70MM 2025716 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X70MM 2025716 CDM 278 RC facility both 647 647 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING COMPR PLATE 4 HOLE / L58MM 2025717 CDM 278 RC facility both 467 467 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING COMPR PLATE 4 HOLE / L58MM 2025717 CDM 278 RC facility both 467 467 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING COMPR PLATE 6 HOLE / L84MM 2025718 CDM 278 RC facility both 597 597 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING COMPR PLATE 6 HOLE / L84MM 2025718 CDM 278 RC facility both 597 597 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING COMPR PLATE 7 HOLE / L97MM 2025719 CDM 278 RC facility both 597 597 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING COMPR PLATE 7 HOLE / L97MM 2025719 CDM 278 RC facility both 597 597 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING COMPR PLATE 8 HOLE / L110MM 2025720 CDM 278 RC facility both 665 665 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING COMPR PLATE 8 HOLE / L110MM 2025720 CDM 278 RC facility both 665 665 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING COMPR PLATE 10 HOLE / L136MM 2025721 CDM 278 RC facility both 665 665 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING COMPR PLATE 10 HOLE / L136MM 2025721 CDM 278 RC facility both 665 665 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING RECON PLATE 4 HOLE / L48MM 2025722 CDM 278 RC facility both 1686 1686 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING RECON PLATE 4 HOLE / L48MM 2025722 CDM 278 RC facility both 1686 1686 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING RECON PLATE 6 HOLE / L72MM 2025723 CDM 278 RC facility both 1901 1901 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING RECON PLATE 6 HOLE / L72MM 2025723 CDM 278 RC facility both 1901 1901 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING RECON PLATE 8 HOLE / L96MM 2025724 CDM 278 RC facility both 2110 2110 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING RECON PLATE 8 HOLE / L96MM 2025724 CDM 278 RC facility both 2110 2110 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING RECON PLATE 10 HOLE / L120MM 2025725 CDM 278 RC facility both 2323 2323 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING RECON PLATE 10 HOLE / L120MM 2025725 CDM 278 RC facility both 2323 2323 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING 1/3 TUB PLATE 4 HOLE / L50MM 2025726 CDM 278 RC facility both 558 558 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING 1/3 TUB PLATE 4 HOLE / L50MM 2025726 CDM 278 RC facility both 558 558 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING 1/3 TUB PLATE 6 HOLE / L76MM 2025727 CDM 278 RC facility both 558 558 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING 1/3 TUB PLATE 6 HOLE / L76MM 2025727 CDM 278 RC facility both 558 558 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING 1/3 TUB PLATE 8 HOLE / L102MM 2025728 CDM 278 RC facility both 607 607 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING 1/3 TUB PLATE 8 HOLE / L102MM 2025728 CDM 278 RC facility both 607 607 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING 1/3 TUB PLATE 10 HOLE / L128MM 2025729 CDM 278 RC facility both 607 607 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING 1/3 TUB PLATE 10 HOLE / L128MM 2025729 CDM 278 RC facility both 607 607 Gross Charge Type: NIHD_Hosp_Profee_Price COMPRESSION PLATE 4 HOLE 2025745 CDM 278 RC facility both 393 393 Gross Charge Type: NIHD_Hosp_Profee_Price COMPRESSION PLATE 4 HOLE 2025745 CDM 278 RC facility both 393 393 Gross Charge Type: NIHD_Hosp_Profee_Price COMPRESSION PLATE 6 HOLE 2025746 CDM 278 RC facility both 523 523 Gross Charge Type: NIHD_Hosp_Profee_Price COMPRESSION PLATE 6 HOLE 2025746 CDM 278 RC facility both 523 523 Gross Charge Type: NIHD_Hosp_Profee_Price COMPRESSION PLATE 7 HOLE 2025747 CDM 278 RC facility both 523 523 Gross Charge Type: NIHD_Hosp_Profee_Price COMPRESSION PLATE 7 HOLE 2025747 CDM 278 RC facility both 523 523 Gross Charge Type: NIHD_Hosp_Profee_Price COMPRESSION PLATE 8 HOLE SS 2025748 CDM 278 RC facility both 523 523 Gross Charge Type: NIHD_Hosp_Profee_Price COMPRESSION PLATE 8 HOLE SS 2025748 CDM 278 RC facility both 523 523 Gross Charge Type: NIHD_Hosp_Profee_Price COMPRESSION PLATE 10 HOLE SS 2025749 CDM 278 RC facility both 523 523 Gross Charge Type: NIHD_Hosp_Profee_Price COMPRESSION PLATE 10 HOLE SS 2025749 CDM 278 RC facility both 523 523 Gross Charge Type: NIHD_Hosp_Profee_Price ONE THIRD TUB. PLATE 2 HOLE SS 2025750 CDM 278 RC facility both 193 193 Gross Charge Type: NIHD_Hosp_Profee_Price ONE THIRD TUB. PLATE 2 HOLE SS 2025750 CDM 278 RC facility both 193 193 Gross Charge Type: NIHD_Hosp_Profee_Price ONE THIRD TUB. PLATE 4 HOLE SS 2025751 CDM 278 RC facility both 237 237 Gross Charge Type: NIHD_Hosp_Profee_Price ONE THIRD TUB. PLATE 4 HOLE SS 2025751 CDM 278 RC facility both 237 237 Gross Charge Type: NIHD_Hosp_Profee_Price ONE THIRD TUB. PLATE 5 HOLE SS 2025752 CDM 278 RC facility both 237 237 Gross Charge Type: NIHD_Hosp_Profee_Price ONE THIRD TUB. PLATE 5 HOLE SS 2025752 CDM 278 RC facility both 237 237 Gross Charge Type: NIHD_Hosp_Profee_Price ONE THIRD TUB. PLATE 6 HOLE SS 2025753 CDM 278 RC facility both 237 237 Gross Charge Type: NIHD_Hosp_Profee_Price ONE THIRD TUB. PLATE 6 HOLE SS 2025753 CDM 278 RC facility both 237 237 Gross Charge Type: NIHD_Hosp_Profee_Price ONE THIRD TUB. PLATE 7 HOLE SS 2025754 CDM 278 RC facility both 262 262 Gross Charge Type: NIHD_Hosp_Profee_Price ONE THIRD TUB. PLATE 7 HOLE SS 2025754 CDM 278 RC facility both 262 262 Gross Charge Type: NIHD_Hosp_Profee_Price ONE THIRD TUB. PLATE 10 HOLE SS 2025756 CDM 278 RC facility both 293 293 Gross Charge Type: NIHD_Hosp_Profee_Price ONE THIRD TUB. PLATE 10 HOLE SS 2025756 CDM 278 RC facility both 293 293 Gross Charge Type: NIHD_Hosp_Profee_Price T-PLATE 4/4 HOLE SS 2025761 CDM 278 RC facility both 653 653 Gross Charge Type: NIHD_Hosp_Profee_Price T-PLATE 4/4 HOLE SS 2025761 CDM 278 RC facility both 653 653 Gross Charge Type: NIHD_Hosp_Profee_Price T-PLATE 4 HOLE L79MM 2025770 CDM 278 RC facility both 809 809 Gross Charge Type: NIHD_Hosp_Profee_Price T-PLATE 4 HOLE L79MM 2025770 CDM 278 RC facility both 809 809 Gross Charge Type: NIHD_Hosp_Profee_Price PROXIMAL LAT HUMERUS PLATE TS 3 HOLE / L 2025775 CDM 278 RC facility both 5333 5333 Gross Charge Type: NIHD_Hosp_Profee_Price PROXIMAL LAT HUMERUS PLATE TS 3 HOLE / L 2025775 CDM 278 RC facility both 5333 5333 Gross Charge Type: NIHD_Hosp_Profee_Price PROXIMAL LAT HUMERUS PLATE TS 3 HOLE / R 2025776 CDM 278 RC facility both 5333 5333 Gross Charge Type: NIHD_Hosp_Profee_Price PROXIMAL LAT HUMERUS PLATE TS 3 HOLE / R 2025776 CDM 278 RC facility both 5333 5333 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL 2.0MM X 102MM WL50MM AO-SHAFT 2025777 CDM 272 RC facility both 437 437 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL 2.0MM X 102MM WL50MM AO-SHAFT 2025777 CDM 272 RC facility both 437 437 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL 2.6MM X 122MM WL70MM AO-SHAFT 2025778 CDM 272 RC facility both 302 302 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL 2.6MM X 122MM WL70MM AO-SHAFT 2025778 CDM 272 RC facility both 302 302 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 03.6MM X 122MM AO FITTING 2025779 CDM 278 RC facility both 485 485 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 03.6MM X 122MM AO FITTING 2025779 CDM 278 RC facility both 485 485 Gross Charge Type: NIHD_Hosp_Profee_Price K-WIRE FULLY THREADED 1.6MM X 200MM 2025780 CDM 278 RC facility both 111 111 Gross Charge Type: NIHD_Hosp_Profee_Price K-WIRE FULLY THREADED 1.6MM X 200MM 2025780 CDM 278 RC facility both 111 111 Gross Charge Type: NIHD_Hosp_Profee_Price K-WIRE SMOOTH 1.4MM X 100MM 2025781 CDM 278 RC facility both 47 47 Gross Charge Type: NIHD_Hosp_Profee_Price K-WIRE SMOOTH 1.4MM X 100MM 2025781 CDM 278 RC facility both 47 47 Gross Charge Type: NIHD_Hosp_Profee_Price HII MRI 10 HOLE PIN CLAMP 2025784 CDM 278 RC facility both 1789 1789 Gross Charge Type: NIHD_Hosp_Profee_Price HII MRI 10 HOLE PIN CLAMP 2025784 CDM 278 RC facility both 1789 1789 Gross Charge Type: NIHD_Hosp_Profee_Price HOFFMANN3 RODTOROD COUPLING DIA 058/11MM 2025785 CDM 272 RC facility both 2200 2200 Gross Charge Type: NIHD_Hosp_Profee_Price HOFFMANN3 RODTOROD COUPLING DIA 058/11MM 2025785 CDM 272 RC facility both 2200 2200 Gross Charge Type: NIHD_Hosp_Profee_Price PINTOROD COUPLING DIA4/5/6MM DIA5/8/11MM 2025787 CDM 272 RC facility both 2014 2014 Gross Charge Type: NIHD_Hosp_Profee_Price PINTOROD COUPLING DIA4/5/6MM DIA5/8/11MM 2025787 CDM 272 RC facility both 2014 2014 Gross Charge Type: NIHD_Hosp_Profee_Price HOFFMANN3 5 HOLE PIN CLAMP DIA 4/5/6MM 2025789 CDM 278 RC facility both 2562 2562 Gross Charge Type: NIHD_Hosp_Profee_Price HOFFMANN3 5 HOLE PIN CLAMP DIA 4/5/6MM 2025789 CDM 278 RC facility both 2562 2562 Gross Charge Type: NIHD_Hosp_Profee_Price HOFFMANN3 POST STRAIGHT DIA 11MM 2025790 CDM 272 RC facility both 484 484 Gross Charge Type: NIHD_Hosp_Profee_Price HOFFMANN3 POST STRAIGHT DIA 11MM 2025790 CDM 272 RC facility both 484 484 Gross Charge Type: NIHD_Hosp_Profee_Price HOFFMANN3 POST 30DEG ANGLED DIA 11MM 2025791 CDM 272 RC facility both 399 399 Gross Charge Type: NIHD_Hosp_Profee_Price HOFFMANN3 POST 30DEG ANGLED DIA 11MM 2025791 CDM 272 RC facility both 399 399 Gross Charge Type: NIHD_Hosp_Profee_Price HOFFMANN3 POST 90DEG ANGLED DIA 11MM 2025792 CDM 272 RC facility both 644 644 Gross Charge Type: NIHD_Hosp_Profee_Price HOFFMANN3 POST 90DEG ANGLED DIA 11MM 2025792 CDM 272 RC facility both 644 644 Gross Charge Type: NIHD_Hosp_Profee_Price 5HOLE PIN CLAMP 2 POSTS 30DEG DIA4/5/6MM 2025793 CDM 278 RC facility both 2472 2472 Gross Charge Type: NIHD_Hosp_Profee_Price 5HOLE PIN CLAMP 2 POSTS 30DEG DIA4/5/6MM 2025793 CDM 278 RC facility both 2472 2472 Gross Charge Type: NIHD_Hosp_Profee_Price SEMI-CIRCULAR CURVED ROD 011X220MM 2025794 CDM 272 RC facility both 1276 1276 Gross Charge Type: NIHD_Hosp_Profee_Price SEMI-CIRCULAR CURVED ROD 011X220MM 2025794 CDM 272 RC facility both 1276 1276 Gross Charge Type: NIHD_Hosp_Profee_Price HOFFMANN3 CONNECTING ROD DIA 11X150MM 2025795 CDM 272 RC facility both 1091 1091 Gross Charge Type: NIHD_Hosp_Profee_Price HOFFMANN3 CONNECTING ROD DIA 11X150MM 2025795 CDM 272 RC facility both 1091 1091 Gross Charge Type: NIHD_Hosp_Profee_Price HOFFMANN3 CONNECTING ROD DIA 11X250MM 2025796 CDM 272 RC facility both 1267 1267 Gross Charge Type: NIHD_Hosp_Profee_Price HOFFMANN3 CONNECTING ROD DIA 11X250MM 2025796 CDM 272 RC facility both 1267 1267 Gross Charge Type: NIHD_Hosp_Profee_Price HOFFMANN3 CONNECTING ROD DIA 11X350MM 2025797 CDM 272 RC facility both 1149 1149 Gross Charge Type: NIHD_Hosp_Profee_Price HOFFMANN3 CONNECTING ROD DIA 11X350MM 2025797 CDM 272 RC facility both 1149 1149 Gross Charge Type: NIHD_Hosp_Profee_Price HOFFMANN3 CONNECTING ROD DIA 11X400MM 2025798 CDM 278 RC facility both 1487 1487 Gross Charge Type: NIHD_Hosp_Profee_Price HOFFMANN3 CONNECTING ROD DIA 11X400MM 2025798 CDM 278 RC facility both 1487 1487 Gross Charge Type: NIHD_Hosp_Profee_Price HOFFMANN3 CONNECTING ROD DIA 11X450MM 2025799 CDM 272 RC facility both 1315 1315 Gross Charge Type: NIHD_Hosp_Profee_Price HOFFMANN3 CONNECTING ROD DIA 11X450MM 2025799 CDM 272 RC facility both 1315 1315 Gross Charge Type: NIHD_Hosp_Profee_Price 5X150 APEX S/D HALF PIN 40 THR 2025811 CDM 278 RC facility both 335 335 Gross Charge Type: NIHD_Hosp_Profee_Price 5X150 APEX S/D HALF PIN 40 THR 2025811 CDM 278 RC facility both 335 335 Gross Charge Type: NIHD_Hosp_Profee_Price 5X150 APEX S/D HALF PIN 50 THR 2025812 CDM 278 RC facility both 589 589 Gross Charge Type: NIHD_Hosp_Profee_Price 5X150 APEX S/D HALF PIN 50 THR 2025812 CDM 278 RC facility both 589 589 Gross Charge Type: NIHD_Hosp_Profee_Price 5X180 APEX S/D HALF PIN 50 THR 5018-6-180 2025813 CDM 278 RC facility both 335 335 Gross Charge Type: NIHD_Hosp_Profee_Price 5X180 APEX S/D HALF PIN 50 THR 5018-6-180 2025813 CDM 278 RC facility both 335 335 Gross Charge Type: NIHD_Hosp_Profee_Price 5X200 APEX S/D HALF PIN 60 THR 2025814 CDM 278 RC facility both 291 291 Gross Charge Type: NIHD_Hosp_Profee_Price 5X200 APEX S/D HALF PIN 60 THR 2025814 CDM 278 RC facility both 291 291 Gross Charge Type: NIHD_Hosp_Profee_Price 5X250 APEX S/D HALF PIN 70 THR 2025815 CDM 278 RC facility both 589 589 Gross Charge Type: NIHD_Hosp_Profee_Price 5X250 APEX S/D HALF PIN 70 THR 2025815 CDM 278 RC facility both 589 589 Gross Charge Type: NIHD_Hosp_Profee_Price 4X120 APEX S/D HALF PIN 30 THR 2025816 CDM 278 RC facility both 476 476 Gross Charge Type: NIHD_Hosp_Profee_Price 4X120 APEX S/D HALF PIN 30 THR 2025816 CDM 278 RC facility both 476 476 Gross Charge Type: NIHD_Hosp_Profee_Price SELF-DRILLING1/2PIN APEX DIA3/5MMX20X120 2025819 CDM 278 RC facility both 617 617 Gross Charge Type: NIHD_Hosp_Profee_Price SELF-DRILLING1/2PIN APEX DIA3/5MMX20X120 2025819 CDM 278 RC facility both 617 617 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM PROTECTIVE TIP CAPS WHITE 2025820 CDM 272 RC facility both 175 175 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM PROTECTIVE TIP CAPS WHITE 2025820 CDM 272 RC facility both 175 175 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM PROTECTIVE TIP CAPS BLUE 2025821 CDM 272 RC facility both 103 103 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM PROTECTIVE TIP CAPS BLUE 2025821 CDM 272 RC facility both 103 103 Gross Charge Type: NIHD_Hosp_Profee_Price APEX TRANSFIX 4X250 PIN 5X50THR 2025822 CDM 278 RC facility both 312 312 Gross Charge Type: NIHD_Hosp_Profee_Price APEX TRANSFIX 4X250 PIN 5X50THR 2025822 CDM 278 RC facility both 312 312 Gross Charge Type: NIHD_Hosp_Profee_Price 3MM PROTECTIVE TIP CAPS WHITE 2025827 CDM 272 RC facility both 177 177 Gross Charge Type: NIHD_Hosp_Profee_Price 3MM PROTECTIVE TIP CAPS WHITE 2025827 CDM 272 RC facility both 177 177 Gross Charge Type: NIHD_Hosp_Profee_Price TRANSFIXING PIN APEX 05/6MM 40MMX300MM 2025834 CDM 278 RC facility both 312 312 Gross Charge Type: NIHD_Hosp_Profee_Price TRANSFIXING PIN APEX 05/6MM 40MMX300MM 2025834 CDM 278 RC facility both 312 312 Gross Charge Type: NIHD_Hosp_Profee_Price GRAY PT DRILL 3.2MMX200MM 2025836 CDM 272 RC facility both 229 229 Gross Charge Type: NIHD_Hosp_Profee_Price GRAY PT DRILL 3.2MMX200MM 2025836 CDM 272 RC facility both 229 229 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL 4.0MM FOR 0.5 PINS 2025837 CDM 272 RC facility both 234 234 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL 4.0MM FOR 0.5 PINS 2025837 CDM 272 RC facility both 234 234 Gross Charge Type: NIHD_Hosp_Profee_Price GRAY PT DRILL 4.5MMX200MM 2025838 CDM 278 RC facility both 249 249 Gross Charge Type: NIHD_Hosp_Profee_Price GRAY PT DRILL 4.5MMX200MM 2025838 CDM 278 RC facility both 249 249 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X5MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025846 CDM 278 RC facility both 413 413 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X5MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025846 CDM 278 RC facility both 413 413 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X6MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025847 CDM 278 RC facility both 413 413 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X6MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025847 CDM 278 RC facility both 413 413 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X7MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025848 CDM 278 RC facility both 413 413 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X7MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025848 CDM 278 RC facility both 413 413 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X8MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025849 CDM 278 RC facility both 335 335 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X8MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025849 CDM 278 RC facility both 335 335 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X9MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025850 CDM 278 RC facility both 335 335 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X9MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025850 CDM 278 RC facility both 335 335 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X10MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025851 CDM 278 RC facility both 335 335 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X10MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025851 CDM 278 RC facility both 335 335 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X11MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025852 CDM 278 RC facility both 413 413 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X11MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025852 CDM 278 RC facility both 413 413 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X12MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025853 CDM 278 RC facility both 413 413 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X12MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025853 CDM 278 RC facility both 413 413 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X13MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025854 CDM 278 RC facility both 335 335 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X13MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025854 CDM 278 RC facility both 335 335 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X14MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025855 CDM 278 RC facility both 335 335 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X14MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025855 CDM 278 RC facility both 335 335 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X15MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025856 CDM 278 RC facility both 413 413 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X15MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025856 CDM 278 RC facility both 413 413 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X16MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025857 CDM 278 RC facility both 413 413 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X16MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025857 CDM 278 RC facility both 413 413 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X18MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025858 CDM 278 RC facility both 413 413 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X18MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025858 CDM 278 RC facility both 413 413 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X20MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025859 CDM 278 RC facility both 413 413 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X20MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025859 CDM 278 RC facility both 413 413 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X22MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025860 CDM 278 RC facility both 413 413 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X22MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025860 CDM 278 RC facility both 413 413 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X24MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025861 CDM 278 RC facility both 413 413 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7X24MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025861 CDM 278 RC facility both 413 413 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING PEGS T7 2.0X16MM 2025862 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING PEGS T7 2.0X16MM 2025862 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING PEGS T7 2.0X18MM 2025863 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING PEGS T7 2.0X18MM 2025863 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING PEGS T7 2.0X20MM 2025864 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING PEGS T7 2.0X20MM 2025864 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING PEGS T7 2.0X22MM 2025865 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING PEGS T7 2.0X22MM 2025865 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING PEGS T7 2.0X24MM 2025866 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING PEGS T7 2.0X24MM 2025866 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING PEGS T7 2.0X26MM 2025867 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING PEGS T7 2.0X26MM 2025867 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price "2.3X6MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025868 CDM 278 RC facility both 414 414 Gross Charge Type: NIHD_Hosp_Profee_Price "2.3X6MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025868 CDM 278 RC facility both 414 414 Gross Charge Type: NIHD_Hosp_Profee_Price "2.3X8MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025869 CDM 278 RC facility both 336 336 Gross Charge Type: NIHD_Hosp_Profee_Price "2.3X8MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025869 CDM 278 RC facility both 336 336 Gross Charge Type: NIHD_Hosp_Profee_Price "2.3X9MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025870 CDM 278 RC facility both 414 414 Gross Charge Type: NIHD_Hosp_Profee_Price "2.3X9MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025870 CDM 278 RC facility both 414 414 Gross Charge Type: NIHD_Hosp_Profee_Price "2.3X10MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025871 CDM 278 RC facility both 230 230 Gross Charge Type: NIHD_Hosp_Profee_Price "2.3X10MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025871 CDM 278 RC facility both 230 230 Gross Charge Type: NIHD_Hosp_Profee_Price "2.3X13MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025874 CDM 278 RC facility both 414 414 Gross Charge Type: NIHD_Hosp_Profee_Price "2.3X13MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025874 CDM 278 RC facility both 414 414 Gross Charge Type: NIHD_Hosp_Profee_Price "2.3X14MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025875 CDM 278 RC facility both 230 230 Gross Charge Type: NIHD_Hosp_Profee_Price "2.3X14MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025875 CDM 278 RC facility both 230 230 Gross Charge Type: NIHD_Hosp_Profee_Price "2.3X15MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025876 CDM 278 RC facility both 414 414 Gross Charge Type: NIHD_Hosp_Profee_Price "2.3X15MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025876 CDM 278 RC facility both 414 414 Gross Charge Type: NIHD_Hosp_Profee_Price "2.3X16MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025877 CDM 278 RC facility both 336 336 Gross Charge Type: NIHD_Hosp_Profee_Price "2.3X16MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025877 CDM 278 RC facility both 336 336 Gross Charge Type: NIHD_Hosp_Profee_Price "2.3X18MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025878 CDM 278 RC facility both 336 336 Gross Charge Type: NIHD_Hosp_Profee_Price "2.3X18MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025878 CDM 278 RC facility both 336 336 Gross Charge Type: NIHD_Hosp_Profee_Price "2.3X20MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025879 CDM 278 RC facility both 414 414 Gross Charge Type: NIHD_Hosp_Profee_Price "2.3X20MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025879 CDM 278 RC facility both 414 414 Gross Charge Type: NIHD_Hosp_Profee_Price "2.3X22MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025880 CDM 278 RC facility both 414 414 Gross Charge Type: NIHD_Hosp_Profee_Price "2.3X22MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025880 CDM 278 RC facility both 414 414 Gross Charge Type: NIHD_Hosp_Profee_Price "2.3X24MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025881 CDM 278 RC facility both 414 414 Gross Charge Type: NIHD_Hosp_Profee_Price "2.3X24MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025881 CDM 278 RC facility both 414 414 Gross Charge Type: NIHD_Hosp_Profee_Price "2.3X26MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025882 CDM 278 RC facility both 336 336 Gross Charge Type: NIHD_Hosp_Profee_Price "2.3X26MM LOCKING SCREWS,CROSS-PIN,SELF-T" 2025882 CDM 278 RC facility both 336 336 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.3X10MM 2025883 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.3X10MM 2025883 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.3X12MM 2025884 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.3X12MM 2025884 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.3X14MM 2025885 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.3X14MM 2025885 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.3X16MM 2025886 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.3X16MM 2025886 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.3X18MM 2025887 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.3X18MM 2025887 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.3X20MM 2025888 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.3X20MM 2025888 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.3X22MM 2025889 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.3X22MM 2025889 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.3X24MM 2025890 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.3X24MM 2025890 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.3X26MM 2025891 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.3X26MM 2025891 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.3X28MM 2025892 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.3X28MM 2025892 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.3X18MM 2025902 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.3X18MM 2025902 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.3X20MM 2025903 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.3X20MM 2025903 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.3X22MM 2025904 CDM 278 RC facility both 242 242 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.3X22MM 2025904 CDM 278 RC facility both 242 242 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.3X24MM 2025905 CDM 278 RC facility both 242 242 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.3X24MM 2025905 CDM 278 RC facility both 242 242 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.3X26MM 2025906 CDM 278 RC facility both 457 457 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.3X26MM 2025906 CDM 278 RC facility both 457 457 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.3X28MM 2025907 CDM 278 RC facility both 457 457 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.3X28MM 2025907 CDM 278 RC facility both 457 457 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.3X30MM 2025908 CDM 278 RC facility both 457 457 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.3X30MM 2025908 CDM 278 RC facility both 457 457 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.3X32MM 2025909 CDM 278 RC facility both 457 457 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.3X32MM 2025909 CDM 278 RC facility both 457 457 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.3X34MM 2025910 CDM 278 RC facility both 457 457 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.3X34MM 2025910 CDM 278 RC facility both 457 457 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.3X36MM 2025911 CDM 278 RC facility both 457 457 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.3X36MM 2025911 CDM 278 RC facility both 457 457 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.3X38MM 2025912 CDM 278 RC facility both 457 457 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.3X38MM 2025912 CDM 278 RC facility both 457 457 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X12MM 53-27212E 2025920 CDM 278 RC facility both 181 181 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X12MM 53-27212E 2025920 CDM 278 RC facility both 181 181 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X14MM 53-27214E 2025921 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X14MM 53-27214E 2025921 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X16MM 53-27216E 2025922 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X16MM 53-27216E 2025922 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X18MM 2025923 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X18MM 2025923 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X20MM 53-27220E 2025924 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X20MM 53-27220E 2025924 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X22MM 53-27222E 2025925 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X22MM 53-27222E 2025925 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X24MM 53-27224E 2025926 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X24MM 53-27224E 2025926 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X26MM 53-27226E 2025927 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T7 2.7X26MM 53-27226E 2025927 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.7X10MM 2025928 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.7X10MM 2025928 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.7X12MM 2025929 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.7X12MM 2025929 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price "2.7MM TITANIUM BONESCREW,CROSSPIN,SELF14" 2025930 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price "2.7MM TITANIUM BONESCREW,CROSSPIN,SELF14" 2025930 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price "2.7MM TITANIUM LOCKING SCREW,CROSS-PIN,S 53-27616E" 2025931 CDM 278 RC facility both 242 242 Gross Charge Type: NIHD_Hosp_Profee_Price "2.7MM TITANIUM LOCKING SCREW,CROSS-PIN,S 53-27616E" 2025931 CDM 278 RC facility both 242 242 Gross Charge Type: NIHD_Hosp_Profee_Price "2.7MM TITANIUM LOCKING SCREW,CROSS-PIN,S 53-27618E" 2025932 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price "2.7MM TITANIUM LOCKING SCREW,CROSS-PIN,S 53-27618E" 2025932 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.7X20MM 2025933 CDM 278 RC facility both 242 242 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.7X20MM 2025933 CDM 278 RC facility both 242 242 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.7X22MM 2025934 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.7X22MM 2025934 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.7X24MM 2025935 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREWS T7 2.7X24MM 2025935 CDM 278 RC facility both 458 458 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR SMARTLOCK DR PLATE NARROW LEFT 2025949 CDM 278 RC facility both 2339 2339 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR SMARTLOCK DR PLATE NARROW LEFT 2025949 CDM 278 RC facility both 2339 2339 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR SMARTLOCK DR PLATE NARROW LFT LONG 2025950 CDM 278 RC facility both 3945 3945 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR SMARTLOCK DR PLATE NARROW LFT LONG 2025950 CDM 278 RC facility both 3945 3945 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR SMARTLOCK DR PLATE STANDARD LEFT 2025951 CDM 278 RC facility both 2339 2339 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR SMARTLOCK DR PLATE STANDARD LEFT 2025951 CDM 278 RC facility both 2339 2339 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR SMARTLOCK DR PLATE STANDARD L LONG 2025952 CDM 278 RC facility both 3945 3945 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR SMARTLOCK DR PLATE STANDARD L LONG 2025952 CDM 278 RC facility both 3945 3945 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR SMARTLOCK DR PLATE NARROW RIGHT 2025953 CDM 278 RC facility both 2339 2339 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR SMARTLOCK DR PLATE NARROW RIGHT 2025953 CDM 278 RC facility both 2339 2339 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR SMARTLOCK DR PLATE NARROW R LONG 2025956 CDM 278 RC facility both 3945 3945 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR SMARTLOCK DR PLATE NARROW R LONG 2025956 CDM 278 RC facility both 3945 3945 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR SMARTLOCK DR PLATE STANDARD RIGHT 2025957 CDM 278 RC facility both 2339 2339 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR SMARTLOCK DR PLATE STANDARD RIGHT 2025957 CDM 278 RC facility both 2339 2339 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR SMARTLOCK DR PLATE STANDARD R LONG 2025958 CDM 278 RC facility both 3945 3945 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR SMARTLOCK DR PLATE STANDARD R LONG 2025958 CDM 278 RC facility both 3945 3945 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR DR PLATE NARROW L 8HOLES XTRASHORT 2025965 CDM 278 RC facility both 3648 3648 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR DR PLATE NARROW L 8HOLES XTRASHORT 2025965 CDM 278 RC facility both 3648 3648 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR DR PLATE NARROW R 8HOLES XTRASHORT 2025966 CDM 278 RC facility both 3648 3648 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR DR PLATE NARROW R 8HOLES XTRASHORT 2025966 CDM 278 RC facility both 3648 3648 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR DR PLATE INTERMEDIATE LEFT 14HOLES 2025967 CDM 278 RC facility both 4204 4204 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR DR PLATE INTERMEDIATE LEFT 14HOLES 2025967 CDM 278 RC facility both 4204 4204 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR DR PLATE INTERMEDIATE RIGHT14HOLES 2025968 CDM 278 RC facility both 4204 4204 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR DR PLATE INTERMEDIATE RIGHT14HOLES 2025968 CDM 278 RC facility both 4204 4204 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR DR PLATE STANDARD LEFT 10HOLES XTR 2025969 CDM 278 RC facility both 3648 3648 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR DR PLATE STANDARD LEFT 10HOLES XTR 2025969 CDM 278 RC facility both 3648 3648 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR DR PLATE STANDARD RIGHT10HOLES XTR 2025970 CDM 278 RC facility both 3648 3648 Gross Charge Type: NIHD_Hosp_Profee_Price VOLAR DR PLATE STANDARD RIGHT10HOLES XTR 2025970 CDM 278 RC facility both 3648 3648 Gross Charge Type: NIHD_Hosp_Profee_Price K-WIRE W/ 17MM STOP 2025971 CDM 278 RC facility both 163 163 Gross Charge Type: NIHD_Hosp_Profee_Price K-WIRE W/ 17MM STOP 2025971 CDM 278 RC facility both 163 163 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7 S PROFYLE HAND LOCK 3-D PLATE,2X2H" 2025982 CDM 278 RC facility both 2021 2021 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7 S PROFYLE HAND LOCK 3-D PLATE,2X2H" 2025982 CDM 278 RC facility both 2021 2021 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7 S PROFYLE HAND LOCK 3-D PLATE,3X2H" 2025983 CDM 278 RC facility both 2021 2021 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7 S PROFYLE HAND LOCK 3-D PLATE,3X2H" 2025983 CDM 278 RC facility both 2021 2021 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7 S PROFYLE HAND LOCK 3-D PLATE,4X2H" 2025984 CDM 278 RC facility both 2021 2021 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7 S PROFYLE HAND LOCK 3-D PLATE,4X2H" 2025984 CDM 278 RC facility both 2021 2021 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7 S PROFYLE HAND LOCK 3-D REPL PL,4X2H" 2025985 CDM 278 RC facility both 2021 2021 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7 S PROFYLE HAND LOCK 3-D REPL PL,4X2H" 2025985 CDM 278 RC facility both 2021 2021 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7 S PROFYLE HAND LOCK 3-D PLATE,2X2+2H" 2025986 CDM 278 RC facility both 2021 2021 Gross Charge Type: NIHD_Hosp_Profee_Price "1.7 S PROFYLE HAND LOCK 3-D PLATE,2X2+2H" 2025986 CDM 278 RC facility both 2021 2021 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X5MM BONE SCREWSCROSSPINSELFTAPPING 2026007 CDM 278 RC facility both 341 341 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X5MM BONE SCREWSCROSSPINSELFTAPPING 2026007 CDM 278 RC facility both 341 341 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X6MM BONE SCREWSCROSSPINSELFTAPPING 2026008 CDM 278 RC facility both 262 262 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X6MM BONE SCREWSCROSSPINSELFTAPPING 2026008 CDM 278 RC facility both 262 262 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X7MM BONE SCREWSCROSSPINSELFTAPPING 2026009 CDM 278 RC facility both 341 341 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X7MM BONE SCREWSCROSSPINSELFTAPPING 2026009 CDM 278 RC facility both 341 341 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X8MM BONE SCREWSCROSSPINSELFTAPPING 2026010 CDM 278 RC facility both 262 262 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X8MM BONE SCREWSCROSSPINSELFTAPPING 2026010 CDM 278 RC facility both 262 262 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X9MM BONE SCREWSCROSSPINSELFTAPPING 2026011 CDM 278 RC facility both 262 262 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X9MM BONE SCREWSCROSSPINSELFTAPPING 2026011 CDM 278 RC facility both 262 262 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X10MM BONE SCREWSCROSSPINSELFTAPPING 2026012 CDM 278 RC facility both 262 262 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X10MM BONE SCREWSCROSSPINSELFTAPPING 2026012 CDM 278 RC facility both 262 262 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X11MM BONE SCREWSCROSSPINSELFTAPPING 2026013 CDM 278 RC facility both 262 262 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X11MM BONE SCREWSCROSSPINSELFTAPPING 2026013 CDM 278 RC facility both 262 262 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X12MM BONE SCREWSCROSSPINSELFTAPPING 2026014 CDM 278 RC facility both 262 262 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X12MM BONE SCREWSCROSSPINSELFTAPPING 2026014 CDM 278 RC facility both 262 262 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X13MM BONE SCREWSCROSSPINSELFTAPPING 2026015 CDM 278 RC facility both 262 262 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X13MM BONE SCREWSCROSSPINSELFTAPPING 2026015 CDM 278 RC facility both 262 262 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X14MM BONE SCREWSCROSSPINSELFTAPPING 2026016 CDM 278 RC facility both 341 341 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X14MM BONE SCREWSCROSSPINSELFTAPPING 2026016 CDM 278 RC facility both 341 341 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X15MM BONE SCREWSCROSSPINSELFTAPPING 2026017 CDM 278 RC facility both 341 341 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X15MM BONE SCREWSCROSSPINSELFTAPPING 2026017 CDM 278 RC facility both 341 341 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X16MM BONE SCREWSCROSSPINSELFTAPPING 2026018 CDM 278 RC facility both 341 341 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X16MM BONE SCREWSCROSSPINSELFTAPPING 2026018 CDM 278 RC facility both 341 341 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X18MM BONE SCREWSCROSSPINSELFTAPPING 2026019 CDM 278 RC facility both 341 341 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X18MM BONE SCREWSCROSSPINSELFTAPPING 2026019 CDM 278 RC facility both 341 341 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X20MM BONE SCREWSCROSSPINSELFTAPPING 2026020 CDM 278 RC facility both 341 341 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X20MM BONE SCREWSCROSSPINSELFTAPPING 2026020 CDM 278 RC facility both 341 341 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X22MM BONE SCREWSCROSSPINSELFTAPPING 2026021 CDM 278 RC facility both 341 341 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X22MM BONE SCREWSCROSSPINSELFTAPPING 2026021 CDM 278 RC facility both 341 341 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X24MM BONE SCREWSCROSSPINSELFTAPPING 2026022 CDM 278 RC facility both 341 341 Gross Charge Type: NIHD_Hosp_Profee_Price 1.7X24MM BONE SCREWSCROSSPINSELFTAPPING 2026022 CDM 278 RC facility both 341 341 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3X6MM BONE SCREWSCROSSPINSELFTAPPING 2026027 CDM 278 RC facility both 264 264 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3X6MM BONE SCREWSCROSSPINSELFTAPPING 2026027 CDM 278 RC facility both 264 264 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3X8MM BONE SCREWSCROSSPINSELFTAPPING 2026028 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3X8MM BONE SCREWSCROSSPINSELFTAPPING 2026028 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3X9MM BONE SCREWSCROSSPINSELFTAPPING 2026029 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3X9MM BONE SCREWSCROSSPINSELFTAPPING 2026029 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3X10MM BONE SCREWSCROSSPINSELFTAPPING 2026030 CDM 278 RC facility both 264 264 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3X10MM BONE SCREWSCROSSPINSELFTAPPING 2026030 CDM 278 RC facility both 264 264 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3X12MM BONE SCREWSCROSSPINSELFTAPPING 2026032 CDM 278 RC facility both 264 264 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3X12MM BONE SCREWSCROSSPINSELFTAPPING 2026032 CDM 278 RC facility both 264 264 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3X13MM BONE SCREWSCROSSPINSELFTAPPING 2026033 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3X13MM BONE SCREWSCROSSPINSELFTAPPING 2026033 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3X14MM BONE SCREWSCROSSPINSELFTAPPING 2026034 CDM 278 RC facility both 264 264 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3X14MM BONE SCREWSCROSSPINSELFTAPPING 2026034 CDM 278 RC facility both 264 264 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3X16MM BONE SCREWSCROSSPINSELFTAPPING 2026036 CDM 278 RC facility both 192 192 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3X16MM BONE SCREWSCROSSPINSELFTAPPING 2026036 CDM 278 RC facility both 192 192 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3X18MM BONE SCREWSCROSSPINSELFTAPPING 2026037 CDM 278 RC facility both 192 192 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3X18MM BONE SCREWSCROSSPINSELFTAPPING 2026037 CDM 278 RC facility both 192 192 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3X20MM BONE SCREWSCROSSPINSELFTAPPING 2026038 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3X20MM BONE SCREWSCROSSPINSELFTAPPING 2026038 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3X22MM BONE SCREWSCROSSPINSELFTAPPING 2026039 CDM 278 RC facility both 264 264 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3X22MM BONE SCREWSCROSSPINSELFTAPPING 2026039 CDM 278 RC facility both 264 264 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3X24MM BONE SCREWSCROSSPINSELFTAPPING 2026040 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3X24MM BONE SCREWSCROSSPINSELFTAPPING 2026040 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3X26MM BONE SCREWSCROSSPINSELFTAPPING 2026041 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3X26MM BONE SCREWSCROSSPINSELFTAPPING 2026041 CDM 278 RC facility both 343 343 Gross Charge Type: NIHD_Hosp_Profee_Price 2.5X6MM EMERG SCREWSCROSSPINSELFT 2026042 CDM 278 RC facility both 341 341 Gross Charge Type: NIHD_Hosp_Profee_Price 2.5X6MM EMERG SCREWSCROSSPINSELFT 2026042 CDM 278 RC facility both 341 341 Gross Charge Type: NIHD_Hosp_Profee_Price 2.5X8MM EMERG SCREWSCROSSPINSELFT 2026043 CDM 278 RC facility both 341 341 Gross Charge Type: NIHD_Hosp_Profee_Price 2.5X8MM EMERG SCREWSCROSSPINSELFT 2026043 CDM 278 RC facility both 341 341 Gross Charge Type: NIHD_Hosp_Profee_Price 2.5X10MM EMERG SCREWSCROSSPINSELFT 2026044 CDM 278 RC facility both 264 264 Gross Charge Type: NIHD_Hosp_Profee_Price 2.5X10MM EMERG SCREWSCROSSPINSELFT 2026044 CDM 278 RC facility both 264 264 Gross Charge Type: NIHD_Hosp_Profee_Price 2.5X12MM EMERG SCREWSCROSSPINSELFT 2026045 CDM 278 RC facility both 264 264 Gross Charge Type: NIHD_Hosp_Profee_Price 2.5X12MM EMERG SCREWSCROSSPINSELFT 2026045 CDM 278 RC facility both 264 264 Gross Charge Type: NIHD_Hosp_Profee_Price "STND BARREL HIP PLATE,KEYED 130DEG,3HOLE" 2026050 CDM 278 RC facility both 2452 2452 Gross Charge Type: NIHD_Hosp_Profee_Price "STND BARREL HIP PLATE,KEYED 130DEG,3HOLE" 2026050 CDM 278 RC facility both 2452 2452 Gross Charge Type: NIHD_Hosp_Profee_Price "STND BARREL HIP PLATE,KEYED 130DEG,4HOLE" 2026051 CDM 278 RC facility both 2452 2452 Gross Charge Type: NIHD_Hosp_Profee_Price "STND BARREL HIP PLATE,KEYED 130DEG,4HOLE" 2026051 CDM 278 RC facility both 2452 2452 Gross Charge Type: NIHD_Hosp_Profee_Price "STND BARREL HIP PLATE,KEYED 135DEG,2HOLE" 2026052 CDM 278 RC facility both 2452 2452 Gross Charge Type: NIHD_Hosp_Profee_Price "STND BARREL HIP PLATE,KEYED 135DEG,2HOLE" 2026052 CDM 278 RC facility both 2452 2452 Gross Charge Type: NIHD_Hosp_Profee_Price "STND BARREL HIP PLATE,KEYED 135DEG,3HOLE" 2026053 CDM 278 RC facility both 2452 2452 Gross Charge Type: NIHD_Hosp_Profee_Price "STND BARREL HIP PLATE,KEYED 135DEG,3HOLE" 2026053 CDM 278 RC facility both 2452 2452 Gross Charge Type: NIHD_Hosp_Profee_Price "STND BARREL HIP PLATE,KEYED 135DEG,4HOLE" 2026054 CDM 278 RC facility both 2452 2452 Gross Charge Type: NIHD_Hosp_Profee_Price "STND BARREL HIP PLATE,KEYED 135DEG,4HOLE" 2026054 CDM 278 RC facility both 2452 2452 Gross Charge Type: NIHD_Hosp_Profee_Price "STND BARREL HIP PLATE,KEYED 140DEG,2HOLE" 2026055 CDM 278 RC facility both 2452 2452 Gross Charge Type: NIHD_Hosp_Profee_Price "STND BARREL HIP PLATE,KEYED 140DEG,2HOLE" 2026055 CDM 278 RC facility both 2452 2452 Gross Charge Type: NIHD_Hosp_Profee_Price "STND BARREL HIP PLATE,KEYED 140DEG,3HOLE" 2026056 CDM 278 RC facility both 2452 2452 Gross Charge Type: NIHD_Hosp_Profee_Price "STND BARREL HIP PLATE,KEYED 140DEG,3HOLE" 2026056 CDM 278 RC facility both 2452 2452 Gross Charge Type: NIHD_Hosp_Profee_Price "STND BARREL HIP PLATE,KEYED 140DEG,4HOLE" 2026057 CDM 278 RC facility both 2452 2452 Gross Charge Type: NIHD_Hosp_Profee_Price "STND BARREL HIP PLATE,KEYED 140DEG,4HOLE" 2026057 CDM 278 RC facility both 2452 2452 Gross Charge Type: NIHD_Hosp_Profee_Price TWIST DRILL 1.4MM DIA AO 2026063 CDM 272 RC facility both 238 238 Gross Charge Type: NIHD_Hosp_Profee_Price TWIST DRILL 1.4MM DIA AO 2026063 CDM 272 RC facility both 238 238 Gross Charge Type: NIHD_Hosp_Profee_Price TWIST DRILL 1.9MM DIA AO 2026064 CDM 272 RC facility both 238 238 Gross Charge Type: NIHD_Hosp_Profee_Price TWIST DRILL 1.9MM DIA AO 2026064 CDM 272 RC facility both 238 238 Gross Charge Type: NIHD_Hosp_Profee_Price TWIST DRILL 100X40MM STRYKER SHAFT 2026065 CDM 272 RC facility both 428 428 Gross Charge Type: NIHD_Hosp_Profee_Price TWIST DRILL 100X40MM STRYKER SHAFT 2026065 CDM 272 RC facility both 428 428 Gross Charge Type: NIHD_Hosp_Profee_Price TWIST DRILL 2.5MM DIA. AO 2026066 CDM 272 RC facility both 238 238 Gross Charge Type: NIHD_Hosp_Profee_Price TWIST DRILL 2.5MM DIA. AO 2026066 CDM 272 RC facility both 238 238 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III TI CANN SCR 5X50MM 2026084 CDM 278 RC facility both 748 748 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III TI CANN SCR 5X50MM 2026084 CDM 278 RC facility both 748 748 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III TI CANN SCR 5X60MM 2026086 CDM 278 RC facility both 748 748 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III TI CANN SCR 5X60MM 2026086 CDM 278 RC facility both 748 748 Gross Charge Type: NIHD_Hosp_Profee_Price 6.5X80MM 20MM TI CANNULATED SCREW 2026099 CDM 278 RC facility both 697 697 Gross Charge Type: NIHD_Hosp_Profee_Price 6.5X80MM 20MM TI CANNULATED SCREW 2026099 CDM 278 RC facility both 697 697 Gross Charge Type: NIHD_Hosp_Profee_Price 6.5X90MM 20MM TI CANNULATED SCREW 2026101 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 6.5X90MM 20MM TI CANNULATED SCREW 2026101 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 6.5X105MM TI CANNULATED SCREW 602705 2026105 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 6.5X105MM TI CANNULATED SCREW 602705 2026105 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 6.5X115MM TI CANNULATED SCREW 602715 2026107 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 6.5X115MM TI CANNULATED SCREW 602715 2026107 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 6.5X120MM TI CANNULATED SCREW 602720 2026108 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 6.5X120MM TI CANNULATED SCREW 602720 2026108 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 6.5X55MM TI CANNULATED SCREW 602855 2026109 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 6.5X55MM TI CANNULATED SCREW 602855 2026109 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 6.5X60MM TI CANNULATED SCREW 602860 2026110 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 6.5X60MM TI CANNULATED SCREW 602860 2026110 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 6.5X80MM PART THREAD 40MMTI CANN SCREW 2026114 CDM 278 RC facility both 697 697 Gross Charge Type: NIHD_Hosp_Profee_Price 6.5X80MM PART THREAD 40MMTI CANN SCREW 2026114 CDM 278 RC facility both 697 697 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X14MM TI CANNULATED SCREW 2026123 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X14MM TI CANNULATED SCREW 2026123 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X16MM TI CANNULATED SCREW 2026124 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X16MM TI CANNULATED SCREW 2026124 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X18MM TI CANNULATED SCREW 2026125 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X18MM TI CANNULATED SCREW 2026125 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X20MM TI CANNULATED SCREW 2026126 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X20MM TI CANNULATED SCREW 2026126 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X22MM TI CANNULATED SCREW 2026127 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X22MM TI CANNULATED SCREW 2026127 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X24MM TI CANNULATED SCREW 2026128 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X24MM TI CANNULATED SCREW 2026128 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X26MM TI CANNULATED SCREW 2026129 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X26MM TI CANNULATED SCREW 2026129 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X28MM TI CANNULATED SCREW 2026130 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X28MM TI CANNULATED SCREW 2026130 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X30MM TI CANNULATED SCREW 2026131 CDM 278 RC facility both 446 446 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X30MM TI CANNULATED SCREW 2026131 CDM 278 RC facility both 446 446 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X32MM TI CANNULATED SCREW 2026132 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X32MM TI CANNULATED SCREW 2026132 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X34MM TI CANNULATED SCREW 2026133 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X34MM TI CANNULATED SCREW 2026133 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X36MM TI CANNULATED SCREW 2026134 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X36MM TI CANNULATED SCREW 2026134 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X38MM TI CANNULATED SCREW 2026135 CDM 278 RC facility both 446 446 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X38MM TI CANNULATED SCREW 2026135 CDM 278 RC facility both 446 446 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X40MM TI CANNULATED SCREW 2026136 CDM 278 RC facility both 446 446 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X40MM TI CANNULATED SCREW 2026136 CDM 278 RC facility both 446 446 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X42MM TI CANNULATED SCREW 2026137 CDM 278 RC facility both 446 446 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X42MM TI CANNULATED SCREW 2026137 CDM 278 RC facility both 446 446 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X44MM TI CANNULATED SCREW 2026138 CDM 278 RC facility both 446 446 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X44MM TI CANNULATED SCREW 2026138 CDM 278 RC facility both 446 446 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X46MM TI CANNULATED SCREW 2026139 CDM 278 RC facility both 446 446 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X46MM TI CANNULATED SCREW 2026139 CDM 278 RC facility both 446 446 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X48MM TI CANNULATED SCREW 2026140 CDM 278 RC facility both 446 446 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X48MM TI CANNULATED SCREW 2026140 CDM 278 RC facility both 446 446 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X50MM TI CANNULATED SCREW 2026141 CDM 278 RC facility both 446 446 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X50MM TI CANNULATED SCREW 2026141 CDM 278 RC facility both 446 446 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X55MM TI CANNULATED SCREW 2026142 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X55MM TI CANNULATED SCREW 2026142 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X60MM TI CANNULATED SCREW 2026143 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X60MM TI CANNULATED SCREW 2026143 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X65MM TI CANNULATED SCREW 2026144 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X65MM TI CANNULATED SCREW 2026144 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X70MM TI CANNULATED SCREW 2026145 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4.0X70MM TI CANNULATED SCREW 2026145 CDM 278 RC facility both 681 681 Gross Charge Type: NIHD_Hosp_Profee_Price 4MMCANCELLOUSTISCREW 04.0MM/L48MM/FULL T 2026163 CDM 278 RC facility both 105 105 Gross Charge Type: NIHD_Hosp_Profee_Price 4MMCANCELLOUSTISCREW 04.0MM/L48MM/FULL T 2026163 CDM 278 RC facility both 105 105 Gross Charge Type: NIHD_Hosp_Profee_Price 4MMCANCELLOUSTISCREW 04.0MM/L16MM/TL6MM 2026170 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price 4MMCANCELLOUSTISCREW 04.0MM/L16MM/TL6MM 2026170 CDM 278 RC facility both 140 140 Gross Charge Type: NIHD_Hosp_Profee_Price 6MMCANCELLOUSTISCREW 06.0MM/L20MM/FULL T 2026192 CDM 278 RC facility both 162 162 Gross Charge Type: NIHD_Hosp_Profee_Price 6MMCANCELLOUSTISCREW 06.0MM/L20MM/FULL T 2026192 CDM 278 RC facility both 162 162 Gross Charge Type: NIHD_Hosp_Profee_Price 6MMCANCELLOUSTISCREW 06.0MM/L85MM/TL16MM 2026219 CDM 272 RC facility both 162 162 Gross Charge Type: NIHD_Hosp_Profee_Price 6MMCANCELLOUSTISCREW 06.0MM/L85MM/TL16MM 2026219 CDM 272 RC facility both 162 162 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X40MM TI CANNULATED SCREW 2026233 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X40MM TI CANNULATED SCREW 2026233 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X45MM TI CANNULATED SCREW 2026234 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X45MM TI CANNULATED SCREW 2026234 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X50MM TI CANNULATED SCREW 2026235 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X50MM TI CANNULATED SCREW 2026235 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X55MM TI CANNULATED SCREW 2026236 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X55MM TI CANNULATED SCREW 2026236 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X60MM TI CANNULATED SCREW 2026237 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X60MM TI CANNULATED SCREW 2026237 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X65MM TI CANNULATED SCREW 2026238 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X65MM TI CANNULATED SCREW 2026238 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X70MM TI CANNULATED SCREW 2026239 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X70MM TI CANNULATED SCREW 2026239 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X75MM TI CANNULATED SCREW 2026240 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X75MM TI CANNULATED SCREW 2026240 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X80MM TI CANNULATED SCREW 2026241 CDM 278 RC facility both 1542 1542 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X80MM TI CANNULATED SCREW 2026241 CDM 278 RC facility both 1542 1542 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X85MM TI CANNULATED SCREW 2026242 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X85MM TI CANNULATED SCREW 2026242 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X90MM TI CANNULATED SCREW 2026243 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X90MM TI CANNULATED SCREW 2026243 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X95MM TI CANNULATED SCREW 2026244 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X95MM TI CANNULATED SCREW 2026244 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X100MM TI CANNULATED SCREW 2026245 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X100MM TI CANNULATED SCREW 2026245 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X105MM TI CANNULATED SCREW 2026246 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X105MM TI CANNULATED SCREW 2026246 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X110MM TI CANNULATED SCREW 2026247 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X110MM TI CANNULATED SCREW 2026247 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X115MM TI CANNULATED SCREW 2026248 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X115MM TI CANNULATED SCREW 2026248 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X120MM TI CANNULATED SCREW 2026249 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price 8.0X120MM TI CANNULATED SCREW 2026249 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 2.7X8MM" 2026250 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 2.7X8MM" 2026250 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 2.7X10MM" 2026251 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 2.7X10MM" 2026251 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 2.7X12MM" 2026252 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 2.7X12MM" 2026252 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 2.7X14MM" 2026253 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 2.7X14MM" 2026253 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 2.7X16MM" 2026254 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 2.7X16MM" 2026254 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 2.7X20MM" 2026256 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 2.7X20MM" 2026256 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 2.7X22MM" 2026257 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 2.7X22MM" 2026257 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 2.7X24MM" 2026258 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 2.7X24MM" 2026258 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 2.7X26MM" 2026259 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 2.7X26MM" 2026259 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 2.7X28MM" 2026260 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 2.7X28MM" 2026260 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 2.7X30MM" 2026261 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 2.7X30MM" 2026261 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X08MM" 2026276 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X08MM" 2026276 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X10MM" 2026277 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X10MM" 2026277 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X12MM" 2026278 CDM 278 RC facility both 352 352 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X12MM" 2026278 CDM 278 RC facility both 352 352 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X14MM" 2026279 CDM 278 RC facility both 352 352 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X14MM" 2026279 CDM 278 RC facility both 352 352 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X16MM" 2026280 CDM 278 RC facility both 352 352 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X16MM" 2026280 CDM 278 RC facility both 352 352 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X18MM" 2026281 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X18MM" 2026281 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X20MM" 2026282 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X20MM" 2026282 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X22MM" 2026283 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X22MM" 2026283 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X24MM" 2026284 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X24MM" 2026284 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X26MM" 2026285 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X26MM" 2026285 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X28MM" 2026286 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X28MM" 2026286 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X30MM" 2026287 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X30MM" 2026287 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X32MM" 2026288 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X32MM" 2026288 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X34MM" 2026289 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X34MM" 2026289 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X36MM" 2026290 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X36MM" 2026290 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X38MM" 2026291 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X38MM" 2026291 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT LOCKING MED 04.3X296MM 2026292 CDM 278 RC facility both 968 968 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT LOCKING MED 04.3X296MM 2026292 CDM 278 RC facility both 968 968 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L95MM 2026302 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L95MM 2026302 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 2.5X125MM(GOLD) 2026304 CDM 272 RC facility both 284 284 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 2.5X125MM(GOLD) 2026304 CDM 272 RC facility both 284 284 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 2.7X125MM 2026305 CDM 272 RC facility both 550 550 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 2.7X125MM 2026305 CDM 272 RC facility both 550 550 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 3.2MM/L180MM AO/CALIB 2026308 CDM 272 RC facility both 438 438 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 3.2MM/L180MM AO/CALIB 2026308 CDM 272 RC facility both 438 438 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 3.2MM/L145MM AO 2026309 CDM 272 RC facility both 662 662 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 3.2MM/L145MM AO 2026309 CDM 272 RC facility both 662 662 Gross Charge Type: NIHD_Hosp_Profee_Price CANN 2.7MM TWIST DRILL W/ AO F 2026310 CDM 272 RC facility both 691 691 Gross Charge Type: NIHD_Hosp_Profee_Price CANN 2.7MM TWIST DRILL W/ AO F 2026310 CDM 272 RC facility both 691 691 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III 1.4X150MM GUIDE WIRE 2026311 CDM 272 RC facility both 176 176 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III 1.4X150MM GUIDE WIRE 2026311 CDM 272 RC facility both 176 176 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III THREADED GUIDE WIRE 3.2X300MM 2026312 CDM 272 RC facility both 112 112 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III THREADED GUIDE WIRE 3.2X300MM 2026312 CDM 272 RC facility both 112 112 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL CANNULATED 4.9MM AO FIT 2026313 CDM 272 RC facility both 1007 1007 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL CANNULATED 4.9MM AO FIT 2026313 CDM 272 RC facility both 1007 1007 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III CANNULATED DRILL 8.0MM LG AO 2026316 CDM 278 RC facility both 1976 1976 Gross Charge Type: NIHD_Hosp_Profee_Price ASNIS III CANNULATED DRILL 8.0MM LG AO 2026316 CDM 278 RC facility both 1976 1976 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 2.3X125MM 2026318 CDM 272 RC facility both 435 435 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 2.3X125MM 2026318 CDM 272 RC facility both 435 435 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 3.1MM X 204MM 2026319 CDM 272 RC facility both 576 576 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 3.1MM X 204MM 2026319 CDM 272 RC facility both 576 576 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 4.3X262MM 2026320 CDM 278 RC facility both 357 357 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 4.3X262MM 2026320 CDM 278 RC facility both 357 357 Gross Charge Type: NIHD_Hosp_Profee_Price "DRILL, 2.0MMX122MM, WL50MM, AO-SHAFT" 2026327 CDM 272 RC facility both 329 329 Gross Charge Type: NIHD_Hosp_Profee_Price "DRILL, 2.0MMX122MM, WL50MM, AO-SHAFT" 2026327 CDM 272 RC facility both 329 329 Gross Charge Type: NIHD_Hosp_Profee_Price "DRILL, 2.6MMX122MM, WL70MM, AO-SHAFT" 2026328 CDM 272 RC facility both 329 329 Gross Charge Type: NIHD_Hosp_Profee_Price "DRILL, 2.6MMX122MM, WL70MM, AO-SHAFT" 2026328 CDM 272 RC facility both 329 329 Gross Charge Type: NIHD_Hosp_Profee_Price OVERDRILL 2.7DIA FOR LAGGING SCREWS 2026329 CDM 272 RC facility both 329 329 Gross Charge Type: NIHD_Hosp_Profee_Price OVERDRILL 2.7DIA FOR LAGGING SCREWS 2026329 CDM 272 RC facility both 329 329 Gross Charge Type: NIHD_Hosp_Profee_Price OVERDRILL 3.5DIA FOR LAGGING SCREWS 2026330 CDM 278 RC facility both 593 593 Gross Charge Type: NIHD_Hosp_Profee_Price OVERDRILL 3.5DIA FOR LAGGING SCREWS 2026330 CDM 278 RC facility both 593 593 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA+2.8MM THREADED TIP GUIDE PIN 230MM 2026333 CDM 272 RC facility both 197 197 Gross Charge Type: NIHD_Hosp_Profee_Price OMEGA+2.8MM THREADED TIP GUIDE PIN 230MM 2026333 CDM 272 RC facility both 197 197 Gross Charge Type: NIHD_Hosp_Profee_Price K-WIRE WITH DRILL TIP 02.0X234MM 2026334 CDM 272 RC facility both 203 203 Gross Charge Type: NIHD_Hosp_Profee_Price K-WIRE WITH DRILL TIP 02.0X234MM 2026334 CDM 272 RC facility both 203 203 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 2.5X216MM NONLOCKING SHORT 2026335 CDM 272 RC facility both 624 624 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 2.5X216MM NONLOCKING SHORT 2026335 CDM 272 RC facility both 624 624 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT LOCKING SHORT 03.1X216MM 2026336 CDM 272 RC facility both 615 615 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT LOCKING SHORT 03.1X216MM 2026336 CDM 272 RC facility both 615 615 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT LOCKING SHORT 03.2X216MM 2026337 CDM 278 RC facility both 992 992 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT LOCKING SHORT 03.2X216MM 2026337 CDM 278 RC facility both 992 992 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT LOCKING SHORT 04.3X216MM 2026339 CDM 278 RC facility both 979 979 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT LOCKING SHORT 04.3X216MM 2026339 CDM 278 RC facility both 979 979 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L50MM 2026340 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L50MM 2026340 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L55MM 2026341 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L55MM 2026341 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L60MM 2026342 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L60MM 2026342 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L65MM 2026343 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L65MM 2026343 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L95MM 2026349 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L95MM 2026349 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L14MM 2026350 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L14MM 2026350 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L16MM 2026351 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L16MM 2026351 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L18MM 2026352 CDM 278 RC facility both 196 196 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L18MM 2026352 CDM 278 RC facility both 196 196 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L20MM 2026353 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L20MM 2026353 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L22MM 2026354 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L22MM 2026354 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L24MM 2026355 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L24MM 2026355 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L26MM 2026356 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L26MM 2026356 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L28MM 2026357 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L28MM 2026357 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L30MM 2026358 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L30MM 2026358 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L32MM 2026359 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L32MM 2026359 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L34MM 2026360 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L34MM 2026360 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L36MM 2026361 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L36MM 2026361 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L38MM 2026362 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L38MM 2026362 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L40MM 2026363 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L40MM 2026363 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L42MM 2026364 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L42MM 2026364 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L44MM 2026365 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L44MM 2026365 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L46MM 2026366 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L46MM 2026366 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L48MM 2026367 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L48MM 2026367 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L50MM 2026368 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L50MM 2026368 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L55MM 2026369 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L55MM 2026369 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L60MM 2026370 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L60MM 2026370 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L65MM 2026371 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L65MM 2026371 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L70MM 2026372 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L70MM 2026372 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L75MM 2026373 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L75MM 2026373 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L80MM 2026374 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L80MM 2026374 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L85MM 2026375 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L85MM 2026375 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L90MM 2026376 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 4.5MM CORTEX TI SCREW 04.5MM/L90MM 2026376 CDM 278 RC facility both 147 147 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L48MM 2026378 CDM 278 RC facility both 648 648 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L48MM 2026378 CDM 278 RC facility both 648 648 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L50MM 2026379 CDM 278 RC facility both 648 648 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L50MM 2026379 CDM 278 RC facility both 648 648 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L55MM 2026380 CDM 278 RC facility both 648 648 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L55MM 2026380 CDM 278 RC facility both 648 648 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L60MM 2026381 CDM 278 RC facility both 648 648 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L60MM 2026381 CDM 278 RC facility both 648 648 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L65MM 2026382 CDM 278 RC facility both 648 648 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L65MM 2026382 CDM 278 RC facility both 648 648 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L70MM 2026383 CDM 278 RC facility both 648 648 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L70MM 2026383 CDM 278 RC facility both 648 648 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L75MM 2026384 CDM 278 RC facility both 648 648 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L75MM 2026384 CDM 278 RC facility both 648 648 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L80MM 2026385 CDM 278 RC facility both 648 648 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L80MM 2026385 CDM 278 RC facility both 648 648 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L85MM 2026386 CDM 278 RC facility both 459 459 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L85MM 2026386 CDM 278 RC facility both 459 459 Gross Charge Type: NIHD_Hosp_Profee_Price PERIPROSTHETIC LOCKING SCREW 5.0MM/L8MM 2026389 CDM 278 RC facility both 748 748 Gross Charge Type: NIHD_Hosp_Profee_Price PERIPROSTHETIC LOCKING SCREW 5.0MM/L8MM 2026389 CDM 278 RC facility both 748 748 Gross Charge Type: NIHD_Hosp_Profee_Price PERIPROSTHETIC LOCKING SCREW 5.0MM/L10MM 2026390 CDM 278 RC facility both 748 748 Gross Charge Type: NIHD_Hosp_Profee_Price PERIPROSTHETIC LOCKING SCREW 5.0MM/L10MM 2026390 CDM 278 RC facility both 748 748 Gross Charge Type: NIHD_Hosp_Profee_Price PERIPROSTHETIC LOCKING SCREW 5.0MM/L12MM 2026391 CDM 278 RC facility both 748 748 Gross Charge Type: NIHD_Hosp_Profee_Price PERIPROSTHETIC LOCKING SCREW 5.0MM/L12MM 2026391 CDM 278 RC facility both 748 748 Gross Charge Type: NIHD_Hosp_Profee_Price PERIPROSTHETIC LOCKING SCREW 5.0MM/L14MM 2026392 CDM 278 RC facility both 748 748 Gross Charge Type: NIHD_Hosp_Profee_Price PERIPROSTHETIC LOCKING SCREW 5.0MM/L14MM 2026392 CDM 278 RC facility both 748 748 Gross Charge Type: NIHD_Hosp_Profee_Price PERIPROSTHETIC LOCKING SCREW 5.0MM/L16MM 2026393 CDM 278 RC facility both 748 748 Gross Charge Type: NIHD_Hosp_Profee_Price PERIPROSTHETIC LOCKING SCREW 5.0MM/L16MM 2026393 CDM 278 RC facility both 748 748 Gross Charge Type: NIHD_Hosp_Profee_Price PERIPROSTHETIC LOCKING SCREW 5.0MM/L18MM 2026394 CDM 278 RC facility both 748 748 Gross Charge Type: NIHD_Hosp_Profee_Price PERIPROSTHETIC LOCKING SCREW 5.0MM/L18MM 2026394 CDM 278 RC facility both 748 748 Gross Charge Type: NIHD_Hosp_Profee_Price PERIPROSTHETIC LOCKING SCREW 5.0MM/L20MM 2026395 CDM 278 RC facility both 748 748 Gross Charge Type: NIHD_Hosp_Profee_Price PERIPROSTHETIC LOCKING SCREW 5.0MM/L20MM 2026395 CDM 278 RC facility both 748 748 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L14MM 2026396 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L14MM 2026396 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L16MM 2026397 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L16MM 2026397 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L18MM 2026398 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L18MM 2026398 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L20MM 2026399 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L20MM 2026399 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L22MM 2026400 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L22MM 2026400 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L24MM 2026401 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L24MM 2026401 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L26MM 2026402 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L26MM 2026402 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L28MM 2026403 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L28MM 2026403 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L30MM 2026404 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L30MM 2026404 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L32MM 2026405 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L32MM 2026405 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L34MM 2026406 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L34MM 2026406 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L36MM 2026407 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L36MM 2026407 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L38MM 2026408 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L38MM 2026408 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L40MM 2026409 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L40MM 2026409 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L42MM 2026410 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L42MM 2026410 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L44MM 2026411 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L44MM 2026411 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L46MM 2026412 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L46MM 2026412 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L48MM 2026413 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L48MM 2026413 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L28MM TITANIUM 2026414 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L28MM TITANIUM 2026414 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L30MM TITANIUM 2026415 CDM 278 RC facility both 550 550 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L30MM TITANIUM 2026415 CDM 278 RC facility both 550 550 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L32MM TITANIUM 2026416 CDM 278 RC facility both 550 550 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L32MM TITANIUM 2026416 CDM 278 RC facility both 550 550 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L34MM TITANIUM 2026417 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L34MM TITANIUM 2026417 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L36MM TITANIUM 2026418 CDM 278 RC facility both 550 550 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L36MM TITANIUM 2026418 CDM 278 RC facility both 550 550 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L38MM TITANIUM 2026419 CDM 278 RC facility both 550 550 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L38MM TITANIUM 2026419 CDM 278 RC facility both 550 550 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L40MM TITANIUM 2026420 CDM 278 RC facility both 550 550 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L40MM TITANIUM 2026420 CDM 278 RC facility both 550 550 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L42MM TITANIUM 2026421 CDM 278 RC facility both 550 550 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L42MM TITANIUM 2026421 CDM 278 RC facility both 550 550 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L44MM TITANIUM 2026422 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L44MM TITANIUM 2026422 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L46MM TITANIUM 2026423 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L46MM TITANIUM 2026423 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L48MM TITANIUM 2026424 CDM 278 RC facility both 550 550 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L48MM TITANIUM 2026424 CDM 278 RC facility both 550 550 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L50MM TITANIUM 2026425 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L50MM TITANIUM 2026425 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L55MM TITIANIUM 2026426 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L55MM TITIANIUM 2026426 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L60MM 2026427 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L60MM 2026427 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L65MM TITANIUM 2026428 CDM 278 RC facility both 550 550 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L65MM TITANIUM 2026428 CDM 278 RC facility both 550 550 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L70MM TITANIUM 2026429 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L70MM TITANIUM 2026429 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L75MM TITANIUM 2026430 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L75MM TITANIUM 2026430 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L80MM TITANIUM 2026431 CDM 278 RC facility both 550 550 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L80MM TITANIUM 2026431 CDM 278 RC facility both 550 550 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L85MM TITANIUM 2026432 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L85MM TITANIUM 2026432 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L90MM TITANIUM 2026433 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L90MM TITANIUM 2026433 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L95MM 2026434 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L95MM 2026434 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L20MM 2026438 CDM 278 RC facility both 71 71 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L20MM 2026438 CDM 278 RC facility both 71 71 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L28MM 2026442 CDM 278 RC facility both 317 317 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L28MM 2026442 CDM 278 RC facility both 317 317 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L30MM 2026443 CDM 278 RC facility both 317 317 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L30MM 2026443 CDM 278 RC facility both 317 317 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L34MM 2026445 CDM 278 RC facility both 648 648 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L34MM 2026445 CDM 278 RC facility both 648 648 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L36MM 2026446 CDM 278 RC facility both 71 71 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L36MM 2026446 CDM 278 RC facility both 71 71 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L38MM 2026447 CDM 278 RC facility both 71 71 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L38MM 2026447 CDM 278 RC facility both 71 71 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L40MM 2026448 CDM 278 RC facility both 459 459 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L40MM 2026448 CDM 278 RC facility both 459 459 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L42MM 2026449 CDM 278 RC facility both 459 459 Gross Charge Type: NIHD_Hosp_Profee_Price 5MM LOCKING SCREW 5.0MM/L42MM 2026449 CDM 278 RC facility both 459 459 Gross Charge Type: NIHD_Hosp_Profee_Price OLECRANON PLATE 6 HOLE/ RIGHT 2026451 CDM 278 RC facility both 3966 3966 Gross Charge Type: NIHD_Hosp_Profee_Price OLECRANON PLATE 6 HOLE/ RIGHT 2026451 CDM 278 RC facility both 3966 3966 Gross Charge Type: NIHD_Hosp_Profee_Price OLECRANON PLATE 8 HOLE/ RIGHT 2026452 CDM 278 RC facility both 5058 5058 Gross Charge Type: NIHD_Hosp_Profee_Price OLECRANON PLATE 8 HOLE/ RIGHT 2026452 CDM 278 RC facility both 5058 5058 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL MEDIAL HUMERUS PLATE 4 HOLE 2026453 CDM 278 RC facility both 3966 3966 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL MEDIAL HUMERUS PLATE 4 HOLE 2026453 CDM 278 RC facility both 3966 3966 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL MEDIAL HUMERUS PLATE 6 HOLE 2026454 CDM 278 RC facility both 3966 3966 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL MEDIAL HUMERUS PLATE 6 HOLE 2026454 CDM 278 RC facility both 3966 3966 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL MEDIAL HUMERUS PLATE 8 HOLE 2026455 CDM 278 RC facility both 5058 5058 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL MEDIAL HUMERUS PLATE 8 HOLE 2026455 CDM 278 RC facility both 5058 5058 Gross Charge Type: NIHD_Hosp_Profee_Price "VARIAXCOMPRESSIONPLATE,NARROW, STR,4HOLE" 2026456 CDM 278 RC facility both 1238 1238 Gross Charge Type: NIHD_Hosp_Profee_Price "VARIAXCOMPRESSIONPLATE,NARROW, STR,4HOLE" 2026456 CDM 278 RC facility both 1238 1238 Gross Charge Type: NIHD_Hosp_Profee_Price "VARIAXCOMPRESSIONPLATE,NARROW, STR,5HOLE" 2026457 CDM 278 RC facility both 1642 1642 Gross Charge Type: NIHD_Hosp_Profee_Price "VARIAXCOMPRESSIONPLATE,NARROW, STR,5HOLE" 2026457 CDM 278 RC facility both 1642 1642 Gross Charge Type: NIHD_Hosp_Profee_Price "VARIAXCOMPRESSIONPLATE,NARROW, STR,6HOLE" 2026458 CDM 278 RC facility both 1642 1642 Gross Charge Type: NIHD_Hosp_Profee_Price "VARIAXCOMPRESSIONPLATE,NARROW, STR,6HOLE" 2026458 CDM 278 RC facility both 1642 1642 Gross Charge Type: NIHD_Hosp_Profee_Price VARIAXCOMPRESSIONPLATE 7HOLE/L90W/2LOCK 2026459 CDM 278 RC facility both 1642 1642 Gross Charge Type: NIHD_Hosp_Profee_Price VARIAXCOMPRESSIONPLATE 7HOLE/L90W/2LOCK 2026459 CDM 278 RC facility both 1642 1642 Gross Charge Type: NIHD_Hosp_Profee_Price "VARIAXCOMPRESSIONPLATENARROW,STR,8HOLES" 2026460 CDM 278 RC facility both 2410 2410 Gross Charge Type: NIHD_Hosp_Profee_Price "VARIAXCOMPRESSIONPLATENARROW,STR,8HOLES" 2026460 CDM 278 RC facility both 2410 2410 Gross Charge Type: NIHD_Hosp_Profee_Price "VARIAXCOMPRESSIONPLATENARROW,STR,9HOLES" 2026461 CDM 278 RC facility both 2410 2410 Gross Charge Type: NIHD_Hosp_Profee_Price "VARIAXCOMPRESSIONPLATENARROW,STR,9HOLES" 2026461 CDM 278 RC facility both 2410 2410 Gross Charge Type: NIHD_Hosp_Profee_Price "VARIAXCOMPRESSIONPLATENARROW,STR,10HOLES" 2026462 CDM 278 RC facility both 2410 2410 Gross Charge Type: NIHD_Hosp_Profee_Price "VARIAXCOMPRESSIONPLATENARROW,STR,10HOLES" 2026462 CDM 278 RC facility both 2410 2410 Gross Charge Type: NIHD_Hosp_Profee_Price VARIAXCOMPRESSIONPLATE7HOLE/L90MMW/4LOCK 2026463 CDM 278 RC facility both 1642 1642 Gross Charge Type: NIHD_Hosp_Profee_Price VARIAXCOMPRESSIONPLATE7HOLE/L90MMW/4LOCK 2026463 CDM 278 RC facility both 1642 1642 Gross Charge Type: NIHD_Hosp_Profee_Price VARIAXCOMPRESSIONPLATE7HOLE/L91MMW/4LOCK 2026464 CDM 278 RC facility both 1642 1642 Gross Charge Type: NIHD_Hosp_Profee_Price VARIAXCOMPRESSIONPLATE7HOLE/L91MMW/4LOCK 2026464 CDM 278 RC facility both 1642 1642 Gross Charge Type: NIHD_Hosp_Profee_Price VARIAXCOMPRESSIONPLATE7HOLE/L91MMW/2LOCK 2026468 CDM 278 RC facility both 1435 1435 Gross Charge Type: NIHD_Hosp_Profee_Price VARIAXCOMPRESSIONPLATE7HOLE/L91MMW/2LOCK 2026468 CDM 278 RC facility both 1435 1435 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L14MM TITANIUM 2026475 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L14MM TITANIUM 2026475 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L16MM TITANIUM 2026476 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L16MM TITANIUM 2026476 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L18MM TITANIUM 2026477 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L18MM TITANIUM 2026477 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L20MM TITANIUM 2026478 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L20MM TITANIUM 2026478 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L22MM TITANIUM 2026479 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L22MM TITANIUM 2026479 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L24MM TITANIUM 2026480 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L24MM TITANIUM 2026480 CDM 278 RC facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L26MM TITANIUM 2026481 CDM 278 RC facility both 550 550 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM LOCKING SCREW 4.0MM/L26MM TITANIUM 2026481 CDM 278 RC facility both 550 550 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIOR LATERAL PLATE-7HOLE/LEFT 2026482 CDM 278 RC facility both 5253 5253 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIOR LATERAL PLATE-7HOLE/LEFT 2026482 CDM 278 RC facility both 5253 5253 Gross Charge Type: NIHD_Hosp_Profee_Price ANTERIOR MIDSHAFT PLATE-6 HOLE 2026487 CDM 278 RC facility both 2946 2946 Gross Charge Type: NIHD_Hosp_Profee_Price ANTERIOR MIDSHAFT PLATE-6 HOLE 2026487 CDM 278 RC facility both 2946 2946 Gross Charge Type: NIHD_Hosp_Profee_Price ANTERIOR MIDSHAFT PLATE-7 HOLE 2026488 CDM facility both 2946 2946 Gross Charge Type: NIHD_Hosp_Profee_Price ANTERIOR MIDSHAFT PLATE-7 HOLE 2026488 CDM facility both 2946 2946 Gross Charge Type: NIHD_Hosp_Profee_Price ANTERIOR MIDSHAFT PLATE-8 HOLE 2026489 CDM 278 RC facility both 586 586 Gross Charge Type: NIHD_Hosp_Profee_Price ANTERIOR MIDSHAFT PLATE-8 HOLE 2026489 CDM 278 RC facility both 586 586 Gross Charge Type: NIHD_Hosp_Profee_Price ANTERIOR MIDSHAFT PLATE-10 HOLE 2026490 CDM 278 RC facility both 586 586 Gross Charge Type: NIHD_Hosp_Profee_Price ANTERIOR MIDSHAFT PLATE-10 HOLE 2026490 CDM 278 RC facility both 586 586 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL LATERAL HUMERUS PLATE 4 HOLE/LEFT 2026494 CDM 278 RC facility both 3966 3966 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL LATERAL HUMERUS PLATE 4 HOLE/LEFT 2026494 CDM 278 RC facility both 3966 3966 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL LATERAL HUMERUS PLATE 6 HOLE/LEFT 2026495 CDM 278 RC facility both 3966 3966 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL LATERAL HUMERUS PLATE 6 HOLE/LEFT 2026495 CDM 278 RC facility both 3966 3966 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL LATERAL HUMERUS PLATE 8 HOLE/LEFT 2026496 CDM 278 RC facility both 5058 5058 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL LATERAL HUMERUS PLATE 8 HOLE/LEFT 2026496 CDM 278 RC facility both 5058 5058 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL LATERAL HUMERUS PLATE 4HOLE/RIGHT 2026497 CDM 278 RC facility both 3966 3966 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL LATERAL HUMERUS PLATE 4HOLE/RIGHT 2026497 CDM 278 RC facility both 3966 3966 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL LATERAL HUMERUS PLATE 6HOLE/RIGHT 2026498 CDM 278 RC facility both 3966 3966 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL LATERAL HUMERUS PLATE 6HOLE/RIGHT 2026498 CDM 278 RC facility both 3966 3966 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL LATERAL HUMERUS PLATE 8HOLE/RIGHT 2026499 CDM 278 RC facility both 5058 5058 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL LATERAL HUMERUS PLATE 8HOLE/RIGHT 2026499 CDM 278 RC facility both 5058 5058 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL MEDIAL HUMERUS PLATE 4HOLE EXTEND 2026506 CDM 278 RC facility both 3966 3966 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL MEDIAL HUMERUS PLATE 4HOLE EXTEND 2026506 CDM 278 RC facility both 3966 3966 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL MEDIAL HUMERUS PLATE 6HOLE EXTEND 2026507 CDM 278 RC facility both 3966 3966 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL MEDIAL HUMERUS PLATE 6HOLE EXTEND 2026507 CDM 278 RC facility both 3966 3966 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL MEDIAL HUMERUS PLATE 8HOLE EXTEND 2026508 CDM 278 RC facility both 5058 5058 Gross Charge Type: NIHD_Hosp_Profee_Price DISTAL MEDIAL HUMERUS PLATE 8HOLE EXTEND 2026508 CDM 278 RC facility both 5058 5058 Gross Charge Type: NIHD_Hosp_Profee_Price OLECRANON PLATE 4 HOLE/LEFT 2026515 CDM 278 RC facility both 2691 2691 Gross Charge Type: NIHD_Hosp_Profee_Price OLECRANON PLATE 4 HOLE/LEFT 2026515 CDM 278 RC facility both 2691 2691 Gross Charge Type: NIHD_Hosp_Profee_Price OLECRANON PLATE 6 HOLE/LEFT 2026516 CDM 278 RC facility both 3966 3966 Gross Charge Type: NIHD_Hosp_Profee_Price OLECRANON PLATE 6 HOLE/LEFT 2026516 CDM 278 RC facility both 3966 3966 Gross Charge Type: NIHD_Hosp_Profee_Price OLECRANON PLATE 8 HOLE/LEFT 2026517 CDM 278 RC facility both 5058 5058 Gross Charge Type: NIHD_Hosp_Profee_Price OLECRANON PLATE 8 HOLE/LEFT 2026517 CDM 278 RC facility both 5058 5058 Gross Charge Type: NIHD_Hosp_Profee_Price OLECRANON PLATE 4 HOLE/RIGHT 2026518 CDM 278 RC facility both 3966 3966 Gross Charge Type: NIHD_Hosp_Profee_Price OLECRANON PLATE 4 HOLE/RIGHT 2026518 CDM 278 RC facility both 3966 3966 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAPLATEFORLEFTTIBIA4HOLE/L71MM 2026525 CDM facility both 5484 5484 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAPLATEFORLEFTTIBIA4HOLE/L71MM 2026525 CDM facility both 5484 5484 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAPLATEFORRIGHTTIBIA6HOLE/L97MM 2026531 CDM facility both 3265 3265 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAPLATEFORRIGHTTIBIA6HOLE/L97MM 2026531 CDM facility both 3265 3265 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIOR PLATE DECREASED-6HOLE/LEFT 2026533 CDM 278 RC facility both 2651 2651 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIOR PLATE DECREASED-6HOLE/LEFT 2026533 CDM 278 RC facility both 2651 2651 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIOR PLATE DECREASED-7HOLE/LEFT 2026534 CDM 278 RC facility both 2651 2651 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIOR PLATE DECREASED-7HOLE/LEFT 2026534 CDM 278 RC facility both 2651 2651 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIOR PLATE DECREASED-8HOLE/LEFT 2026535 CDM 278 RC facility both 2946 2946 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIOR PLATE DECREASED-8HOLE/LEFT 2026535 CDM 278 RC facility both 2946 2946 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIOR PLATE DECREASED-10HOLE/LEFT 2026536 CDM 278 RC facility both 2946 2946 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIOR PLATE DECREASED-10HOLE/LEFT 2026536 CDM 278 RC facility both 2946 2946 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIOR PLATE DECREASED-7HOLE/RIGHT 2026538 CDM 278 RC facility both 2651 2651 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIOR PLATE DECREASED-7HOLE/RIGHT 2026538 CDM 278 RC facility both 2651 2651 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIOR PLATE DECREASED-8HOLE/RIGHT 2026539 CDM 278 RC facility both 2946 2946 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIOR PLATE DECREASED-8HOLE/RIGHT 2026539 CDM 278 RC facility both 2946 2946 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIOR PLATE DECREASED-10HOLE/RIGHT 2026540 CDM 278 RC facility both 2946 2946 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIOR PLATE DECREASED-10HOLE/RIGHT 2026540 CDM 278 RC facility both 2946 2946 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIORPLATEDECREASED-6HOLE/BRIDGE LEFT 2026541 CDM 278 RC facility both 658 658 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIORPLATEDECREASED-6HOLE/BRIDGE LEFT 2026541 CDM 278 RC facility both 658 658 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIORPLATEDECREASED-8HOLE/BRIDGE LEFT 2026542 CDM 278 RC facility both 658 658 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIORPLATEDECREASED-8HOLE/BRIDGE LEFT 2026542 CDM 278 RC facility both 658 658 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIORPLATEDECREASED-6HOLE/BRIDGERIGHT 2026543 CDM 278 RC facility both 658 658 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIORPLATEDECREASED-6HOLE/BRIDGERIGHT 2026543 CDM 278 RC facility both 658 658 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIORPLATEDECREASED-8HOLE/BRIDGERIGHT 2026544 CDM 278 RC facility both 658 658 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIORPLATEDECREASED-8HOLE/BRIDGERIGHT 2026544 CDM 278 RC facility both 658 658 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIOR PLATE INCREASED - 8 HOLE/LEFT 2026545 CDM 278 RC facility both 2946 2946 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIOR PLATE INCREASED - 8 HOLE/LEFT 2026545 CDM 278 RC facility both 2946 2946 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIORPLATEINCREASED-6HOLE/BRIDGELEFT 2026549 CDM facility both 4682 4682 Gross Charge Type: NIHD_Hosp_Profee_Price SUPERIORPLATEINCREASED-6HOLE/BRIDGELEFT 2026549 CDM facility both 4682 4682 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAPLATEFORLEFTTIBIA4HOLE/L121MM 2026556 CDM facility both 6291 6291 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAPLATEFORLEFTTIBIA4HOLE/L121MM 2026556 CDM facility both 6291 6291 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAPLATEFORLEFTTIBIA6HOLE/L147MM 2026557 CDM 278 RC facility both 760 760 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAPLATEFORLEFTTIBIA6HOLE/L147MM 2026557 CDM 278 RC facility both 760 760 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAPLATEFORLEFTTIBIA8HOLE/L173MM 2026558 CDM 278 RC facility both 776 776 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAPLATEFORLEFTTIBIA8HOLE/L173MM 2026558 CDM 278 RC facility both 776 776 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAPLATEFORLEFTTIBIA10HOLE/L199MM 2026559 CDM 278 RC facility both 396 396 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAPLATEFORLEFTTIBIA10HOLE/L199MM 2026559 CDM 278 RC facility both 396 396 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAPLATEFORLEFTTIBIA12HOLE/L225MM 2026560 CDM 278 RC facility both 807 807 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAPLATEFORLEFTTIBIA12HOLE/L225MM 2026560 CDM 278 RC facility both 807 807 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAPLATEFORLEFTTIBIA14HOLE/L251MM 2026561 CDM 278 RC facility both 412 412 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAPLATEFORLEFTTIBIA14HOLE/L251MM 2026561 CDM 278 RC facility both 412 412 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAPLATEFORLEFTTIBIA8HOLE/L149MM 2026571 CDM 278 RC facility both 6304 6304 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAPLATEFORLEFTTIBIA8HOLE/L149MM 2026571 CDM 278 RC facility both 6304 6304 Gross Charge Type: NIHD_Hosp_Profee_Price FEMURPLATEFORLEFTFEMUR4HOLE/L130MM 2026585 CDM 278 RC facility both 7455 7455 Gross Charge Type: NIHD_Hosp_Profee_Price FEMURPLATEFORLEFTFEMUR4HOLE/L130MM 2026585 CDM 278 RC facility both 7455 7455 Gross Charge Type: NIHD_Hosp_Profee_Price FEMURPLATEFORLEFTFEMUR8HOLE/L202MM 2026587 CDM 278 RC facility both 5586 5586 Gross Charge Type: NIHD_Hosp_Profee_Price FEMURPLATEFORLEFTFEMUR8HOLE/L202MM 2026587 CDM 278 RC facility both 5586 5586 Gross Charge Type: NIHD_Hosp_Profee_Price FEMURPLATEFORLEFTFEMUR14HOLE/L310MM 2026590 CDM 278 RC facility both 8323 8323 Gross Charge Type: NIHD_Hosp_Profee_Price FEMURPLATEFORLEFTFEMUR14HOLE/L310MM 2026590 CDM 278 RC facility both 8323 8323 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X12MM" 2026595 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X12MM" 2026595 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X14MM" 2026596 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X14MM" 2026596 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X16MM" 2026597 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X16MM" 2026597 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X18MM" 2026598 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X18MM" 2026598 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X20MM" 2026599 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X20MM" 2026599 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X22MM" 2026600 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X22MM" 2026600 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X24MM" 2026601 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X24MM" 2026601 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X26MM" 2026602 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X26MM" 2026602 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X28MM" 2026603 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X28MM" 2026603 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X30MM" 2026604 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X30MM" 2026604 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X32MM" 2026605 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X32MM" 2026605 CDM 278 RC facility both 183 183 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X34MM" 2026606 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X34MM" 2026606 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X36MM" 2026607 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X36MM" 2026607 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X38MM" 2026608 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X38MM" 2026608 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X40MM" 2026609 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X40MM" 2026609 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X44MM" 2026611 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X44MM" 2026611 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price TI ASNIS III WASHER FOR 6.5/8.0MM SCREWS 2026619 CDM 278 RC facility both 154 154 Gross Charge Type: NIHD_Hosp_Profee_Price TI ASNIS III WASHER FOR 6.5/8.0MM SCREWS 2026619 CDM 278 RC facility both 154 154 Gross Charge Type: NIHD_Hosp_Profee_Price TI ASNIS III WASHER 4.0MM 2026620 CDM 278 RC facility both 76 76 Gross Charge Type: NIHD_Hosp_Profee_Price TI ASNIS III WASHER 4.0MM 2026620 CDM 278 RC facility both 76 76 Gross Charge Type: NIHD_Hosp_Profee_Price TI ASNIS III WASHER 5.0MM 2026621 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price TI ASNIS III WASHER 5.0MM 2026621 CDM 278 RC facility both 129 129 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERUS PLATE FOR LEFT HUMERUS 3 HOLE 2026622 CDM 278 RC facility both 5785 5785 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERUS PLATE FOR LEFT HUMERUS 3 HOLE 2026622 CDM 278 RC facility both 5785 5785 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERUS PLATE FOR LEFT HUMERUS 4 HOLE 2026623 CDM 278 RC facility both 5785 5785 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERUS PLATE FOR LEFT HUMERUS 4 HOLE 2026623 CDM 278 RC facility both 5785 5785 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERUS PLATE FOR LEFT HUMERUS 5 HOLE 2026624 CDM 278 RC facility both 5785 5785 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERUS PLATE FOR LEFT HUMERUS 5 HOLE 2026624 CDM 278 RC facility both 5785 5785 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERUS PLATE FOR LEFT HUMERUS 6 HOLE 2026625 CDM 278 RC facility both 6677 6677 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERUS PLATE FOR LEFT HUMERUS 6 HOLE 2026625 CDM 278 RC facility both 6677 6677 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERUS PLATE FOR RIGHT HUMERUS 3 HOLE 2026626 CDM 278 RC facility both 5785 5785 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERUS PLATE FOR RIGHT HUMERUS 3 HOLE 2026626 CDM 278 RC facility both 5785 5785 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERUS PLATE FOR RIGHT HUMERUS 4 HOLE 2026627 CDM 278 RC facility both 5785 5785 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERUS PLATE FOR RIGHT HUMERUS 4 HOLE 2026627 CDM 278 RC facility both 5785 5785 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERUS PLATE FOR RIGHT HUMERUS 5 HOLE 2026628 CDM 278 RC facility both 5785 5785 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERUS PLATE FOR RIGHT HUMERUS 5 HOLE 2026628 CDM 278 RC facility both 5785 5785 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERUS PLATE FOR RIGHT HUMERUS 6 HOLE 2026629 CDM 278 RC facility both 6677 6677 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERUS PLATE FOR RIGHT HUMERUS 6 HOLE 2026629 CDM 278 RC facility both 6677 6677 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIA PLATE FOR LEFT TIBIA 2 HOLE/L95MM 2026630 CDM facility both 6160 6160 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIA PLATE FOR LEFT TIBIA 2 HOLE/L95MM 2026630 CDM facility both 6160 6160 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X40MM" 2026631 CDM 278 RC facility both 352 352 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X40MM" 2026631 CDM 278 RC facility both 352 352 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X42MM" 2026632 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X42MM" 2026632 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X44MM" 2026633 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X44MM" 2026633 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X46MM" 2026634 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X46MM" 2026634 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X48MM" 2026635 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X48MM" 2026635 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X50MM" 2026636 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X50MM" 2026636 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X55MM" 2026637 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X55MM" 2026637 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X60MM" 2026638 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X60MM" 2026638 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X65MM" 2026639 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X65MM" 2026639 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X70MM" 2026640 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCKING SCREW, T10, 3.5X70MM" 2026640 CDM 278 RC facility both 666 666 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X8MM" 2026641 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X8MM" 2026641 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X10MM" 2026642 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X10MM" 2026642 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X12MM" 2026643 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X12MM" 2026643 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X14MM" 2026644 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X14MM" 2026644 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X16MM" 2026645 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X16MM" 2026645 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X18MM" 2026646 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X18MM" 2026646 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X20MM" 2026647 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X20MM" 2026647 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X22MM" 2026648 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X22MM" 2026648 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X24MM" 2026649 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X24MM" 2026649 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X26MM" 2026650 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X26MM" 2026650 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X28MM" 2026651 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X28MM" 2026651 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X30MM" 2026652 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X30MM" 2026652 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X32MM" 2026653 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X32MM" 2026653 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X34MM" 2026654 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X34MM" 2026654 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X36MM" 2026655 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X36MM" 2026655 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X38MM" 2026656 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X38MM" 2026656 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X40MM" 2026657 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X40MM" 2026657 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X42MM" 2026658 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X42MM" 2026658 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X44MM" 2026659 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X44MM" 2026659 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X46MM" 2026660 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X46MM" 2026660 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X48MM" 2026661 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X48MM" 2026661 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X50MM" 2026662 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X50MM" 2026662 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X55MM" 2026663 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X55MM" 2026663 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X60MM" 2026664 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X60MM" 2026664 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X65MM" 2026665 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X65MM" 2026665 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X70MM" 2026666 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 2.7X70MM" 2026666 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X8MM" 2026667 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price "BONE SCREW, T10, 3.5X8MM" 2026667 CDM 278 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X36MM 2026669 CDM 278 RC facility both 88 88 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW T10 3.5X36MM 2026669 CDM 278 RC facility both 88 88 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L75MM 2026671 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L75MM 2026671 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L80MM 2026672 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L80MM 2026672 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L85MM 2026673 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM CORTEX TI SCREW 03.5MM/L85MM 2026673 CDM 278 RC facility both 115 115 Gross Charge Type: NIHD_Hosp_Profee_Price CANNULATED DRILL 6.5MM LG AO FITTING 2026675 CDM 278 RC facility both 2011 2011 Gross Charge Type: NIHD_Hosp_Profee_Price CANNULATED DRILL 6.5MM LG AO FITTING 2026675 CDM 278 RC facility both 2011 2011 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERUS PLATE FOR LEFT HUMERUS 8 HOLE 2026684 CDM 278 RC facility both 6677 6677 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERUS PLATE FOR LEFT HUMERUS 8 HOLE 2026684 CDM 278 RC facility both 6677 6677 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERUS PLATE FOR LEFT HUMERUS 12 HOLE 2026686 CDM 278 RC facility both 5619 5619 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERUS PLATE FOR LEFT HUMERUS 12 HOLE 2026686 CDM 278 RC facility both 5619 5619 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERUS PLATE FOR RIGHT HUMERUS 8 HOLE 2026687 CDM 278 RC facility both 6677 6677 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERUS PLATE FOR RIGHT HUMERUS 8 HOLE 2026687 CDM 278 RC facility both 6677 6677 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERUS PLATE FOR RIGHT HUMERUS 10 HOLE 2026688 CDM 278 RC facility both 5619 5619 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERUS PLATE FOR RIGHT HUMERUS 10 HOLE 2026688 CDM 278 RC facility both 5619 5619 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERUS PLATE FOR RIGHT HUMERUS 12 HOLE 2026689 CDM 278 RC facility both 5619 5619 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERUS PLATE FOR RIGHT HUMERUS 12 HOLE 2026689 CDM 278 RC facility both 5619 5619 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL CANNULATED 4.0MM WITH AO COUPLING 2026700 CDM 272 RC facility both 716 716 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL CANNULATED 4.0MM WITH AO COUPLING 2026700 CDM 272 RC facility both 716 716 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE TAK 3.0X14.5MM W/ #2 TIGERTAILS 2026706 CDM 272 RC facility both 960 960 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE TAK 3.0X14.5MM W/ #2 TIGERTAILS 2026706 CDM 272 RC facility both 960 960 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE TAK 3.O WITH #2 FIBERWIRE 2026707 CDM 272 RC facility both 1020 1020 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE TAK 3.O WITH #2 FIBERWIRE 2026707 CDM 272 RC facility both 1020 1020 Gross Charge Type: NIHD_Hosp_Profee_Price PASSPORT BUTTON CANNULA 8X4MM 2026708 CDM 272 RC facility both 96 96 Gross Charge Type: NIHD_Hosp_Profee_Price PASSPORT BUTTON CANNULA 8X4MM 2026708 CDM 272 RC facility both 96 96 Gross Charge Type: NIHD_Hosp_Profee_Price PASSPORT BUTTON CANNULA 10MMX3CM 2026710 CDM 272 RC facility both 96 96 Gross Charge Type: NIHD_Hosp_Profee_Price PASSPORT BUTTON CANNULA 10MMX3CM 2026710 CDM 272 RC facility both 96 96 Gross Charge Type: NIHD_Hosp_Profee_Price PASSPORT BUTTON CANNULA 10X4MM 2026711 CDM 272 RC facility both 96 96 Gross Charge Type: NIHD_Hosp_Profee_Price PASSPORT BUTTON CANNULA 10X4MM 2026711 CDM 272 RC facility both 96 96 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE TAK 1.3MM WHITE/BLUE SUTURE TAPE 2026716 CDM 272 RC facility both 1020 1020 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE TAK 1.3MM WHITE/BLUE SUTURE TAPE 2026716 CDM 272 RC facility both 1020 1020 Gross Charge Type: NIHD_Hosp_Profee_Price CABLE DALL-MILES BEADED 2.0MM/SLEEVE SET 2026717 CDM 278 RC facility both 1815 1815 Gross Charge Type: NIHD_Hosp_Profee_Price CABLE DALL-MILES BEADED 2.0MM/SLEEVE SET 2026717 CDM 278 RC facility both 1815 1815 Gross Charge Type: NIHD_Hosp_Profee_Price CABLE DALL-MILES 1.6MM HOLES SLEEVE 2026718 CDM 278 RC facility both 1083 1083 Gross Charge Type: NIHD_Hosp_Profee_Price CABLE DALL-MILES 1.6MM HOLES SLEEVE 2026718 CDM 278 RC facility both 1083 1083 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE DALL-MILES TROC GRIP MED 200MM 2026719 CDM 278 RC facility both 11595 11595 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE DALL-MILES TROC GRIP MED 200MM 2026719 CDM 278 RC facility both 11595 11595 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE DALL-MILES TROC GRIP MED 100MM 2026720 CDM 278 RC facility both 7137 7137 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE DALL-MILES TROC GRIP MED 100MM 2026720 CDM 278 RC facility both 7137 7137 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE DALL-MILES TROC GRIP MED 150MM 2026721 CDM 278 RC facility both 5145 5145 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE DALL-MILES TROC GRIP MED 150MM 2026721 CDM 278 RC facility both 5145 5145 Gross Charge Type: NIHD_Hosp_Profee_Price ADVANTAGE FIT SYSTEM (TVT) 2026746 CDM 278 RC facility both 3490 3490 Gross Charge Type: NIHD_Hosp_Profee_Price ADVANTAGE FIT SYSTEM (TVT) 2026746 CDM 278 RC facility both 3490 3490 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE KEYLESS STD BARREL 2026793 CDM 278 RC facility both 2452 2452 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE KEYLESS STD BARREL 2026793 CDM 278 RC facility both 2452 2452 Gross Charge Type: NIHD_Hosp_Profee_Price GUIDEPIN 2026795 CDM 272 RC facility both 197 197 Gross Charge Type: NIHD_Hosp_Profee_Price GUIDEPIN 2026795 CDM 272 RC facility both 197 197 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW AXNIS 111 CANNULATED 6.5X20X90MM 2026797 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW AXNIS 111 CANNULATED 6.5X20X90MM 2026797 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price HALFPIN 4.5 THREADED 40X150MM 2026799 CDM 278 RC facility both 776 776 Gross Charge Type: NIHD_Hosp_Profee_Price HALFPIN 4.5 THREADED 40X150MM 2026799 CDM 278 RC facility both 776 776 Gross Charge Type: NIHD_Hosp_Profee_Price HALFPIN 4.5 THREADED 30X150MM 2026800 CDM 278 RC facility both 776 776 Gross Charge Type: NIHD_Hosp_Profee_Price HALFPIN 4.5 THREADED 30X150MM 2026800 CDM 278 RC facility both 776 776 Gross Charge Type: NIHD_Hosp_Profee_Price HALFPIN 4.5 THREADED 20X150MM 2026801 CDM 278 RC facility both 776 776 Gross Charge Type: NIHD_Hosp_Profee_Price HALFPIN 4.5 THREADED 20X150MM 2026801 CDM 278 RC facility both 776 776 Gross Charge Type: NIHD_Hosp_Profee_Price DRILLTIP WIRE 1.8X385MM 2026802 CDM 272 RC facility both 735 735 Gross Charge Type: NIHD_Hosp_Profee_Price DRILLTIP WIRE 1.8X385MM 2026802 CDM 272 RC facility both 735 735 Gross Charge Type: NIHD_Hosp_Profee_Price DRILLTIP WIRE WITH STOPPER 1.8X385MM 2026803 CDM 272 RC facility both 1103 1103 Gross Charge Type: NIHD_Hosp_Profee_Price DRILLTIP WIRE WITH STOPPER 1.8X385MM 2026803 CDM 272 RC facility both 1103 1103 Gross Charge Type: NIHD_Hosp_Profee_Price RING 2/3 180MM ILIZ0V 2026804 CDM 272 RC facility both 5517 5517 Gross Charge Type: NIHD_Hosp_Profee_Price RING 2/3 180MM ILIZ0V 2026804 CDM 272 RC facility both 5517 5517 Gross Charge Type: NIHD_Hosp_Profee_Price RING FULL 180MM ILIZ0V 2026805 CDM 272 RC facility both 5773 5773 Gross Charge Type: NIHD_Hosp_Profee_Price RING FULL 180MM ILIZ0V 2026805 CDM 272 RC facility both 5773 5773 Gross Charge Type: NIHD_Hosp_Profee_Price RING FOOT 180MM LONG ILIZ0V 2026806 CDM 272 RC facility both 5593 5593 Gross Charge Type: NIHD_Hosp_Profee_Price RING FOOT 180MM LONG ILIZ0V 2026806 CDM 272 RC facility both 5593 5593 Gross Charge Type: NIHD_Hosp_Profee_Price RING HALF 180MM ILIZ0V 2026807 CDM 272 RC facility both 4737 4737 Gross Charge Type: NIHD_Hosp_Profee_Price RING HALF 180MM ILIZ0V 2026807 CDM 272 RC facility both 4737 4737 Gross Charge Type: NIHD_Hosp_Profee_Price FASTFIX STRUT FOR TSF MEDIUM 2026808 CDM 272 RC facility both 4551 4551 Gross Charge Type: NIHD_Hosp_Profee_Price FASTFIX STRUT FOR TSF MEDIUM 2026808 CDM 272 RC facility both 4551 4551 Gross Charge Type: NIHD_Hosp_Profee_Price FASTFIX STRUT FOR TSF LONG 2026809 CDM 272 RC facility both 4551 4551 Gross Charge Type: NIHD_Hosp_Profee_Price FASTFIX STRUT FOR TSF LONG 2026809 CDM 272 RC facility both 4551 4551 Gross Charge Type: NIHD_Hosp_Profee_Price RANCHO CUBE WITH POST 2 HOLE 2026810 CDM 272 RC facility both 984 984 Gross Charge Type: NIHD_Hosp_Profee_Price RANCHO CUBE WITH POST 2 HOLE 2026810 CDM 272 RC facility both 984 984 Gross Charge Type: NIHD_Hosp_Profee_Price RANCHO CUBE 2 HOLE 2026811 CDM 272 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price RANCHO CUBE 2 HOLE 2026811 CDM 272 RC facility both 442 442 Gross Charge Type: NIHD_Hosp_Profee_Price RANCHO CUBE 4 HOLE 2026812 CDM 272 RC facility both 909 909 Gross Charge Type: NIHD_Hosp_Profee_Price RANCHO CUBE 4 HOLE 2026812 CDM 272 RC facility both 909 909 Gross Charge Type: NIHD_Hosp_Profee_Price RANCHO CUBE 5 HOLE 2026813 CDM 272 RC facility both 1007 1007 Gross Charge Type: NIHD_Hosp_Profee_Price RANCHO CUBE 5 HOLE 2026813 CDM 272 RC facility both 1007 1007 Gross Charge Type: NIHD_Hosp_Profee_Price CONNECTOR ANGLE PIN 35MM 2026814 CDM 272 RC facility both 1859 1859 Gross Charge Type: NIHD_Hosp_Profee_Price CONNECTOR ANGLE PIN 35MM 2026814 CDM 272 RC facility both 1859 1859 Gross Charge Type: NIHD_Hosp_Profee_Price NUT THICK ITALIAN 2026815 CDM 272 RC facility both 178 178 Gross Charge Type: NIHD_Hosp_Profee_Price NUT THICK ITALIAN 2026815 CDM 272 RC facility both 178 178 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW SET FOR HEX-FIX 2026816 CDM 272 RC facility both 47 47 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW SET FOR HEX-FIX 2026816 CDM 272 RC facility both 47 47 Gross Charge Type: NIHD_Hosp_Profee_Price BOLT CANNULA WITH FIX 2026817 CDM 272 RC facility both 190 190 Gross Charge Type: NIHD_Hosp_Profee_Price BOLT CANNULA WITH FIX 2026817 CDM 272 RC facility both 190 190 Gross Charge Type: NIHD_Hosp_Profee_Price HALF PIN CAP 6MM 2026819 CDM 272 RC facility both 135 135 Gross Charge Type: NIHD_Hosp_Profee_Price HALF PIN CAP 6MM 2026819 CDM 272 RC facility both 135 135 Gross Charge Type: NIHD_Hosp_Profee_Price ILIZAROV DISCLIP 5MM 2026820 CDM 272 RC facility both 37 37 Gross Charge Type: NIHD_Hosp_Profee_Price ILIZAROV DISCLIP 5MM 2026820 CDM 272 RC facility both 37 37 Gross Charge Type: NIHD_Hosp_Profee_Price BOLT 16MM 2026821 CDM 272 RC facility both 37 37 Gross Charge Type: NIHD_Hosp_Profee_Price BOLT 16MM 2026821 CDM 272 RC facility both 37 37 Gross Charge Type: NIHD_Hosp_Profee_Price LOW PROFILE MALE HINGE 2026822 CDM 272 RC facility both 480 480 Gross Charge Type: NIHD_Hosp_Profee_Price LOW PROFILE MALE HINGE 2026822 CDM 272 RC facility both 480 480 Gross Charge Type: NIHD_Hosp_Profee_Price OVERDRILL 2.7X122MM AO STRYKER 2026834 CDM 272 RC facility both 485 485 Gross Charge Type: NIHD_Hosp_Profee_Price OVERDRILL 2.7X122MM AO STRYKER 2026834 CDM 272 RC facility both 485 485 Gross Charge Type: NIHD_Hosp_Profee_Price GRAFT RECTOPEXY BIODESIGN 7X20 2026839 CDM 278 RC facility both 3823 3823 Gross Charge Type: NIHD_Hosp_Profee_Price GRAFT RECTOPEXY BIODESIGN 7X20 2026839 CDM 278 RC facility both 3823 3823 Gross Charge Type: NIHD_Hosp_Profee_Price OSSTEOTOME THIN LONG 8X5MM 2026844 CDM 272 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price OSSTEOTOME THIN LONG 8X5MM 2026844 CDM 272 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price OSSTEOTOME THIN LONG 8X21/2MM 2026845 CDM 272 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price OSSTEOTOME THIN LONG 8X21/2MM 2026845 CDM 272 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price OSSTEOTOME RADIAL 6X5MM 2026846 CDM 272 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price OSSTEOTOME RADIAL 6X5MM 2026846 CDM 272 RC facility both 1062 1062 Gross Charge Type: NIHD_Hosp_Profee_Price CABLE SLEEVE SET DALL-MILES 2026854 CDM 278 RC facility both 1764 1764 Gross Charge Type: NIHD_Hosp_Profee_Price CABLE SLEEVE SET DALL-MILES 2026854 CDM 278 RC facility both 1764 1764 Gross Charge Type: NIHD_Hosp_Profee_Price PREVENA INCISION MANAGEMENT SYS 13 CM 2026863 CDM 271 RC facility both 2078 2078 Gross Charge Type: NIHD_RHC_Price PREVENA INCISION MANAGEMENT SYS 13 CM 2026863 CDM 271 RC facility both 2078 2078 Gross Charge Type: NIHD_Clinic_Price PREVENA INCISION MANAGEMENT SYS 13 CM 2026863 CDM 271 RC facility both 1159 1159 Gross Charge Type: NIHD_Hosp_Profee_Price PREVENA INCISION MANAGEMENT SYS 13 CM 2026863 CDM 271 RC facility both 1159 1159 Gross Charge Type: NIHD_Hosp_Profee_Price DRG PEEL AND PLACE PREVENA 13 ML 2026870 CDM 271 RC facility both 6805 6805 Gross Charge Type: NIHD_Hosp_Profee_Price DRG PEEL AND PLACE PREVENA 13 ML 2026870 CDM 271 RC facility both 6805 6805 Gross Charge Type: NIHD_Hosp_Profee_Price HALFPIN 4.5 THREADED 50X150MM 2026902 CDM 278 RC facility both 776 776 Gross Charge Type: NIHD_Hosp_Profee_Price HALFPIN 4.5 THREADED 50X150MM 2026902 CDM 278 RC facility both 776 776 Gross Charge Type: NIHD_Hosp_Profee_Price NUT 10MM 2026903 CDM 278 RC facility both 37 37 Gross Charge Type: NIHD_Hosp_Profee_Price NUT 10MM 2026903 CDM 278 RC facility both 37 37 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL STEP 3.8MM LONG 2026904 CDM 272 RC facility both 1779 1779 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL STEP 3.8MM LONG 2026904 CDM 272 RC facility both 1779 1779 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW CANCELLEOUS BONE TORX 6.5X40MM 2026907 CDM 278 RC facility both 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW CANCELLEOUS BONE TORX 6.5X40MM 2026907 CDM 278 RC facility both 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price STEM HIP 132DEG SZ10X35X160MM 2026909 CDM 278 RC facility both 23552 23552 Gross Charge Type: NIHD_Hosp_Profee_Price STEM HIP 132DEG SZ10X35X160MM 2026909 CDM 278 RC facility both 23552 23552 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD FEMORAL CERAMIC 28MMX-2.5MM 2026910 CDM 278 RC facility both 8345 8345 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD FEMORAL CERAMIC 28MMX-2.5MM 2026910 CDM 278 RC facility both 8345 8345 Gross Charge Type: NIHD_Hosp_Profee_Price RESTORATION MOD HIP SYSTEM 155 X 19 MM 2026920 CDM 278 RC facility both 14652 14652 Gross Charge Type: NIHD_Hosp_Profee_Price RESTORATION MOD HIP SYSTEM 155 X 19 MM 2026920 CDM 278 RC facility both 14652 14652 Gross Charge Type: NIHD_Hosp_Profee_Price RESTORATION MOD HIP SYSTEM 155 X 21 MM 2026922 CDM 278 RC facility both 14652 14652 Gross Charge Type: NIHD_Hosp_Profee_Price RESTORATION MOD HIP SYSTEM 155 X 21 MM 2026922 CDM 278 RC facility both 14652 14652 Gross Charge Type: NIHD_Hosp_Profee_Price RESTORATION MOD HIP SYSTEM 25 MM X +10MM 2026924 CDM 278 RC facility both 20450 20450 Gross Charge Type: NIHD_Hosp_Profee_Price RESTORATION MOD HIP SYSTEM 25 MM X +10MM 2026924 CDM 278 RC facility both 20450 20450 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW LOW PROFILE HEX 6.5 MMX 40 MM 2026925 CDM 278 RC facility both 545 545 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW LOW PROFILE HEX 6.5 MMX 40 MM 2026925 CDM 278 RC facility both 545 545 Gross Charge Type: NIHD_Hosp_Profee_Price RESTORATION ADM X3 28MM X 52 X46F 2026926 CDM 278 RC facility both 7170 7170 Gross Charge Type: NIHD_Hosp_Profee_Price RESTORATION ADM X3 28MM X 52 X46F 2026926 CDM 278 RC facility both 7170 7170 Gross Charge Type: NIHD_Hosp_Profee_Price ACTIVAPATCH® INTELLIDOSE™ 2.5 2026945 CDM facility both 68 68 Gross Charge Type: NIHD_Hosp_Profee_Price ACTIVAPATCH® INTELLIDOSE™ 2.5 2026945 CDM facility both 68 68 Gross Charge Type: NIHD_Hosp_Profee_Price ARTICULAR INSERT JOURNEY 11 2026947 CDM 278 RC facility both 18560 18560 Gross Charge Type: NIHD_Hosp_Profee_Price ARTICULAR INSERT JOURNEY 11 2026947 CDM 278 RC facility both 18560 18560 Gross Charge Type: NIHD_Hosp_Profee_Price WAYNE PNEUMOTHORAX TRAY 29 CM 14 FR 2026950 CDM 272 RC facility both 694 694 Gross Charge Type: NIHD_Hosp_Profee_Price WAYNE PNEUMOTHORAX TRAY 29 CM 14 FR 2026950 CDM 272 RC facility both 694 694 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 05.0BDL 2026968 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 05.0BDL 2026968 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 05.5BDL 2026969 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 05.5BDL 2026969 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 06.0 BDL 2026970 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 06.0 BDL 2026970 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 07.0 BDL 2026971 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 07.0 BDL 2026971 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 07.5 BDL 2026972 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 07.5 BDL 2026972 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 08.0 BDL 2026973 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 08.0 BDL 2026973 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 08.5 BDL 2026974 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 08.5 BDL 2026974 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 09.0 BDL 2026975 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 09.0 BDL 2026975 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 09.5 BDL 2026976 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 09.5 BDL 2026976 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 10.0 BDL 2026978 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 10.0 BDL 2026978 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 10.5 BDL 2026979 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 10.5 BDL 2026979 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 11.0 BDL 2026980 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 11.0 BDL 2026980 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 12.0 BDL 2026981 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 12.0 BDL 2026981 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 13.0 BDL 2026982 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 13.0 BDL 2026982 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 13.5 BDL 2026983 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 13.5 BDL 2026983 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 14.0 BDL 2026984 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 14.0 BDL 2026984 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 14.5 BDL 2026985 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 14.5 BDL 2026985 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 15.0 BDL 2026986 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 15.0 BDL 2026986 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 15.5 BDL 2026987 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 15.5 BDL 2026987 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 16.0 BDL 2026988 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 16.0 BDL 2026988 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 16.5 BDL 2026989 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 16.5 BDL 2026989 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 17.0 BDL 2026990 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 17.0 BDL 2026990 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 19.0 BDL 2026991 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 19.0 BDL 2026991 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 18.0 BDL 2026992 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 18.0 BDL 2026992 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 19.5 BDL 2026993 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 19.5 BDL 2026993 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 20.0 BDL 2026994 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 20.0 BDL 2026994 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 20.5 BDL 2026995 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 20.5 BDL 2026995 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 21.0 BDL 2026996 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 21.0 BDL 2026996 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 21.5 BDL 2026997 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 21.5 BDL 2026997 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 22.0 BDL 2026998 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 22.0 BDL 2026998 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 22.5 BDL 2026999 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 22.5 BDL 2026999 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 23.0 BDL 2027000 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 23.0 BDL 2027000 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 23.5 BDL 2027001 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 23.5 BDL 2027001 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 24.0 BDL 2027002 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 24.0 BDL 2027002 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 24.5 BDL 2027004 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV 24.5 BDL 2027004 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV25.0 BDL 2027005 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV25.0 BDL 2027005 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV25.5 BDL 2027006 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV25.5 BDL 2027006 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV26.5 BDL 2027007 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price IOL LI22UV26.5 BDL 2027007 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD FEMORAL C-TAPER L-FIT SZ 32X-2.5MM 2027030 CDM 278 RC facility both 8759 8759 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD FEMORAL C-TAPER L-FIT SZ 32X-2.5MM 2027030 CDM 278 RC facility both 8759 8759 Gross Charge Type: NIHD_Hosp_Profee_Price INSERT POLYETHLENE TRIDENT 0 DEGREE 32MM 623-00-32D 2027031 CDM 278 RC facility both 7817 7817 Gross Charge Type: NIHD_Hosp_Profee_Price INSERT POLYETHLENE TRIDENT 0 DEGREE 32MM 623-00-32D 2027031 CDM 278 RC facility both 7817 7817 Gross Charge Type: NIHD_Hosp_Profee_Price HIP STEM 132 DEG SZ9 35X150MM ANGLE 2027033 CDM 278 RC facility both 22865 22865 Gross Charge Type: NIHD_Hosp_Profee_Price HIP STEM 132 DEG SZ9 35X150MM ANGLE 2027033 CDM 278 RC facility both 22865 22865 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE COMPRESSION 6-HOLE 2027049 CDM 278 RC facility both 1642 1642 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE COMPRESSION 6-HOLE 2027049 CDM 278 RC facility both 1642 1642 Gross Charge Type: NIHD_Hosp_Profee_Price SAWBLADE PRECISION 25X1.27X105MM 2027079 CDM 272 RC facility both 1196 1196 Gross Charge Type: NIHD_Hosp_Profee_Price SAWBLADE PRECISION 25X1.27X105MM 2027079 CDM 272 RC facility both 1196 1196 Gross Charge Type: NIHD_Hosp_Profee_Price ACETABULAR LINER ELEVATED 40MM SZ MM 2027124 CDM 278 RC facility both 10284 10284 Gross Charge Type: NIHD_Hosp_Profee_Price ACETABULAR LINER ELEVATED 40MM SZ MM 2027124 CDM 278 RC facility both 10284 10284 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL HEAD 40MM 12/14 TAP NECK +0 2027125 CDM 278 RC facility both 4767 4767 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL HEAD 40MM 12/14 TAP NECK +0 2027125 CDM 278 RC facility both 4767 4767 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL RADIOLUCENT 3.2X148MM ZIMMER 2027130 CDM 272 RC facility both 330 330 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL RADIOLUCENT 3.2X148MM ZIMMER 2027130 CDM 272 RC facility both 330 330 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL RADIOLUCENT 4.0X148MM ZIMMER 2027131 CDM 272 RC facility both 330 330 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL RADIOLUCENT 4.0X148MM ZIMMER 2027131 CDM 272 RC facility both 330 330 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER PNEUMOTHORAX KIT 8 FR 2027135 CDM facility both 352 352 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER PNEUMOTHORAX KIT 8 FR 2027135 CDM facility both 352 352 Gross Charge Type: NIHD_Hosp_Profee_Price HIP STEM 132 DEG SZ7 35X150MM ANGLE 2027142 CDM 278 RC facility both 22865 22865 Gross Charge Type: NIHD_Hosp_Profee_Price HIP STEM 132 DEG SZ7 35X150MM ANGLE 2027142 CDM 278 RC facility both 22865 22865 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD FEMORAL C-TAPER CERAMIC SZ 32MM 18-3200 2027143 CDM 278 RC facility both 8345 8345 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD FEMORAL C-TAPER CERAMIC SZ 32MM 18-3200 2027143 CDM 278 RC facility both 8345 8345 Gross Charge Type: NIHD_Hosp_Profee_Price STEM SHOULDER MINI HUMERAL 9MM BIOMET 2027181 CDM 278 RC facility both 21228 21228 Gross Charge Type: NIHD_Hosp_Profee_Price STEM SHOULDER MINI HUMERAL 9MM BIOMET 2027181 CDM 278 RC facility both 21228 21228 Gross Charge Type: NIHD_Hosp_Profee_Price TIGHTROPE MINI FT LISFRANC 4.5X14MM 2027184 CDM 278 RC facility both 2915 2915 Gross Charge Type: NIHD_Hosp_Profee_Price TIGHTROPE MINI FT LISFRANC 4.5X14MM 2027184 CDM 278 RC facility both 2915 2915 Gross Charge Type: NIHD_Hosp_Profee_Price TIGHTROPE MINI REPAIR IMPLANT CAN 2027185 CDM 278 RC facility both 2249 2249 Gross Charge Type: NIHD_Hosp_Profee_Price TIGHTROPE MINI REPAIR IMPLANT CAN 2027185 CDM 278 RC facility both 2249 2249 Gross Charge Type: NIHD_Hosp_Profee_Price EVICEL FIBRIN SEALANT LAP FLEXIBLE TIP 2027211 CDM 272 RC facility both 340 340 Gross Charge Type: NIHD_Hosp_Profee_Price EVICEL FIBRIN SEALANT LAP FLEXIBLE TIP 2027211 CDM 272 RC facility both 340 340 Gross Charge Type: NIHD_Hosp_Profee_Price EVICEL FIBRIN HUMAN SEALANT SYRINGE 2027212 CDM 272 RC facility both 964 964 Gross Charge Type: NIHD_Hosp_Profee_Price EVICEL FIBRIN HUMAN SEALANT SYRINGE 2027212 CDM 272 RC facility both 964 964 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X20X55MM 2027214 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X20X55MM 2027214 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X20X60MM 2027215 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X20X60MM 2027215 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X20X70MM 2027216 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X20X70MM 2027216 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X20X85MM 2027217 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X20X85MM 2027217 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X40X90MM 2027218 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X40X90MM 2027218 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price KNEE LIGAMENT AUGMENTATION REPAIR KIT 2027226 CDM 278 RC facility both 5121 5121 Gross Charge Type: NIHD_Hosp_Profee_Price KNEE LIGAMENT AUGMENTATION REPAIR KIT 2027226 CDM 278 RC facility both 5121 5121 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE LASSO WIRE LOOP 2027227 CDM 272 RC facility both 85 85 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE LASSO WIRE LOOP 2027227 CDM 272 RC facility both 85 85 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL MICRO-ACUTRAK 2 2027234 CDM 272 RC facility both 1344 1344 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL MICRO-ACUTRAK 2 2027234 CDM 272 RC facility both 1344 1344 Gross Charge Type: NIHD_Hosp_Profee_Price FASTFIX STRUT LONG 2027252 CDM 272 RC facility both 4848 4848 Gross Charge Type: NIHD_Hosp_Profee_Price FASTFIX STRUT LONG 2027252 CDM 272 RC facility both 4848 4848 Gross Charge Type: NIHD_Hosp_Profee_Price FLIP CUTTER 7MM 2027266 CDM 272 RC facility both 975 975 Gross Charge Type: NIHD_Hosp_Profee_Price FLIP CUTTER 7MM 2027266 CDM 272 RC facility both 975 975 Gross Charge Type: NIHD_Hosp_Profee_Price FLIP CUTTER 7.5MM 2027267 CDM 272 RC facility both 975 975 Gross Charge Type: NIHD_Hosp_Profee_Price FLIP CUTTER 7.5MM 2027267 CDM 272 RC facility both 975 975 Gross Charge Type: NIHD_Hosp_Profee_Price NEEDLE SCORPION KNEE 2027325 CDM 272 RC facility both 586 586 Gross Charge Type: NIHD_Hosp_Profee_Price NEEDLE SCORPION KNEE 2027325 CDM 272 RC facility both 586 586 Gross Charge Type: NIHD_Hosp_Profee_Price ARTICULAR SURFACE CR BLUE /C-H 14MM 005976-40-14 2027331 CDM 278 RC facility both 7406 7406 Gross Charge Type: NIHD_Hosp_Profee_Price ARTICULAR SURFACE CR BLUE /C-H 14MM 005976-40-14 2027331 CDM 278 RC facility both 7406 7406 Gross Charge Type: NIHD_Hosp_Profee_Price GRAFT AFLEX301 40X70X3.0 2027367 CDM 278 RC facility both 11835 11835 Gross Charge Type: NIHD_Hosp_Profee_Price GRAFT AFLEX301 40X70X3.0 2027367 CDM 278 RC facility both 11835 11835 Gross Charge Type: NIHD_Hosp_Profee_Price VARIAX TAP 3.5X70MM 2027390 CDM 278 RC facility both 514 514 Gross Charge Type: NIHD_Hosp_Profee_Price VARIAX TAP 3.5X70MM 2027390 CDM 278 RC facility both 514 514 Gross Charge Type: NIHD_Hosp_Profee_Price PASSPORT BUTTON CANNULA 12X30MM 2027431 CDM 272 RC facility both 37 37 Gross Charge Type: NIHD_Hosp_Profee_Price PASSPORT BUTTON CANNULA 12X30MM 2027431 CDM 272 RC facility both 37 37 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE ANCHOR SWVLOC 4.75X19.1 W/TAPE 2027441 CDM 272 RC facility both 1410 1410 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE ANCHOR SWVLOC 4.75X19.1 W/TAPE 2027441 CDM 272 RC facility both 1410 1410 Gross Charge Type: NIHD_Hosp_Profee_Price INSERT POLYETHLENE TRIDENT 0 DEGREE 32-E 2027445 CDM 278 RC facility both 7817 7817 Gross Charge Type: NIHD_Hosp_Profee_Price INSERT POLYETHLENE TRIDENT 0 DEGREE 32-E 2027445 CDM 278 RC facility both 7817 7817 Gross Charge Type: NIHD_Hosp_Profee_Price STEM HIP 127 NECK ANGLE 8X30MM C-TPR 2027446 CDM 278 RC facility both 22865 22865 Gross Charge Type: NIHD_Hosp_Profee_Price STEM HIP 127 NECK ANGLE 8X30MM C-TPR 2027446 CDM 278 RC facility both 22865 22865 Gross Charge Type: NIHD_Hosp_Profee_Price SHELL HEMI CLUSTER HOLE SZ 60 MM F 2027457 CDM 278 RC facility both 11484 11484 Gross Charge Type: NIHD_Hosp_Profee_Price SHELL HEMI CLUSTER HOLE SZ 60 MM F 2027457 CDM 278 RC facility both 11484 11484 Gross Charge Type: NIHD_Hosp_Profee_Price INSERT RESTORATION SIZE 28/52 SIZE 46F 2027459 CDM 278 RC facility both 7969 7969 Gross Charge Type: NIHD_Hosp_Profee_Price INSERT RESTORATION SIZE 28/52 SIZE 46F 2027459 CDM 278 RC facility both 7969 7969 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD FEMORAL C-TAPER CERAMIC SZ 28MM+5 2027461 CDM 278 RC facility both 8345 8345 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD FEMORAL C-TAPER CERAMIC SZ 28MM+5 2027461 CDM 278 RC facility both 8345 8345 Gross Charge Type: NIHD_Hosp_Profee_Price LINER CEMENTLESS 46MM F 2027462 CDM 278 RC facility both 10117 10117 Gross Charge Type: NIHD_Hosp_Profee_Price LINER CEMENTLESS 46MM F 2027462 CDM 278 RC facility both 10117 10117 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL COMPONENT CR-FLEX G- RIGHT 2027463 CDM 278 RC facility both 23747 23747 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL COMPONENT CR-FLEX G- RIGHT 2027463 CDM 278 RC facility both 23747 23747 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREAD STAINLESS 6.5X20X100MM 2027500 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREAD STAINLESS 6.5X20X100MM 2027500 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREAD STAINLESS 6.5X20X115MM 2027501 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREAD STAINLESS 6.5X20X115MM 2027501 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREAD STAINLESS 6.5X20X120MM 2027502 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREAD STAINLESS 6.5X20X120MM 2027502 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREAD STAINLESS 6.5X40X110MM 2027503 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREAD STAINLESS 6.5X40X110MM 2027503 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SPEED BRIDGE SWIVELOCK 4.75X19.1MM 2027509 CDM 278 RC facility both 5218 5218 Gross Charge Type: NIHD_Hosp_Profee_Price SPEED BRIDGE SWIVELOCK 4.75X19.1MM 2027509 CDM 278 RC facility both 5218 5218 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 1.4X1.5MM FOOT 2027525 CDM 272 RC facility both 440 440 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 1.4X1.5MM FOOT 2027525 CDM 272 RC facility both 440 440 Gross Charge Type: NIHD_Hosp_Profee_Price CUFF AND COLLAR SLING 2027535 CDM 271 RC facility both 40 40 Gross Charge Type: NIHD_Hosp_Profee_Price CUFF AND COLLAR SLING 2027535 CDM 271 RC facility both 40 40 Gross Charge Type: NIHD_Hosp_Profee_Price URETERAL CATHETER CONNECTOR ( DR DAVIS) 2027555 CDM 272 RC facility both 131 131 Gross Charge Type: NIHD_Hosp_Profee_Price URETERAL CATHETER CONNECTOR ( DR DAVIS) 2027555 CDM 272 RC facility both 131 131 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREAD STAINLESS 8.0X25X60MM 2027557 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREAD STAINLESS 8.0X25X60MM 2027557 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREAD STAINLESS 8.0X25X75MM 2027558 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREAD STAINLESS 8.0X25X75MM 2027558 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREAD STAINLESS 8.0X25X95MM 2027559 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREAD STAINLESS 8.0X25X95MM 2027559 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREAD STAINLESS 6.5X20X105MM 2027575 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREAD STAINLESS 6.5X20X105MM 2027575 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X20X110MM 2027576 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X20X110MM 2027576 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X20X80MM 2027578 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X20X80MM 2027578 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X20X45MM 2027579 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X20X45MM 2027579 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X20X50MM 2027580 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X20X50MM 2027580 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X20X65MM 2027581 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X20X65MM 2027581 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X20X75MM 2027583 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X20X75MM 2027583 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREAD STAINLESS 8.0X25X85MM 2027584 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREAD STAINLESS 8.0X25X85MM 2027584 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X20X40MM 2027596 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X20X40MM 2027596 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X20X95MM 2027598 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X20X95MM 2027598 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X40X95MM 2027611 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X40X95MM 2027611 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X40X100MM 2027612 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 6.5X40X100MM 2027612 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price ROD SEMI CIRCLE CURVED HOFFMAN 3 11X100M 2027634 CDM 272 RC facility both 1091 1091 Gross Charge Type: NIHD_Hosp_Profee_Price ROD SEMI CIRCLE CURVED HOFFMAN 3 11X100M 2027634 CDM 272 RC facility both 1091 1091 Gross Charge Type: NIHD_Hosp_Profee_Price K-WIRE THREADED 2.0X1.5MM STYKER 2027635 CDM 272 RC facility both 313 313 Gross Charge Type: NIHD_Hosp_Profee_Price K-WIRE THREADED 2.0X1.5MM STYKER 2027635 CDM 272 RC facility both 313 313 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT CANNULATED 3.5MM AO 2027637 CDM 272 RC facility both 1211 1211 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT CANNULATED 3.5MM AO 2027637 CDM 272 RC facility both 1211 1211 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 2.0X1.5 MM AO COUPLING 2027640 CDM 272 RC facility both 709 709 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 2.0X1.5 MM AO COUPLING 2027640 CDM 272 RC facility both 709 709 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD FEMORAL LFIT V40 32X8MM 2027698 CDM 278 RC facility both 3832 3832 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD FEMORAL LFIT V40 32X8MM 2027698 CDM 278 RC facility both 3832 3832 Gross Charge Type: NIHD_Hosp_Profee_Price STEM HIP ANGLE ACC 11 3X30X102MM 2027699 CDM 278 RC facility both 24008 24008 Gross Charge Type: NIHD_Hosp_Profee_Price STEM HIP ANGLE ACC 11 3X30X102MM 2027699 CDM 278 RC facility both 24008 24008 Gross Charge Type: NIHD_Hosp_Profee_Price STEM HIP ANGLE 125 DEG ACC 11 2X30X99MM 2027701 CDM 278 RC facility both 24008 24008 Gross Charge Type: NIHD_Hosp_Profee_Price STEM HIP ANGLE 125 DEG ACC 11 2X30X99MM 2027701 CDM 278 RC facility both 24008 24008 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD FEMORAL LFIT V40 32X +0MM 2027703 CDM 278 RC facility both 8345 8345 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD FEMORAL LFIT V40 32X +0MM 2027703 CDM 278 RC facility both 8345 8345 Gross Charge Type: NIHD_Hosp_Profee_Price ELECTRODE RESECT LOOP 24 FR 0.2 WIRE 2027718 CDM 272 RC facility both 1372 1372 Gross Charge Type: NIHD_Hosp_Profee_Price ELECTRODE RESECT LOOP 24 FR 0.2 WIRE 2027718 CDM 272 RC facility both 1372 1372 Gross Charge Type: NIHD_Hosp_Profee_Price ELECTRODE RESECT LOOP 24 FR 0.2 2027719 CDM 272 RC facility both 1569 1569 Gross Charge Type: NIHD_Hosp_Profee_Price ELECTRODE RESECT LOOP 24 FR 0.2 2027719 CDM 272 RC facility both 1569 1569 Gross Charge Type: NIHD_Hosp_Profee_Price STENT URETERAL SOFT CURL 6FR X 30CM 2027727 CDM 278 RC facility both 403 403 Gross Charge Type: NIHD_Hosp_Profee_Price STENT URETERAL SOFT CURL 6FR X 30CM 2027727 CDM 278 RC facility both 403 403 Gross Charge Type: NIHD_Hosp_Profee_Price STENT URETERAL SOFT CURL 6FR X 28CM 2027728 CDM 278 RC facility both 403 403 Gross Charge Type: NIHD_Hosp_Profee_Price STENT URETERAL SOFT CURL 6FR X 28CM 2027728 CDM 278 RC facility both 403 403 Gross Charge Type: NIHD_Hosp_Profee_Price STENT URETERAL SOFT CURL 6FR X 26CM 2027729 CDM 278 RC facility both 401 401 Gross Charge Type: NIHD_Hosp_Profee_Price STENT URETERAL SOFT CURL 6FR X 26CM 2027729 CDM 278 RC facility both 401 401 Gross Charge Type: NIHD_Hosp_Profee_Price STENT URETERAL SOFT CURL 6FR X 24CM 2027730 CDM 278 RC facility both 197 197 Gross Charge Type: NIHD_Hosp_Profee_Price STENT URETERAL SOFT CURL 6FR X 24CM 2027730 CDM 278 RC facility both 197 197 Gross Charge Type: NIHD_Hosp_Profee_Price STENT URETERAL SOFT CURL 6FR X 22CM 2027731 CDM 278 RC facility both 403 403 Gross Charge Type: NIHD_Hosp_Profee_Price STENT URETERAL SOFT CURL 6FR X 22CM 2027731 CDM 278 RC facility both 403 403 Gross Charge Type: NIHD_Hosp_Profee_Price STENT URETERAL SOFT CURL 4.5FR X 30CM 2027732 CDM 278 RC facility both 403 403 Gross Charge Type: NIHD_Hosp_Profee_Price STENT URETERAL SOFT CURL 4.5FR X 30CM 2027732 CDM 278 RC facility both 403 403 Gross Charge Type: NIHD_Hosp_Profee_Price STENT URETERAL SOFT CURL 4.5FR X 28CM 2027733 CDM 278 RC facility both 403 403 Gross Charge Type: NIHD_Hosp_Profee_Price STENT URETERAL SOFT CURL 4.5FR X 28CM 2027733 CDM 278 RC facility both 403 403 Gross Charge Type: NIHD_Hosp_Profee_Price STENT URETERAL SOFT CURL 4.5FR X 26CM 2027734 CDM 278 RC facility both 403 403 Gross Charge Type: NIHD_Hosp_Profee_Price STENT URETERAL SOFT CURL 4.5FR X 26CM 2027734 CDM 278 RC facility both 403 403 Gross Charge Type: NIHD_Hosp_Profee_Price STENT URETERAL SOFT CURL 4.5FR X 24CM 2027735 CDM 278 RC facility both 403 403 Gross Charge Type: NIHD_Hosp_Profee_Price STENT URETERAL SOFT CURL 4.5FR X 24CM 2027735 CDM 278 RC facility both 403 403 Gross Charge Type: NIHD_Hosp_Profee_Price WIRE ANGLETIP HYBRID 0.0035 2027737 CDM 272 RC facility both 146 146 Gross Charge Type: NIHD_Hosp_Profee_Price WIRE ANGLETIP HYBRID 0.0035 2027737 CDM 272 RC facility both 146 146 Gross Charge Type: NIHD_Hosp_Profee_Price WIRE HYBRID 0.0035 2027738 CDM 272 RC facility both 110 110 Gross Charge Type: NIHD_Hosp_Profee_Price WIRE HYBRID 0.0035 2027738 CDM 272 RC facility both 110 110 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER DUAL LUMEN 10 FR 2027740 CDM 272 RC facility both 603 603 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER DUAL LUMEN 10 FR 2027740 CDM 272 RC facility both 603 603 Gross Charge Type: NIHD_Hosp_Profee_Price GLIDEWIRE ANG TIP REG BODY 3 CM 2027741 CDM 272 RC facility both 765 765 Gross Charge Type: NIHD_Hosp_Profee_Price GLIDEWIRE ANG TIP REG BODY 3 CM 2027741 CDM 272 RC facility both 765 765 Gross Charge Type: NIHD_Hosp_Profee_Price GLIDEWIRE 0.035 ANG TIP STIFF BODY 3 CM 2027742 CDM 272 RC facility both 131 131 Gross Charge Type: NIHD_Hosp_Profee_Price GLIDEWIRE 0.035 ANG TIP STIFF BODY 3 CM 2027742 CDM 272 RC facility both 131 131 Gross Charge Type: NIHD_Hosp_Profee_Price GLIDEWIRE 0.035 STRTIP REG BODY 3 CM 2027743 CDM 272 RC facility both 765 765 Gross Charge Type: NIHD_Hosp_Profee_Price GLIDEWIRE 0.035 STRTIP REG BODY 3 CM 2027743 CDM 272 RC facility both 765 765 Gross Charge Type: NIHD_Hosp_Profee_Price UROPASS AS 11/13FR X 46 CM 2027745 CDM 278 RC facility both 2003 2003 Gross Charge Type: NIHD_Hosp_Profee_Price UROPASS AS 11/13FR X 46 CM 2027745 CDM 278 RC facility both 2003 2003 Gross Charge Type: NIHD_Hosp_Profee_Price UROPASS AS 11/13FR X 24 CM 2027747 CDM 272 RC facility both 2003 2003 Gross Charge Type: NIHD_Hosp_Profee_Price UROPASS AS 11/13FR X 24 CM 2027747 CDM 272 RC facility both 2003 2003 Gross Charge Type: NIHD_Hosp_Profee_Price UROPASS AS SHEATH 11/12FRX38 CM 2027750 CDM 278 RC facility both 267 267 Gross Charge Type: NIHD_Hosp_Profee_Price UROPASS AS SHEATH 11/12FRX38 CM 2027750 CDM 278 RC facility both 267 267 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE VLOC 2-0 GS-22 6 INCH A ROBINSON 2027752 CDM 272 RC facility both 92 92 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE VLOC 2-0 GS-22 6 INCH A ROBINSON 2027752 CDM 272 RC facility both 92 92 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER URETERAL 5 FR OPEN ENDED 2027757 CDM 272 RC facility both 40 40 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER URETERAL 5 FR OPEN ENDED 2027757 CDM 272 RC facility both 40 40 Gross Charge Type: NIHD_Hosp_Profee_Price PERK-N-CIRCLE 10 FR UROLOGY 2027758 CDM 272 RC facility both 534 534 Gross Charge Type: NIHD_Hosp_Profee_Price PERK-N-CIRCLE 10 FR UROLOGY 2027758 CDM 272 RC facility both 534 534 Gross Charge Type: NIHD_Hosp_Profee_Price PERK-N-CIRCLE 12 FR UROLOGY 2027759 CDM 272 RC facility both 534 534 Gross Charge Type: NIHD_Hosp_Profee_Price PERK-N-CIRCLE 12 FR UROLOGY 2027759 CDM 272 RC facility both 534 534 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TECNIS PCB00 19.5 2027762 CDM 276 RC facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TECNIS PCB00 19.5 2027762 CDM 276 RC facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TECNIS PCB00 20.0 2027763 CDM 276 RC facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TECNIS PCB00 20.0 2027763 CDM 276 RC facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TECNIS PCB00 20.5 2027765 CDM 276 RC facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TECNIS PCB00 20.5 2027765 CDM 276 RC facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TECNIS PCB00 15.5 2027766 CDM 276 RC facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TECNIS PCB00 15.5 2027766 CDM 276 RC facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price BIOZORB MARKER 2CMX 2CM 2027782 CDM 278 RC facility both 3748 3748 Gross Charge Type: NIHD_Hosp_Profee_Price BIOZORB MARKER 2CMX 2CM 2027782 CDM 278 RC facility both 3748 3748 Gross Charge Type: NIHD_Hosp_Profee_Price BIOZORB MARKER 2CMX 3CM 2027783 CDM 278 RC facility both 3748 3748 Gross Charge Type: NIHD_Hosp_Profee_Price BIOZORB MARKER 2CMX 3CM 2027783 CDM 278 RC facility both 3748 3748 Gross Charge Type: NIHD_Hosp_Profee_Price BIOZORB 3CMX3CM 2027785 CDM 278 RC facility both 3748 3748 Gross Charge Type: NIHD_Hosp_Profee_Price BIOZORB 3CMX3CM 2027785 CDM 278 RC facility both 3748 3748 Gross Charge Type: NIHD_Hosp_Profee_Price BIOZORB 3CMX4CM 2027786 CDM 278 RC facility both 3748 3748 Gross Charge Type: NIHD_Hosp_Profee_Price BIOZORB 3CMX4CM 2027786 CDM 278 RC facility both 3748 3748 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER DILATION FILIFORM COUDE TIP 5FR 2027790 CDM 272 RC facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER DILATION FILIFORM COUDE TIP 5FR 2027790 CDM 272 RC facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER DILATION FILIFORM COUDE TIP 6FR 2027791 CDM 272 RC facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER DILATION FILIFORM COUDE TIP 6FR 2027791 CDM 272 RC facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER DIL FILIFORM COUDE TIP 4FR 12.5 2027792 CDM 272 RC facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER DIL FILIFORM COUDE TIP 4FR 12.5 2027792 CDM 272 RC facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER DIL FILIFORM COUDE TIP 5FR 12.5 2027793 CDM 272 RC facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER DIL FILIFORM COUDE TIP 5FR 12.5 2027793 CDM 272 RC facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER DIL FILIFORM COUDE TIP 6FR 12.5 2027794 CDM 272 RC facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER DIL FILIFORM COUDE TIP 6FR 12.5 2027794 CDM 272 RC facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER DIL FILIFORM SPIRALTIP 4FR 18IN 2027795 CDM 272 RC facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER DIL FILIFORM SPIRALTIP 4FR 18IN 2027795 CDM 272 RC facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER DIL FILIFORM SPIRAL TIP 4FR 18 2027798 CDM 272 RC facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER DIL FILIFORM SPIRAL TIP 4FR 18 2027798 CDM 272 RC facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER DIL FILIFORM SPIRAL TIP 6FR 18 2027799 CDM 272 RC facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER DIL FILIFORM SPIRAL TIP 6FR 18 2027799 CDM 272 RC facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER DIL FILIFORM STRAIGH TIP 4FR 18 2027800 CDM 272 RC facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER DIL FILIFORM STRAIGH TIP 4FR 18 2027800 CDM 272 RC facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER DIL FILIFORM STRAIGH TIP 5FR 18 2027801 CDM 272 RC facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER DIL FILIFORM STRAIGH TIP 5FR 18 2027801 CDM 272 RC facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER DIL FILIFORM STRT TIP 6FR 18IN 2027802 CDM 272 RC facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER DIL FILIFORM STRT TIP 6FR 18IN 2027802 CDM 272 RC facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER DIL FILIFORM STRT TIP 5FR 12.5 2027804 CDM 272 RC facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER DIL FILIFORM STRT TIP 5FR 12.5 2027804 CDM 272 RC facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price MINI JOINT DISTRACTOR TRACTI SCREW 16MM 2027819 CDM 278 RC facility both 526 526 Gross Charge Type: NIHD_Hosp_Profee_Price MINI JOINT DISTRACTOR TRACTI SCREW 16MM 2027819 CDM 278 RC facility both 526 526 Gross Charge Type: NIHD_Hosp_Profee_Price MINI JOINT DISTRACTOR TRACT SCREW 20MM 2027820 CDM 278 RC facility both 526 526 Gross Charge Type: NIHD_Hosp_Profee_Price MINI JOINT DISTRACTOR TRACT SCREW 20MM 2027820 CDM 278 RC facility both 526 526 Gross Charge Type: NIHD_Hosp_Profee_Price LITHOVUE SINGLE USE DIG FLEX URETEROSCOP 2027822 CDM 272 RC facility both 4498 4498 Gross Charge Type: NIHD_Hosp_Profee_Price LITHOVUE SINGLE USE DIG FLEX URETEROSCOP 2027822 CDM 272 RC facility both 4498 4498 Gross Charge Type: NIHD_Hosp_Profee_Price LASER FIBER 150 UM HOLM RD TIP SMA905 2027826 CDM 272 RC facility both 494 494 Gross Charge Type: NIHD_Hosp_Profee_Price LASER FIBER 150 UM HOLM RD TIP SMA905 2027826 CDM 272 RC facility both 494 494 Gross Charge Type: NIHD_Hosp_Profee_Price LASER FIBER 200 UM HOLM RD TIP SMA905 2027827 CDM 272 RC facility both 494 494 Gross Charge Type: NIHD_Hosp_Profee_Price LASER FIBER 200 UM HOLM RD TIP SMA905 2027827 CDM 272 RC facility both 494 494 Gross Charge Type: NIHD_Hosp_Profee_Price LASER FIBER 365 UM HOLM RD TIP SMA905 2027829 CDM 272 RC facility both 525 525 Gross Charge Type: NIHD_Hosp_Profee_Price LASER FIBER 365 UM HOLM RD TIP SMA905 2027829 CDM 272 RC facility both 525 525 Gross Charge Type: NIHD_Hosp_Profee_Price LASER FIBER 500 UM HOLM RD TIP SMA905 2027830 CDM 272 RC facility both 591 591 Gross Charge Type: NIHD_Hosp_Profee_Price LASER FIBER 500 UM HOLM RD TIP SMA905 2027830 CDM 272 RC facility both 591 591 Gross Charge Type: NIHD_Hosp_Profee_Price LASER FIBER 940 UM HOLM RD TIP SMA905 2027831 CDM 272 RC facility both 1089 1089 Gross Charge Type: NIHD_Hosp_Profee_Price LASER FIBER 940 UM HOLM RD TIP SMA905 2027831 CDM 272 RC facility both 1089 1089 Gross Charge Type: NIHD_Hosp_Profee_Price ELECTRODE SAL LARGE PLASMALOOP BIP 12&30 2027832 CDM 272 RC facility both 975 975 Gross Charge Type: NIHD_Hosp_Profee_Price ELECTRODE SAL LARGE PLASMALOOP BIP 12&30 2027832 CDM 272 RC facility both 975 975 Gross Charge Type: NIHD_Hosp_Profee_Price ELECTRODE SAL MED PLASMA LOOP BIP12&30 2027834 CDM 272 RC facility both 975 975 Gross Charge Type: NIHD_Hosp_Profee_Price ELECTRODE SAL MED PLASMA LOOP BIP12&30 2027834 CDM 272 RC facility both 975 975 Gross Charge Type: NIHD_Hosp_Profee_Price RING PESSARY W/ SUPPORT RING SZ 0 2027840 CDM facility both 192 192 Gross Charge Type: NIHD_Hosp_Profee_Price RING PESSARY W/ SUPPORT RING SZ 0 2027840 CDM facility both 192 192 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT-CS SZ 2 X 13MM 2027843 CDM 278 RC facility both 11010 11010 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT-CS SZ 2 X 13MM 2027843 CDM 278 RC facility both 11010 11010 Gross Charge Type: NIHD_Hosp_Profee_Price HEYMEN FOLLOWER KIT 10FR-24FR SET COUDE 2027845 CDM 272 RC facility both 109 109 Gross Charge Type: NIHD_Hosp_Profee_Price HEYMEN FOLLOWER KIT 10FR-24FR SET COUDE 2027845 CDM 272 RC facility both 109 109 Gross Charge Type: NIHD_Hosp_Profee_Price K WIRE 2.4 MM ARTHREX MINI DISECT TRAY 2027850 CDM 272 RC facility both 37 37 Gross Charge Type: NIHD_Hosp_Profee_Price K WIRE 2.4 MM ARTHREX MINI DISECT TRAY 2027850 CDM 272 RC facility both 37 37 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE DHS 145 DEG X 2HL SHORT BARREL 2027856 CDM 278 RC facility both 2973 2973 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE DHS 145 DEG X 2HL SHORT BARREL 2027856 CDM 278 RC facility both 2973 2973 Gross Charge Type: NIHD_Hosp_Profee_Price FOLLOWERS WOVEN 12FR URETHRAL CATH 2027861 CDM 272 RC facility both 323 323 Gross Charge Type: NIHD_Hosp_Profee_Price FOLLOWERS WOVEN 12FR URETHRAL CATH 2027861 CDM 272 RC facility both 323 323 Gross Charge Type: NIHD_Hosp_Profee_Price FOLLOWERS PHILLIPS WOVEN 8FR URET CATH 2027862 CDM 272 RC facility both 323 323 Gross Charge Type: NIHD_Hosp_Profee_Price FOLLOWERS PHILLIPS WOVEN 8FR URET CATH 2027862 CDM 272 RC facility both 323 323 Gross Charge Type: NIHD_Hosp_Profee_Price FOLLOWERS PHILLIPS WOVEN 10FR URETHERAL 2027863 CDM 272 RC facility both 323 323 Gross Charge Type: NIHD_Hosp_Profee_Price FOLLOWERS PHILLIPS WOVEN 10FR URETHERAL 2027863 CDM 272 RC facility both 323 323 Gross Charge Type: NIHD_Hosp_Profee_Price FOLLOWERS WOVEN PHIL 20FR URETHRAL CATH 2027864 CDM 272 RC facility both 325 325 Gross Charge Type: NIHD_Hosp_Profee_Price FOLLOWERS WOVEN PHIL 20FR URETHRAL CATH 2027864 CDM 272 RC facility both 325 325 Gross Charge Type: NIHD_Hosp_Profee_Price FOLLOWERS WOVEN 22FR URETHRAL CATH 2027865 CDM 272 RC facility both 323 323 Gross Charge Type: NIHD_Hosp_Profee_Price FOLLOWERS WOVEN 22FR URETHRAL CATH 2027865 CDM 272 RC facility both 323 323 Gross Charge Type: NIHD_Hosp_Profee_Price CATH DILATOR WALTHER FEMALE ALE 34FR 2027887 CDM 272 RC facility both 328 328 Gross Charge Type: NIHD_Hosp_Profee_Price CATH DILATOR WALTHER FEMALE ALE 34FR 2027887 CDM 272 RC facility both 328 328 Gross Charge Type: NIHD_Hosp_Profee_Price SUPRAPUBIC FOLEY TRAY 2027896 CDM 278 RC facility both 1750 1750 Gross Charge Type: NIHD_Hosp_Profee_Price SUPRAPUBIC FOLEY TRAY 2027896 CDM 278 RC facility both 1750 1750 Gross Charge Type: NIHD_Hosp_Profee_Price SUPRAPUBIC FOLEY TRAY 143112 2027898 CDM 272 RC facility both 421 421 Gross Charge Type: NIHD_Hosp_Profee_Price SUPRAPUBIC FOLEY TRAY 143112 2027898 CDM 272 RC facility both 421 421 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD HUMERAL MOD VERSA-DIAL 46X21X50 2027904 CDM 278 RC facility both 9325 9325 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD HUMERAL MOD VERSA-DIAL 46X21X50 2027904 CDM 278 RC facility both 9325 9325 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 6.5MMX25MM CENTRAL 2027905 CDM 278 RC facility both 711 711 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 6.5MMX25MM CENTRAL 2027905 CDM 278 RC facility both 711 711 Gross Charge Type: NIHD_Hosp_Profee_Price FOLLOWER WOVEN URETHRAL BOUGIE 8FR 2027928 CDM 272 RC facility both 323 323 Gross Charge Type: NIHD_Hosp_Profee_Price FOLLOWER WOVEN URETHRAL BOUGIE 8FR 2027928 CDM 272 RC facility both 323 323 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL STEM 12/14 TAPER SZ 2- STDDEPUY 2027943 CDM 278 RC facility both 27749 27749 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL STEM 12/14 TAPER SZ 2- STDDEPUY 2027943 CDM 278 RC facility both 27749 27749 Gross Charge Type: NIHD_Hosp_Profee_Price GLYCINE 3000 BAGS 2027945 CDM 272 RC facility both 48 48 Gross Charge Type: NIHD_Hosp_Profee_Price GLYCINE 3000 BAGS 2027945 CDM 272 RC facility both 48 48 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 8.0X25X100MM 2027951 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 8.0X25X100MM 2027951 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 8.0X25X105MM 2027953 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 8.0X25X105MM 2027953 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 8MM LENGTH" 2027954 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 8MM LENGTH" 2027954 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 9MM LENGTH" 2027955 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 9MM LENGTH" 2027955 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 10MM LENGTH" 2027956 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 10MM LENGTH" 2027956 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 11MM LENGTH" 2027957 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 11MM LENGTH" 2027957 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 12MM LENGTH" 2027958 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 12MM LENGTH" 2027958 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 13MM LENGTH" 2027959 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 13MM LENGTH" 2027959 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 14MM LENGTH" 2027960 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 14MM LENGTH" 2027960 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 16MM LENGTH" 2027961 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 16MM LENGTH" 2027961 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 18MM LENGTH" 2027962 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 18MM LENGTH" 2027962 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 20MM LENGTH" 2027963 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 20MM LENGTH" 2027963 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 22MM LENGTH" 2027964 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 22MM LENGTH" 2027964 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 24MM LENGTH" 2027965 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 24MM LENGTH" 2027965 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 26MM LENGTH" 2027966 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 26MM LENGTH" 2027966 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 28MM LENGTH" 2027967 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 28MM LENGTH" 2027967 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 30MM LENGTH" 2027968 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 2.5 MICRO, 30MM LENGTH" 2027968 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 3.5 MINI, 12MM LENGTH" 2027969 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 3.5 MINI, 12MM LENGTH" 2027969 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 3.5 MINI, 14MM LENGTH" 2027970 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 3.5 MINI, 14MM LENGTH" 2027970 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW COMPR-FT 3.5 MINI 16MM LENGTH 2027971 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW COMPR-FT 3.5 MINI 16MM LENGTH 2027971 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 3.5 MINI, 18MM LENGTH" 2027972 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 3.5 MINI, 18MM LENGTH" 2027972 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW COMPR-FT 3.5 MINI 20MM LENGTH 2027973 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW COMPR-FT 3.5 MINI 20MM LENGTH 2027973 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 3.5 MINI, 22MM LENGTH" 2027974 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 3.5 MINI, 22MM LENGTH" 2027974 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 3.5 MINI, 24MM LENGTH" 2027975 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 3.5 MINI, 24MM LENGTH" 2027975 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 3.5 MINI, 26MM LENGTH" 2027976 CDM 278 RC facility both 92 92 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 3.5 MINI, 26MM LENGTH" 2027976 CDM 278 RC facility both 92 92 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW COMPR-FT 3.5 MINI 28MM LENGTH 2027977 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW COMPR-FT 3.5 MINI 28MM LENGTH 2027977 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 3.5 MINI, 30MM LENGTH" 2027978 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 3.5 MINI, 30MM LENGTH" 2027978 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 3.5 MINI, 32MM LENGTH" 2027979 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 3.5 MINI, 32MM LENGTH" 2027979 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 3.5 MINI, 34MM LENGTH" 2027980 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "SCREW COMPR-FT 3.5 MINI, 34MM LENGTH" 2027980 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 2.0MM COMP FT CALIBRATED 2027981 CDM 272 RC facility both 586 586 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 2.0MM COMP FT CALIBRATED 2027981 CDM 272 RC facility both 586 586 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 2.7MM COMP FT CALIBRATED 2027982 CDM 272 RC facility both 586 586 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 2.7MM COMP FT CALIBRATED 2027982 CDM 272 RC facility both 586 586 Gross Charge Type: NIHD_Hosp_Profee_Price GUIDE WIRE TROCAR TIP 0.86MM 2027983 CDM 272 RC facility both 66 66 Gross Charge Type: NIHD_Hosp_Profee_Price GUIDE WIRE TROCAR TIP 0.86MM 2027983 CDM 272 RC facility both 66 66 Gross Charge Type: NIHD_Hosp_Profee_Price GUIDE WIRE TROCAR THREADED TIP 0.86MM 2027984 CDM 272 RC facility both 79 79 Gross Charge Type: NIHD_Hosp_Profee_Price GUIDE WIRE TROCAR THREADED TIP 0.86MM 2027984 CDM 272 RC facility both 79 79 Gross Charge Type: NIHD_Hosp_Profee_Price GUIDE WIRE TROCAR TIP 0.45 2027985 CDM 272 RC facility both 66 66 Gross Charge Type: NIHD_Hosp_Profee_Price GUIDE WIRE TROCAR TIP 0.45 2027985 CDM 272 RC facility both 66 66 Gross Charge Type: NIHD_Hosp_Profee_Price GUIDE WIRE TROCAR THREADED TIP 0.45 2027986 CDM 272 RC facility both 79 79 Gross Charge Type: NIHD_Hosp_Profee_Price GUIDE WIRE TROCAR THREADED TIP 0.45 2027986 CDM 272 RC facility both 79 79 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL PROFILE MICR COMP FT 2027987 CDM 272 RC facility both 450 450 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL PROFILE MICR COMP FT 2027987 CDM 272 RC facility both 450 450 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL PROFILE MINI COMP FT 2027988 CDM 272 RC facility both 450 450 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL PROFILE MINI COMP FT 2027988 CDM 272 RC facility both 450 450 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT COMP FT 3.2 MM CALIBRATED 2027989 CDM 272 RC facility both 586 586 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT COMP FT 3.2 MM CALIBRATED 2027989 CDM 272 RC facility both 586 586 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 16MM LENGTH COMP FT 2027990 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 16MM LENGTH COMP FT 2027990 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 18MM LENGTH COMP FT 2027991 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 18MM LENGTH COMP FT 2027991 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 20MM LENGTH COMP FT 2027992 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 20MM LENGTH COMP FT 2027992 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 22MM LENGTH COMP FT 2027993 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 22MM LENGTH COMP FT 2027993 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 24MM LENGTH COMP FT 2027994 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 24MM LENGTH COMP FT 2027994 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 26MM LENGTH COMP FT 2027995 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 26MM LENGTH COMP FT 2027995 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 28MM LENGTH COMP FT 2027996 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 28MM LENGTH COMP FT 2027996 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 30MM LENGTH COMP FT 2027997 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 30MM LENGTH COMP FT 2027997 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 32MM LENGTH COMP FT 2027998 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 32MM LENGTH COMP FT 2027998 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 36MM LENGTH COMP FT 2027999 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 36MM LENGTH COMP FT 2027999 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 38MM LENGTH COMP FT 2028000 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 38MM LENGTH COMP FT 2028000 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 40HMM LENGTH COMP FT 2028001 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 40HMM LENGTH COMP FT 2028001 CDM 278 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 42MM LENGTH COMP FT 2028002 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 42MM LENGTH COMP FT 2028002 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 44MM LENGTH COMP FT 2028003 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 44MM LENGTH COMP FT 2028003 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 46MM LENGTH COMP FT 2028004 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 46MM LENGTH COMP FT 2028004 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 48MM LENGTH COMP FT 2028005 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 48MM LENGTH COMP FT 2028005 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 50MM LENGTH COMP FT 2028006 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 4.0 STD 50MM LENGTH COMP FT 2028006 CDM 278 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price STEM HIP ANGLE NECK ACCOLADE 11 4X35X140 2028007 CDM 278 RC facility both 24008 24008 Gross Charge Type: NIHD_Hosp_Profee_Price STEM HIP ANGLE NECK ACCOLADE 11 4X35X140 2028007 CDM 278 RC facility both 24008 24008 Gross Charge Type: NIHD_Hosp_Profee_Price CEMENT BONE REFOBACIN WITH GENT 2028008 CDM 278 RC facility both 450 450 Gross Charge Type: NIHD_Hosp_Profee_Price CEMENT BONE REFOBACIN WITH GENT 2028008 CDM 278 RC facility both 450 450 Gross Charge Type: NIHD_Hosp_Profee_Price IOL SYMFONY ZXR0017.5 2028015 CDM 276 RC facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price IOL SYMFONY ZXR0017.5 2028015 CDM 276 RC facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price EPIFIX 2CM X 2 CM SHEET 2028021 CDM 636 RC facility both 798 798 Gross Charge Type: NIHD_Hosp_Profee_Price EPIFIX 2CM X 2 CM SHEET 2028021 CDM 636 RC facility both 798 798 Gross Charge Type: NIHD_Hosp_Profee_Price EPIFIX 2CM X 3CM SHEET 2028022 CDM 636 RC facility both 572 572 Gross Charge Type: NIHD_Hosp_Profee_Price EPIFIX 2CM X 3CM SHEET 2028022 CDM 636 RC facility both 572 572 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TECNIS MF ZLB00 21.5 1 PIECE 3.25 2028027 CDM 276 RC facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TECNIS MF ZLB00 21.5 1 PIECE 3.25 2028027 CDM 276 RC facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price BACTISURE WOUND LAVAGE 2028029 CDM 272 RC facility both 2984 2984 Gross Charge Type: NIHD_Hosp_Profee_Price BACTISURE WOUND LAVAGE 2028029 CDM 272 RC facility both 2984 2984 Gross Charge Type: NIHD_Hosp_Profee_Price HIP HEAD CEMENT MOLD SIS 431183 2028032 CDM 278 RC facility both 5487 5487 Gross Charge Type: NIHD_Hosp_Profee_Price HIP HEAD CEMENT MOLD SIS 431183 2028032 CDM 278 RC facility both 5487 5487 Gross Charge Type: NIHD_Hosp_Profee_Price HIP MOLD STEM E REINF 9X125 2028033 CDM 278 RC facility both 6866 6866 Gross Charge Type: NIHD_Hosp_Profee_Price HIP MOLD STEM E REINF 9X125 2028033 CDM 278 RC facility both 6866 6866 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW BONE SELF TAP 6.5X50MM 2028034 CDM 278 RC facility both 720 720 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW BONE SELF TAP 6.5X50MM 2028034 CDM 278 RC facility both 720 720 Gross Charge Type: NIHD_Hosp_Profee_Price AMNIOFILL 500MG 2028040 CDM 278 RC facility both 3448 3448 Gross Charge Type: NIHD_Hosp_Profee_Price AMNIOFILL 500MG 2028040 CDM 278 RC facility both 3448 3448 Gross Charge Type: NIHD_Hosp_Profee_Price AMNIOFILL 1000MG 2028041 CDM 278 RC facility both 6747 6747 Gross Charge Type: NIHD_Hosp_Profee_Price AMNIOFILL 1000MG 2028041 CDM 278 RC facility both 6747 6747 Gross Charge Type: NIHD_Hosp_Profee_Price CEMENT BONE REFOBACIN PLAIN 2028045 CDM 278 RC facility both 570 570 Gross Charge Type: NIHD_Hosp_Profee_Price CEMENT BONE REFOBACIN PLAIN 2028045 CDM 278 RC facility both 570 570 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM SMALL HYBRID GLENOID BASE 113952 2028046 CDM 278 RC facility both 7976 7976 Gross Charge Type: NIHD_Hosp_Profee_Price 4MM SMALL HYBRID GLENOID BASE 113952 2028046 CDM 278 RC facility both 7976 7976 Gross Charge Type: NIHD_Hosp_Profee_Price HYBRID GLENOID POST 2028047 CDM 278 RC facility both 1350 1350 Gross Charge Type: NIHD_Hosp_Profee_Price HYBRID GLENOID POST 2028047 CDM 278 RC facility both 1350 1350 Gross Charge Type: NIHD_Hosp_Profee_Price BLADE EXPLANT TRUNCATED 56MM 2028049 CDM 272 RC facility both 3538 3538 Gross Charge Type: NIHD_Hosp_Profee_Price BLADE EXPLANT TRUNCATED 56MM 2028049 CDM 272 RC facility both 3538 3538 Gross Charge Type: NIHD_Hosp_Profee_Price BLADE EXPLANT FULL 56MM ZIMMER 2028050 CDM 272 RC facility both 3538 3538 Gross Charge Type: NIHD_Hosp_Profee_Price BLADE EXPLANT FULL 56MM ZIMMER 2028050 CDM 272 RC facility both 3538 3538 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TECNIS MF ZLB00 22.0 PIECE 3.25 2028052 CDM 278 RC facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TECNIS MF ZLB00 22.0 PIECE 3.25 2028052 CDM 278 RC facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL COMPONENT CR-FLEX D RIGHT 00575001402 2028063 CDM 278 RC facility both 23747 23747 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL COMPONENT CR-FLEX D RIGHT 00575001402 2028063 CDM 278 RC facility both 23747 23747 Gross Charge Type: NIHD_Hosp_Profee_Price ARM SLING XX SMALL 2028080 CDM 271 RC facility both 25 25 Gross Charge Type: NIHD_Hosp_Profee_Price ARM SLING XX SMALL 2028080 CDM 271 RC facility both 25 25 Gross Charge Type: NIHD_Hosp_Profee_Price ARM SLING X SMALL 2028081 CDM 271 RC facility both 21 21 Gross Charge Type: NIHD_Hosp_Profee_Price ARM SLING X SMALL 2028081 CDM 271 RC facility both 21 21 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD FEMORAL LFIT V40 32X -4MM 2028083 CDM 278 RC facility both 8345 8345 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD FEMORAL LFIT V40 32X -4MM 2028083 CDM 278 RC facility both 8345 8345 Gross Charge Type: NIHD_Hosp_Profee_Price STEM HIP ANGLE ACC 11 SIZE#4 35X105MM 2028084 CDM 278 RC facility both 24008 24008 Gross Charge Type: NIHD_Hosp_Profee_Price STEM HIP ANGLE ACC 11 SIZE#4 35X105MM 2028084 CDM 278 RC facility both 24008 24008 Gross Charge Type: NIHD_Hosp_Profee_Price SHVR 3.5 TORPEDO SMALL JOINT AR-7350TD 2028101 CDM 272 RC facility both 436 436 Gross Charge Type: NIHD_Hosp_Profee_Price SHVR 3.5 TORPEDO SMALL JOINT AR-7350TD 2028101 CDM 272 RC facility both 436 436 Gross Charge Type: NIHD_Hosp_Profee_Price OSTEOCHONDRAL FLAP REPAIR SGLE SHOT INST 2028102 CDM 272 RC facility both 880 880 Gross Charge Type: NIHD_Hosp_Profee_Price OSTEOCHONDRAL FLAP REPAIR SGLE SHOT INST 2028102 CDM 272 RC facility both 880 880 Gross Charge Type: NIHD_Hosp_Profee_Price ARTHREX CHONDRAL DART 1.3X18MM 2028104 CDM 278 RC facility both 1815 1815 Gross Charge Type: NIHD_Hosp_Profee_Price ARTHREX CHONDRAL DART 1.3X18MM 2028104 CDM 278 RC facility both 1815 1815 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE ANCHOR CORKSCREW AR-1927BCT 2028105 CDM 272 RC facility both 1065 1065 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE ANCHOR CORKSCREW AR-1927BCT 2028105 CDM 272 RC facility both 1065 1065 Gross Charge Type: NIHD_Hosp_Profee_Price STEM HIP ANGLE ACC 11 SIZE# 6 35X111MM 2028106 CDM 278 RC facility both 24008 24008 Gross Charge Type: NIHD_Hosp_Profee_Price STEM HIP ANGLE ACC 11 SIZE# 6 35X111MM 2028106 CDM 278 RC facility both 24008 24008 Gross Charge Type: NIHD_Hosp_Profee_Price 5X180 APEX S/D HALF PIN 50 THR 5018-8-180 2028112 CDM 278 RC facility both 589 589 Gross Charge Type: NIHD_Hosp_Profee_Price 5X180 APEX S/D HALF PIN 50 THR 5018-8-180 2028112 CDM 278 RC facility both 589 589 Gross Charge Type: NIHD_Hosp_Profee_Price SINGLE ACTION PUMP SYSTEM 2028116 CDM 272 RC facility both 188 188 Gross Charge Type: NIHD_Hosp_Profee_Price SINGLE ACTION PUMP SYSTEM 2028116 CDM 272 RC facility both 188 188 Gross Charge Type: NIHD_Hosp_Profee_Price REVERSE GLENOSPHERE 36MM +3 CURVED/STAND 2028134 CDM 278 RC facility both 7646 7646 Gross Charge Type: NIHD_Hosp_Profee_Price REVERSE GLENOSPHERE 36MM +3 CURVED/STAND 2028134 CDM 278 RC facility both 7646 7646 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TECNIS MF ZMA00 21.0 3 PIECE 2028140 CDM 276 RC facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TECNIS MF ZMA00 21.0 3 PIECE 2028140 CDM 276 RC facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price FOLLOWERS PHILLIPS WOVEN 14FR URET CATH 2028142 CDM 272 RC facility both 323 323 Gross Charge Type: NIHD_Hosp_Profee_Price FOLLOWERS PHILLIPS WOVEN 14FR URET CATH 2028142 CDM 272 RC facility both 323 323 Gross Charge Type: NIHD_Hosp_Profee_Price FOLLOWERS PHILLIPS WOVEN 16FR URET CATH 2028143 CDM 272 RC facility both 325 325 Gross Charge Type: NIHD_Hosp_Profee_Price FOLLOWERS PHILLIPS WOVEN 16FR URET CATH 2028143 CDM 272 RC facility both 325 325 Gross Charge Type: NIHD_Hosp_Profee_Price FOLLOWERS PHILLIPS WOVEN 18FR URET CATH 2028144 CDM 272 RC facility both 323 323 Gross Charge Type: NIHD_Hosp_Profee_Price FOLLOWERS PHILLIPS WOVEN 18FR URET CATH 2028144 CDM 272 RC facility both 323 323 Gross Charge Type: NIHD_Hosp_Profee_Price STEM HIP ANGLE 127 DEG ACC 11 6X35X111M 2028145 CDM 278 RC facility both 24008 24008 Gross Charge Type: NIHD_Hosp_Profee_Price STEM HIP ANGLE 127 DEG ACC 11 6X35X111M 2028145 CDM 278 RC facility both 24008 24008 Gross Charge Type: NIHD_Hosp_Profee_Price PROSTATE BIOPSY CORE NEEDLE 14X10 2028146 CDM 272 RC facility both 367 367 Gross Charge Type: NIHD_Hosp_Profee_Price PROSTATE BIOPSY CORE NEEDLE 14X10 2028146 CDM 272 RC facility both 367 367 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE VLOCK 90 4.0 - P14 12 INCHES LONG 2028173 CDM 272 RC facility both 89 89 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE VLOCK 90 4.0 - P14 12 INCHES LONG 2028173 CDM 272 RC facility both 89 89 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE VLOCK 90 4.0 - P14 18 INCHES LONG 2028174 CDM 272 RC facility both 106 106 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE VLOCK 90 4.0 - P14 18 INCHES LONG 2028174 CDM 272 RC facility both 106 106 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE VLOCK 90 4.0 - P14 23 INCHES LONG 2028175 CDM 272 RC facility both 119 119 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE VLOCK 90 4.0 - P14 23 INCHES LONG 2028175 CDM 272 RC facility both 119 119 Gross Charge Type: NIHD_Hosp_Profee_Price VERSAONE FASCIAL CLOSURE SYS OPTICAL 2028176 CDM 272 RC facility both 256 256 Gross Charge Type: NIHD_Hosp_Profee_Price VERSAONE FASCIAL CLOSURE SYS OPTICAL 2028176 CDM 272 RC facility both 256 256 Gross Charge Type: NIHD_Hosp_Profee_Price LIGASURE PRECISE EXACT DISSECTOR 2028178 CDM 272 RC facility both 1487 1487 Gross Charge Type: NIHD_Hosp_Profee_Price LIGASURE PRECISE EXACT DISSECTOR 2028178 CDM 272 RC facility both 1487 1487 Gross Charge Type: NIHD_Hosp_Profee_Price CONTINUUM CONSTRAINED LINER 28MM X 50HH 2028180 CDM 278 RC facility both 18919 18919 Gross Charge Type: NIHD_Hosp_Profee_Price CONTINUUM CONSTRAINED LINER 28MM X 50HH 2028180 CDM 278 RC facility both 18919 18919 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL HEAD 12/14 COCR 28MM+0 2028181 CDM 278 RC facility both 4018 4018 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL HEAD 12/14 COCR 28MM+0 2028181 CDM 278 RC facility both 4018 4018 Gross Charge Type: NIHD_Hosp_Profee_Price ALLOSYNC DBM GEL 5CC ARTHREX 2028216 CDM 278 RC facility both 3428 3428 Gross Charge Type: NIHD_Hosp_Profee_Price ALLOSYNC DBM GEL 5CC ARTHREX 2028216 CDM 278 RC facility both 3428 3428 Gross Charge Type: NIHD_Hosp_Profee_Price RETRIEVEL BAG 5MM LAP INZII UNIVERSAL 2028221 CDM 272 RC facility both 301 301 Gross Charge Type: NIHD_Hosp_Profee_Price RETRIEVEL BAG 5MM LAP INZII UNIVERSAL 2028221 CDM 272 RC facility both 301 301 Gross Charge Type: NIHD_Hosp_Profee_Price GELPOINT PATH MINI PLATFORM 2028222 CDM 272 RC facility both 2025 2025 Gross Charge Type: NIHD_Hosp_Profee_Price GELPOINT PATH MINI PLATFORM 2028222 CDM 272 RC facility both 2025 2025 Gross Charge Type: NIHD_Hosp_Profee_Price GELPOINT PATH PLATFORM WITH ISB 2028223 CDM 272 RC facility both 2625 2625 Gross Charge Type: NIHD_Hosp_Profee_Price GELPOINT PATH PLATFORM WITH ISB 2028223 CDM 272 RC facility both 2625 2625 Gross Charge Type: NIHD_Hosp_Profee_Price ALEXIS O WOUND PROTECTOR MEDIUM RIGID 2028224 CDM 272 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price ALEXIS O WOUND PROTECTOR MEDIUM RIGID 2028224 CDM 272 RC facility both 127 127 Gross Charge Type: NIHD_Hosp_Profee_Price SHELL HEMI CLUSTER HOLE SZ 62MM G 2028230 CDM 278 RC facility both 11484 11484 Gross Charge Type: NIHD_Hosp_Profee_Price SHELL HEMI CLUSTER HOLE SZ 62MM G 2028230 CDM 278 RC facility both 11484 11484 Gross Charge Type: NIHD_Hosp_Profee_Price INSERT POLYETHLENE TRIDENT 0 DEGREE 36MM 2028231 CDM 278 RC facility both 7681 7681 Gross Charge Type: NIHD_Hosp_Profee_Price INSERT POLYETHLENE TRIDENT 0 DEGREE 36MM 2028231 CDM 278 RC facility both 7681 7681 Gross Charge Type: NIHD_Hosp_Profee_Price ALEXIS LAPAROSCOPIC SYSTEM WITH KI TROCA 2028234 CDM 272 RC facility both 750 750 Gross Charge Type: NIHD_Hosp_Profee_Price ALEXIS LAPAROSCOPIC SYSTEM WITH KI TROCA 2028234 CDM 272 RC facility both 750 750 Gross Charge Type: NIHD_Hosp_Profee_Price DRAIN LATEX MALECOT 4WING 20FR 2028237 CDM 272 RC C1729 HCPCS facility both 31 31 Gross Charge Type: NIHD_RHC_Price DRAIN LATEX MALECOT 4WING 20FR 2028237 CDM 272 RC C1729 HCPCS facility both 31 31 Gross Charge Type: NIHD_Clinic_Price DRAIN LATEX MALECOT 4WING 20FR 2028237 CDM 272 RC facility both 31 31 Gross Charge Type: NIHD_Hosp_Profee_Price DRAIN LATEX MALECOT 4WING 20FR 2028237 CDM 272 RC facility both 31 31 Gross Charge Type: NIHD_Hosp_Profee_Price DRAIN LATEX MALECOT 4WING 22FR 2028238 CDM 272 RC C1729 HCPCS facility both 31 31 Gross Charge Type: NIHD_RHC_Price DRAIN LATEX MALECOT 4WING 22FR 2028238 CDM 272 RC C1729 HCPCS facility both 31 31 Gross Charge Type: NIHD_Clinic_Price DRAIN LATEX MALECOT 4WING 22FR 2028238 CDM 272 RC facility both 31 31 Gross Charge Type: NIHD_Hosp_Profee_Price DRAIN LATEX MALECOT 4WING 22FR 2028238 CDM 272 RC facility both 31 31 Gross Charge Type: NIHD_Hosp_Profee_Price DRAIN LATEX MALECOT 4WING 24FR 2028239 CDM 272 RC C1729 HCPCS facility both 31 31 Gross Charge Type: NIHD_RHC_Price DRAIN LATEX MALECOT 4WING 24FR 2028239 CDM 272 RC C1729 HCPCS facility both 31 31 Gross Charge Type: NIHD_Clinic_Price DRAIN LATEX MALECOT 4WING 24FR 2028239 CDM 272 RC facility both 31 31 Gross Charge Type: NIHD_Hosp_Profee_Price DRAIN LATEX MALECOT 4WING 24FR 2028239 CDM 272 RC facility both 31 31 Gross Charge Type: NIHD_Hosp_Profee_Price POLY PATELLA STANDARD SIZE 32MM DIAMETER 5972-65-32 2028243 CDM 278 RC facility both 3959 3959 Gross Charge Type: NIHD_Hosp_Profee_Price POLY PATELLA STANDARD SIZE 32MM DIAMETER 5972-65-32 2028243 CDM 278 RC facility both 3959 3959 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 3.5 CORTICAL OPENER 2028244 CDM 278 RC facility both 438 438 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 3.5 CORTICAL OPENER 2028244 CDM 278 RC facility both 438 438 Gross Charge Type: NIHD_Hosp_Profee_Price GRAFT LEFT MEDIAL FEMORAL CONDYLE 2028246 CDM 278 RC facility both 34990 34990 Gross Charge Type: NIHD_Hosp_Profee_Price GRAFT LEFT MEDIAL FEMORAL CONDYLE 2028246 CDM 278 RC facility both 34990 34990 Gross Charge Type: NIHD_Hosp_Profee_Price GRAFT ACHILLES PRE SHAPED 10MMX26LENGTH 2028251 CDM 278 RC facility both 8118 8118 Gross Charge Type: NIHD_Hosp_Profee_Price GRAFT ACHILLES PRE SHAPED 10MMX26LENGTH 2028251 CDM 278 RC facility both 8118 8118 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT-CS SZ 2 X 16MM 2028258 CDM 278 RC facility both 11010 11010 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT-CS SZ 2 X 16MM 2028258 CDM 278 RC facility both 11010 11010 Gross Charge Type: NIHD_Hosp_Profee_Price FIBERSTICK #2 2028262 CDM 272 RC facility both 151 151 Gross Charge Type: NIHD_Hosp_Profee_Price FIBERSTICK #2 2028262 CDM 272 RC facility both 151 151 Gross Charge Type: NIHD_Hosp_Profee_Price TIGERSTICK 2028263 CDM 272 RC facility both 151 151 Gross Charge Type: NIHD_Hosp_Profee_Price TIGERSTICK 2028263 CDM 272 RC facility both 151 151 Gross Charge Type: NIHD_Hosp_Profee_Price TIGHTROPE ABS BUTTON ROUND CONCAVE 2028264 CDM 278 RC facility both 672 672 Gross Charge Type: NIHD_Hosp_Profee_Price TIGHTROPE ABS BUTTON ROUND CONCAVE 2028264 CDM 278 RC facility both 672 672 Gross Charge Type: NIHD_Hosp_Profee_Price STEM MINI HUMERAL BIOMET 13MMX83MM LONG 2028273 CDM 278 RC facility both 21228 21228 Gross Charge Type: NIHD_Hosp_Profee_Price STEM MINI HUMERAL BIOMET 13MMX83MM LONG 2028273 CDM 278 RC facility both 21228 21228 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT-CS SZ 4 X16MM 2028274 CDM 278 RC facility both 11010 11010 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT-CS SZ 4 X16MM 2028274 CDM 278 RC facility both 11010 11010 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 8.0X25X110MM 2028279 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 8.0X25X110MM 2028279 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 8.0X25X90MM 2028280 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW PART THREADED 8.0X25X90MM 2028280 CDM 278 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERAL NAIL T2 7 X 210MM 2028286 CDM 278 RC facility both 2758 2758 Gross Charge Type: NIHD_Hosp_Profee_Price HUMERAL NAIL T2 7 X 210MM 2028286 CDM 278 RC facility both 2758 2758 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD FEMORAL CERAMIC V40 SZ 28MM -4MM 2028288 CDM 278 RC facility both 8594 8594 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD FEMORAL CERAMIC V40 SZ 28MM -4MM 2028288 CDM 278 RC facility both 8594 8594 Gross Charge Type: NIHD_Hosp_Profee_Price GUIDEWIRE SMOOTH T2 HUMERUS SET 2028294 CDM 272 RC facility both 333 333 Gross Charge Type: NIHD_Hosp_Profee_Price GUIDEWIRE SMOOTH T2 HUMERUS SET 2028294 CDM 272 RC facility both 333 333 Gross Charge Type: NIHD_Hosp_Profee_Price GUIDEWIRE BALL TIP 02.5X800 T2 HUMERAL 2028296 CDM 272 RC facility both 727 727 Gross Charge Type: NIHD_Hosp_Profee_Price GUIDEWIRE BALL TIP 02.5X800 T2 HUMERAL 2028296 CDM 272 RC facility both 727 727 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 03.5X230MM 2028297 CDM 272 RC facility both 734 734 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 03.5X230MM 2028297 CDM 272 RC facility both 734 734 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 03.5X130MM 2028298 CDM 272 RC facility both 734 734 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 03.5X130MM 2028298 CDM 272 RC facility both 734 734 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW FULLY THREADED 04X45MM 2028299 CDM 278 RC facility both 354 354 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW FULLY THREADED 04X45MM 2028299 CDM 278 RC facility both 354 354 Gross Charge Type: NIHD_Hosp_Profee_Price TUBE TEFLON T2- HUMERAL NAIL 2028300 CDM 272 RC facility both 999 999 Gross Charge Type: NIHD_Hosp_Profee_Price TUBE TEFLON T2- HUMERAL NAIL 2028300 CDM 272 RC facility both 999 999 Gross Charge Type: NIHD_Hosp_Profee_Price ENDCAP 0.10-+2 T2- HUMERAL NAIL 2028302 CDM 278 RC facility both 711 711 Gross Charge Type: NIHD_Hosp_Profee_Price ENDCAP 0.10-+2 T2- HUMERAL NAIL 2028302 CDM 278 RC facility both 711 711 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW FULLY THREAD 04X30MM 2028305 CDM 278 RC facility both 738 738 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW FULLY THREAD 04X30MM 2028305 CDM 278 RC facility both 738 738 Gross Charge Type: NIHD_Hosp_Profee_Price GRAFT CARDIFF TISSUE 2028307 CDM 278 RC facility both 25486 25486 Gross Charge Type: NIHD_Hosp_Profee_Price GRAFT CARDIFF TISSUE 2028307 CDM 278 RC facility both 25486 25486 Gross Charge Type: NIHD_Hosp_Profee_Price FLIP CUTTER 10.5MM 2028308 CDM 272 RC facility both 975 975 Gross Charge Type: NIHD_Hosp_Profee_Price FLIP CUTTER 10.5MM 2028308 CDM 272 RC facility both 975 975 Gross Charge Type: NIHD_Hosp_Profee_Price PASSPORT BUTTON CANNULA 12X40MM 2028310 CDM 272 RC facility both 180 180 Gross Charge Type: NIHD_Hosp_Profee_Price PASSPORT BUTTON CANNULA 12X40MM 2028310 CDM 272 RC facility both 180 180 Gross Charge Type: NIHD_Hosp_Profee_Price TIGHTROPE BTB 2028315 CDM 278 RC facility both 1276 1276 Gross Charge Type: NIHD_Hosp_Profee_Price TIGHTROPE BTB 2028315 CDM 278 RC facility both 1276 1276 Gross Charge Type: NIHD_Hosp_Profee_Price TIGHTROPE ABS IMPLANT OPEN 2028316 CDM 278 RC facility both 582 582 Gross Charge Type: NIHD_Hosp_Profee_Price TIGHTROPE ABS IMPLANT OPEN 2028316 CDM 278 RC facility both 582 582 Gross Charge Type: NIHD_Hosp_Profee_Price FLIP CUTTER - ARTHREX AR-1204AF-110 2028318 CDM 272 RC facility both 1395 1395 Gross Charge Type: NIHD_Hosp_Profee_Price FLIP CUTTER - ARTHREX AR-1204AF-110 2028318 CDM 272 RC facility both 1395 1395 Gross Charge Type: NIHD_Hosp_Profee_Price STAPLER TLC75 SINGLE INSTRUMENT 2028330 CDM 278 RC facility both 303 303 Gross Charge Type: NIHD_Hosp_Profee_Price STAPLER TLC75 SINGLE INSTRUMENT 2028330 CDM 278 RC facility both 303 303 Gross Charge Type: NIHD_Hosp_Profee_Price CUTTER RELOAD UNIT 75MM 2028331 CDM 272 RC facility both 1641 1641 Gross Charge Type: NIHD_Hosp_Profee_Price CUTTER RELOAD UNIT 75MM 2028331 CDM 272 RC facility both 1641 1641 Gross Charge Type: NIHD_Hosp_Profee_Price STEM HIP ANGLE ACC 11 SIZE# 3 30X102MM 2028336 CDM 278 RC facility both 24008 24008 Gross Charge Type: NIHD_Hosp_Profee_Price STEM HIP ANGLE ACC 11 SIZE# 3 30X102MM 2028336 CDM 278 RC facility both 24008 24008 Gross Charge Type: NIHD_Hosp_Profee_Price DISPOSABLE T3 AMZ KIT (ARTHREX) 2028337 CDM 272 RC facility both 2139 2139 Gross Charge Type: NIHD_Hosp_Profee_Price DISPOSABLE T3 AMZ KIT (ARTHREX) 2028337 CDM 272 RC facility both 2139 2139 Gross Charge Type: NIHD_Hosp_Profee_Price FOOT AND ANKLE SCP KIT (ZIMMER) 2028338 CDM 278 RC facility both 9175 9175 Gross Charge Type: NIHD_Hosp_Profee_Price FOOT AND ANKLE SCP KIT (ZIMMER) 2028338 CDM 278 RC facility both 9175 9175 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL CANNULATED S-CP 2.9X70MM 2028339 CDM 272 RC facility both 1020 1020 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL CANNULATED S-CP 2.9X70MM 2028339 CDM 272 RC facility both 1020 1020 Gross Charge Type: NIHD_Hosp_Profee_Price K-WIRE 1.6MM THD TROCAR TIP NS 2028340 CDM 272 RC facility both 180 180 Gross Charge Type: NIHD_Hosp_Profee_Price K-WIRE 1.6MM THD TROCAR TIP NS 2028340 CDM 272 RC facility both 180 180 Gross Charge Type: NIHD_Hosp_Profee_Price 1.6MMX6IN STEIN PIN BAY TIP NS 2028341 CDM 272 RC facility both 180 180 Gross Charge Type: NIHD_Hosp_Profee_Price 1.6MMX6IN STEIN PIN BAY TIP NS 2028341 CDM 272 RC facility both 180 180 Gross Charge Type: NIHD_Hosp_Profee_Price COUNTERSINK CANN SCOUPLE 2028342 CDM 278 RC facility both 1289 1289 Gross Charge Type: NIHD_Hosp_Profee_Price COUNTERSINK CANN SCOUPLE 2028342 CDM 278 RC facility both 1289 1289 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW CANN CANC SM HD FT 55MM NS 2028343 CDM 278 RC facility both 840 840 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW CANN CANC SM HD FT 55MM NS 2028343 CDM 278 RC facility both 840 840 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW CANN CANC SM HD FT 65MM NS 2028344 CDM 278 RC facility both 840 840 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW CANN CANC SM HD FT 65MM NS 2028344 CDM 278 RC facility both 840 840 Gross Charge Type: NIHD_Hosp_Profee_Price CARBON FIBER VECTRAN CONN ROD 8X200 2028346 CDM 272 RC facility both 1197 1197 Gross Charge Type: NIHD_Hosp_Profee_Price CARBON FIBER VECTRAN CONN ROD 8X200 2028346 CDM 272 RC facility both 1197 1197 Gross Charge Type: NIHD_Hosp_Profee_Price CARBON FIBER VECTRAN CONN ROD 8X250 2028347 CDM 272 RC facility both 1197 1197 Gross Charge Type: NIHD_Hosp_Profee_Price CARBON FIBER VECTRAN CONN ROD 8X250 2028347 CDM 272 RC facility both 1197 1197 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW CANN CANC SM HD FT 60MM NS 2028351 CDM 278 RC facility both 840 840 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW CANN CANC SM HD FT 60MM NS 2028351 CDM 278 RC facility both 840 840 Gross Charge Type: NIHD_Hosp_Profee_Price HOFFMANN3 CONNECTING ROD DIA 11X300MM 2028359 CDM 272 RC facility both 1149 1149 Gross Charge Type: NIHD_Hosp_Profee_Price HOFFMANN3 CONNECTING ROD DIA 11X300MM 2028359 CDM 272 RC facility both 1149 1149 Gross Charge Type: NIHD_Hosp_Profee_Price JGRLOC DISPOSABLE CANNULA KIT 2028366 CDM 272 RC facility both 870 870 Gross Charge Type: NIHD_Hosp_Profee_Price JGRLOC DISPOSABLE CANNULA KIT 2028366 CDM 272 RC facility both 870 870 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL STEM VERSYS SIZE 12 2028376 CDM 278 RC facility both 24436 24436 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL STEM VERSYS SIZE 12 2028376 CDM 278 RC facility both 24436 24436 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL HEAD 36MM 12/14 TAP 36MM -3.5MM 2028377 CDM 278 RC facility both 4888 4888 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL HEAD 36MM 12/14 TAP 36MM -3.5MM 2028377 CDM 278 RC facility both 4888 4888 Gross Charge Type: NIHD_Hosp_Profee_Price HIP S1S HEAD CEMENT MOLD 48MM 2028402 CDM 278 RC facility both 5487 5487 Gross Charge Type: NIHD_Hosp_Profee_Price HIP S1S HEAD CEMENT MOLD 48MM 2028402 CDM 278 RC facility both 5487 5487 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TECNIS MF ZLB00 21.0 1 PIECE 3.25 2028405 CDM 276 RC facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TECNIS MF ZLB00 21.0 1 PIECE 3.25 2028405 CDM 276 RC facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price HIP HEAD CEMENT MOLD SIS 431197 2028420 CDM 278 RC facility both 6866 6866 Gross Charge Type: NIHD_Hosp_Profee_Price HIP HEAD CEMENT MOLD SIS 431197 2028420 CDM 278 RC facility both 6866 6866 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL STEM VERSYS CEMENT 14X135MM 2028426 CDM 278 RC facility both 6836 6836 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL STEM VERSYS CEMENT 14X135MM 2028426 CDM 278 RC facility both 6836 6836 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL COMPONENT CR-FLEX E- RIGHT 00595001402 2028428 CDM 278 RC facility both 20200 20200 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL COMPONENT CR-FLEX E- RIGHT 00595001402 2028428 CDM 278 RC facility both 20200 20200 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL TRIPLE REAMER DHS 8.0MM 2028432 CDM 272 RC facility both 3508 3508 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL TRIPLE REAMER DHS 8.0MM 2028432 CDM 272 RC facility both 3508 3508 Gross Charge Type: NIHD_Hosp_Profee_Price CANNULA ACCUPORT DELIVERY END TARGETING 2028434 CDM 272 RC facility both 1516 1516 Gross Charge Type: NIHD_Hosp_Profee_Price CANNULA ACCUPORT DELIVERY END TARGETING 2028434 CDM 272 RC facility both 1516 1516 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL PROFILE COMP FT STANDARD 2028436 CDM 272 RC facility both 450 450 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL PROFILE COMP FT STANDARD 2028436 CDM 272 RC facility both 450 450 Gross Charge Type: NIHD_Hosp_Profee_Price DELUXE WRIST CONTOUR SPLINT LT SM 2028443 CDM 274 RC L3908 HCPCS facility both 17 17 Gross Charge Type: NIHD_RHC_Price DELUXE WRIST CONTOUR SPLINT LT SM 2028443 CDM 274 RC L3908 HCPCS facility both 17 17 Gross Charge Type: NIHD_Clinic_Price DELUXE WRIST CONTOUR SPLINT LT SM 2028443 CDM 274 RC facility both 17 17 Gross Charge Type: NIHD_Hosp_Profee_Price DELUXE WRIST CONTOUR SPLINT LT SM 2028443 CDM 274 RC facility both 17 17 Gross Charge Type: NIHD_Hosp_Profee_Price DELUXE WRIST CONTOUR SPLINT LT MED 2028444 CDM 274 RC L3908 HCPCS facility both 17 17 Gross Charge Type: NIHD_RHC_Price DELUXE WRIST CONTOUR SPLINT LT MED 2028444 CDM 274 RC L3908 HCPCS facility both 17 17 Gross Charge Type: NIHD_Clinic_Price DELUXE WRIST CONTOUR SPLINT LT MED 2028444 CDM 274 RC facility both 17 17 Gross Charge Type: NIHD_Hosp_Profee_Price DELUXE WRIST CONTOUR SPLINT LT MED 2028444 CDM 274 RC facility both 17 17 Gross Charge Type: NIHD_Hosp_Profee_Price DELUXE WRIST CONTOUR SPLINT LT XLG 2028446 CDM 274 RC L3908 HCPCS facility both 17 17 Gross Charge Type: NIHD_RHC_Price DELUXE WRIST CONTOUR SPLINT LT XLG 2028446 CDM 274 RC L3908 HCPCS facility both 17 17 Gross Charge Type: NIHD_Clinic_Price DELUXE WRIST CONTOUR SPLINT LT XLG 2028446 CDM 274 RC facility both 17 17 Gross Charge Type: NIHD_Hosp_Profee_Price DELUXE WRIST CONTOUR SPLINT LT XLG 2028446 CDM 274 RC facility both 17 17 Gross Charge Type: NIHD_Hosp_Profee_Price DELUXE WRIST CONTOUR SPLINT RT SMALL 2028447 CDM 274 RC L3908 HCPCS facility both 17 17 Gross Charge Type: NIHD_RHC_Price DELUXE WRIST CONTOUR SPLINT RT SMALL 2028447 CDM 274 RC L3908 HCPCS facility both 17 17 Gross Charge Type: NIHD_Clinic_Price DELUXE WRIST CONTOUR SPLINT RT SMALL 2028447 CDM 274 RC facility both 17 17 Gross Charge Type: NIHD_Hosp_Profee_Price DELUXE WRIST CONTOUR SPLINT RT SMALL 2028447 CDM 274 RC facility both 17 17 Gross Charge Type: NIHD_Hosp_Profee_Price DELUXE WRIST CONTOUR SPLINT RT LG 2028449 CDM 274 RC L3908 HCPCS facility both 40 40 Gross Charge Type: NIHD_RHC_Price DELUXE WRIST CONTOUR SPLINT RT LG 2028449 CDM 274 RC L3908 HCPCS facility both 40 40 Gross Charge Type: NIHD_Clinic_Price DELUXE WRIST CONTOUR SPLINT RT LG 2028449 CDM 274 RC facility both 40 40 Gross Charge Type: NIHD_Hosp_Profee_Price DELUXE WRIST CONTOUR SPLINT RT LG 2028449 CDM 274 RC facility both 40 40 Gross Charge Type: NIHD_Hosp_Profee_Price DELUXE WRIST CONTOUR SPLINT RT XLG 2028450 CDM 274 RC L3908 HCPCS facility both 17 17 Gross Charge Type: NIHD_RHC_Price DELUXE WRIST CONTOUR SPLINT RT XLG 2028450 CDM 274 RC L3908 HCPCS facility both 17 17 Gross Charge Type: NIHD_Clinic_Price DELUXE WRIST CONTOUR SPLINT RT XLG 2028450 CDM 274 RC facility both 17 17 Gross Charge Type: NIHD_Hosp_Profee_Price DELUXE WRIST CONTOUR SPLINT RT XLG 2028450 CDM 274 RC facility both 17 17 Gross Charge Type: NIHD_Hosp_Profee_Price GASTROSTOMY TUBE 18 FR REPLACEMENT 2028452 CDM 272 RC facility both 634 634 Gross Charge Type: NIHD_Hosp_Profee_Price GASTROSTOMY TUBE 18 FR REPLACEMENT 2028452 CDM 272 RC facility both 634 634 Gross Charge Type: NIHD_Hosp_Profee_Price BLADE OSTEOTOME THIN 10X21/2 MM 2028465 CDM 272 RC facility both 1086 1086 Gross Charge Type: NIHD_Hosp_Profee_Price BLADE OSTEOTOME THIN 10X21/2 MM 2028465 CDM 272 RC facility both 1086 1086 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT RINGLOC 3.2X30MM BIOMET 2028466 CDM 272 RC facility both 510 510 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT RINGLOC 3.2X30MM BIOMET 2028466 CDM 272 RC facility both 510 510 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 2.5MM CALIBRATED ARTHREX 2028488 CDM 272 RC facility both 256 256 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 2.5MM CALIBRATED ARTHREX 2028488 CDM 272 RC facility both 256 256 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TECNIS MF ZMA00 22.5 3 PIECE 2028490 CDM 276 RC facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TECNIS MF ZMA00 22.5 3 PIECE 2028490 CDM 276 RC facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL STEM NECK VERSYS SZ 13X14 FMMC 2028498 CDM 278 RC facility both 24436 24436 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL STEM NECK VERSYS SZ 13X14 FMMC 2028498 CDM 278 RC facility both 24436 24436 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD FEMORAL C-TAP CERAMIC SZ 36MM +2.5M 2028502 CDM 278 RC facility both 8345 8345 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD FEMORAL C-TAP CERAMIC SZ 36MM +2.5M 2028502 CDM 278 RC facility both 8345 8345 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE 3-0 VICRYL RAPIDE ON CT-1 2028505 CDM 272 RC facility both 37 37 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE 3-0 VICRYL RAPIDE ON CT-1 2028505 CDM 272 RC facility both 37 37 Gross Charge Type: NIHD_Hosp_Profee_Price SWITCHCUT REAMER KIT 4.5X9.0MM 2028516 CDM 278 RC facility both 2099 2099 Gross Charge Type: NIHD_Hosp_Profee_Price SWITCHCUT REAMER KIT 4.5X9.0MM 2028516 CDM 278 RC facility both 2099 2099 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL STEM ML TAPER STD SZ 9 2028517 CDM 278 RC facility both 23926 23926 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL STEM ML TAPER STD SZ 9 2028517 CDM 278 RC facility both 23926 23926 Gross Charge Type: NIHD_Hosp_Profee_Price "SUTURE VICRYL 30"" 3-0 CV23" 2028532 CDM 272 RC facility both 19 19 Gross Charge Type: NIHD_Hosp_Profee_Price "SUTURE VICRYL 30"" 3-0 CV23" 2028532 CDM 272 RC facility both 19 19 Gross Charge Type: NIHD_Hosp_Profee_Price "MEDEBRA WMNS MED 34-36"" B-D" 2028535 CDM 270 RC facility both 88 88 Gross Charge Type: NIHD_Hosp_Profee_Price "MEDEBRA WMNS MED 34-36"" B-D" 2028535 CDM 270 RC facility both 88 88 Gross Charge Type: NIHD_Hosp_Profee_Price "MEDEBRA WMNS LG 38-40"" B-D" 2028536 CDM 270 RC facility both 88 88 Gross Charge Type: NIHD_Hosp_Profee_Price "MEDEBRA WMNS LG 38-40"" B-D" 2028536 CDM 270 RC facility both 88 88 Gross Charge Type: NIHD_Hosp_Profee_Price "MEDEBRA WMNS 1X 40-42"" B-D" 2028537 CDM 270 RC facility both 88 88 Gross Charge Type: NIHD_Hosp_Profee_Price "MEDEBRA WMNS 1X 40-42"" B-D" 2028537 CDM 270 RC facility both 88 88 Gross Charge Type: NIHD_Hosp_Profee_Price "XI STAPLER,SUREFORM 60,SPU,IS4000" 2028542 CDM 272 RC facility both 1589 1589 Gross Charge Type: NIHD_Hosp_Profee_Price "XI STAPLER,SUREFORM 60,SPU,IS4000" 2028542 CDM 272 RC facility both 1589 1589 Gross Charge Type: NIHD_Hosp_Profee_Price "XI RELOAD,SUREFORM 60,4.3 GREEN," 2028543 CDM 272 RC facility both 690 690 Gross Charge Type: NIHD_Hosp_Profee_Price "XI RELOAD,SUREFORM 60,4.3 GREEN," 2028543 CDM 272 RC facility both 690 690 Gross Charge Type: NIHD_Hosp_Profee_Price XI MONOPOLAR CURVED SCISSORS 2028547 CDM 272 RC facility both 838 838 Gross Charge Type: NIHD_Hosp_Profee_Price XI MONOPOLAR CURVED SCISSORS 2028547 CDM 272 RC facility both 838 838 Gross Charge Type: NIHD_Hosp_Profee_Price XI MARYLAND BIPOLAR FORCEPS 2028550 CDM 272 RC facility both 707 707 Gross Charge Type: NIHD_Hosp_Profee_Price XI MARYLAND BIPOLAR FORCEPS 2028550 CDM 272 RC facility both 707 707 Gross Charge Type: NIHD_Hosp_Profee_Price XI FENESTRATED BIPOLAR FORCEPS 2028551 CDM 272 RC facility both 707 707 Gross Charge Type: NIHD_Hosp_Profee_Price XI FENESTRATED BIPOLAR FORCEPS 2028551 CDM 272 RC facility both 707 707 Gross Charge Type: NIHD_Hosp_Profee_Price XI MEGA SUTURECUT NEEDLE DRIVER 2028553 CDM 272 RC facility both 629 629 Gross Charge Type: NIHD_Hosp_Profee_Price XI MEGA SUTURECUT NEEDLE DRIVER 2028553 CDM 272 RC facility both 629 629 Gross Charge Type: NIHD_Hosp_Profee_Price XI LARGE NEEDLE DRIVER 2028554 CDM 272 RC facility both 576 576 Gross Charge Type: NIHD_Hosp_Profee_Price XI LARGE NEEDLE DRIVER 2028554 CDM 272 RC facility both 576 576 Gross Charge Type: NIHD_Hosp_Profee_Price XI PROGRASP FORCEPS 2028555 CDM 272 RC facility both 506 506 Gross Charge Type: NIHD_Hosp_Profee_Price XI PROGRASP FORCEPS 2028555 CDM 272 RC facility both 506 506 Gross Charge Type: NIHD_Hosp_Profee_Price XI TIP-UP FENESTRATED GRASPER XI 2028556 CDM 272 RC facility both 576 576 Gross Charge Type: NIHD_Hosp_Profee_Price XI TIP-UP FENESTRATED GRASPER XI 2028556 CDM 272 RC facility both 576 576 Gross Charge Type: NIHD_Hosp_Profee_Price XI LARGE CLIP APPLIER XI 2028558 CDM 272 RC facility both 367 367 Gross Charge Type: NIHD_Hosp_Profee_Price XI LARGE CLIP APPLIER XI 2028558 CDM 272 RC facility both 367 367 Gross Charge Type: NIHD_Hosp_Profee_Price "XI 12 MM & STAPLER CANNULA, LONG" 2028559 CDM 272 RC facility both 3898 3898 Gross Charge Type: NIHD_Hosp_Profee_Price "XI 12 MM & STAPLER CANNULA, LONG" 2028559 CDM 272 RC facility both 3898 3898 Gross Charge Type: NIHD_Hosp_Profee_Price XI 12 MM & STAPLER CANNULA 2028560 CDM 272 RC facility both 3748 3748 Gross Charge Type: NIHD_Hosp_Profee_Price XI 12 MM & STAPLER CANNULA 2028560 CDM 272 RC facility both 3748 3748 Gross Charge Type: NIHD_Hosp_Profee_Price "XI 12MM STAPLER BLADELESS OBTURATOR, LON" 2028561 CDM 272 RC facility both 2460 2460 Gross Charge Type: NIHD_Hosp_Profee_Price "XI 12MM STAPLER BLADELESS OBTURATOR, LON" 2028561 CDM 272 RC facility both 2460 2460 Gross Charge Type: NIHD_Hosp_Profee_Price "XI 8 MM INSTRUMENT CANNULA, LONG" 2028563 CDM 272 RC facility both 1949 1949 Gross Charge Type: NIHD_Hosp_Profee_Price "XI 8 MM INSTRUMENT CANNULA, LONG" 2028563 CDM 272 RC facility both 1949 1949 Gross Charge Type: NIHD_Hosp_Profee_Price XI 8 MM INSTRUMENT CANNULA 2028564 CDM 272 RC facility both 1800 1800 Gross Charge Type: NIHD_Hosp_Profee_Price XI 8 MM INSTRUMENT CANNULA 2028564 CDM 272 RC facility both 1800 1800 Gross Charge Type: NIHD_Hosp_Profee_Price XI 12 - 8 MM REDUCER 2028566 CDM 272 RC facility both 76 76 Gross Charge Type: NIHD_Hosp_Profee_Price XI 12 - 8 MM REDUCER 2028566 CDM 272 RC facility both 76 76 Gross Charge Type: NIHD_Hosp_Profee_Price "XI SEAL,IS4000 PORTS,12MM&STAPLER," 2028569 CDM 272 RC facility both 61 61 Gross Charge Type: NIHD_Hosp_Profee_Price "XI SEAL,IS4000 PORTS,12MM&STAPLER," 2028569 CDM 272 RC facility both 61 61 Gross Charge Type: NIHD_Hosp_Profee_Price "MEDEBRA WMNS SM 32-34"" A-C" 2028571 CDM 270 RC facility both 88 88 Gross Charge Type: NIHD_Hosp_Profee_Price "MEDEBRA WMNS SM 32-34"" A-C" 2028571 CDM 270 RC facility both 88 88 Gross Charge Type: NIHD_Hosp_Profee_Price "XI SUREFORM RELOAD 60, 2.5 WHITE" 2028572 CDM 272 RC facility both 723 723 Gross Charge Type: NIHD_Hosp_Profee_Price "XI SUREFORM RELOAD 60, 2.5 WHITE" 2028572 CDM 272 RC facility both 723 723 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE STRATAFIX 3-0 PDS 27 IN SH NDL 2028580 CDM 272 RC facility both 82 82 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE STRATAFIX 3-0 PDS 27 IN SH NDL 2028580 CDM 272 RC facility both 82 82 Gross Charge Type: NIHD_Hosp_Profee_Price 2.7MM/3.5MM DISTAL FIBULA PLATE 3H/RT/77 2028582 CDM facility both 3464 3464 Gross Charge Type: NIHD_Hosp_Profee_Price 2.7MM/3.5MM DISTAL FIBULA PLATE 3H/RT/77 2028582 CDM facility both 3464 3464 Gross Charge Type: NIHD_Hosp_Profee_Price 2.7MM/3.5MM DISTAL FIBULA PLATE 4H/LT/90 2028584 CDM 278 RC facility both 1990 1990 Gross Charge Type: NIHD_Hosp_Profee_Price 2.7MM/3.5MM DISTAL FIBULA PLATE 4H/LT/90 2028584 CDM 278 RC facility both 1990 1990 Gross Charge Type: NIHD_Hosp_Profee_Price 2.7MM/3.5MM DISTAL FIBULA PLTE 5H/RT/103 2028585 CDM facility both 2311 2311 Gross Charge Type: NIHD_Hosp_Profee_Price 2.7MM/3.5MM DISTAL FIBULA PLTE 5H/RT/103 2028585 CDM facility both 2311 2311 Gross Charge Type: NIHD_Hosp_Profee_Price 2.7MM/3.5MM DISTAL FIBULA PLTE 5H/LT/103 2028586 CDM 278 RC facility both 2311 2311 Gross Charge Type: NIHD_Hosp_Profee_Price 2.7MM/3.5MM DISTAL FIBULA PLTE 5H/LT/103 2028586 CDM 278 RC facility both 2311 2311 Gross Charge Type: NIHD_Hosp_Profee_Price 2.7MM/3.5MM DISTAL FIBULA PLATE 6H/RT116 2028587 CDM 278 RC facility both 2346 2346 Gross Charge Type: NIHD_Hosp_Profee_Price 2.7MM/3.5MM DISTAL FIBULA PLATE 6H/RT116 2028587 CDM 278 RC facility both 2346 2346 Gross Charge Type: NIHD_Hosp_Profee_Price 2.7MM/3.5MM DISTAL FIBULA PLATE 6H/LT116 2028588 CDM 278 RC facility both 3561 3561 Gross Charge Type: NIHD_Hosp_Profee_Price 2.7MM/3.5MM DISTAL FIBULA PLATE 6H/LT116 2028588 CDM 278 RC facility both 3561 3561 Gross Charge Type: NIHD_Hosp_Profee_Price 2.7MM/3.5MM DISTAL FIBULA PLATE 9H/LT155 2028592 CDM facility both 3662 3662 Gross Charge Type: NIHD_Hosp_Profee_Price 2.7MM/3.5MM DISTAL FIBULA PLATE 9H/LT155 2028592 CDM facility both 3662 3662 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL QUICK RELEASE 1/8 INCH BIOMET 2028601 CDM 272 RC facility both 541 541 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL QUICK RELEASE 1/8 INCH BIOMET 2028601 CDM 272 RC facility both 541 541 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL COMPONENT CR SIZE H LEFT 2028604 CDM 278 RC facility both 14902 14902 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL COMPONENT CR SIZE H LEFT 2028604 CDM 278 RC facility both 14902 14902 Gross Charge Type: NIHD_Hosp_Profee_Price TWIST DRILL 1.4 X27MM DIA AO 2028605 CDM 272 RC facility both 238 238 Gross Charge Type: NIHD_Hosp_Profee_Price TWIST DRILL 1.4 X27MM DIA AO 2028605 CDM 272 RC facility both 238 238 Gross Charge Type: NIHD_Hosp_Profee_Price DAVINCI XI CANNULA SEALS 5MM-8MM XI 2028616 CDM 272 RC facility both 54 54 Gross Charge Type: NIHD_Hosp_Profee_Price DAVINCI XI CANNULA SEALS 5MM-8MM XI 2028616 CDM 272 RC facility both 54 54 Gross Charge Type: NIHD_Hosp_Profee_Price ZONE NAVIGATOR CANNULA LEFT/MID/POSTER 2028619 CDM 272 RC facility both 2249 2249 Gross Charge Type: NIHD_Hosp_Profee_Price ZONE NAVIGATOR CANNULA LEFT/MID/POSTER 2028619 CDM 272 RC facility both 2249 2249 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE MENISCUS REPAIR W/ 0.9MM TAPE 2028621 CDM 272 RC facility both 3448 3448 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE MENISCUS REPAIR W/ 0.9MM TAPE 2028621 CDM 272 RC facility both 3448 3448 Gross Charge Type: NIHD_Hosp_Profee_Price ZONENAVIGATOR CANNULA ANTERIOR 2028623 CDM 272 RC facility both 2249 2249 Gross Charge Type: NIHD_Hosp_Profee_Price ZONENAVIGATOR CANNULA ANTERIOR 2028623 CDM 272 RC facility both 2249 2249 Gross Charge Type: NIHD_Hosp_Profee_Price CRUCIATE RETAINING FEMORAL SZ 1 LEFT 2028659 CDM 278 RC facility both 15003 15003 Gross Charge Type: NIHD_Hosp_Profee_Price CRUCIATE RETAINING FEMORAL SZ 1 LEFT 2028659 CDM 278 RC facility both 15003 15003 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT SZ1 X 11MM 2028662 CDM 278 RC facility both 11010 11010 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT SZ1 X 11MM 2028662 CDM 278 RC facility both 11010 11010 Gross Charge Type: NIHD_Hosp_Profee_Price GRAFT FEMORAL HEAD FF 2028712 CDM 278 RC facility both 1618 1618 Gross Charge Type: NIHD_Hosp_Profee_Price GRAFT FEMORAL HEAD FF 2028712 CDM 278 RC facility both 1618 1618 Gross Charge Type: NIHD_Hosp_Profee_Price ARISTA AH 1 GRAM 2028729 CDM 272 RC facility both 510 510 Gross Charge Type: NIHD_Hosp_Profee_Price ARISTA AH 1 GRAM 2028729 CDM 272 RC facility both 510 510 Gross Charge Type: NIHD_Hosp_Profee_Price ARISTA AH 3 GRAM 2028731 CDM 272 RC facility both 1019 1019 Gross Charge Type: NIHD_Hosp_Profee_Price ARISTA AH 3 GRAM 2028731 CDM 272 RC facility both 1019 1019 Gross Charge Type: NIHD_Hosp_Profee_Price MEDEBRA WOMENS SZ 2X 42-44 INCHES 2028735 CDM 270 RC facility both 88 88 Gross Charge Type: NIHD_Hosp_Profee_Price MEDEBRA WOMENS SZ 2X 42-44 INCHES 2028735 CDM 270 RC facility both 88 88 Gross Charge Type: NIHD_Hosp_Profee_Price LACERATION KIT MEDLINE 2028746 CDM 272 RC facility both 16 16 Gross Charge Type: NIHD_Hosp_Profee_Price LACERATION KIT MEDLINE 2028746 CDM 272 RC facility both 16 16 Gross Charge Type: NIHD_Hosp_Profee_Price MEDEBRA WOMENS SZ 3X 46-48INCHES 2028754 CDM 270 RC facility both 88 88 Gross Charge Type: NIHD_Hosp_Profee_Price MEDEBRA WOMENS SZ 3X 46-48INCHES 2028754 CDM 270 RC facility both 88 88 Gross Charge Type: NIHD_Hosp_Profee_Price PADDED ARM SLING (X-LARGE) 2028765 CDM facility both 19 19 Gross Charge Type: NIHD_Hosp_Profee_Price PADDED ARM SLING (X-LARGE) 2028765 CDM facility both 19 19 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TORIC SN6AT9 23.0 2028792 CDM 276 RC facility both 505 505 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TORIC SN6AT9 23.0 2028792 CDM 276 RC facility both 505 505 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD FEMORAL LFIT V40 36 +0 V40 2028795 CDM 278 RC facility both 7286 7286 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD FEMORAL LFIT V40 36 +0 V40 2028795 CDM 278 RC facility both 7286 7286 Gross Charge Type: NIHD_Hosp_Profee_Price 5.0MM VARIABLE ANGLE EXTENSION ARM 2028806 CDM 272 RC facility both 2549 2549 Gross Charge Type: NIHD_Hosp_Profee_Price 5.0MM VARIABLE ANGLE EXTENSION ARM 2028806 CDM 272 RC facility both 2549 2549 Gross Charge Type: NIHD_Hosp_Profee_Price FLIP CUTTER 111 ARTHREX 2028814 CDM 272 RC facility both 1245 1245 Gross Charge Type: NIHD_Hosp_Profee_Price FLIP CUTTER 111 ARTHREX 2028814 CDM 272 RC facility both 1245 1245 Gross Charge Type: NIHD_Hosp_Profee_Price ZONENAVIGATOR RIGHT MID/POST CANNULA 2028815 CDM 272 RC facility both 2249 2249 Gross Charge Type: NIHD_Hosp_Profee_Price ZONENAVIGATOR RIGHT MID/POST CANNULA 2028815 CDM 272 RC facility both 2249 2249 Gross Charge Type: NIHD_Hosp_Profee_Price NEEDLE CATCHER ARTHREX 2028816 CDM 272 RC facility both 1182 1182 Gross Charge Type: NIHD_Hosp_Profee_Price NEEDLE CATCHER ARTHREX 2028816 CDM 272 RC facility both 1182 1182 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL POSTERIOR STABILIZER 5515-F-302 2028852 CDM 278 RC facility both 15157 15157 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL POSTERIOR STABILIZER 5515-F-302 2028852 CDM 278 RC facility both 15157 15157 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT-PS SZ3 11MM 2028853 CDM 278 RC facility both 10440 10440 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT-PS SZ3 11MM 2028853 CDM 278 RC facility both 10440 10440 Gross Charge Type: NIHD_Hosp_Profee_Price "XI RELOAD,STAPLER 45 WHITE" 2028857 CDM 272 RC facility both 6285 6285 Gross Charge Type: NIHD_Hosp_Profee_Price "XI RELOAD,STAPLER 45 WHITE" 2028857 CDM 272 RC facility both 6285 6285 Gross Charge Type: NIHD_Hosp_Profee_Price "XI RELOAD,STAPLER 45 BLUE" 2028858 CDM 272 RC facility both 7196 7196 Gross Charge Type: NIHD_Hosp_Profee_Price "XI RELOAD,STAPLER 45 BLUE" 2028858 CDM 272 RC facility both 7196 7196 Gross Charge Type: NIHD_Hosp_Profee_Price PROX MEDIAL TIBIA 10 HOLE RIGHT 2028862 CDM 278 RC facility both 2756 2756 Gross Charge Type: NIHD_Hosp_Profee_Price PROX MEDIAL TIBIA 10 HOLE RIGHT 2028862 CDM 278 RC facility both 2756 2756 Gross Charge Type: NIHD_Hosp_Profee_Price PROX MEDIAL TIBIA 12 HOLE RIGHT 2028863 CDM 278 RC facility both 2836 2836 Gross Charge Type: NIHD_Hosp_Profee_Price PROX MEDIAL TIBIA 12 HOLE RIGHT 2028863 CDM 278 RC facility both 2836 2836 Gross Charge Type: NIHD_Hosp_Profee_Price LO-PRO SCRW TM SS 2.7X22MM CORTEX 2028880 CDM 278 RC facility both 136 136 Gross Charge Type: NIHD_Hosp_Profee_Price LO-PRO SCRW TM SS 2.7X22MM CORTEX 2028880 CDM 278 RC facility both 136 136 Gross Charge Type: NIHD_Hosp_Profee_Price LO-PRO LOCK SCRW SS 2.7X12MM 2028881 CDM facility both 346 346 Gross Charge Type: NIHD_Hosp_Profee_Price LO-PRO LOCK SCRW SS 2.7X12MM 2028881 CDM facility both 346 346 Gross Charge Type: NIHD_Hosp_Profee_Price "LO-PRO SCRW TM,SS 3.5X12MM CORTEX" 2028883 CDM 278 RC facility both 106 106 Gross Charge Type: NIHD_Hosp_Profee_Price "LO-PRO SCRW TM,SS 3.5X12MM CORTEX" 2028883 CDM 278 RC facility both 106 106 Gross Charge Type: NIHD_Hosp_Profee_Price "LO-PRO LOCK SCRW,SS 3.5X10MM" 2028884 CDM facility both 346 346 Gross Charge Type: NIHD_Hosp_Profee_Price "LO-PRO LOCK SCRW,SS 3.5X10MM" 2028884 CDM facility both 346 346 Gross Charge Type: NIHD_Hosp_Profee_Price "LO-PRO LOCK SCRW,SS 3.5X12MM" 2028885 CDM 278 RC facility both 346 346 Gross Charge Type: NIHD_Hosp_Profee_Price "LO-PRO LOCK SCRW,SS 3.5X12MM" 2028885 CDM 278 RC facility both 346 346 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 2.6MM CANNULATED 2028889 CDM 272 RC facility both 526 526 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 2.6MM CANNULATED 2028889 CDM 272 RC facility both 526 526 Gross Charge Type: NIHD_Hosp_Profee_Price GUIDEWIRE THRDED W/TRCR TIP 1.35MM 2028893 CDM 272 RC facility both 61 61 Gross Charge Type: NIHD_Hosp_Profee_Price GUIDEWIRE THRDED W/TRCR TIP 1.35MM 2028893 CDM 272 RC facility both 61 61 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE DISTAL FIBULA LOCK SS LEFT 5 HOLE 2028895 CDM facility both 1949 1949 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE DISTAL FIBULA LOCK SS LEFT 5 HOLE 2028895 CDM facility both 1949 1949 Gross Charge Type: NIHD_Hosp_Profee_Price GRAFT LINK 10 X 70 2028897 CDM facility both 7388 7388 Gross Charge Type: NIHD_Hosp_Profee_Price GRAFT LINK 10 X 70 2028897 CDM facility both 7388 7388 Gross Charge Type: NIHD_Hosp_Profee_Price HOFFMANN3 CONNECTING ROD DIA 11X500MM 2028898 CDM 272 RC facility both 1487 1487 Gross Charge Type: NIHD_Hosp_Profee_Price HOFFMANN3 CONNECTING ROD DIA 11X500MM 2028898 CDM 272 RC facility both 1487 1487 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TORIC SN6AT9 24.0 2028900 CDM 276 RC facility both 505 505 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TORIC SN6AT9 24.0 2028900 CDM 276 RC facility both 505 505 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW FULLY THREADED 4X40MM 20289000 CDM 278 RC facility both 354 354 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING SCREW FULLY THREADED 4X40MM 20289000 CDM 278 RC facility both 354 354 Gross Charge Type: NIHD_Hosp_Profee_Price ARTICULAR SURFACE NEXGEN 7-10 BLUE 10MM 2028904 CDM 278 RC facility both 6417 6417 Gross Charge Type: NIHD_Hosp_Profee_Price ARTICULAR SURFACE NEXGEN 7-10 BLUE 10MM 2028904 CDM 278 RC facility both 6417 6417 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL COMPONENT SIZE 9 NEXGEN 2028905 CDM 278 RC facility both 10824 10824 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL COMPONENT SIZE 9 NEXGEN 2028905 CDM 278 RC facility both 10824 10824 Gross Charge Type: NIHD_Hosp_Profee_Price ACL TIGHTROPE WITH FIBERTAG 2028910 CDM 278 RC facility both 1575 1575 Gross Charge Type: NIHD_Hosp_Profee_Price ACL TIGHTROPE WITH FIBERTAG 2028910 CDM 278 RC facility both 1575 1575 Gross Charge Type: NIHD_Hosp_Profee_Price "TIGHTROPE ACL WITH FIBERTAG, ABS" 2028911 CDM 278 RC facility both 1006 1006 Gross Charge Type: NIHD_Hosp_Profee_Price "TIGHTROPE ACL WITH FIBERTAG, ABS" 2028911 CDM 278 RC facility both 1006 1006 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL POSTERIOR STABILIZER SZ 5 5515-F-501 2028914 CDM 278 RC facility both 15157 15157 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL POSTERIOR STABILIZER SZ 5 5515-F-501 2028914 CDM 278 RC facility both 15157 15157 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT-PS SZ5 13MM 2028915 CDM 278 RC facility both 10440 10440 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT-PS SZ5 13MM 2028915 CDM 278 RC facility both 10440 10440 Gross Charge Type: NIHD_Hosp_Profee_Price HEMOLOK M/L POLYMER CLIPS 2028916 CDM 272 RC facility both 83 83 Gross Charge Type: NIHD_Hosp_Profee_Price HEMOLOK M/L POLYMER CLIPS 2028916 CDM 272 RC facility both 83 83 Gross Charge Type: NIHD_Hosp_Profee_Price HOFFMANN3 CONNECTING ROD DIA 11X20MM 2028917 CDM 272 RC facility both 1267 1267 Gross Charge Type: NIHD_Hosp_Profee_Price HOFFMANN3 CONNECTING ROD DIA 11X20MM 2028917 CDM 272 RC facility both 1267 1267 Gross Charge Type: NIHD_Hosp_Profee_Price ARTICULAR SURFACE CR AC GREEN 10MM 005976-40-14 2028924 CDM 278 RC facility both 5878 5878 Gross Charge Type: NIHD_Hosp_Profee_Price ARTICULAR SURFACE CR AC GREEN 10MM 005976-40-14 2028924 CDM 278 RC facility both 5878 5878 Gross Charge Type: NIHD_Hosp_Profee_Price DRESSING JUMPSTART 4 X 4 (10CMX10CM) 2028932 CDM 272 RC facility both 101 101 Gross Charge Type: NIHD_Hosp_Profee_Price DRESSING JUMPSTART 4 X 4 (10CMX10CM) 2028932 CDM 272 RC facility both 101 101 Gross Charge Type: NIHD_Hosp_Profee_Price DRESSING JUMPSTART 1.5 X 8 (3.5CM X 20CM 2028934 CDM 272 RC facility both 58 58 Gross Charge Type: NIHD_Hosp_Profee_Price DRESSING JUMPSTART 1.5 X 8 (3.5CM X 20CM 2028934 CDM 272 RC facility both 58 58 Gross Charge Type: NIHD_Hosp_Profee_Price DRESSING JUMPSTART 6 X 115 15CMX29CM 2028935 CDM 272 RC facility both 138 138 Gross Charge Type: NIHD_Hosp_Profee_Price DRESSING JUMPSTART 6 X 115 15CMX29CM 2028935 CDM 272 RC facility both 138 138 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW N0N-LOCK 3.5MM HEX 4.75X15MM 2028941 CDM 278 RC facility both 840 840 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW N0N-LOCK 3.5MM HEX 4.75X15MM 2028941 CDM 278 RC facility both 840 840 Gross Charge Type: NIHD_Hosp_Profee_Price SHELL CLUSTER HOLE SZ 54MM E 2028946 CDM 278 RC facility both 11484 11484 Gross Charge Type: NIHD_Hosp_Profee_Price SHELL CLUSTER HOLE SZ 54MM E 2028946 CDM 278 RC facility both 11484 11484 Gross Charge Type: NIHD_Hosp_Profee_Price JUGGERSTITCH STRAIGHT IMPLANT 2028969 CDM 278 RC facility both 1023 1023 Gross Charge Type: NIHD_Hosp_Profee_Price JUGGERSTITCH STRAIGHT IMPLANT 2028969 CDM 278 RC facility both 1023 1023 Gross Charge Type: NIHD_Hosp_Profee_Price JUGGERSTITCH CURVED IMPLANT 2028970 CDM 278 RC facility both 1023 1023 Gross Charge Type: NIHD_Hosp_Profee_Price JUGGERSTITCH CURVED IMPLANT 2028970 CDM 278 RC facility both 1023 1023 Gross Charge Type: NIHD_Hosp_Profee_Price JUGGERSTITCH SUTURE CUTTER 2028972 CDM 272 RC facility both 512 512 Gross Charge Type: NIHD_Hosp_Profee_Price JUGGERSTITCH SUTURE CUTTER 2028972 CDM 272 RC facility both 512 512 Gross Charge Type: NIHD_Hosp_Profee_Price MARYLAND LIGASURE XP SEALER/DIVIDER ONE STEP SEALING 37 CM 20289758 CDM 272 RC facility both 1576 1576 Gross Charge Type: NIHD_Hosp_Profee_Price MARYLAND LIGASURE XP SEALER/DIVIDER ONE STEP SEALING 37 CM 20289758 CDM 272 RC facility both 1576 1576 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD FEMORAL V40 SZ 28MM +0MM 2028985 CDM 278 RC facility both 3832 3832 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD FEMORAL V40 SZ 28MM +0MM 2028985 CDM 278 RC facility both 3832 3832 Gross Charge Type: NIHD_Hosp_Profee_Price UNIVERSAL HEAD BIPOLAR COMPONENT 2028986 CDM 278 RC facility both 5176 5176 Gross Charge Type: NIHD_Hosp_Profee_Price UNIVERSAL HEAD BIPOLAR COMPONENT 2028986 CDM 278 RC facility both 5176 5176 Gross Charge Type: NIHD_Hosp_Profee_Price RESTORATION MOD HIP SYSTEM 195MM X 18 MM 2028988 CDM 278 RC facility both 18030 18030 Gross Charge Type: NIHD_Hosp_Profee_Price RESTORATION MOD HIP SYSTEM 195MM X 18 MM 2028988 CDM 278 RC facility both 18030 18030 Gross Charge Type: NIHD_Hosp_Profee_Price RESTORATION MOD HIP SYSTEM 21 +0 V40 2028989 CDM 278 RC facility both 22515 22515 Gross Charge Type: NIHD_Hosp_Profee_Price RESTORATION MOD HIP SYSTEM 21 +0 V40 2028989 CDM 278 RC facility both 22515 22515 Gross Charge Type: NIHD_Hosp_Profee_Price TRIDENT X3 O DEGREE POLYETHYLENE INSERT SZ 36MM E 2028990 CDM 278 RC facility both 9217 9217 Gross Charge Type: NIHD_Hosp_Profee_Price TRIDENT X3 O DEGREE POLYETHYLENE INSERT SZ 36MM E 2028990 CDM 278 RC facility both 9217 9217 Gross Charge Type: NIHD_Hosp_Profee_Price INSIGNIA HIP STEM SZ 3 X32.5 X 101 2028991 CDM 278 RC facility both 32025 32025 Gross Charge Type: NIHD_Hosp_Profee_Price INSIGNIA HIP STEM SZ 3 X32.5 X 101 2028991 CDM 278 RC facility both 32025 32025 Gross Charge Type: NIHD_Hosp_Profee_Price QUATTRO LINK SP KNOTLESS ANCHOR 4.5 MM 2028992 CDM 278 RC facility both 2039 2039 Gross Charge Type: NIHD_Hosp_Profee_Price QUATTRO LINK SP KNOTLESS ANCHOR 4.5 MM 2028992 CDM 278 RC facility both 2039 2039 Gross Charge Type: NIHD_Hosp_Profee_Price QUATTRO LINK KNOTLESS ANCHOR 4.5 MM 2028993 CDM 278 RC facility both 1949 1949 Gross Charge Type: NIHD_Hosp_Profee_Price QUATTRO LINK KNOTLESS ANCHOR 4.5 MM 2028993 CDM 278 RC facility both 1949 1949 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT-CS SZ 5 2028999 CDM 278 RC facility both 8995 8995 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT-CS SZ 5 2028999 CDM 278 RC facility both 8995 8995 Gross Charge Type: NIHD_Hosp_Profee_Price UROLIFT® SYSTEM 2029000 CDM facility both 2925 2925 Gross Charge Type: NIHD_Hosp_Profee_Price UROLIFT® SYSTEM 2029000 CDM facility both 2925 2925 Gross Charge Type: NIHD_Hosp_Profee_Price ACHILLES MIDSUBSTANCE SPEED BRIDGE 2029031 CDM 278 RC facility both 2925 2925 Gross Charge Type: NIHD_Hosp_Profee_Price ACHILLES MIDSUBSTANCE SPEED BRIDGE 2029031 CDM 278 RC facility both 2925 2925 Gross Charge Type: NIHD_Hosp_Profee_Price FIBERTAPE BLU W/NDLS 17 IN TAPE 2029032 CDM 272 RC facility both 228 228 Gross Charge Type: NIHD_Hosp_Profee_Price FIBERTAPE BLU W/NDLS 17 IN TAPE 2029032 CDM 272 RC facility both 228 228 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE SILK 0 30 INCHES 424H 2029035 CDM 272 RC facility both 19 19 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE SILK 0 30 INCHES 424H 2029035 CDM 272 RC facility both 19 19 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING DISTAL FIBULA PLATE RIGHT 4 HOLE 2029036 CDM 278 RC facility both 1650 1650 Gross Charge Type: NIHD_Hosp_Profee_Price LOCKING DISTAL FIBULA PLATE RIGHT 4 HOLE 2029036 CDM 278 RC facility both 1650 1650 Gross Charge Type: NIHD_Hosp_Profee_Price BB-TAK SMOOTH 2029037 CDM 278 RC facility both 151 151 Gross Charge Type: NIHD_Hosp_Profee_Price BB-TAK SMOOTH 2029037 CDM 278 RC facility both 151 151 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW CORTICAL 3.5 X 14MM 2029038 CDM 278 RC facility both 92 92 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW CORTICAL 3.5 X 14MM 2029038 CDM 278 RC facility both 92 92 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW LOCKING 3.5 X 14MM 2029040 CDM 278 RC facility both 346 346 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW LOCKING 3.5 X 14MM 2029040 CDM 278 RC facility both 346 346 Gross Charge Type: NIHD_Hosp_Profee_Price REVERSED INSERT 36X6X12.5 2029074 CDM facility both 6935 6935 Gross Charge Type: NIHD_Hosp_Profee_Price REVERSED INSERT 36X6X12.5 2029074 CDM facility both 6935 6935 Gross Charge Type: NIHD_Hosp_Profee_Price ASCEND FLEX ECCENTRIC REVERSEDTRAY DIA 4 2029075 CDM 278 RC facility both 7053 7053 Gross Charge Type: NIHD_Hosp_Profee_Price ASCEND FLEX ECCENTRIC REVERSEDTRAY DIA 4 2029075 CDM 278 RC facility both 7053 7053 Gross Charge Type: NIHD_Hosp_Profee_Price PERFORM REVERSED STANDARD GLENOSPHERE 36 2029076 CDM facility both 18799 18799 Gross Charge Type: NIHD_Hosp_Profee_Price PERFORM REVERSED STANDARD GLENOSPHERE 36 2029076 CDM facility both 18799 18799 Gross Charge Type: NIHD_Hosp_Profee_Price PERFORM REVERSED STANDARD BASEPLATE 29 M 2029077 CDM facility both 10003 10003 Gross Charge Type: NIHD_Hosp_Profee_Price PERFORM REVERSED STANDARD BASEPLATE 29 M 2029077 CDM facility both 10003 10003 Gross Charge Type: NIHD_Hosp_Profee_Price AEQUALIS PERFORM+ GUIDE PIN 2.5MMX220MM 2029078 CDM 272 RC facility both 471 471 Gross Charge Type: NIHD_Hosp_Profee_Price AEQUALIS PERFORM+ GUIDE PIN 2.5MMX220MM 2029078 CDM 272 RC facility both 471 471 Gross Charge Type: NIHD_Hosp_Profee_Price PERFORM REVERSED PERIPHERALSCREW DRILL B 2029079 CDM 272 RC facility both 495 495 Gross Charge Type: NIHD_Hosp_Profee_Price PERFORM REVERSED PERIPHERALSCREW DRILL B 2029079 CDM 272 RC facility both 495 495 Gross Charge Type: NIHD_Hosp_Profee_Price PERFORM REVERSED PERIPHERAL SCREW 5.0MM DWJ338 2029080 CDM facility both 993 993 Gross Charge Type: NIHD_Hosp_Profee_Price PERFORM REVERSED PERIPHERAL SCREW 5.0MM DWJ338 2029080 CDM facility both 993 993 Gross Charge Type: NIHD_Hosp_Profee_Price PERFORM REVERSED PERIPHERAL SCREW 5.0MM DWJ330 2029081 CDM facility both 993 993 Gross Charge Type: NIHD_Hosp_Profee_Price PERFORM REVERSED PERIPHERAL SCREW 5.0MM DWJ330 2029081 CDM facility both 993 993 Gross Charge Type: NIHD_Hosp_Profee_Price PERFORM REVERSED PERIPHERAL SCREW 5.0MM DWJ318 2029082 CDM facility both 993 993 Gross Charge Type: NIHD_Hosp_Profee_Price PERFORM REVERSED PERIPHERAL SCREW 5.0MM DWJ318 2029082 CDM facility both 993 993 Gross Charge Type: NIHD_Hosp_Profee_Price PERFORM REVERSED CENTRAL SCREW6.5MM X 35 2029083 CDM facility both 3334 3334 Gross Charge Type: NIHD_Hosp_Profee_Price PERFORM REVERSED CENTRAL SCREW6.5MM X 35 2029083 CDM facility both 3334 3334 Gross Charge Type: NIHD_Hosp_Profee_Price PERFORM REVERSED PERIPHERAL SCREW 5.0MM DWJ334 2029084 CDM facility both 993 993 Gross Charge Type: NIHD_Hosp_Profee_Price PERFORM REVERSED PERIPHERAL SCREW 5.0MM DWJ334 2029084 CDM facility both 993 993 Gross Charge Type: NIHD_Hosp_Profee_Price SHELL CLUSTER HOLE SZ 52MM E 2029089 CDM 278 RC facility both 11484 11484 Gross Charge Type: NIHD_Hosp_Profee_Price SHELL CLUSTER HOLE SZ 52MM E 2029089 CDM 278 RC facility both 11484 11484 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 6.5 X 20MM LOW PROFILE HEX 2029090 CDM 278 RC facility both 570 570 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 6.5 X 20MM LOW PROFILE HEX 2029090 CDM 278 RC facility both 570 570 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE CLAVICLE SMALL CURVE LEFT 8 HOLE 2029096 CDM 278 RC facility both 2549 2549 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE CLAVICLE SMALL CURVE LEFT 8 HOLE 2029096 CDM 278 RC facility both 2549 2549 Gross Charge Type: NIHD_Hosp_Profee_Price WIRE-K 0.062X3IN ARTHREX 2029097 CDM 272 RC facility both 61 61 Gross Charge Type: NIHD_Hosp_Profee_Price WIRE-K 0.062X3IN ARTHREX 2029097 CDM 272 RC facility both 61 61 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW LOW PROFILE NON-LOCK 3.5X16MM 2029115 CDM 278 RC facility both 106 106 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW LOW PROFILE NON-LOCK 3.5X16MM 2029115 CDM 278 RC facility both 106 106 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW LO PROFILE NON-LOCK CORT 3.5X16MM 2029119 CDM 278 RC facility both 346 346 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW LO PROFILE NON-LOCK CORT 3.5X16MM 2029119 CDM 278 RC facility both 346 346 Gross Charge Type: NIHD_Hosp_Profee_Price PASSPORT 8MM CANNULA INSERTER 2029129 CDM facility both 1485 1485 Gross Charge Type: NIHD_Hosp_Profee_Price PASSPORT 8MM CANNULA INSERTER 2029129 CDM facility both 1485 1485 Gross Charge Type: NIHD_Hosp_Profee_Price PASSPORT 10MM CANNULA INSERTER 2029130 CDM facility both 1485 1485 Gross Charge Type: NIHD_Hosp_Profee_Price PASSPORT 10MM CANNULA INSERTER 2029130 CDM facility both 1485 1485 Gross Charge Type: NIHD_Hosp_Profee_Price SWITCHING STICK 2.6MM X 305MM 2029131 CDM facility both 240 240 Gross Charge Type: NIHD_Hosp_Profee_Price SWITCHING STICK 2.6MM X 305MM 2029131 CDM facility both 240 240 Gross Charge Type: NIHD_Hosp_Profee_Price "NANOGRASPER, STRAIGHT 70 MM DISPOSABLE" 2029138 CDM 272 RC facility both 796 796 Gross Charge Type: NIHD_Hosp_Profee_Price "NANOGRASPER, STRAIGHT 70 MM DISPOSABLE" 2029138 CDM 272 RC facility both 796 796 Gross Charge Type: NIHD_Hosp_Profee_Price GASTROSTOMY FEEDING TUBE MIC 24FR 2029140 CDM 272 RC facility both 58 58 Gross Charge Type: NIHD_Hosp_Profee_Price GASTROSTOMY FEEDING TUBE MIC 24FR 2029140 CDM 272 RC facility both 58 58 Gross Charge Type: NIHD_Hosp_Profee_Price GASTROSTOMY FEEDING TUBE MIC 22FR 2029141 CDM 272 RC facility both 58 58 Gross Charge Type: NIHD_Hosp_Profee_Price GASTROSTOMY FEEDING TUBE MIC 22FR 2029141 CDM 272 RC facility both 58 58 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM X 10MM NON-LOCKING HEXALOBE SCREW 2029162 CDM facility both 367 367 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM X 10MM NON-LOCKING HEXALOBE SCREW 2029162 CDM facility both 367 367 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM X 18MM NON-LOCKING HEXALOBE SCREW 2029163 CDM facility both 367 367 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM X 18MM NON-LOCKING HEXALOBE SCREW 2029163 CDM facility both 367 367 Gross Charge Type: NIHD_Hosp_Profee_Price ACU-LOC® VDU PLATE LEFT LONG 2029164 CDM facility both 4654 4654 Gross Charge Type: NIHD_Hosp_Profee_Price ACU-LOC® VDU PLATE LEFT LONG 2029164 CDM facility both 4654 4654 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3MM X 14MM NON-TOGGLING CORTICAL SCREW 2029165 CDM facility both 444 444 Gross Charge Type: NIHD_Hosp_Profee_Price 2.3MM X 14MM NON-TOGGLING CORTICAL SCREW 2029165 CDM facility both 444 444 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE TACK 2029166 CDM facility both 280 280 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE TACK 2029166 CDM facility both 280 280 Gross Charge Type: NIHD_Hosp_Profee_Price Pressure Injectable One-Lumen PICC 2029188 CDM 278 RC facility both 344 344 Gross Charge Type: NIHD_Hosp_Profee_Price Pressure Injectable One-Lumen PICC 2029188 CDM 278 RC facility both 344 344 Gross Charge Type: NIHD_Hosp_Profee_Price POW-TRIALYSIS SHORT TERM CATH 20CM DIALY 2029189 CDM facility both 526 526 Gross Charge Type: NIHD_Hosp_Profee_Price POW-TRIALYSIS SHORT TERM CATH 20CM DIALY 2029189 CDM facility both 526 526 Gross Charge Type: NIHD_Hosp_Profee_Price POW-TRIALYSIS SLIM CATH 215CM BASIC KIT 2029190 CDM facility both 556 556 Gross Charge Type: NIHD_Hosp_Profee_Price POW-TRIALYSIS SLIM CATH 215CM BASIC KIT 2029190 CDM facility both 556 556 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW CORTICAL LOCK 2.3X14MM ACUMED 2029231 CDM facility both 499 499 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW CORTICAL LOCK 2.3X14MM ACUMED 2029231 CDM facility both 499 499 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM X 12MM NON-LOCKING HEXALOBE SCREW 2029232 CDM facility both 690 690 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5MM X 12MM NON-LOCKING HEXALOBE SCREW 2029232 CDM facility both 690 690 Gross Charge Type: NIHD_Hosp_Profee_Price ACU-LOC® EX STANDARD PLATE 2029234 CDM facility both 4294 4294 Gross Charge Type: NIHD_Hosp_Profee_Price ACU-LOC® EX STANDARD PLATE 2029234 CDM facility both 4294 4294 Gross Charge Type: NIHD_Hosp_Profee_Price HEMODIALYSIS CATHETER SET 15.5F X 24CM 2029240 CDM 278 RC facility both 796 796 Gross Charge Type: NIHD_Hosp_Profee_Price HEMODIALYSIS CATHETER SET 15.5F X 24CM 2029240 CDM 278 RC facility both 796 796 Gross Charge Type: NIHD_Hosp_Profee_Price PALINDROME - P 19/36 VT SPORT CATH 14.5F 2029241 CDM 272 RC facility both 720 720 Gross Charge Type: NIHD_Hosp_Profee_Price PALINDROME - P 19/36 VT SPORT CATH 14.5F 2029241 CDM 272 RC facility both 720 720 Gross Charge Type: NIHD_Hosp_Profee_Price PALINDROME - P 23/40 VT SPORT CATH 14.5F 2029242 CDM facility both 1530 1530 Gross Charge Type: NIHD_Hosp_Profee_Price PALINDROME - P 23/40 VT SPORT CATH 14.5F 2029242 CDM facility both 1530 1530 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW CORTICAL LOCK 2.3X14MM ACCUMED 2029245 CDM 278 RC facility both 499 499 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW CORTICAL LOCK 2.3X14MM ACCUMED 2029245 CDM 278 RC facility both 499 499 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW HEXALOBE LOCK 3.5MMX10MM 2029246 CDM 278 RC facility both 690 690 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW HEXALOBE LOCK 3.5MMX10MM 2029246 CDM 278 RC facility both 690 690 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW HEXALOBE NON-LOCK 3.5MMX12MM 2029247 CDM 278 RC facility both 367 367 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW HEXALOBE NON-LOCK 3.5MMX12MM 2029247 CDM 278 RC facility both 367 367 Gross Charge Type: NIHD_Hosp_Profee_Price SHELL CLUSTER HOLE SZ 62MM G 2029260 CDM 278 RC facility both 11484 11484 Gross Charge Type: NIHD_Hosp_Profee_Price SHELL CLUSTER HOLE SZ 62MM G 2029260 CDM 278 RC facility both 11484 11484 Gross Charge Type: NIHD_Hosp_Profee_Price STEM HIP ANGLE ACC 11 SIZE# 8 37X117MM 2029262 CDM 278 RC facility both 24008 24008 Gross Charge Type: NIHD_Hosp_Profee_Price STEM HIP ANGLE ACC 11 SIZE# 8 37X117MM 2029262 CDM 278 RC facility both 24008 24008 Gross Charge Type: NIHD_Hosp_Profee_Price HIP STEM STANDARD OFFSET 5X105MM 20292621 CDM 278 RC facility both 26688 26688 Gross Charge Type: NIHD_Hosp_Profee_Price HIP STEM STANDARD OFFSET 5X105MM 20292621 CDM 278 RC facility both 26688 26688 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD FEMORAL LFIT V40 36 X +0MM 2029273 CDM 278 RC facility both 8345 8345 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD FEMORAL LFIT V40 36 X +0MM 2029273 CDM 278 RC facility both 8345 8345 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE DISTAL FIBULA RIGHT 5 HOLE 2029278 CDM 278 RC facility both 1949 1949 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE DISTAL FIBULA RIGHT 5 HOLE 2029278 CDM 278 RC facility both 1949 1949 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW LOW PROFILE CORTICAL 2.7X 16 2029281 CDM facility both 136 136 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW LOW PROFILE CORTICAL 2.7X 16 2029281 CDM facility both 136 136 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW LOW PROFILE CORTICAL 2.7X 18 2029282 CDM 278 RC facility both 136 136 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW LOW PROFILE CORTICAL 2.7X 18 2029282 CDM 278 RC facility both 136 136 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW LOW PROFILE CORTICAL 2.7X 20 2029283 CDM 278 RC facility both 136 136 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW LOW PROFILE CORTICAL 2.7X 20 2029283 CDM 278 RC facility both 136 136 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE ANCHOR MICRO CORKSCREW 2-0 FIBERW 2029286 CDM facility both 856 856 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE ANCHOR MICRO CORKSCREW 2-0 FIBERW 2029286 CDM facility both 856 856 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE ANCHOR NANO CORKSCREW 3-0 FIBERWI 2029287 CDM 272 RC facility both 1276 1276 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE ANCHOR NANO CORKSCREW 3-0 FIBERWI 2029287 CDM 272 RC facility both 1276 1276 Gross Charge Type: NIHD_Hosp_Profee_Price CATH TRAY IC 16FR DL TMP SENS W/UR METR 2029302 CDM 272 RC facility both 82 82 Gross Charge Type: NIHD_Hosp_Profee_Price CATH TRAY IC 16FR DL TMP SENS W/UR METR 2029302 CDM 272 RC facility both 82 82 Gross Charge Type: NIHD_Hosp_Profee_Price CATH TRAY IC 16FR TMP SENS W/UR METR DOV 2029303 CDM 272 RC facility both 40 40 Gross Charge Type: NIHD_Hosp_Profee_Price CATH TRAY IC 16FR TMP SENS W/UR METR DOV 2029303 CDM 272 RC facility both 40 40 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD FEMORAL C-TAP CERAMIC SZ 36MM +5MM 2029315 CDM 278 RC facility both 8345 8345 Gross Charge Type: NIHD_Hosp_Profee_Price HEAD FEMORAL C-TAP CERAMIC SZ 36MM +5MM 2029315 CDM 278 RC facility both 8345 8345 Gross Charge Type: NIHD_Hosp_Profee_Price TWIST DRILL 1.0X15MM 2029316 CDM 272 RC facility both 413 413 Gross Charge Type: NIHD_Hosp_Profee_Price TWIST DRILL 1.0X15MM 2029316 CDM 272 RC facility both 413 413 Gross Charge Type: NIHD_Hosp_Profee_Price TWIST DRILL 1.0X15MM AO 2029317 CDM 272 RC facility both 413 413 Gross Charge Type: NIHD_Hosp_Profee_Price TWIST DRILL 1.0X15MM AO 2029317 CDM 272 RC facility both 413 413 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TORIC SN6AT4 15.0 2029321 CDM 276 RC facility both 505 505 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TORIC SN6AT4 15.0 2029321 CDM 276 RC facility both 505 505 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TECNIS MF ZMB00 11.0 1 PIECE 2029355 CDM 276 RC facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TECNIS MF ZMB00 11.0 1 PIECE 2029355 CDM 276 RC facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TECNIS MF ZMA00 10.5 3 PIECE 2029357 CDM 276 RC facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TECNIS MF ZMA00 10.5 3 PIECE 2029357 CDM 276 RC facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price DRESSING PURAPLY 5X5 25 SQ CM 2029364 CDM 278 RC facility both 7202 7202 Gross Charge Type: NIHD_Hosp_Profee_Price DRESSING PURAPLY 5X5 25 SQ CM 2029364 CDM 278 RC facility both 7202 7202 Gross Charge Type: NIHD_Hosp_Profee_Price DRESSING PURAPLY AM 1.6 SQ CM DISC 2029365 CDM 636 RC facility both 1350 1350 Gross Charge Type: NIHD_Hosp_Profee_Price DRESSING PURAPLY AM 1.6 SQ CM DISC 2029365 CDM 636 RC facility both 1350 1350 Gross Charge Type: NIHD_Hosp_Profee_Price DRESSING PURAPLY AM 2X2 4 SQ CM 2029366 CDM 636 RC facility both 2249 2249 Gross Charge Type: NIHD_Hosp_Profee_Price DRESSING PURAPLY AM 2X2 4 SQ CM 2029366 CDM 636 RC facility both 2249 2249 Gross Charge Type: NIHD_Hosp_Profee_Price DRESSING PURAPLY AM 2X4 8 SQ CM 2029367 CDM 636 RC facility both 2849 2849 Gross Charge Type: NIHD_Hosp_Profee_Price DRESSING PURAPLY AM 2X4 8 SQ CM 2029367 CDM 636 RC facility both 2849 2849 Gross Charge Type: NIHD_Hosp_Profee_Price DRESSING PURAPLY AM 5X5 25 SQ CM 2029368 CDM 278 RC facility both 8246 8246 Gross Charge Type: NIHD_Hosp_Profee_Price DRESSING PURAPLY AM 5X5 25 SQ CM 2029368 CDM 278 RC facility both 8246 8246 Gross Charge Type: NIHD_Hosp_Profee_Price DRESSING PURAPLY AM 6X9 54 SQ CM 2029369 CDM 278 RC facility both 17810 17810 Gross Charge Type: NIHD_Hosp_Profee_Price DRESSING PURAPLY AM 6X9 54 SQ CM 2029369 CDM 278 RC facility both 17810 17810 Gross Charge Type: NIHD_Hosp_Profee_Price DRESSING PURAPLY AM 8X16 128 SQ CM 2029370 CDM 278 RC facility both 41975 41975 Gross Charge Type: NIHD_Hosp_Profee_Price DRESSING PURAPLY AM 8X16 128 SQ CM 2029370 CDM 278 RC facility both 41975 41975 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL POSTERIOR STABILIZER SZ 6 2029372 CDM 278 RC facility both 15157 15157 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL POSTERIOR STABILIZER SZ 6 2029372 CDM 278 RC facility both 15157 15157 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT-PS SZ 6 11MM 2029373 CDM 278 RC facility both 10440 10440 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT-PS SZ 6 11MM 2029373 CDM 278 RC facility both 10440 10440 Gross Charge Type: NIHD_Hosp_Profee_Price RADIAL HEAD 22.0MM LEFT 2029377 CDM 278 RC facility both 16179 16179 Gross Charge Type: NIHD_Hosp_Profee_Price RADIAL HEAD 22.0MM LEFT 2029377 CDM 278 RC facility both 16179 16179 Gross Charge Type: NIHD_Hosp_Profee_Price RADIAL STEM 8.0 X0.0MM 2029378 CDM 278 RC facility both 9473 9473 Gross Charge Type: NIHD_Hosp_Profee_Price RADIAL STEM 8.0 X0.0MM 2029378 CDM 278 RC facility both 9473 9473 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW LOW PROFILE CORTICAL 2.7X 26 2029381 CDM facility both 136 136 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW LOW PROFILE CORTICAL 2.7X 26 2029381 CDM facility both 136 136 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE CLAVICLE CENTRAL THIRD CURVE LEFT 2029383 CDM facility both 2549 2549 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE CLAVICLE CENTRAL THIRD CURVE LEFT 2029383 CDM facility both 2549 2549 Gross Charge Type: NIHD_Hosp_Profee_Price POWER PICC CATHETER KIT TWO LUMEN 2029395 CDM 272 RC facility both 281 281 Gross Charge Type: NIHD_Hosp_Profee_Price POWER PICC CATHETER KIT TWO LUMEN 2029395 CDM 272 RC facility both 281 281 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL POSTERIOR STABILIZER SZ 5 5515-F-502 2029396 CDM 278 RC facility both 15157 15157 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL POSTERIOR STABILIZER SZ 5 5515-F-502 2029396 CDM 278 RC facility both 15157 15157 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE DISTAL FIBULA LOCK SS LEFT 6 HOLE 2029400 CDM facility both 2175 2175 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE DISTAL FIBULA LOCK SS LEFT 6 HOLE 2029400 CDM facility both 2175 2175 Gross Charge Type: NIHD_Hosp_Profee_Price ARH SOLUTIONS 2 HEAD 20MM LEFT 2029411 CDM 278 RC facility both 16179 16179 Gross Charge Type: NIHD_Hosp_Profee_Price ARH SOLUTIONS 2 HEAD 20MM LEFT 2029411 CDM 278 RC facility both 16179 16179 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TECNIS MF ZMA00 10.0 3 PIECE 2029417 CDM facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TECNIS MF ZMA00 10.0 3 PIECE 2029417 CDM facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price Primary Tubing CONNECTOR 15 DROPS/ML UNIVER SPIKE 2029418 CDM 272 RC facility both 37 37 Gross Charge Type: NIHD_Hosp_Profee_Price Primary Tubing CONNECTOR 15 DROPS/ML UNIVER SPIKE 2029418 CDM 272 RC facility both 37 37 Gross Charge Type: NIHD_Hosp_Profee_Price STEM HIP ANGLE ACC 11 SIZE# 7 37X114MM 2029442 CDM 278 RC facility both 24008 24008 Gross Charge Type: NIHD_Hosp_Profee_Price STEM HIP ANGLE ACC 11 SIZE# 7 37X114MM 2029442 CDM 278 RC facility both 24008 24008 Gross Charge Type: NIHD_Hosp_Profee_Price STEM CEMENTED 15X50MM 2029444 CDM 278 RC facility both 6264 6264 Gross Charge Type: NIHD_Hosp_Profee_Price STEM CEMENTED 15X50MM 2029444 CDM 278 RC facility both 6264 6264 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL INSERT TOTAL STABILIZER SZ 3X19M 2029445 CDM 278 RC facility both 12530 12530 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL INSERT TOTAL STABILIZER SZ 3X19M 2029445 CDM 278 RC facility both 12530 12530 Gross Charge Type: NIHD_Hosp_Profee_Price FLEXIGRAFT QUADLINK-ZORC 10X70 2029455 CDM 278 RC facility both 7795 7795 Gross Charge Type: NIHD_Hosp_Profee_Price FLEXIGRAFT QUADLINK-ZORC 10X70 2029455 CDM 278 RC facility both 7795 7795 Gross Charge Type: NIHD_Hosp_Profee_Price 10MM TENDON STRIPPER BLADE 2029458 CDM 272 RC facility both 526 526 Gross Charge Type: NIHD_Hosp_Profee_Price 10MM TENDON STRIPPER BLADE 2029458 CDM 272 RC facility both 526 526 Gross Charge Type: NIHD_Hosp_Profee_Price TIGHTROPE ABS BUTTON ROUND CONCAVE 14 2029460 CDM 278 RC facility both 672 672 Gross Charge Type: NIHD_Hosp_Profee_Price TIGHTROPE ABS BUTTON ROUND CONCAVE 14 2029460 CDM 278 RC facility both 672 672 Gross Charge Type: NIHD_Hosp_Profee_Price TIGHTROPE ABS BUTTON ROUND CONCAVE 20 2029461 CDM 278 RC facility both 672 672 Gross Charge Type: NIHD_Hosp_Profee_Price TIGHTROPE ABS BUTTON ROUND CONCAVE 20 2029461 CDM 278 RC facility both 672 672 Gross Charge Type: NIHD_Hosp_Profee_Price TIGHTROPE SUTURE TENSIONER 2029462 CDM facility both 2474 2474 Gross Charge Type: NIHD_Hosp_Profee_Price TIGHTROPE SUTURE TENSIONER 2029462 CDM facility both 2474 2474 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TECNIS MF ZMB00 19.0 3 PIECE 2029464 CDM facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TECNIS MF ZMB00 19.0 3 PIECE 2029464 CDM facility both 895 895 Gross Charge Type: NIHD_Hosp_Profee_Price "PEEK, MENISCAL ROOT REPAIR KIT" 2029472 CDM 278 RC facility both 4184 4184 Gross Charge Type: NIHD_Hosp_Profee_Price "PEEK, MENISCAL ROOT REPAIR KIT" 2029472 CDM 278 RC facility both 4184 4184 Gross Charge Type: NIHD_Hosp_Profee_Price FIBERLINK SUTURETAPE 0.9MM WH/BL 2029473 CDM facility both 286 286 Gross Charge Type: NIHD_Hosp_Profee_Price FIBERLINK SUTURETAPE 0.9MM WH/BL 2029473 CDM facility both 286 286 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW BONE 6.5X25MM SELF TAPPING 2029485 CDM 278 RC facility both 720 720 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW BONE 6.5X25MM SELF TAPPING 2029485 CDM 278 RC facility both 720 720 Gross Charge Type: NIHD_Hosp_Profee_Price XI-E CARDIERE FORCEPS 2029495 CDM 272 RC facility both 450 450 Gross Charge Type: NIHD_Hosp_Profee_Price XI-E CARDIERE FORCEPS 2029495 CDM 272 RC facility both 450 450 Gross Charge Type: NIHD_Hosp_Profee_Price XI-E PROGRASP FORCEPS 2029496 CDM 272 RC facility both 450 450 Gross Charge Type: NIHD_Hosp_Profee_Price XI-E PROGRASP FORCEPS 2029496 CDM 272 RC facility both 450 450 Gross Charge Type: NIHD_Hosp_Profee_Price XI-E LARGE NEEDLE DRIVER 2029497 CDM 272 RC facility both 576 576 Gross Charge Type: NIHD_Hosp_Profee_Price XI-E LARGE NEEDLE DRIVER 2029497 CDM 272 RC facility both 576 576 Gross Charge Type: NIHD_Hosp_Profee_Price XI-E MEGA SUTURECUT NEEDLE DRIVER 2029498 CDM 272 RC facility both 526 526 Gross Charge Type: NIHD_Hosp_Profee_Price XI-E MEGA SUTURECUT NEEDLE DRIVER 2029498 CDM 272 RC facility both 526 526 Gross Charge Type: NIHD_Hosp_Profee_Price XI-E MARYLAND BIPOLAR FORCEPS 2029499 CDM 272 RC facility both 706 706 Gross Charge Type: NIHD_Hosp_Profee_Price XI-E MARYLAND BIPOLAR FORCEPS 2029499 CDM 272 RC facility both 706 706 Gross Charge Type: NIHD_Hosp_Profee_Price XI-E FENESTRATED BIPOLAR FORCEPS 2029500 CDM 272 RC facility both 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price XI-E FENESTRATED BIPOLAR FORCEPS 2029500 CDM 272 RC facility both 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price XI-E CURVED BIPOLAR DISSECTOR XI 2029501 CDM 272 RC facility both 810 810 Gross Charge Type: NIHD_Hosp_Profee_Price XI-E CURVED BIPOLAR DISSECTOR XI 2029501 CDM 272 RC facility both 810 810 Gross Charge Type: NIHD_Hosp_Profee_Price XI-E LONG BIPOLAR GRASPER 2029502 CDM 272 RC facility both 870 870 Gross Charge Type: NIHD_Hosp_Profee_Price XI-E LONG BIPOLAR GRASPER 2029502 CDM 272 RC facility both 870 870 Gross Charge Type: NIHD_Hosp_Profee_Price "XI-E 8MM,FORCE BIPOLAR,IS4000" 2029503 CDM 272 RC facility both 706 706 Gross Charge Type: NIHD_Hosp_Profee_Price "XI-E 8MM,FORCE BIPOLAR,IS4000" 2029503 CDM 272 RC facility both 706 706 Gross Charge Type: NIHD_Hosp_Profee_Price MESH PARIETENE 1515 6X6 FLAT SHEET 2029508 CDM 278 RC facility both 287 287 Gross Charge Type: NIHD_Hosp_Profee_Price MESH PARIETENE 1515 6X6 FLAT SHEET 2029508 CDM 278 RC facility both 287 287 Gross Charge Type: NIHD_Hosp_Profee_Price MESH PRE SHAPED K-HOLE 6 X 13 2029525 CDM 278 RC facility both 1042 1042 Gross Charge Type: NIHD_Hosp_Profee_Price MESH PRE SHAPED K-HOLE 6 X 13 2029525 CDM 278 RC facility both 1042 1042 Gross Charge Type: NIHD_Hosp_Profee_Price FLEXIGRAFT QUADLINK(9.5X71) 2029531 CDM 278 RC facility both 7406 7406 Gross Charge Type: NIHD_Hosp_Profee_Price FLEXIGRAFT QUADLINK(9.5X71) 2029531 CDM 278 RC facility both 7406 7406 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT-CS SZ 4 X10MM 2029596 CDM 278 RC facility both 11010 11010 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT-CS SZ 4 X10MM 2029596 CDM 278 RC facility both 11010 11010 Gross Charge Type: NIHD_Hosp_Profee_Price "XI STAPLER,SUREFORM 40,SPU,IS4000" 2029604 CDM 272 RC facility both 1485 1485 Gross Charge Type: NIHD_Hosp_Profee_Price "XI STAPLER,SUREFORM 40,SPU,IS4000" 2029604 CDM 272 RC facility both 1485 1485 Gross Charge Type: NIHD_Hosp_Profee_Price ELELECTRODE BIPOLAR VAP DISC 24 FR 2029609 CDM 272 RC facility both 975 975 Gross Charge Type: NIHD_Hosp_Profee_Price ELELECTRODE BIPOLAR VAP DISC 24 FR 2029609 CDM 272 RC facility both 975 975 Gross Charge Type: NIHD_Hosp_Profee_Price GUIDEWIRE W TROCAR THREADED 2 X 130MM 2029613 CDM 272 RC facility both 37 37 Gross Charge Type: NIHD_Hosp_Profee_Price GUIDEWIRE W TROCAR THREADED 2 X 130MM 2029613 CDM 272 RC facility both 37 37 Gross Charge Type: NIHD_Hosp_Profee_Price MESH PRESHAPED KEYHOLE1.8 X4.0 2029629 CDM 272 RC facility both 417 417 Gross Charge Type: NIHD_Hosp_Profee_Price MESH PRESHAPED KEYHOLE1.8 X4.0 2029629 CDM 272 RC facility both 417 417 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 1.7 MM LASER MARKED 2029675 CDM 272 RC facility both 238 238 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 1.7 MM LASER MARKED 2029675 CDM 272 RC facility both 238 238 Gross Charge Type: NIHD_Hosp_Profee_Price CORKSCREW 3.9 MM KNOTLESS W/SPEAR 2029691 CDM facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price CORKSCREW 3.9 MM KNOTLESS W/SPEAR 2029691 CDM facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE ANCHOR SWIVLOCK/TIT W #2FIBERWIRE 2029693 CDM 272 RC facility both 1260 1260 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE ANCHOR SWIVLOCK/TIT W #2FIBERWIRE 2029693 CDM 272 RC facility both 1260 1260 Gross Charge Type: NIHD_Hosp_Profee_Price PERCUTNEOUS INSERTION 3.0 KIT 2029704 CDM facility both 975 975 Gross Charge Type: NIHD_Hosp_Profee_Price PERCUTNEOUS INSERTION 3.0 KIT 2029704 CDM facility both 975 975 Gross Charge Type: NIHD_Hosp_Profee_Price URET BALLOON UROMA 15CM X 4CM 2029728 CDM 272 RC facility both 1724 1724 Gross Charge Type: NIHD_Hosp_Profee_Price URET BALLOON UROMA 15CM X 4CM 2029728 CDM 272 RC facility both 1724 1724 Gross Charge Type: NIHD_Hosp_Profee_Price KNOTLESS FIBERTAK 1.8MM CURVED 2029732 CDM 278 RC facility both 586 586 Gross Charge Type: NIHD_Hosp_Profee_Price KNOTLESS FIBERTAK 1.8MM CURVED 2029732 CDM 278 RC facility both 586 586 Gross Charge Type: NIHD_Hosp_Profee_Price STAPLER ENDO GIA REFILL 30-3.5 30452 2029736 CDM facility both 550 550 Gross Charge Type: NIHD_Hosp_Profee_Price STAPLER ENDO GIA REFILL 30-3.5 30452 2029736 CDM facility both 550 550 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 6.5 CANNULATED 30 X 16 MM 2029742 CDM facility both 1521 1521 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 6.5 CANNULATED 30 X 16 MM 2029742 CDM facility both 1521 1521 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 6.5 CANNULATED 35 X 16 MM 2029743 CDM facility both 1521 1521 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW 6.5 CANNULATED 35 X 16 MM 2029743 CDM facility both 1521 1521 Gross Charge Type: NIHD_Hosp_Profee_Price SHELL HEMI CLUSTER HOLE SZ 60 MM G 2029751 CDM 278 RC facility both 10641 10641 Gross Charge Type: NIHD_Hosp_Profee_Price SHELL HEMI CLUSTER HOLE SZ 60 MM G 2029751 CDM 278 RC facility both 10641 10641 Gross Charge Type: NIHD_Hosp_Profee_Price Fibertak 2.6 RC black and blue 2029788 CDM 278 RC facility both 1477 1477 Gross Charge Type: NIHD_Hosp_Profee_Price Fibertak 2.6 RC black and blue 2029788 CDM 278 RC facility both 1477 1477 Gross Charge Type: NIHD_Hosp_Profee_Price FIBERTAK 2.6 RC WHITE AND BLACK 2029790 CDM 278 RC facility both 1477 1477 Gross Charge Type: NIHD_Hosp_Profee_Price FIBERTAK 2.6 RC WHITE AND BLACK 2029790 CDM 278 RC facility both 1477 1477 Gross Charge Type: NIHD_Hosp_Profee_Price ASM-EVAC1 TRI-LUMEN FILTERED TUBE SET (AIRSEAL) 2029812 CDM 272 RC facility both 237 237 Gross Charge Type: NIHD_Hosp_Profee_Price ASM-EVAC1 TRI-LUMEN FILTERED TUBE SET (AIRSEAL) 2029812 CDM 272 RC facility both 237 237 Gross Charge Type: NIHD_Hosp_Profee_Price ASM-EVAC1-B 1FURCATED FILTERED TUBE (AIR-SEAL) 2029813 CDM 272 RC facility both 315 315 Gross Charge Type: NIHD_Hosp_Profee_Price ASM-EVAC1-B 1FURCATED FILTERED TUBE (AIR-SEAL) 2029813 CDM 272 RC facility both 315 315 Gross Charge Type: NIHD_Hosp_Profee_Price AIRSEAL 12/120MM LPI PORT 2029814 CDM 272 RC facility both 246 246 Gross Charge Type: NIHD_Hosp_Profee_Price AIRSEAL 12/120MM LPI PORT 2029814 CDM 272 RC facility both 246 246 Gross Charge Type: NIHD_Hosp_Profee_Price AIRSEAL 5/100MM LPI PORT 2029815 CDM 272 RC facility both 231 231 Gross Charge Type: NIHD_Hosp_Profee_Price AIRSEAL 5/100MM LPI PORT 2029815 CDM 272 RC facility both 231 231 Gross Charge Type: NIHD_Hosp_Profee_Price AIRSEAL 5/120MM PORT 2029816 CDM 272 RC facility both 231 231 Gross Charge Type: NIHD_Hosp_Profee_Price AIRSEAL 5/120MM PORT 2029816 CDM 272 RC facility both 231 231 Gross Charge Type: NIHD_Hosp_Profee_Price AIRSEAL 8/120MM PORT 2029817 CDM 272 RC facility both 231 231 Gross Charge Type: NIHD_Hosp_Profee_Price AIRSEAL 8/120MM PORT 2029817 CDM 272 RC facility both 231 231 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT-PS SZ 5 11MM 2029873 CDM 278 RC facility both 10440 10440 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT-PS SZ 5 11MM 2029873 CDM 278 RC facility both 10440 10440 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT-CS SZ 4 X12MM 2029907 CDM 278 RC facility both 9904 9904 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT-CS SZ 4 X12MM 2029907 CDM 278 RC facility both 9904 9904 Gross Charge Type: NIHD_Hosp_Profee_Price STEM TRIATHLON CEMENTED 2029925 CDM 278 RC facility both 6519 6519 Gross Charge Type: NIHD_Hosp_Profee_Price STEM TRIATHLON CEMENTED 2029925 CDM 278 RC facility both 6519 6519 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL POSTERIOR STABILIZER SZ 1 2029950 CDM 278 RC facility both 16363 16363 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL POSTERIOR STABILIZER SZ 1 2029950 CDM 278 RC facility both 16363 16363 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT-PS SZ 2 13MM 2029952 CDM 278 RC facility both 11269 11269 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT-PS SZ 2 13MM 2029952 CDM 278 RC facility both 11269 11269 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5 Cortical Screws Synthes 40mm 2043400 CDM 278 RC facility both 98 98 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5 Cortical Screws Synthes 40mm 2043400 CDM 278 RC facility both 98 98 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5 Cortical Screw Synthes 60mm 2043600 CDM 278 RC facility both 98 98 Gross Charge Type: NIHD_Hosp_Profee_Price 3.5 Cortical Screw Synthes 60mm 2043600 CDM 278 RC facility both 98 98 Gross Charge Type: NIHD_Hosp_Profee_Price 20520 Removal of foreign body in muscle or tendon sheath; simple 205201 CDM 521 RC 20520 HCPCS facility both 450 450 Gross Charge Type: NIHD_RHC_Price 20520 Removal of foreign body in muscle or tendon sheath; simple 205201 CDM 521 RC 20520 HCPCS facility both 450 450 Gross Charge Type: NIHD_Clinic_Price 20520 REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE TechFee 205202 CDM 450 RC facility both 1310 1310 Gross Charge Type: NIHD_Hosp_Profee_Price 20520 REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE TechFee 205202 CDM 450 RC facility both 1310 1310 Gross Charge Type: NIHD_Hosp_Profee_Price 20520 REMOVAL OF FOREIGN BODY IN MUSCLE OR TENDON SHEATH; SIMPLE ProFee 205203 CDM 982 RC 20520 HCPCS facility both 438 438 Gross Charge Type: NIHD_Hosp_Profee_Price 20520 REMOVAL OF FOREIGN BODY IN MUSCLE OR TENDON SHEATH; SIMPLE ProFee 205203 CDM 982 RC 20520 HCPCS facility both 438 438 Gross Charge Type: NIHD_Hosp_Profee_Price 20525 REMOVAL OF FOREIGN BODY IN MUSCLE OR TENDON SHEATH; DEEP OR COMPLICATED ProFee 20525 CDM 982 RC 20525 HCPCS facility both 1023 1023 Gross Charge Type: NIHD_Hosp_Profee_Price 20525 REMOVAL OF FOREIGN BODY IN MUSCLE OR TENDON SHEATH; DEEP OR COMPLICATED ProFee 20525 CDM 982 RC 20525 HCPCS facility both 1023 1023 Gross Charge Type: NIHD_Hosp_Profee_Price "20526 Injection, therapeutic (eg, local anesthetic, corticosteroid), carpal tunnel" 205261 CDM 521 RC 20526 HCPCS facility both 341 341 Gross Charge Type: NIHD_RHC_Price "20526 Injection, therapeutic (eg, local anesthetic, corticosteroid), carpal tunnel" 205261 CDM 521 RC 20526 HCPCS facility both 341 341 Gross Charge Type: NIHD_Clinic_Price 20526 INJECT CARPAL TUNNEL CHARGE 205262 CDM 761 RC facility both 421 421 Gross Charge Type: NIHD_Hosp_Profee_Price 20526 INJECT CARPAL TUNNEL CHARGE 205262 CDM 761 RC facility both 421 421 Gross Charge Type: NIHD_Hosp_Profee_Price "20527 Injection, enzyme, palmar fascial cord (Dupuytren's contracture)" 20527 CDM 521 RC 20527 HCPCS facility both 153 153 Gross Charge Type: NIHD_RHC_Price "20527 Injection, enzyme, palmar fascial cord (Dupuytren's contracture)" 20527 CDM 521 RC 20527 HCPCS facility both 153 153 Gross Charge Type: NIHD_Clinic_Price INJ TENDON SHEATH/LIGAMENT 20550 CDM 521 RC 20550 HCPCS facility both 462 462 Gross Charge Type: NIHD_RHC_Price INJ TENDON SHEATH/LIGAMENT 20550 CDM 521 RC 20550 HCPCS facility both 198 198 Gross Charge Type: NIHD_Clinic_Price 20551 Injection(s); single tendon origin/insertion 20551 CDM 521 RC 20551 HCPCS facility both 473 473 Gross Charge Type: NIHD_RHC_Price 20551 Injection(s); single tendon origin/insertion 20551 CDM 521 RC 20551 HCPCS facility both 266 266 Gross Charge Type: NIHD_Clinic_Price "20552 Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)" 205521 CDM 521 RC 20552 HCPCS facility both 437 437 Gross Charge Type: NIHD_RHC_Price "20552 Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)" 205521 CDM 521 RC 20552 HCPCS facility both 215 215 Gross Charge Type: NIHD_Clinic_Price 20552 INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES TechFee 205522 CDM 450 RC facility both 370 370 Gross Charge Type: NIHD_Hosp_Profee_Price 20552 INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES TechFee 205522 CDM 450 RC facility both 370 370 Gross Charge Type: NIHD_Hosp_Profee_Price "20552 INJECTION(S); SINGLE OR MULTIPLE TRIGGER POINT(S), 1 OR 2 MUSCLE(S) ProFee" 205523 CDM 982 RC 20552 HCPCS facility both 83 83 Gross Charge Type: NIHD_Hosp_Profee_Price "20552 INJECTION(S); SINGLE OR MULTIPLE TRIGGER POINT(S), 1 OR 2 MUSCLE(S) ProFee" 205523 CDM 982 RC 20552 HCPCS facility both 83 83 Gross Charge Type: NIHD_Hosp_Profee_Price XR Biopsy Muscle 205524 CDM 761 RC facility both 840 840 Gross Charge Type: NIHD_Hosp_Profee_Price XR Biopsy Muscle 205524 CDM 761 RC facility both 840 840 Gross Charge Type: NIHD_Hosp_Profee_Price XR Injection Trigger Pnt 1 or 2 Muscles 205526 CDM 761 RC facility both TC 733 733 Gross Charge Type: NIHD_Hosp_Profee_Price XR Injection Trigger Pnt 1 or 2 Muscles 205526 CDM 761 RC facility both TC 733 733 Gross Charge Type: NIHD_Hosp_Profee_Price XR Injection Trigger Pnt 1 or 2 Muscles - Report 205527 CDM 982 RC 20552 HCPCS facility both 26 214 214 Gross Charge Type: NIHD_Hosp_Profee_Price XR Injection Trigger Pnt 1 or 2 Muscles - Report 205527 CDM 982 RC 20552 HCPCS facility both 26 214 214 Gross Charge Type: NIHD_Hosp_Profee_Price NIHD XR TRIGGER POINT INJ 3+ MUSCLES 20553 CDM 761 RC facility both TC 791 791 Gross Charge Type: NIHD_Hosp_Profee_Price NIHD XR TRIGGER POINT INJ 3+ MUSCLES 20553 CDM 761 RC facility both TC 791 791 Gross Charge Type: NIHD_Hosp_Profee_Price "20553 Injection(s); single or multiple trigger point(s), 3 or more muscle(s)" 205531 CDM 521 RC 20553 HCPCS facility both 654 654 Gross Charge Type: NIHD_RHC_Price "20553 Injection(s); single or multiple trigger point(s), 3 or more muscle(s)" 205531 CDM 521 RC 20553 HCPCS facility both 654 654 Gross Charge Type: NIHD_Clinic_Price 20553 INJECTION SINGLE/MLT TRIGGER POINT 3/> MUSCLES TechFee 205532 CDM 450 RC facility both 556 556 Gross Charge Type: NIHD_Hosp_Profee_Price 20553 INJECTION SINGLE/MLT TRIGGER POINT 3/> MUSCLES TechFee 205532 CDM 450 RC facility both 556 556 Gross Charge Type: NIHD_Hosp_Profee_Price "20553 INJECTION(S); SINGLE OR MULTIPLE TRIGGER POINT(S), 3 OR MORE MUSCLES ProFee" 205533 CDM 982 RC 20553 HCPCS facility both 83 83 Gross Charge Type: NIHD_Hosp_Profee_Price "20553 INJECTION(S); SINGLE OR MULTIPLE TRIGGER POINT(S), 3 OR MORE MUSCLES ProFee" 205533 CDM 982 RC 20553 HCPCS facility both 83 83 Gross Charge Type: NIHD_Hosp_Profee_Price NIHD XR TRIGGER POINT INJ 3+ MUSCLES 205534 CDM 761 RC facility both TC 791 791 Gross Charge Type: NIHD_Hosp_Profee_Price NIHD XR TRIGGER POINT INJ 3+ MUSCLES 205534 CDM 761 RC facility both TC 791 791 Gross Charge Type: NIHD_Hosp_Profee_Price XR Injection Trigger Pnt 3+ Muscles 205535 CDM 761 RC facility both TC 791 791 Gross Charge Type: NIHD_Hosp_Profee_Price XR Injection Trigger Pnt 3+ Muscles 205535 CDM 761 RC facility both TC 791 791 Gross Charge Type: NIHD_Hosp_Profee_Price XR Injection Trigger Pnt 3+ Muscles - Report 205536 CDM 982 RC 20553 HCPCS facility both 26 146 146 Gross Charge Type: NIHD_Hosp_Profee_Price XR Injection Trigger Pnt 3+ Muscles - Report 205536 CDM 982 RC 20553 HCPCS facility both 26 146 146 Gross Charge Type: NIHD_Hosp_Profee_Price 20560 Needle insertion(s) without injection(s); 1 or 2 muscle(s) 20560 CDM 521 RC 20560 HCPCS facility both 80 80 Gross Charge Type: NIHD_RHC_Price 20560 Needle insertion(s) without injection(s); 1 or 2 muscle(s) 20560 CDM 521 RC 20560 HCPCS facility both 84 84 Gross Charge Type: NIHD_Clinic_Price DRN/INJ SML JT/BRSA W/O US 206001 CDM 521 RC 20600 HCPCS facility both 600 600 Gross Charge Type: NIHD_RHC_Price DRN/INJ SML JT/BRSA W/O US 206001 CDM 521 RC 20600 HCPCS facility both 262 262 Gross Charge Type: NIHD_Clinic_Price 20600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US TechFee 206002 CDM 450 RC facility both 512 512 Gross Charge Type: NIHD_Hosp_Profee_Price 20600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US TechFee 206002 CDM 450 RC facility both 512 512 Gross Charge Type: NIHD_Hosp_Profee_Price "20600 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, SMALL JOINT OR BURSA (EG, FINGERS, TOES); ProFee" 206004 CDM 982 RC 20600 HCPCS facility both 101 101 Gross Charge Type: NIHD_Hosp_Profee_Price "20600 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, SMALL JOINT OR BURSA (EG, FINGERS, TOES); ProFee" 206004 CDM 982 RC 20600 HCPCS facility both 101 101 Gross Charge Type: NIHD_Hosp_Profee_Price XR Joint/Bursa Small Arthr/Asp/Inj Left 206005 CDM 761 RC facility both TCLT 587 587 Gross Charge Type: NIHD_Hosp_Profee_Price XR Joint/Bursa Small Arthr/Asp/Inj Left 206005 CDM 761 RC facility both TCLT 587 587 Gross Charge Type: NIHD_Hosp_Profee_Price XR Joint/Bursa Small Arthr/Asp/Inj Left - Report 206006 CDM 982 RC 20600 HCPCS facility both 26LT 176 176 Gross Charge Type: NIHD_Hosp_Profee_Price XR Joint/Bursa Small Arthr/Asp/Inj Left - Report 206006 CDM 982 RC 20600 HCPCS facility both 26LT 176 176 Gross Charge Type: NIHD_Hosp_Profee_Price 20600 ARTHROC ASPI/INJ;SM JNT/BURSA CHARGE 206007 CDM 761 RC facility both 673 673 Gross Charge Type: NIHD_Hosp_Profee_Price 20600 ARTHROC ASPI/INJ;SM JNT/BURSA CHARGE 206007 CDM 761 RC facility both 673 673 Gross Charge Type: NIHD_Hosp_Profee_Price XR Joint/Bursa Small Arthr/Asp/Inj Right 206008 CDM 761 RC facility both TCRT 587 587 Gross Charge Type: NIHD_Hosp_Profee_Price XR Joint/Bursa Small Arthr/Asp/Inj Right 206008 CDM 761 RC facility both TCRT 587 587 Gross Charge Type: NIHD_Hosp_Profee_Price XR Joint/Bursa Small Arthr/Asp/Inj Right - Report 206009 CDM 982 RC 20600 HCPCS facility both 26RT 176 176 Gross Charge Type: NIHD_Hosp_Profee_Price XR Joint/Bursa Small Arthr/Asp/Inj Right - Report 206009 CDM 982 RC 20600 HCPCS facility both 26RT 176 176 Gross Charge Type: NIHD_Hosp_Profee_Price 20604 ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT CHARGE 20604 CDM 761 RC facility both 745 745 Gross Charge Type: NIHD_Hosp_Profee_Price 20604 ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT CHARGE 20604 CDM 761 RC facility both 745 745 Gross Charge Type: NIHD_Hosp_Profee_Price 20604 DRAIN/INJ JOINT/BURSA W/US TechFee 206041 CDM 450 RC facility both 745 745 Gross Charge Type: NIHD_Hosp_Profee_Price 20604 DRAIN/INJ JOINT/BURSA W/US TechFee 206041 CDM 450 RC facility both 745 745 Gross Charge Type: NIHD_Hosp_Profee_Price "20604 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, SMALL JOINT OR BURSA (EG, FINGERS, TOES); ProFee" 206042 CDM 982 RC 20604 HCPCS facility both 83 83 Gross Charge Type: NIHD_Hosp_Profee_Price "20604 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, SMALL JOINT OR BURSA (EG, FINGERS, TOES); ProFee" 206042 CDM 982 RC 20604 HCPCS facility both 83 83 Gross Charge Type: NIHD_Hosp_Profee_Price DRN/INJ INTER JT/BRSA W/O US 206051 CDM 521 RC 20605 HCPCS facility both 600 600 Gross Charge Type: NIHD_RHC_Price DRN/INJ INTER JT/BRSA W/O US 206051 CDM 521 RC 20605 HCPCS facility both 218 218 Gross Charge Type: NIHD_Clinic_Price XR Joint/Bursa Intmd Arthr/Asp/Inj Left 2060510 CDM 761 RC facility both TCLT 613 613 Gross Charge Type: NIHD_Hosp_Profee_Price XR Joint/Bursa Intmd Arthr/Asp/Inj Left 2060510 CDM 761 RC facility both TCLT 613 613 Gross Charge Type: NIHD_Hosp_Profee_Price XR Joint/Bursa Intmd Arthr/Asp/Inj Left - Report 2060511 CDM 982 RC 20605 HCPCS facility both 26LT 176 176 Gross Charge Type: NIHD_Hosp_Profee_Price XR Joint/Bursa Intmd Arthr/Asp/Inj Left - Report 2060511 CDM 982 RC 20605 HCPCS facility both 26LT 176 176 Gross Charge Type: NIHD_Hosp_Profee_Price XR Joint/Bursa Intmd Arthr/Asp/Inj Right 2060512 CDM 761 RC facility both TCRT 613 613 Gross Charge Type: NIHD_Hosp_Profee_Price XR Joint/Bursa Intmd Arthr/Asp/Inj Right 2060512 CDM 761 RC facility both TCRT 613 613 Gross Charge Type: NIHD_Hosp_Profee_Price XR Joint/Bursa Intmd Arthr/Asp/Inj Right - Report 2060513 CDM 982 RC 20605 HCPCS facility both 26RT 176 176 Gross Charge Type: NIHD_Hosp_Profee_Price XR Joint/Bursa Intmd Arthr/Asp/Inj Right - Report 2060513 CDM 982 RC 20605 HCPCS facility both 26RT 176 176 Gross Charge Type: NIHD_Hosp_Profee_Price 20605 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US TechFee 206052 CDM 450 RC facility both 551 551 Gross Charge Type: NIHD_Hosp_Profee_Price 20605 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US TechFee 206052 CDM 450 RC facility both 551 551 Gross Charge Type: NIHD_Hosp_Profee_Price "20605 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, INTERMEDIATE JOINT OR BURSA (EG, TEMPOROM ProFee" 206053 CDM 982 RC 20605 HCPCS facility both 108 108 Gross Charge Type: NIHD_Hosp_Profee_Price "20605 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, INTERMEDIATE JOINT OR BURSA (EG, TEMPOROM ProFee" 206053 CDM 982 RC 20605 HCPCS facility both 108 108 Gross Charge Type: NIHD_Hosp_Profee_Price 20605 ARTHROCINTMED JNT CHARGE 206055 CDM 761 RC facility both 551 551 Gross Charge Type: NIHD_Hosp_Profee_Price 20605 ARTHROCINTMED JNT CHARGE 206055 CDM 761 RC facility both 551 551 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Elbow Left 206056 CDM 761 RC facility both TCLT 613 613 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Elbow Left 206056 CDM 761 RC facility both TCLT 613 613 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Elbow Left - Report 206057 CDM 982 RC 20605 HCPCS facility both 26LT 176 176 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Elbow Left - Report 206057 CDM 982 RC 20605 HCPCS facility both 26LT 176 176 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Elbow Right 206058 CDM 761 RC facility both TCRT 613 613 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Elbow Right 206058 CDM 761 RC facility both TCRT 613 613 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Elbow Right - Report 206059 CDM 982 RC 20605 HCPCS facility both 26RT 176 176 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Elbow Right - Report 206059 CDM 982 RC 20605 HCPCS facility both 26RT 176 176 Gross Charge Type: NIHD_Hosp_Profee_Price 20606 ARTHROCENTESIS W US GUIDANCE CHARGE 20606 CDM 761 RC facility both 425 425 Gross Charge Type: NIHD_Hosp_Profee_Price 20606 ARTHROCENTESIS W US GUIDANCE CHARGE 20606 CDM 761 RC facility both 425 425 Gross Charge Type: NIHD_Hosp_Profee_Price 20606 ARTHROCENTESIS W US GUIDANCE 206061 CDM 450 RC facility both 425 425 Gross Charge Type: NIHD_Hosp_Profee_Price 20606 ARTHROCENTESIS W US GUIDANCE 206061 CDM 450 RC facility both 425 425 Gross Charge Type: NIHD_Hosp_Profee_Price "20606 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, INTERMEDIATE JOINT OR BURSA (EG, TEMPOROM ProFee" 206062 CDM 982 RC 20606 HCPCS facility both 114 114 Gross Charge Type: NIHD_Hosp_Profee_Price "20606 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, INTERMEDIATE JOINT OR BURSA (EG, TEMPOROM ProFee" 206062 CDM 982 RC 20606 HCPCS facility both 114 114 Gross Charge Type: NIHD_Hosp_Profee_Price "20610 Arthrocentesis, aspiration and/or injection, major joint or bursa; without ultrasound guidance" 206101 CDM 521 RC 20610 HCPCS facility both 698 698 Gross Charge Type: NIHD_RHC_Price "20610 Arthrocentesis, aspiration and/or injection, major joint or bursa; without ultrasound guidance" 206101 CDM 521 RC 20610 HCPCS facility both 254 254 Gross Charge Type: NIHD_Clinic_Price US Joint/Bursa Up Maj Arth/Asp/Inj Left - Report 2061010 CDM 982 RC 20610 HCPCS facility both 26LT 176 176 Gross Charge Type: NIHD_Hosp_Profee_Price US Joint/Bursa Up Maj Arth/Asp/Inj Left - Report 2061010 CDM 982 RC 20610 HCPCS facility both 26LT 176 176 Gross Charge Type: NIHD_Hosp_Profee_Price US Joint/Bursa Up Maj Arth/Asp/Inj Right 2061011 CDM 761 RC facility both TCRT 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price US Joint/Bursa Up Maj Arth/Asp/Inj Right 2061011 CDM 761 RC facility both TCRT 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price US Joint/Bursa Up Maj Arth/Asp/Inj Right - Report 2061012 CDM 982 RC 20610 HCPCS facility both 26RT 176 176 Gross Charge Type: NIHD_Hosp_Profee_Price US Joint/Bursa Up Maj Arth/Asp/Inj Right - Report 2061012 CDM 982 RC 20610 HCPCS facility both 26RT 176 176 Gross Charge Type: NIHD_Hosp_Profee_Price XR Joint/Bursa Major Arthr/Asp/Inj Left 2061013 CDM 761 RC facility both TCLT 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price XR Joint/Bursa Major Arthr/Asp/Inj Left 2061013 CDM 761 RC facility both TCLT 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price XR Joint/Bursa Major Arthr/Asp/Inj Left - Report 2061014 CDM 982 RC 20610 HCPCS facility both 26LT 169 169 Gross Charge Type: NIHD_Hosp_Profee_Price XR Joint/Bursa Major Arthr/Asp/Inj Left - Report 2061014 CDM 982 RC 20610 HCPCS facility both 26LT 169 169 Gross Charge Type: NIHD_Hosp_Profee_Price XR Joint/Bursa Major Arthr/Asp/Inj Right 2061015 CDM 761 RC facility both TCRT 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price XR Joint/Bursa Major Arthr/Asp/Inj Right 2061015 CDM 761 RC facility both TCRT 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price XR Joint/Bursa Major Arthr/Asp/Inj Right - Report 2061016 CDM 982 RC 20610 HCPCS facility both 26RT 169 169 Gross Charge Type: NIHD_Hosp_Profee_Price XR Joint/Bursa Major Arthr/Asp/Inj Right - Report 2061016 CDM 982 RC 20610 HCPCS facility both 26RT 169 169 Gross Charge Type: NIHD_Hosp_Profee_Price 20610 XR Joint/Bursa Major Arthr/Asp/Inj Unilateral 2061017 CDM 761 RC facility both TC 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price 20610 XR Joint/Bursa Major Arthr/Asp/Inj Unilateral 2061017 CDM 761 RC facility both TC 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price 20610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US TechFee 206102 CDM 450 RC facility both 712 712 Gross Charge Type: NIHD_Hosp_Profee_Price 20610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US TechFee 206102 CDM 450 RC facility both 712 712 Gross Charge Type: NIHD_Hosp_Profee_Price "20610 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, MAJOR JOINT OR BURSA (EG, SHOULDER, HIP, ProFee" 206103 CDM 982 RC 20610 HCPCS facility both 126 126 Gross Charge Type: NIHD_Hosp_Profee_Price "20610 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, MAJOR JOINT OR BURSA (EG, SHOULDER, HIP, ProFee" 206103 CDM 982 RC 20610 HCPCS facility both 126 126 Gross Charge Type: NIHD_Hosp_Profee_Price CT Joint/Bursa Major Arthr/Asp/Inj Left 206105 CDM 761 RC facility both TCLT 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price CT Joint/Bursa Major Arthr/Asp/Inj Left 206105 CDM 761 RC facility both TCLT 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price CT Joint/Bursa Major Arthr/Asp/Inj Left - Report 206106 CDM 982 RC 20610 HCPCS facility both 26LT 169 169 Gross Charge Type: NIHD_Hosp_Profee_Price CT Joint/Bursa Major Arthr/Asp/Inj Left - Report 206106 CDM 982 RC 20610 HCPCS facility both 26LT 169 169 Gross Charge Type: NIHD_Hosp_Profee_Price CT Joint/Bursa Major Arthr/Asp/Inj Right 206107 CDM 761 RC facility both TCRT 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price CT Joint/Bursa Major Arthr/Asp/Inj Right 206107 CDM 761 RC facility both TCRT 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price CT Joint/Bursa Major Arthr/Asp/Inj Right - Report 206108 CDM 982 RC 20610 HCPCS facility both 26RT 169 169 Gross Charge Type: NIHD_Hosp_Profee_Price CT Joint/Bursa Major Arthr/Asp/Inj Right - Report 206108 CDM 982 RC 20610 HCPCS facility both 26RT 169 169 Gross Charge Type: NIHD_Hosp_Profee_Price US Joint/Bursa Up Maj Arth/Asp/Inj Left 206109 CDM 761 RC facility both TCLT 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price US Joint/Bursa Up Maj Arth/Asp/Inj Left 206109 CDM 761 RC facility both TCLT 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price 20611 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US 206111 CDM 450 RC facility both 1078 1078 Gross Charge Type: NIHD_Hosp_Profee_Price 20611 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US 206111 CDM 450 RC facility both 1078 1078 Gross Charge Type: NIHD_Hosp_Profee_Price "20611 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, MAJOR JOINT OR BURSA (EG, SHOULDER, HIP, ProFee" 206112 CDM 982 RC 20611 HCPCS facility both 107 107 Gross Charge Type: NIHD_Hosp_Profee_Price "20611 ARTHROCENTESIS, ASPIRATION AND/OR INJECTION, MAJOR JOINT OR BURSA (EG, SHOULDER, HIP, ProFee" 206112 CDM 982 RC 20611 HCPCS facility both 107 107 Gross Charge Type: NIHD_Hosp_Profee_Price 20612 Aspiration and/or injection of ganglion cyst(s) any location 206121 CDM 521 RC 20612 HCPCS facility both 333 333 Gross Charge Type: NIHD_RHC_Price 20612 Aspiration and/or injection of ganglion cyst(s) any location 206121 CDM 521 RC 20612 HCPCS facility both 266 266 Gross Charge Type: NIHD_Clinic_Price US Aspiration/Inject Ganglion Cyst 206122 CDM 761 RC facility both TC 890 890 Gross Charge Type: NIHD_Hosp_Profee_Price US Aspiration/Inject Ganglion Cyst 206122 CDM 761 RC facility both TC 890 890 Gross Charge Type: NIHD_Hosp_Profee_Price US Aspiration/Inject Ganglion Cyst - Report 206123 CDM 972 RC 20612 HCPCS facility both 26 133 133 Gross Charge Type: NIHD_Hosp_Profee_Price US Aspiration/Inject Ganglion Cyst - Report 206123 CDM 972 RC 20612 HCPCS facility both 26 133 133 Gross Charge Type: NIHD_Hosp_Profee_Price 20612 US Aspiration/Inject Ganglion Cyst 206124 CDM 761 RC facility both TC 890 890 Gross Charge Type: NIHD_Hosp_Profee_Price 20612 US Aspiration/Inject Ganglion Cyst 206124 CDM 761 RC facility both TC 890 890 Gross Charge Type: NIHD_Hosp_Profee_Price 20612 US Aspiration/Inject Ganglion Cyst PROFEE 206125 CDM 972 RC 20612 HCPCS facility both 26 133 133 Gross Charge Type: NIHD_Hosp_Profee_Price 20612 US Aspiration/Inject Ganglion Cyst PROFEE 206125 CDM 972 RC 20612 HCPCS facility both 26 133 133 Gross Charge Type: NIHD_Hosp_Profee_Price "20650 Insertion of wire or pin with application of skeletal traction, including removal" 20650 CDM 521 RC 20650 HCPCS facility both 716 716 Gross Charge Type: NIHD_RHC_Price "20650 Insertion of wire or pin with application of skeletal traction, including removal" 20650 CDM 521 RC 20650 HCPCS facility both 750 750 Gross Charge Type: NIHD_Clinic_Price "20670 Removal of implant; superficial (buried wire, pin or rod)" 206701 CDM 521 RC 20670 HCPCS facility both 1590 1590 Gross Charge Type: NIHD_Clinic_Price "20670 REMOVAL OF IMPLANT; SUPERFICIAL (EG, BURIED WIRE, PIN OR ROD) (SEPARATE PROCEDURE) ProFee" 206702 CDM 982 RC 20670 HCPCS facility both 812 812 Gross Charge Type: NIHD_Hosp_Profee_Price "20670 REMOVAL OF IMPLANT; SUPERFICIAL (EG, BURIED WIRE, PIN OR ROD) (SEPARATE PROCEDURE) ProFee" 206702 CDM 982 RC 20670 HCPCS facility both 812 812 Gross Charge Type: NIHD_Hosp_Profee_Price "20680 REMOVAL OF IMPLANT; DEEP (EG, BURIED WIRE, PIN, SCREW, METAL BAND, NAIL, ROD OR PLATE) ProFee" 20680 CDM 982 RC 20680 HCPCS facility both 1310 1310 Gross Charge Type: NIHD_Hosp_Profee_Price "20680 REMOVAL OF IMPLANT; DEEP (EG, BURIED WIRE, PIN, SCREW, METAL BAND, NAIL, ROD OR PLATE) ProFee" 20680 CDM 982 RC 20680 HCPCS facility both 1310 1310 Gross Charge Type: NIHD_Hosp_Profee_Price "20690 APPLICATION OF A UNIPLANE (PINS OR WIRES IN 1 PLANE), UNILATERAL, EXTERNAL FIXATION SY ProFee" 20690 CDM 982 RC 20690 HCPCS facility both 1225 1225 Gross Charge Type: NIHD_Hosp_Profee_Price "20690 APPLICATION OF A UNIPLANE (PINS OR WIRES IN 1 PLANE), UNILATERAL, EXTERNAL FIXATION SY ProFee" 20690 CDM 982 RC 20690 HCPCS facility both 1225 1225 Gross Charge Type: NIHD_Hosp_Profee_Price "20692 APPLICATION OF A MULTIPLANE (PINS OR WIRES IN MORE THAN 1 PLANE), UNILATERAL, EXTERNAL ProFee" 20692 CDM 982 RC 20692 HCPCS facility both 2372 2372 Gross Charge Type: NIHD_Hosp_Profee_Price "20692 APPLICATION OF A MULTIPLANE (PINS OR WIRES IN MORE THAN 1 PLANE), UNILATERAL, EXTERNAL ProFee" 20692 CDM 982 RC 20692 HCPCS facility both 2372 2372 Gross Charge Type: NIHD_Hosp_Profee_Price "20693 ADJUSTMENT OR REVISION OF EXTERNAL FIXATION SYSTEM REQUIRING ANESTHESIA (EG, NEW PIN[S ProFee" 20693 CDM 982 RC 20693 HCPCS facility both 936 936 Gross Charge Type: NIHD_Hosp_Profee_Price "20693 ADJUSTMENT OR REVISION OF EXTERNAL FIXATION SYSTEM REQUIRING ANESTHESIA (EG, NEW PIN[S ProFee" 20693 CDM 982 RC 20693 HCPCS facility both 936 936 Gross Charge Type: NIHD_Hosp_Profee_Price "20694 REMOVAL, UNDER ANESTHESIA, OF EXTERNAL FIXATION SYSTEM ProFee" 20694 CDM 982 RC 20694 HCPCS facility both 912 912 Gross Charge Type: NIHD_Hosp_Profee_Price "20694 REMOVAL, UNDER ANESTHESIA, OF EXTERNAL FIXATION SYSTEM ProFee" 20694 CDM 982 RC 20694 HCPCS facility both 912 912 Gross Charge Type: NIHD_Hosp_Profee_Price "20900 BONE GRAFT, ANY DONOR AREA; MINOR OR SMALL (EG, DOWEL OR BUTTON) ProFee" 20900 CDM 982 RC 20900 HCPCS facility both 900 900 Gross Charge Type: NIHD_Hosp_Profee_Price "20900 BONE GRAFT, ANY DONOR AREA; MINOR OR SMALL (EG, DOWEL OR BUTTON) ProFee" 20900 CDM 982 RC 20900 HCPCS facility both 900 900 Gross Charge Type: NIHD_Hosp_Profee_Price "20950 MONITORING OF INTERSTITIAL FLUID PRESSURE (INCLUDES INSERTION OF DEVICE, EG, WICK CATH ProFee" 20950 CDM 982 RC 20950 HCPCS facility both 278 278 Gross Charge Type: NIHD_Hosp_Profee_Price "20950 MONITORING OF INTERSTITIAL FLUID PRESSURE (INCLUDES INSERTION OF DEVICE, EG, WICK CATH ProFee" 20950 CDM 982 RC 20950 HCPCS facility both 278 278 Gross Charge Type: NIHD_Hosp_Profee_Price "20985 COMPUTER-ASSISTED SURGICAL NAVIGATIONAL PROCEDURE FOR MUSCULOSKELETAL PROCEDURES, IMAG ProFee" 20985 CDM 982 RC 20985 HCPCS facility both 301 301 Gross Charge Type: NIHD_Hosp_Profee_Price "20985 COMPUTER-ASSISTED SURGICAL NAVIGATIONAL PROCEDURE FOR MUSCULOSKELETAL PROCEDURES, IMAG ProFee" 20985 CDM 982 RC 20985 HCPCS facility both 301 301 Gross Charge Type: NIHD_Hosp_Profee_Price 20999 IMS-dry needling 20999 CDM 521 RC 20999 HCPCS facility both 81 81 Gross Charge Type: NIHD_RHC_Price 20999 IMS-dry needling 20999 CDM 521 RC 20999 HCPCS facility both 81 81 Gross Charge Type: NIHD_Clinic_Price "21011 Excision, tumor, soft tissue of face or scalp, subcutaneous; less than 2 cm" 210111 CDM 521 RC 21011 HCPCS facility both 476 476 Gross Charge Type: NIHD_Clinic_Price "21011 EXCISION, TUMOR, SOFT TISSUE OF FACE OR SCALP, SUBCUTANEOUS; LESS THAN 2 CM ProFee" 210112 CDM 982 RC 21011 HCPCS facility both 476 476 Gross Charge Type: NIHD_Hosp_Profee_Price "21011 EXCISION, TUMOR, SOFT TISSUE OF FACE OR SCALP, SUBCUTANEOUS; LESS THAN 2 CM ProFee" 210112 CDM 982 RC 21011 HCPCS facility both 476 476 Gross Charge Type: NIHD_Hosp_Profee_Price "21012 Excision, tumor, soft tissue of face or scalp, subcutaneous; 2 cm or greater" 210121 CDM 521 RC 21012 HCPCS facility both 617 617 Gross Charge Type: NIHD_Clinic_Price "21012 EXCISION, TUMOR, SOFT TISSUE OF FACE OR SCALP, SUBCUTANEOUS; 2 CM OR GREATER ProFee" 210122 CDM 982 RC 21012 HCPCS facility both 617 617 Gross Charge Type: NIHD_Hosp_Profee_Price "21012 EXCISION, TUMOR, SOFT TISSUE OF FACE OR SCALP, SUBCUTANEOUS; 2 CM OR GREATER ProFee" 210122 CDM 982 RC 21012 HCPCS facility both 617 617 Gross Charge Type: NIHD_Hosp_Profee_Price 21110 APPL INTERDENTAL FIX DEV CONDITIONS OTHER THAN FRAC ProFee 21110 CDM 21110 HCPCS facility both 1146 1146 Gross Charge Type: NIHD_Hosp_Profee_Price 21110 APPL INTERDENTAL FIX DEV CONDITIONS OTHER THAN FRAC ProFee 21110 CDM 21110 HCPCS facility both 1146 1146 Gross Charge Type: NIHD_Hosp_Profee_Price ROOM/BED: ICU 2120844 CDM 200 RC facility both 7297 7297 Gross Charge Type: NIHD_Hosp_Profee_Price ROOM/BED: ICU 2120844 CDM 200 RC facility both 7297 7297 Gross Charge Type: NIHD_Hosp_Profee_Price 21315 - Nasal Bone Fx w/o Stabilization 213151 CDM 450 RC facility both 3145 3145 Gross Charge Type: NIHD_Hosp_Profee_Price 21315 - Nasal Bone Fx w/o Stabilization 213151 CDM 450 RC facility both 3145 3145 Gross Charge Type: NIHD_Hosp_Profee_Price 21315 CLOSED TREATMENT OF NASAL BONE FRACTURE; WITHOUT STABILIZATION ProFee 213152 CDM 982 RC 21315 HCPCS facility both 887 887 Gross Charge Type: NIHD_Hosp_Profee_Price 21315 CLOSED TREATMENT OF NASAL BONE FRACTURE; WITHOUT STABILIZATION ProFee 213152 CDM 982 RC 21315 HCPCS facility both 887 887 Gross Charge Type: NIHD_Hosp_Profee_Price 21480 CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ TechFee 214801 CDM 450 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price 21480 CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ TechFee 214801 CDM 450 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price 21480 CLOSED TREATMENT OF TEMPOROMANDIBULAR DISLOCATION; INITIAL OR SUBSEQUENT ProFee 214802 CDM 982 RC 21480 HCPCS facility both 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price 21480 CLOSED TREATMENT OF TEMPOROMANDIBULAR DISLOCATION; INITIAL OR SUBSEQUENT ProFee 214802 CDM 982 RC 21480 HCPCS facility both 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price "21501 I & D deep abscess/hematoma, soft tissue/neck/thorax" 21501 CDM 982 RC 21501 HCPCS facility both 510 510 Gross Charge Type: NIHD_Hosp_Profee_Price "21501 I & D deep abscess/hematoma, soft tissue/neck/thorax" 21501 CDM 982 RC 21501 HCPCS facility both 510 510 Gross Charge Type: NIHD_Hosp_Profee_Price "21550 Biopsy, soft tissue of neck or thorax" 215501 CDM 521 RC 21550 HCPCS facility both 557 557 Gross Charge Type: NIHD_RHC_Price "21550 Biopsy, soft tissue of neck or thorax" 215501 CDM 521 RC 21550 HCPCS facility both 979 979 Gross Charge Type: NIHD_Clinic_Price CT Biopsy Neck or Chest 215502 CDM 320 RC facility both TC 2786 2786 Gross Charge Type: NIHD_Hosp_Profee_Price CT Biopsy Neck or Chest 215502 CDM 320 RC facility both TC 2786 2786 Gross Charge Type: NIHD_Hosp_Profee_Price CT Biopsy Neck or Chest - Report 215503 CDM 982 RC 21550 HCPCS facility both 26 804 804 Gross Charge Type: NIHD_Hosp_Profee_Price CT Biopsy Neck or Chest - Report 215503 CDM 982 RC 21550 HCPCS facility both 26 804 804 Gross Charge Type: NIHD_Hosp_Profee_Price US Biopsy Soft Tissue Neck/Thorax 215504 CDM 761 RC facility both TC 2786 2786 Gross Charge Type: NIHD_Hosp_Profee_Price US Biopsy Soft Tissue Neck/Thorax 215504 CDM 761 RC facility both TC 2786 2786 Gross Charge Type: NIHD_Hosp_Profee_Price US Biopsy Soft Tissue Neck/Thorax - Report 215505 CDM 982 RC 21550 HCPCS facility both 26 804 804 Gross Charge Type: NIHD_Hosp_Profee_Price US Biopsy Soft Tissue Neck/Thorax - Report 215505 CDM 982 RC 21550 HCPCS facility both 26 804 804 Gross Charge Type: NIHD_Hosp_Profee_Price "21552 Excision, tumor, soft tissue of neck or anterior thorax, subcu, 3cm/>" 21552 CDM 982 RC 21552 HCPCS facility both 1349 1349 Gross Charge Type: NIHD_Hosp_Profee_Price "21552 Excision, tumor, soft tissue of neck or anterior thorax, subcu, 3cm/>" 21552 CDM 982 RC 21552 HCPCS facility both 1349 1349 Gross Charge Type: NIHD_Hosp_Profee_Price "21554 EXCISION, TUMOR, SOFT TISSUE OF NECK OR ANTERIOR THORAX, SUBFASCIAL (EG, INTRAMUSCULAR ProFee" 21554 CDM 982 RC 21554 HCPCS facility both 1435 1435 Gross Charge Type: NIHD_Hosp_Profee_Price "21554 EXCISION, TUMOR, SOFT TISSUE OF NECK OR ANTERIOR THORAX, SUBFASCIAL (EG, INTRAMUSCULAR ProFee" 21554 CDM 982 RC 21554 HCPCS facility both 1435 1435 Gross Charge Type: NIHD_Hosp_Profee_Price "21555 Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; less than 3 cm" 21555 CDM 521 RC 21555 HCPCS facility both 1876 1876 Gross Charge Type: NIHD_RHC_Price "21555 Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; less than 3 cm" 21555 CDM 521 RC 21555 HCPCS facility both 1395 1395 Gross Charge Type: NIHD_Clinic_Price 21601 ASST REMOVAL OF CHEST WALL LES 21601 CDM 982 RC 21601 HCPCS facility both 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price 21601 ASST REMOVAL OF CHEST WALL LES 21601 CDM 982 RC 21601 HCPCS facility both 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price 21602 ASST REVISION OF CHEST WALL 21602 CDM 982 RC 21602 HCPCS facility both 812 812 Gross Charge Type: NIHD_Hosp_Profee_Price 21602 ASST REVISION OF CHEST WALL 21602 CDM 982 RC 21602 HCPCS facility both 812 812 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCK DISTAL FIBULA PLT, SS LT, 4H" 2183781 CDM 278 RC facility both 1611 1611 Gross Charge Type: NIHD_Hosp_Profee_Price "LOCK DISTAL FIBULA PLT, SS LT, 4H" 2183781 CDM 278 RC facility both 1611 1611 Gross Charge Type: NIHD_Hosp_Profee_Price SPLINT KNEE UNIVERSAL 16 INCH 2189933 CDM 274 RC facility both 40 40 Gross Charge Type: NIHD_Hosp_Profee_Price SPLINT KNEE UNIVERSAL 16 INCH 2189933 CDM 274 RC facility both 40 40 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER WOVEN FILIFORM STRAIGHT 5FR 12. 219051 CDM 272 RC facility both 212 212 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER WOVEN FILIFORM STRAIGHT 5FR 12. 219051 CDM 272 RC facility both 212 212 Gross Charge Type: NIHD_Hosp_Profee_Price "21930 Excision, tumor, soft tissue of back or flank, subcutaneous; less than 3 cm" 21930 CDM 521 RC 21930 HCPCS facility both 936 936 Gross Charge Type: NIHD_RHC_Price "21930 Excision, tumor, soft tissue of back or flank, subcutaneous; less than 3 cm" 21930 CDM 521 RC 21930 HCPCS facility both 1813 1813 Gross Charge Type: NIHD_Clinic_Price "21931 Excision, tumor, soft tissue of back or flank, subcutaneous; 3 cm or greater" 219311 CDM 521 RC 21931 HCPCS facility both 936 936 Gross Charge Type: NIHD_Clinic_Price "21931 EXCISION, TUMOR, SOFT TISSUE OF BACK OR FLANK, SUBCUTANEOUS; 3 CM OR GREATER ProFee" 219312 CDM 982 RC 21931 HCPCS facility both 936 936 Gross Charge Type: NIHD_Hosp_Profee_Price "21931 EXCISION, TUMOR, SOFT TISSUE OF BACK OR FLANK, SUBCUTANEOUS; 3 CM OR GREATER ProFee" 219312 CDM 982 RC 21931 HCPCS facility both 936 936 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON TORIC LENS 12.0 21955500 CDM 276 RC facility both 1205 1205 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON TORIC LENS 12.0 21955500 CDM 276 RC facility both 1205 1205 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON TORIC LENS CNWOT4 10.5 21955507 CDM 276 RC facility both 1205 1205 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON TORIC LENS CNWOT4 10.5 21955507 CDM 276 RC facility both 1205 1205 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON IOL LENS 10.0 2195799 CDM 276 RC facility both 525 525 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON IOL LENS 10.0 2195799 CDM 276 RC facility both 525 525 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON IOL LENS 10.5 2195800 CDM 276 RC facility both 525 525 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON IOL LENS 10.5 2195800 CDM 276 RC facility both 525 525 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON IOL LENS 11.5 2195801 CDM 276 RC facility both 525 525 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON IOL LENS 11.5 2195801 CDM 276 RC facility both 525 525 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL SYMMETRIC CONE AUGMENT SZ B 2200620 CDM 278 RC facility both 19861 19861 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL SYMMETRIC CONE AUGMENT SZ B 2200620 CDM 278 RC facility both 19861 19861 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL AUGMENT HALF BLOCK #3 10MM 2200621 CDM 278 RC facility both 5009 5009 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL AUGMENT HALF BLOCK #3 10MM 2200621 CDM 278 RC facility both 5009 5009 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL POSTERIOR STABILIZER 5515-F-201 2200622 CDM 278 RC facility both 13636 13636 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL POSTERIOR STABILIZER 5515-F-201 2200622 CDM 278 RC facility both 13636 13636 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE 2.7MM BROAD LOCKING STRAIGHT PLATE 8 HOLE 2200650 CDM 278 RC facility both 1821 1821 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE 2.7MM BROAD LOCKING STRAIGHT PLATE 8 HOLE 2200650 CDM 278 RC facility both 1821 1821 Gross Charge Type: NIHD_Hosp_Profee_Price Precision Thin Saw Blade 9.0 x 0.38 x25.0 2207809 CDM 272 RC facility both 64 64 Gross Charge Type: NIHD_Hosp_Profee_Price Precision Thin Saw Blade 9.0 x 0.38 x25.0 2207809 CDM 272 RC facility both 64 64 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER WOVEN FILIFORM SPIRAL 5FR 12.5 221051 CDM 272 RC facility both 212 212 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER WOVEN FILIFORM SPIRAL 5FR 12.5 221051 CDM 272 RC facility both 212 212 Gross Charge Type: NIHD_Hosp_Profee_Price 2.7mm Non-Locking Screws 28mm 2211940 CDM 278 RC facility both 248 248 Gross Charge Type: NIHD_Hosp_Profee_Price 2.7mm Non-Locking Screws 28mm 2211940 CDM 278 RC facility both 248 248 Gross Charge Type: NIHD_Hosp_Profee_Price 2.7mm Locking Screws 20mm 2211941 CDM 278 RC facility both 425 425 Gross Charge Type: NIHD_Hosp_Profee_Price 2.7mm Locking Screws 20mm 2211941 CDM 278 RC facility both 425 425 Gross Charge Type: NIHD_Hosp_Profee_Price 2.7mm Locking Screws 24mm 2211942 CDM 278 RC facility both 425 425 Gross Charge Type: NIHD_Hosp_Profee_Price 2.7mm Locking Screws 24mm 2211942 CDM 278 RC facility both 425 425 Gross Charge Type: NIHD_Hosp_Profee_Price Drill Bit AO 2.0mm x 135mm Scaled 2211944 CDM 272 RC facility both 387 387 Gross Charge Type: NIHD_Hosp_Profee_Price Drill Bit AO 2.0mm x 135mm Scaled 2211944 CDM 272 RC facility both 387 387 Gross Charge Type: NIHD_Hosp_Profee_Price baclofen 10 mg Tab [INYO] 2212 CDM 00904-6475-61 NDC facility both 1 EA 6 6 Gross Charge Type: Pharmacy | NDC EA = 1 TAB baclofen 10 mg Tab [INYO] 2212 CDM 00172-4096-60 NDC facility both 1 EA 14.83 14.83 Gross Charge Type: Pharmacy | NDC EA = 1 TAB HIP STEM INSIGNIA STANDARD OFFSET SZE 4 2217877 CDM 278 RC facility both 22060 22060 Gross Charge Type: NIHD_Hosp_Profee_Price HIP STEM INSIGNIA STANDARD OFFSET SZE 4 2217877 CDM 278 RC facility both 22060 22060 Gross Charge Type: NIHD_Hosp_Profee_Price HIP STEM INSIGNIA STANDARD OFFSET SZE 6 2217878 CDM 278 RC facility both 22060 22060 Gross Charge Type: NIHD_Hosp_Profee_Price HIP STEM INSIGNIA STANDARD OFFSET SZE 6 2217878 CDM 278 RC facility both 22060 22060 Gross Charge Type: NIHD_Hosp_Profee_Price INSERT POLYETHLENE TRIDENT 0 DEGREE 36D 2217879 CDM 278 RC facility both 8539 8539 Gross Charge Type: NIHD_Hosp_Profee_Price INSERT POLYETHLENE TRIDENT 0 DEGREE 36D 2217879 CDM 278 RC facility both 8539 8539 Gross Charge Type: NIHD_Hosp_Profee_Price HIP STEM ACCOLADE C V40 SZ 3 X 35 X131MM 2217920 CDM 278 RC facility both 13528 13528 Gross Charge Type: NIHD_Hosp_Profee_Price HIP STEM ACCOLADE C V40 SZ 3 X 35 X131MM 2217920 CDM 278 RC facility both 13528 13528 Gross Charge Type: NIHD_Hosp_Profee_Price HIP STEM ACCOLADE C V40 SZ 4 X 35 X137MM 2217950 CDM 278 RC facility both 16234 16234 Gross Charge Type: NIHD_Hosp_Profee_Price HIP STEM ACCOLADE C V40 SZ 4 X 35 X137MM 2217950 CDM 278 RC facility both 16234 16234 Gross Charge Type: NIHD_Hosp_Profee_Price "X-Act ROM Elbow Brace, Left" 2221812 CDM 274 RC facility both 238 238 Gross Charge Type: NIHD_Hosp_Profee_Price "X-Act ROM Elbow Brace, Left" 2221812 CDM 274 RC facility both 238 238 Gross Charge Type: NIHD_Hosp_Profee_Price XI DAVINCI PERMANENT CAUTERY HOOK 2223823 CDM 272 RC facility both 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price XI DAVINCI PERMANENT CAUTERY HOOK 2223823 CDM 272 RC facility both 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price Knee Support med 2223872 CDM 274 RC facility both 40 40 Gross Charge Type: NIHD_Hosp_Profee_Price Knee Support med 2223872 CDM 274 RC facility both 40 40 Gross Charge Type: NIHD_Hosp_Profee_Price Knee Support XL 2223873 CDM 274 RC facility both 40 40 Gross Charge Type: NIHD_Hosp_Profee_Price Knee Support XL 2223873 CDM 274 RC facility both 40 40 Gross Charge Type: NIHD_Hosp_Profee_Price "22310 CLOSED TREATMENT OF VERTEBRAL BODY FRACTURE(S), WITHOUT MANIPULATION, REQUIRING AND IN ProFee" 22310 CDM 982 RC 22310 HCPCS facility both 512 512 Gross Charge Type: NIHD_Hosp_Profee_Price "22310 CLOSED TREATMENT OF VERTEBRAL BODY FRACTURE(S), WITHOUT MANIPULATION, REQUIRING AND IN ProFee" 22310 CDM 982 RC 22310 HCPCS facility both 512 512 Gross Charge Type: NIHD_Hosp_Profee_Price "22310 Closed tx of vertebral body fracture(s), w/o manip, requiring and including casting or bracing" 223101 CDM 521 RC 22310 HCPCS facility both 477 477 Gross Charge Type: NIHD_RHC_Price "22310 Closed tx of vertebral body fracture(s), w/o manip, requiring and including casting or bracing" 223101 CDM 521 RC 22310 HCPCS facility both 477 477 Gross Charge Type: NIHD_Clinic_Price XR Vertebroplasty Cervicothoracic 225101 CDM 982 RC facility both 960 960 Gross Charge Type: NIHD_Hosp_Profee_Price XR Vertebroplasty Cervicothoracic 225101 CDM 982 RC facility both 960 960 Gross Charge Type: NIHD_Hosp_Profee_Price XR Vertebroplasty Cervicothoracic - Report 225102 CDM 972 RC 22510 HCPCS facility both 26 960 960 Gross Charge Type: NIHD_Hosp_Profee_Price XR Vertebroplasty Cervicothoracic - Report 225102 CDM 972 RC 22510 HCPCS facility both 26 960 960 Gross Charge Type: NIHD_Hosp_Profee_Price XR Vertebroplasty Lumbosacral 225111 CDM 320 RC facility both TC 4682 4682 Gross Charge Type: NIHD_Hosp_Profee_Price XR Vertebroplasty Lumbosacral 225111 CDM 320 RC facility both TC 4682 4682 Gross Charge Type: NIHD_Hosp_Profee_Price XR Vertebroplasty Lumbosacral - Report 225112 CDM 982 RC 22511 HCPCS facility both 26 901 901 Gross Charge Type: NIHD_Hosp_Profee_Price XR Vertebroplasty Lumbosacral - Report 225112 CDM 982 RC 22511 HCPCS facility both 26 901 901 Gross Charge Type: NIHD_Hosp_Profee_Price zzNIHD XR VERTEBROPLASTY LUMBAR EA ADDL 225121 CDM facility both TC 346 346 Gross Charge Type: NIHD_Hosp_Profee_Price zzNIHD XR VERTEBROPLASTY LUMBAR EA ADDL 225121 CDM facility both TC 346 346 Gross Charge Type: NIHD_Hosp_Profee_Price NIHD XR VERTEBROPLASTY THORACIC EA ADDL 225122 CDM 330 RC facility both TC 346 346 Gross Charge Type: NIHD_Hosp_Profee_Price NIHD XR VERTEBROPLASTY THORACIC EA ADDL 225122 CDM 330 RC facility both TC 346 346 Gross Charge Type: NIHD_Hosp_Profee_Price NIHD XR VERTEBROPLASTY LUMBAR EA ADDL 225123 CDM 330 RC facility both TC 346 346 Gross Charge Type: NIHD_Hosp_Profee_Price NIHD XR VERTEBROPLASTY LUMBAR EA ADDL 225123 CDM 330 RC facility both TC 346 346 Gross Charge Type: NIHD_Hosp_Profee_Price VAPR WEDGE ELECTRODE(INTEGRATED) 2272030 CDM 272 RC facility both 924 924 Gross Charge Type: NIHD_Hosp_Profee_Price VAPR WEDGE ELECTRODE(INTEGRATED) 2272030 CDM 272 RC facility both 924 924 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL FLEX BIT HIP 35MM - DEPUY 2274355 CDM 272 RC facility both 3686 3686 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL FLEX BIT HIP 35MM - DEPUY 2274355 CDM 272 RC facility both 3686 3686 Gross Charge Type: NIHD_Hosp_Profee_Price Ureteral Balloon straight tip Cath 2276059 CDM 272 RC facility both 469 469 Gross Charge Type: NIHD_Hosp_Profee_Price Ureteral Balloon straight tip Cath 2276059 CDM 272 RC facility both 469 469 Gross Charge Type: NIHD_Hosp_Profee_Price Back Brace DonJoy SM/MED 2276115 CDM 274 RC L0650 HCPCS facility both 136 136 Gross Charge Type: NIHD_RHC_Price Back Brace DonJoy SM/MED 2276115 CDM 274 RC L0650 HCPCS facility both 136 136 Gross Charge Type: NIHD_Clinic_Price Back Brace DonJoy SM/MED 2276115 CDM 274 RC facility both 136 136 Gross Charge Type: NIHD_Hosp_Profee_Price Back Brace DonJoy SM/MED 2276115 CDM 274 RC facility both 136 136 Gross Charge Type: NIHD_Hosp_Profee_Price Back Brace DonJoy L/XL 2276117 CDM 274 RC L0650 HCPCS facility both 507 507 Gross Charge Type: NIHD_RHC_Price Back Brace DonJoy L/XL 2276117 CDM 274 RC L0650 HCPCS facility both 507 507 Gross Charge Type: NIHD_Clinic_Price Back Brace DonJoy L/XL 2276117 CDM 274 RC facility both 507 507 Gross Charge Type: NIHD_Hosp_Profee_Price Back Brace DonJoy L/XL 2276117 CDM 274 RC facility both 507 507 Gross Charge Type: NIHD_Hosp_Profee_Price Back Brace DonJoy Large 2276118 CDM 274 RC facility both 109 109 Gross Charge Type: NIHD_Hosp_Profee_Price Back Brace DonJoy Large 2276118 CDM 274 RC facility both 109 109 Gross Charge Type: NIHD_Hosp_Profee_Price Back Brace DonJoy XL 2276121 CDM 274 RC facility both 109 109 Gross Charge Type: NIHD_Hosp_Profee_Price Back Brace DonJoy XL 2276121 CDM 274 RC facility both 109 109 Gross Charge Type: NIHD_Hosp_Profee_Price Back Brace DonJoy XXL 2276122 CDM 274 RC facility both 109 109 Gross Charge Type: NIHD_Hosp_Profee_Price Back Brace DonJoy XXL 2276122 CDM 274 RC facility both 109 109 Gross Charge Type: NIHD_Hosp_Profee_Price Snap Cartridge 125mmHg w/Reset US 2280948 CDM 271 RC facility both 356 356 Gross Charge Type: NIHD_RHC_Price Snap Cartridge 125mmHg w/Reset US 2280948 CDM 271 RC facility both 356 356 Gross Charge Type: NIHD_Clinic_Price Snap Cartridge 125mmHg w/Reset US 2280948 CDM 271 RC facility both 346 346 Gross Charge Type: NIHD_Hosp_Profee_Price Snap Cartridge 125mmHg w/Reset US 2280948 CDM 271 RC facility both 346 346 Gross Charge Type: NIHD_Hosp_Profee_Price KNOTLESS FIBERTAK 1.8MM #2 SUTURE 2284064 CDM 278 RC facility both 1260 1260 Gross Charge Type: NIHD_Hosp_Profee_Price KNOTLESS FIBERTAK 1.8MM #2 SUTURE 2284064 CDM 278 RC facility both 1260 1260 Gross Charge Type: NIHD_Hosp_Profee_Price PERCUTNEOUS INSERTION KIT 1.8 ANCHOR 2284065 CDM 278 RC facility both 676 676 Gross Charge Type: NIHD_Hosp_Profee_Price PERCUTNEOUS INSERTION KIT 1.8 ANCHOR 2284065 CDM 278 RC facility both 676 676 Gross Charge Type: NIHD_Hosp_Profee_Price "22901 Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular); 5 cm or greate" 229011 CDM 521 RC 22901 HCPCS facility both 1324 1324 Gross Charge Type: NIHD_Clinic_Price "22901 EXCISION, TUMOR, SOFT TISSUE OF ABDOMINAL WALL, SUBFASCIAL (EG, INTRAMUSCULAR); 5 CM O ProFee" 229012 CDM 982 RC 22901 HCPCS facility both 1324 1324 Gross Charge Type: NIHD_Hosp_Profee_Price "22901 EXCISION, TUMOR, SOFT TISSUE OF ABDOMINAL WALL, SUBFASCIAL (EG, INTRAMUSCULAR); 5 CM O ProFee" 229012 CDM 982 RC 22901 HCPCS facility both 1324 1324 Gross Charge Type: NIHD_Hosp_Profee_Price "22902 Excision, tumor, soft tissue of abdominal wall, subcutaneous; less than 3 cm" 229021 CDM 521 RC 22902 HCPCS facility both 1652 1652 Gross Charge Type: NIHD_Clinic_Price "22902 EXCISION, TUMOR, SOFT TISSUE OF ABDOMINAL WALL, SUBCUTANEOUS; LESS THAN 3 CM ProFee" 229022 CDM 982 RC 22902 HCPCS facility both 924 924 Gross Charge Type: NIHD_Hosp_Profee_Price "22902 EXCISION, TUMOR, SOFT TISSUE OF ABDOMINAL WALL, SUBCUTANEOUS; LESS THAN 3 CM ProFee" 229022 CDM 982 RC 22902 HCPCS facility both 924 924 Gross Charge Type: NIHD_Hosp_Profee_Price "22903 Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater" 229031 CDM 521 RC 22903 HCPCS facility both 799 799 Gross Charge Type: NIHD_Clinic_Price "22903 EXCISION, TUMOR, SOFT TISSUE OF ABDOMINAL WALL, SUBCUTANEOUS; 3 CM OR GREATER ProFee" 229032 CDM 982 RC 22903 HCPCS facility both 799 799 Gross Charge Type: NIHD_Hosp_Profee_Price "22903 EXCISION, TUMOR, SOFT TISSUE OF ABDOMINAL WALL, SUBCUTANEOUS; 3 CM OR GREATER ProFee" 229032 CDM 982 RC 22903 HCPCS facility both 799 799 Gross Charge Type: NIHD_Hosp_Profee_Price 22904 ASST RAD RESECT ABD TUMOR <5 22904 CDM 982 RC 22904 HCPCS facility both 512 512 Gross Charge Type: NIHD_Hosp_Profee_Price 22904 ASST RAD RESECT ABD TUMOR <5 22904 CDM 982 RC 22904 HCPCS facility both 512 512 Gross Charge Type: NIHD_Hosp_Profee_Price Broad Band Suture tape with needle 2293875 CDM 272 RC facility both 220 220 Gross Charge Type: NIHD_Hosp_Profee_Price Broad Band Suture tape with needle 2293875 CDM 272 RC facility both 220 220 Gross Charge Type: NIHD_Hosp_Profee_Price K-WIRE 0.062 X 3 IN 2300094 CDM 272 RC facility both 70 70 Gross Charge Type: NIHD_Hosp_Profee_Price K-WIRE 0.062 X 3 IN 2300094 CDM 272 RC facility both 70 70 Gross Charge Type: NIHD_Hosp_Profee_Price HIP STEM ACCOLADE C V40 SZ 7 X 40 X158MM 2300119 CDM 278 RC facility both 15498 15498 Gross Charge Type: NIHD_Hosp_Profee_Price HIP STEM ACCOLADE C V40 SZ 7 X 40 X158MM 2300119 CDM 278 RC facility both 15498 15498 Gross Charge Type: NIHD_Hosp_Profee_Price SURGICEL ZIP 4 SKIN CLOSURE DEVICE 2300151 CDM 272 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price SURGICEL ZIP 4 SKIN CLOSURE DEVICE 2300151 CDM 272 RC facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price ZIP 8 SURGICAL SKIN CLOSURE DEVICE 2300152 CDM 272 RC facility both 1800 1800 Gross Charge Type: NIHD_Hosp_Profee_Price ZIP 8 SURGICAL SKIN CLOSURE DEVICE 2300152 CDM 272 RC facility both 1800 1800 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE SILK TIES 4-0 30 INCHES 2300155 CDM 272 RC facility both 15 15 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE SILK TIES 4-0 30 INCHES 2300155 CDM 272 RC facility both 15 15 Gross Charge Type: NIHD_Hosp_Profee_Price SURGICLIP CLIP APPLIER 9.0 SMALL 2300156 CDM 272 RC facility both 620 620 Gross Charge Type: NIHD_Hosp_Profee_Price SURGICLIP CLIP APPLIER 9.0 SMALL 2300156 CDM 272 RC facility both 620 620 Gross Charge Type: NIHD_Hosp_Profee_Price BIODFENCE G3 PLACENTAL TISSUE MEMBRANE 4.0 X 8.0 CM 2300200 CDM 272 RC facility both 13104 13104 Gross Charge Type: NIHD_Hosp_Profee_Price BIODFENCE G3 PLACENTAL TISSUE MEMBRANE 4.0 X 8.0 CM 2300200 CDM 272 RC facility both 13104 13104 Gross Charge Type: NIHD_Hosp_Profee_Price UNIVERSAL DAVINCI CANNULA SEAL 2300205 CDM 272 RC facility both 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price UNIVERSAL DAVINCI CANNULA SEAL 2300205 CDM 272 RC facility both 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER MALECOT SIZE 30 FR 2300206 CDM 272 RC facility both 87 87 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER MALECOT SIZE 30 FR 2300206 CDM 272 RC facility both 87 87 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER MALECOT SIZE 32 FR 2300207 CDM 272 RC facility both 87 87 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER MALECOT SIZE 32 FR 2300207 CDM 272 RC facility both 87 87 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER MALECOT SIZE 34 FR 2300208 CDM 272 RC facility both 87 87 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER MALECOT SIZE 34 FR 2300208 CDM 272 RC facility both 87 87 Gross Charge Type: NIHD_Hosp_Profee_Price ETHICON POWERED EEA STAPLER SIZE 29 2300209 CDM 278 RC facility both 1056 1056 Gross Charge Type: NIHD_Hosp_Profee_Price ETHICON POWERED EEA STAPLER SIZE 29 2300209 CDM 278 RC facility both 1056 1056 Gross Charge Type: NIHD_Hosp_Profee_Price ACRYSOF MP FOLDABLE 14.0 OPTIC LENS 2300225 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price ACRYSOF MP FOLDABLE 14.0 OPTIC LENS 2300225 CDM 276 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price UROLOGY ELECTRODE QUICK FIRE 12 DEG LARGE LOOP 2300253 CDM 272 RC facility both 897 897 Gross Charge Type: NIHD_Hosp_Profee_Price UROLOGY ELECTRODE QUICK FIRE 12 DEG LARGE LOOP 2300253 CDM 272 RC facility both 897 897 Gross Charge Type: NIHD_Hosp_Profee_Price ANTERIOR VITRECTOMY PROBE 23 GAUGE (ALCON) 2300300 CDM 272 RC facility both 555 555 Gross Charge Type: NIHD_Hosp_Profee_Price ANTERIOR VITRECTOMY PROBE 23 GAUGE (ALCON) 2300300 CDM 272 RC facility both 555 555 Gross Charge Type: NIHD_Hosp_Profee_Price "SUTURE MONOCRYL 4-0 PS-2 27""" 2300426 CDM 272 RC facility both 47 47 Gross Charge Type: NIHD_Hosp_Profee_Price "SUTURE MONOCRYL 4-0 PS-2 27""" 2300426 CDM 272 RC facility both 47 47 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW BONE SELF TAPPING CROSSPIN 1.2X12MM 2300620 CDM 278 RC facility both 236 236 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW BONE SELF TAPPING CROSSPIN 1.2X12MM 2300620 CDM 278 RC facility both 236 236 Gross Charge Type: NIHD_Hosp_Profee_Price 0 PDS LIGATURE ENDOLOOPS 2300621 CDM 272 RC facility both 71 71 Gross Charge Type: NIHD_Hosp_Profee_Price 0 PDS LIGATURE ENDOLOOPS 2300621 CDM 272 RC facility both 71 71 Gross Charge Type: NIHD_Hosp_Profee_Price ENDOCLIP 10MM CLIP APPLIER 2300622 CDM 272 RC facility both 1113 1113 Gross Charge Type: NIHD_Hosp_Profee_Price ENDOCLIP 10MM CLIP APPLIER 2300622 CDM 272 RC facility both 1113 1113 Gross Charge Type: NIHD_Hosp_Profee_Price 5 FR OPEN ENDED CATHETER (POLLACK) BOSTON SCIENTIFIC 2300700 CDM 272 RC facility both 24 24 Gross Charge Type: NIHD_Hosp_Profee_Price 5 FR OPEN ENDED CATHETER (POLLACK) BOSTON SCIENTIFIC 2300700 CDM 272 RC facility both 24 24 Gross Charge Type: NIHD_Hosp_Profee_Price INTRODUCER BERCI-CYSTIC DUCT SET 2300701 CDM 272 RC facility both 270 270 Gross Charge Type: NIHD_Hosp_Profee_Price INTRODUCER BERCI-CYSTIC DUCT SET 2300701 CDM 272 RC facility both 270 270 Gross Charge Type: NIHD_Hosp_Profee_Price ADAPTER-200 3-WAY MULTIPURPOSE FOR COMMON DUCT EXPLORATION 2300702 CDM 272 RC facility both 105 105 Gross Charge Type: NIHD_Hosp_Profee_Price ADAPTER-200 3-WAY MULTIPURPOSE FOR COMMON DUCT EXPLORATION 2300702 CDM 272 RC facility both 105 105 Gross Charge Type: NIHD_Hosp_Profee_Price STONE EXTRACTOR NITINOL TIPLESS FOR COMMONDUCT BILE 2300703 CDM 272 RC facility both 822 822 Gross Charge Type: NIHD_Hosp_Profee_Price STONE EXTRACTOR NITINOL TIPLESS FOR COMMONDUCT BILE 2300703 CDM 272 RC facility both 822 822 Gross Charge Type: NIHD_Hosp_Profee_Price BALLO0N CATHETER 5.0 fr 40CM LONG FOR COMMONDUCT EXPLORATION 2300704 CDM 278 RC facility both 1244 1244 Gross Charge Type: NIHD_Hosp_Profee_Price BALLO0N CATHETER 5.0 fr 40CM LONG FOR COMMONDUCT EXPLORATION 2300704 CDM 278 RC facility both 1244 1244 Gross Charge Type: NIHD_Hosp_Profee_Price BILIARY WIRE .035IN X 145CM LONG GUIDE FOR COMMONBILE DUCT EXPLORATION 2300705 CDM 278 RC facility both 249 249 Gross Charge Type: NIHD_Hosp_Profee_Price BILIARY WIRE .035IN X 145CM LONG GUIDE FOR COMMONBILE DUCT EXPLORATION 2300705 CDM 278 RC facility both 249 249 Gross Charge Type: NIHD_Hosp_Profee_Price COMPLIANCE ENDO KITS 2300753 CDM 272 RC facility both 67 67 Gross Charge Type: NIHD_Hosp_Profee_Price COMPLIANCE ENDO KITS 2300753 CDM 272 RC facility both 67 67 Gross Charge Type: NIHD_Hosp_Profee_Price SNARE ROTATABLE 13 MM (BOSTON SCIENTIFIC) 2300754 CDM 272 RC facility both 60 60 Gross Charge Type: NIHD_Hosp_Profee_Price SNARE ROTATABLE 13 MM (BOSTON SCIENTIFIC) 2300754 CDM 272 RC facility both 60 60 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS COARSE 4-10 MM BONE CHIPS 2300762 CDM 272 RC facility both 465 465 Gross Charge Type: NIHD_Hosp_Profee_Price CANCELLOUS COARSE 4-10 MM BONE CHIPS 2300762 CDM 272 RC facility both 465 465 Gross Charge Type: NIHD_Hosp_Profee_Price LASER FIBER QUANTA HOLIUM 200 MICRON (NEW LASER) 2300766 CDM 272 RC facility both 810 810 Gross Charge Type: NIHD_Hosp_Profee_Price LASER FIBER QUANTA HOLIUM 200 MICRON (NEW LASER) 2300766 CDM 272 RC facility both 810 810 Gross Charge Type: NIHD_Hosp_Profee_Price TRIATHLON TIBIAL COMPONENT SIZE 8 2300767 CDM 278 RC facility both 15267 15267 Gross Charge Type: NIHD_Hosp_Profee_Price TRIATHLON TIBIAL COMPONENT SIZE 8 2300767 CDM 278 RC facility both 15267 15267 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT-CS-SZ 8 2300768 CDM 278 RC facility both 11346 11346 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT-CS-SZ 8 2300768 CDM 278 RC facility both 11346 11346 Gross Charge Type: NIHD_Hosp_Profee_Price AIRSEAL 8 MM CANNULA CAP AND OBTURATOR (IAS8-dv) 2300769 CDM 278 RC facility both 315 315 Gross Charge Type: NIHD_Hosp_Profee_Price AIRSEAL 8 MM CANNULA CAP AND OBTURATOR (IAS8-dv) 2300769 CDM 278 RC facility both 315 315 Gross Charge Type: NIHD_Hosp_Profee_Price LASER QUANTA HOLMIUM 272 FIBER MICRON (NEW LASER) 2300770 CDM 272 RC facility both 810 810 Gross Charge Type: NIHD_Hosp_Profee_Price LASER QUANTA HOLMIUM 272 FIBER MICRON (NEW LASER) 2300770 CDM 272 RC facility both 810 810 Gross Charge Type: NIHD_Hosp_Profee_Price LASER QUANTA HOLMIUM 365 MICRON FIBER (NEW LASER) 2300771 CDM 272 RC facility both 855 855 Gross Charge Type: NIHD_Hosp_Profee_Price LASER QUANTA HOLMIUM 365 MICRON FIBER (NEW LASER) 2300771 CDM 272 RC facility both 855 855 Gross Charge Type: NIHD_Hosp_Profee_Price LASER QUANTA HOLMIUM 500 MICRON FIBER (NEW LASER) 2300772 CDM 272 RC facility both 1005 1005 Gross Charge Type: NIHD_Hosp_Profee_Price LASER QUANTA HOLMIUM 500 MICRON FIBER (NEW LASER) 2300772 CDM 272 RC facility both 1005 1005 Gross Charge Type: NIHD_Hosp_Profee_Price LASER QUANTA HOLMIUM 800 MICRON FIBER (NEW LASER) 2300773 CDM 272 RC facility both 1677 1677 Gross Charge Type: NIHD_Hosp_Profee_Price LASER QUANTA HOLMIUM 800 MICRON FIBER (NEW LASER) 2300773 CDM 272 RC facility both 1677 1677 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON IOL PANOPTIX LENS 14.5 2300801 CDM 276 RC facility both 1015 1015 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON IOL PANOPTIX LENS 14.5 2300801 CDM 276 RC facility both 1015 1015 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE 2-0 MONODERM QUILL 16 IN 2300802 CDM 272 RC facility both 51 51 Gross Charge Type: NIHD_Hosp_Profee_Price SUTURE 2-0 MONODERM QUILL 16 IN 2300802 CDM 272 RC facility both 51 51 Gross Charge Type: NIHD_Hosp_Profee_Price PREVENA PLUS 125 THERAPY UNIT 2300809 CDM 271 RC facility both 1230 1230 Gross Charge Type: NIHD_Hosp_Profee_Price PREVENA PLUS 125 THERAPY UNIT 2300809 CDM 271 RC facility both 1230 1230 Gross Charge Type: NIHD_Hosp_Profee_Price Q LARGE BIOPOLAR PLASMA LOOP ELECTRODE 2300851 CDM 272 RC facility both 852 852 Gross Charge Type: NIHD_Hosp_Profee_Price Q LARGE BIOPOLAR PLASMA LOOP ELECTRODE 2300851 CDM 272 RC facility both 852 852 Gross Charge Type: NIHD_Hosp_Profee_Price KNOTLESS DISTAL CLAVICLE PLATE BUTTON TIGHTROPE 2300900 CDM 278 RC facility both 2580 2580 Gross Charge Type: NIHD_Hosp_Profee_Price KNOTLESS DISTAL CLAVICLE PLATE BUTTON TIGHTROPE 2300900 CDM 278 RC facility both 2580 2580 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL PIN BUTTON 2300901 CDM 272 RC facility both 372 372 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL PIN BUTTON 2300901 CDM 272 RC facility both 372 372 Gross Charge Type: NIHD_Hosp_Profee_Price TRIATHLON X3 ASYMMETRIC PATELLA SZ A35 10MM 2300902 CDM 278 RC facility both 5334 5334 Gross Charge Type: NIHD_Hosp_Profee_Price TRIATHLON X3 ASYMMETRIC PATELLA SZ A35 10MM 2300902 CDM 278 RC facility both 5334 5334 Gross Charge Type: NIHD_Hosp_Profee_Price TRIATHALON UNIVERSAL TIBIAL BASEPLATE SZ 8 2300904 CDM 278 RC facility both 13602 13602 Gross Charge Type: NIHD_Hosp_Profee_Price TRIATHALON UNIVERSAL TIBIAL BASEPLATE SZ 8 2300904 CDM 278 RC facility both 13602 13602 Gross Charge Type: NIHD_Hosp_Profee_Price TRIATHLON BEARING INSERT-CS SIZE 8 13MM 2300905 CDM 278 RC facility both 11346 11346 Gross Charge Type: NIHD_Hosp_Profee_Price TRIATHLON BEARING INSERT-CS SIZE 8 13MM 2300905 CDM 278 RC facility both 11346 11346 Gross Charge Type: NIHD_Hosp_Profee_Price SEE SHARP ENHANCED 150MM TROCAR (ROBOTIC) 2300915 CDM 278 RC facility both 135 135 Gross Charge Type: NIHD_Hosp_Profee_Price SEE SHARP ENHANCED 150MM TROCAR (ROBOTIC) 2300915 CDM 278 RC facility both 135 135 Gross Charge Type: NIHD_Hosp_Profee_Price HAND/WRIST LIGAMENT AUGMENTATION REPAIR CONVIENCE KIT 2300925 CDM 272 RC facility both 4485 4485 Gross Charge Type: NIHD_Hosp_Profee_Price HAND/WRIST LIGAMENT AUGMENTATION REPAIR CONVIENCE KIT 2300925 CDM 272 RC facility both 4485 4485 Gross Charge Type: NIHD_Hosp_Profee_Price ACRYSOF IQ PANOPTIX TRIFOCAL IOL 9.5 2300930 CDM 276 RC facility both 995 995 Gross Charge Type: NIHD_Hosp_Profee_Price ACRYSOF IQ PANOPTIX TRIFOCAL IOL 9.5 2300930 CDM 276 RC facility both 995 995 Gross Charge Type: NIHD_Hosp_Profee_Price HEMASTATIC HEMO-7 SPRAY 2300941 CDM 250 RC facility both 6023 6023 Gross Charge Type: NIHD_Hosp_Profee_Price HEMASTATIC HEMO-7 SPRAY 2300941 CDM 250 RC facility both 6023 6023 Gross Charge Type: NIHD_Hosp_Profee_Price RESOLUTION 360 CLIPS 2300942 CDM 278 RC facility both 625 625 Gross Charge Type: NIHD_Hosp_Profee_Price RESOLUTION 360 CLIPS 2300942 CDM 278 RC facility both 625 625 Gross Charge Type: NIHD_Hosp_Profee_Price RESOLUTION ULTRA 360 LARGE CLIP 2300943 CDM 278 RC facility both 574 574 Gross Charge Type: NIHD_Hosp_Profee_Price RESOLUTION ULTRA 360 LARGE CLIP 2300943 CDM 278 RC facility both 574 574 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER 18 FR WITH 10CC BALLOON SILICONIZED 2300945 CDM 272 RC facility both 47 47 Gross Charge Type: NIHD_Hosp_Profee_Price CATHETER 18 FR WITH 10CC BALLOON SILICONIZED 2300945 CDM 272 RC facility both 47 47 Gross Charge Type: NIHD_Hosp_Profee_Price BIO-PREP BONE PREPARATION KIT ( STRYKER) 2300963 CDM 272 RC facility both 1992 1992 Gross Charge Type: NIHD_Hosp_Profee_Price BIO-PREP BONE PREPARATION KIT ( STRYKER) 2300963 CDM 272 RC facility both 1992 1992 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL CANAL PRESSURIZER WITHOUT HUB MED BLUE 2300964 CDM 272 RC facility both 289 289 Gross Charge Type: NIHD_Hosp_Profee_Price FEMORAL CANAL PRESSURIZER WITHOUT HUB MED BLUE 2300964 CDM 272 RC facility both 289 289 Gross Charge Type: NIHD_Hosp_Profee_Price REVOLUTION CEMENT MIXING SYSTEM WITH MIS FEMORAL BREAKAWAY NOZZEL AND CANAL PRESSURIZER 2300965 CDM 272 RC facility both 285 285 Gross Charge Type: NIHD_Hosp_Profee_Price REVOLUTION CEMENT MIXING SYSTEM WITH MIS FEMORAL BREAKAWAY NOZZEL AND CANAL PRESSURIZER 2300965 CDM 272 RC facility both 285 285 Gross Charge Type: NIHD_Hosp_Profee_Price KUMPE ACCESS CATHETER 5 FRENCH 2300975 CDM 272 RC facility both 81 81 Gross Charge Type: NIHD_Hosp_Profee_Price KUMPE ACCESS CATHETER 5 FRENCH 2300975 CDM 272 RC facility both 81 81 Gross Charge Type: NIHD_Hosp_Profee_Price ARTHREX DISTAL THIRD CLAVICLE PLATE 70MM 5 HOLE 2300985 CDM 278 RC facility both 2226 2226 Gross Charge Type: NIHD_Hosp_Profee_Price ARTHREX DISTAL THIRD CLAVICLE PLATE 70MM 5 HOLE 2300985 CDM 278 RC facility both 2226 2226 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW LOW PROFILE CLAVICLE 2.7 X 14MM LOCKING ARTHREX 2300987 CDM 278 RC facility both 302 302 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW LOW PROFILE CLAVICLE 2.7 X 14MM LOCKING ARTHREX 2300987 CDM 278 RC facility both 302 302 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW CLAVICLE LOW PROFILE 2.7 X 16MM ARTHREX 2300988 CDM 278 RC facility both 302 302 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW CLAVICLE LOW PROFILE 2.7 X 16MM ARTHREX 2300988 CDM 278 RC facility both 302 302 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW CLAVICLE LOW PROFILE 2.7 X 16MM NONLOCKING ARTHREX 2300989 CDM 278 RC facility both 118 118 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW CLAVICLE LOW PROFILE 2.7 X 16MM NONLOCKING ARTHREX 2300989 CDM 278 RC facility both 118 118 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW CLAVICLE LOW PROFILE 3.5 X 14 MM CORTICAL NONLOCKING ARTHREX 2300992 CDM 278 RC facility both 93 93 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW CLAVICLE LOW PROFILE 3.5 X 14 MM CORTICAL NONLOCKING ARTHREX 2300992 CDM 278 RC facility both 93 93 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW CLAVICLE LOW PROFILE 3.5 X 16MM CORTICAL NONLOCKING ARTHREX 2300993 CDM 278 RC facility both 93 93 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW CLAVICLE LOW PROFILE 3.5 X 16MM CORTICAL NONLOCKING ARTHREX 2300993 CDM 278 RC facility both 93 93 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE VAR ANGLE 1.5 CHONDYLAR 2 HOLE HEAD 6 HOLE SHAFT 2300997 CDM 278 RC facility both 1603 1603 Gross Charge Type: NIHD_Hosp_Profee_Price PLATE VAR ANGLE 1.5 CHONDYLAR 2 HOLE HEAD 6 HOLE SHAFT 2300997 CDM 278 RC facility both 1603 1603 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW SELF TAP 1.5 X 10MM CORTEX WITH T4 STARDRIVE RECESS 2300998 CDM 278 RC facility both 162 162 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW SELF TAP 1.5 X 10MM CORTEX WITH T4 STARDRIVE RECESS 2300998 CDM 278 RC facility both 162 162 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW SELF TAP 1.5 X 14 MM CORTEX WITH T4 STARDRIVE RECESS 2300999 CDM 278 RC facility both 162 162 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW SELF TAP 1.5 X 14 MM CORTEX WITH T4 STARDRIVE RECESS 2300999 CDM 278 RC facility both 162 162 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW SELF TAP 1.5 X 15 MM CORTEX WITH T4 STARDRIVE RECESS 2301000 CDM 278 RC facility both 162 162 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW SELF TAP 1.5 X 15 MM CORTEX WITH T4 STARDRIVE RECESS 2301000 CDM 278 RC facility both 162 162 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW SELF TAP 1.5 X 16 MM CORTEX WITH T4 STARDRIVE RECESS 2301001 CDM 278 RC facility both 162 162 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW SELF TAP 1.5 X 16 MM CORTEX WITH T4 STARDRIVE RECESS 2301001 CDM 278 RC facility both 162 162 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW SELF-TAP VAR ANGLE LOCKING 1.5 X 11 MM WITH T4 STARDRIVE RECESS 2301002 CDM 278 RC facility both 422 422 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW SELF-TAP VAR ANGLE LOCKING 1.5 X 11 MM WITH T4 STARDRIVE RECESS 2301002 CDM 278 RC facility both 422 422 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW SELF-TAP VAR ANGLE LOCKING 1.5 X 13 MM WITH T4 STARDRIVE RECESS 2301003 CDM 278 RC facility both 422 422 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW SELF-TAP VAR ANGLE LOCKING 1.5 X 13 MM WITH T4 STARDRIVE RECESS 2301003 CDM 278 RC facility both 422 422 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 1.1 MM MINI QUICK COUPLING 2301004 CDM 272 RC facility both 288 288 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 1.1 MM MINI QUICK COUPLING 2301004 CDM 272 RC facility both 288 288 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 2.0 MM MINI QUICK COUPLING 2301005 CDM 272 RC facility both 288 288 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT 2.0 MM MINI QUICK COUPLING 2301005 CDM 272 RC facility both 288 288 Gross Charge Type: NIHD_Hosp_Profee_Price ACETABULAR CLUSTERHOLE SHELL 46MM C 2301010 CDM 278 RC facility both 10641 10641 Gross Charge Type: NIHD_Hosp_Profee_Price ACETABULAR CLUSTERHOLE SHELL 46MM C 2301010 CDM 278 RC facility both 10641 10641 Gross Charge Type: NIHD_Hosp_Profee_Price HIP STEM INSIGNIA HIGH OFFSET SZ 1 X 33.5 X 96MM 2301011 CDM 278 RC facility both 26688 26688 Gross Charge Type: NIHD_Hosp_Profee_Price HIP STEM INSIGNIA HIGH OFFSET SZ 1 X 33.5 X 96MM 2301011 CDM 278 RC facility both 26688 26688 Gross Charge Type: NIHD_Hosp_Profee_Price TRIATHLON TIBIAL BEARING INSERT SZ 3 X 12 MM 2301013 CDM 278 RC facility both 9904 9904 Gross Charge Type: NIHD_Hosp_Profee_Price TRIATHLON TIBIAL BEARING INSERT SZ 3 X 12 MM 2301013 CDM 278 RC facility both 9904 9904 Gross Charge Type: NIHD_Hosp_Profee_Price TRIATHLON TIBIAL BEARING INSERT SZ 3 X 16 MM 2301014 CDM 278 RC facility both 9904 9904 Gross Charge Type: NIHD_Hosp_Profee_Price TRIATHLON TIBIAL BEARING INSERT SZ 3 X 16 MM 2301014 CDM 278 RC facility both 9904 9904 Gross Charge Type: NIHD_Hosp_Profee_Price ACRYSOF MP FOLDABLE 16.5 OPTIC LENS 2301015 CDM 276 RC facility both 310 310 Gross Charge Type: NIHD_Hosp_Profee_Price ACRYSOF MP FOLDABLE 16.5 OPTIC LENS 2301015 CDM 276 RC facility both 310 310 Gross Charge Type: NIHD_Hosp_Profee_Price ACRYSOF MULTIFOCAL FOLDABLE 16.5 OPTIC LENS 2301016 CDM 276 RC facility both 310 310 Gross Charge Type: NIHD_Hosp_Profee_Price ACRYSOF MULTIFOCAL FOLDABLE 16.5 OPTIC LENS 2301016 CDM 276 RC facility both 310 310 Gross Charge Type: NIHD_Hosp_Profee_Price ACRYSOF MP FOLDABLE 10.0 OPTIC LENS 2301017 CDM 276 RC facility both 505 505 Gross Charge Type: NIHD_Hosp_Profee_Price ACRYSOF MP FOLDABLE 10.0 OPTIC LENS 2301017 CDM 276 RC facility both 505 505 Gross Charge Type: NIHD_Hosp_Profee_Price AcrySof IQ PanOptix Trifocal IOL 09.0 2301018 CDM 276 RC facility both 995 995 Gross Charge Type: NIHD_Hosp_Profee_Price AcrySof IQ PanOptix Trifocal IOL 09.0 2301018 CDM 276 RC facility both 995 995 Gross Charge Type: NIHD_Hosp_Profee_Price HIP STEM ACCOLADE C SZ 5 X 37 X145MM 2301020 CDM 278 RC facility both 13528 13528 Gross Charge Type: NIHD_Hosp_Profee_Price HIP STEM ACCOLADE C SZ 5 X 37 X145MM 2301020 CDM 278 RC facility both 13528 13528 Gross Charge Type: NIHD_Hosp_Profee_Price EMG TUBE NIM TRIVANTAGE 6.0 ID 2301021 CDM 272 RC facility both 925 925 Gross Charge Type: NIHD_Hosp_Profee_Price EMG TUBE NIM TRIVANTAGE 6.0 ID 2301021 CDM 272 RC facility both 925 925 Gross Charge Type: NIHD_Hosp_Profee_Price EMG TUBE NIM TRIVANTAGE 7.0 MM ID 2301022 CDM 272 RC facility both 925 925 Gross Charge Type: NIHD_Hosp_Profee_Price EMG TUBE NIM TRIVANTAGE 7.0 MM ID 2301022 CDM 272 RC facility both 925 925 Gross Charge Type: NIHD_Hosp_Profee_Price PROBE 5 PK STD PRASS FL TIP ROHS FOR NIM NEUROTRANSMITTER 2301023 CDM 272 RC facility both 312 312 Gross Charge Type: NIHD_Hosp_Profee_Price PROBE 5 PK STD PRASS FL TIP ROHS FOR NIM NEUROTRANSMITTER 2301023 CDM 272 RC facility both 312 312 Gross Charge Type: NIHD_Hosp_Profee_Price EMG TUBE TRIVANTAGE 6.0 MM REPLACEMENT 2301024 CDM 272 RC facility both 925 925 Gross Charge Type: NIHD_Hosp_Profee_Price EMG TUBE TRIVANTAGE 6.0 MM REPLACEMENT 2301024 CDM 272 RC facility both 925 925 Gross Charge Type: NIHD_Hosp_Profee_Price FOLEY CATHETER SILCONE 18 FR 10ML 2-WAY STRAIGHT 2301025 CDM 272 RC facility both 181 181 Gross Charge Type: NIHD_Hosp_Profee_Price FOLEY CATHETER SILCONE 18 FR 10ML 2-WAY STRAIGHT 2301025 CDM 272 RC facility both 181 181 Gross Charge Type: NIHD_Hosp_Profee_Price BIOPSY RADIAL JAW 2.8 MM BOSTON SCIENTIFIC 2301029 CDM 272 RC facility both 73 73 Gross Charge Type: NIHD_Hosp_Profee_Price BIOPSY RADIAL JAW 2.8 MM BOSTON SCIENTIFIC 2301029 CDM 272 RC facility both 73 73 Gross Charge Type: NIHD_Hosp_Profee_Price BIOPSY FORCEP HOT RADIAL JAW 4 2.8MM 2301030 CDM 278 RC facility both 255 255 Gross Charge Type: NIHD_Hosp_Profee_Price BIOPSY FORCEP HOT RADIAL JAW 4 2.8MM 2301030 CDM 278 RC facility both 255 255 Gross Charge Type: NIHD_Hosp_Profee_Price STENT SOFT PERCUFLEX URETERAL 6 X 22 BOSTON SCIENTIFIC 2301031 CDM 278 RC facility both 377 377 Gross Charge Type: NIHD_Hosp_Profee_Price STENT SOFT PERCUFLEX URETERAL 6 X 22 BOSTON SCIENTIFIC 2301031 CDM 278 RC facility both 377 377 Gross Charge Type: NIHD_Hosp_Profee_Price STENT SOFT PERCUFLEX 6 X 24 BOSTON SCIENTIFIC 2301032 CDM 278 RC facility both 360 360 Gross Charge Type: NIHD_Hosp_Profee_Price STENT SOFT PERCUFLEX 6 X 24 BOSTON SCIENTIFIC 2301032 CDM 278 RC facility both 360 360 Gross Charge Type: NIHD_Hosp_Profee_Price "23030 INCISION AND DRAINAGE, SHOULDER AREA; DEEP ABSCESS OR HEMATOMA ProFee" 23030 CDM 982 RC 23030 HCPCS facility both 385 385 Gross Charge Type: NIHD_Hosp_Profee_Price "23030 INCISION AND DRAINAGE, SHOULDER AREA; DEEP ABSCESS OR HEMATOMA ProFee" 23030 CDM 982 RC 23030 HCPCS facility both 385 385 Gross Charge Type: NIHD_Hosp_Profee_Price "23040 ARTHROTOMY, GLENOHUMERAL JOINT, INCLUDING EXPLORATION, DRAINAGE, OR REMOVAL OF FOREIGN ProFee" 23040 CDM 982 RC 23040 HCPCS facility both 1498 1498 Gross Charge Type: NIHD_Hosp_Profee_Price "23040 ARTHROTOMY, GLENOHUMERAL JOINT, INCLUDING EXPLORATION, DRAINAGE, OR REMOVAL OF FOREIGN ProFee" 23040 CDM 982 RC 23040 HCPCS facility both 1498 1498 Gross Charge Type: NIHD_Hosp_Profee_Price QUICKVUE STREP A TEST 2304305 CDM facility both 19 19 Gross Charge Type: NIHD_Hosp_Profee_Price QUICKVUE STREP A TEST 2304305 CDM facility both 19 19 Gross Charge Type: NIHD_Hosp_Profee_Price "23044 ARTHROTOMY, ACROMIOCLAVICULAR, STERNOCLAVICULAR JOINT, INCLUDING EXPLORATION, DRAINAGE ProFee" 23044 CDM 982 RC 23044 HCPCS facility both 1124 1124 Gross Charge Type: NIHD_Hosp_Profee_Price "23044 ARTHROTOMY, ACROMIOCLAVICULAR, STERNOCLAVICULAR JOINT, INCLUDING EXPLORATION, DRAINAGE ProFee" 23044 CDM 982 RC 23044 HCPCS facility both 1124 1124 Gross Charge Type: NIHD_Hosp_Profee_Price "23071 EXCISION, TUMOR, SOFT TISSUE OF SHOULDER AREA, SUBCUTANEOUS; 3 CM OR GREATER ProFee" 23071 CDM 982 RC 23071 HCPCS facility both 727 727 Gross Charge Type: NIHD_Hosp_Profee_Price "23071 EXCISION, TUMOR, SOFT TISSUE OF SHOULDER AREA, SUBCUTANEOUS; 3 CM OR GREATER ProFee" 23071 CDM 982 RC 23071 HCPCS facility both 727 727 Gross Charge Type: NIHD_Hosp_Profee_Price "23073 Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); 5 cm or greater" 230731 CDM 521 RC 23073 HCPCS facility both 1373 1373 Gross Charge Type: NIHD_Clinic_Price "23073 EXCISION, TUMOR, SOFT TISSUE OF SHOULDER AREA, SUBFASCIAL (EG, INTRAMUSCULAR); 5 CM OR ProFee" 230732 CDM 982 RC 23073 HCPCS facility both 1373 1373 Gross Charge Type: NIHD_Hosp_Profee_Price "23073 EXCISION, TUMOR, SOFT TISSUE OF SHOULDER AREA, SUBFASCIAL (EG, INTRAMUSCULAR); 5 CM OR ProFee" 230732 CDM 982 RC 23073 HCPCS facility both 1373 1373 Gross Charge Type: NIHD_Hosp_Profee_Price "23075 EXCISION, TUMOR, SOFT TISSUE OF SHOULDER AREA, SUBCUTANEOUS; LESS THAN 3 CM ProFee" 23075 CDM 982 RC 23075 HCPCS facility both 571 571 Gross Charge Type: NIHD_Hosp_Profee_Price "23075 EXCISION, TUMOR, SOFT TISSUE OF SHOULDER AREA, SUBCUTANEOUS; LESS THAN 3 CM ProFee" 23075 CDM 982 RC 23075 HCPCS facility both 571 571 Gross Charge Type: NIHD_Hosp_Profee_Price SPLINT FINGER STAX SIZE 1 2307943 CDM 274 RC L3927 HCPCS facility both 16 16 Gross Charge Type: NIHD_RHC_Price SPLINT FINGER STAX SIZE 1 2307943 CDM 274 RC L3927 HCPCS facility both 16 16 Gross Charge Type: NIHD_Clinic_Price SPLINT FINGER STAX SIZE 1 2307943 CDM 274 RC facility both 16 16 Gross Charge Type: NIHD_Hosp_Profee_Price SPLINT FINGER STAX SIZE 1 2307943 CDM 274 RC facility both 16 16 Gross Charge Type: NIHD_Hosp_Profee_Price "23107 ARTHROTOMY, GLENOHUMERAL JOINT, WITH JOINT EXPLORATION, WITH OR WITHOUT REMOVAL OF LOO ProFee" 23107 CDM 982 RC 23107 HCPCS facility both 1225 1225 Gross Charge Type: NIHD_Hosp_Profee_Price "23107 ARTHROTOMY, GLENOHUMERAL JOINT, WITH JOINT EXPLORATION, WITH OR WITHOUT REMOVAL OF LOO ProFee" 23107 CDM 982 RC 23107 HCPCS facility both 1225 1225 Gross Charge Type: NIHD_Hosp_Profee_Price Triathalon Cruciate Retaining Femoral SZ 2 LT 2311121 CDM 278 RC facility both 20521 20521 Gross Charge Type: NIHD_Hosp_Profee_Price Triathalon Cruciate Retaining Femoral SZ 2 LT 2311121 CDM 278 RC facility both 20521 20521 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TORIC SN6AT3 9.5 2313870 CDM 276 RC facility both 505 505 Gross Charge Type: NIHD_Hosp_Profee_Price IOL TORIC SN6AT3 9.5 2313870 CDM 276 RC facility both 505 505 Gross Charge Type: NIHD_Hosp_Profee_Price HIPSTEM-HIGH OFFSET INSIGNIA SZ 3 36MM LENGTH 2313885 CDM 278 RC facility both 26688 26688 Gross Charge Type: NIHD_Hosp_Profee_Price HIPSTEM-HIGH OFFSET INSIGNIA SZ 3 36MM LENGTH 2313885 CDM 278 RC facility both 26688 26688 Gross Charge Type: NIHD_Hosp_Profee_Price PRESSURE INJECTABLE PICC 1 LUMEN 2320504 CDM 271 RC facility both 279 279 Gross Charge Type: NIHD_Hosp_Profee_Price PRESSURE INJECTABLE PICC 1 LUMEN 2320504 CDM 271 RC facility both 279 279 Gross Charge Type: NIHD_Hosp_Profee_Price Lens Multifocal MN6AD1 17.0 2330352 CDM 276 RC facility both 995 995 Gross Charge Type: NIHD_Hosp_Profee_Price Lens Multifocal MN6AD1 17.0 2330352 CDM 276 RC facility both 995 995 Gross Charge Type: NIHD_Hosp_Profee_Price Hysterosalpingography (HSG) Catheter 5.5Fr x 40cm 2330570 CDM 272 RC C1726 HCPCS facility both 165 165 Gross Charge Type: NIHD_RHC_Price Hysterosalpingography (HSG) Catheter 5.5Fr x 40cm 2330570 CDM 272 RC C1726 HCPCS facility both 165 165 Gross Charge Type: NIHD_Clinic_Price Hysterosalpingography (HSG) Catheter 5.5Fr x 40cm 2330570 CDM 272 RC facility both 165 165 Gross Charge Type: NIHD_Hosp_Profee_Price Hysterosalpingography (HSG) Catheter 5.5Fr x 40cm 2330570 CDM 272 RC facility both 165 165 Gross Charge Type: NIHD_Hosp_Profee_Price "23335 REMOVAL OF PROSTHESIS, INCLUDES DEBRIDEMENT AND SYNOVECTOMY WHEN PERFORMED; HUMERAL AN ProFee" 23335 CDM 975 RC 23335 HCPCS facility both 1903 1903 Gross Charge Type: NIHD_Hosp_Profee_Price "23335 REMOVAL OF PROSTHESIS, INCLUDES DEBRIDEMENT AND SYNOVECTOMY WHEN PERFORMED; HUMERAL AN ProFee" 23335 CDM 975 RC 23335 HCPCS facility both 1903 1903 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Shoulder Right - Report 233501 CDM 972 RC 23350 HCPCS facility both RT 181 181 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Shoulder Right - Report 233501 CDM 972 RC 23350 HCPCS facility both RT 181 181 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Shoulder Left - Report 233502 CDM 972 RC 23350 HCPCS facility both LT 181 181 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Shoulder Left - Report 233502 CDM 972 RC 23350 HCPCS facility both LT 181 181 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Shoulder Left 233503 CDM 761 RC facility both TCLT 629 629 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Shoulder Left 233503 CDM 761 RC facility both TCLT 629 629 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Shoulder Right 233504 CDM 761 RC facility both TCRT 629 629 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Shoulder Right 233504 CDM 761 RC facility both TCRT 629 629 Gross Charge Type: NIHD_Hosp_Profee_Price 23350 XR INJ ARTHROGRAM SHOULDER 233505 CDM 761 RC facility both TC50 629 629 Gross Charge Type: NIHD_Hosp_Profee_Price 23350 XR INJ ARTHROGRAM SHOULDER 233505 CDM 761 RC facility both TC50 629 629 Gross Charge Type: NIHD_Hosp_Profee_Price 23350 XR INJ ARTHROGRAM SHOULDER:PRO 233506 CDM 972 RC 23350 HCPCS facility both 2650 181 181 Gross Charge Type: NIHD_Hosp_Profee_Price 23350 XR INJ ARTHROGRAM SHOULDER:PRO 233506 CDM 972 RC 23350 HCPCS facility both 2650 181 181 Gross Charge Type: NIHD_Hosp_Profee_Price "23405 TENOTOMY, SHOULDER AREA; SINGLE TENDON ProFee" 23405 CDM 975 RC 23405 HCPCS facility both 1090 1090 Gross Charge Type: NIHD_Hosp_Profee_Price "23405 TENOTOMY, SHOULDER AREA; SINGLE TENDON ProFee" 23405 CDM 975 RC 23405 HCPCS facility both 1090 1090 Gross Charge Type: NIHD_Hosp_Profee_Price "23410 REPAIR OF RUPTURED MUSCULOTENDINOUS CUFF (EG, ROTATOR CUFF) OPEN; ACUTE ProFee" 23410 CDM 982 RC 23410 HCPCS facility both 1685 1685 Gross Charge Type: NIHD_Hosp_Profee_Price "23410 REPAIR OF RUPTURED MUSCULOTENDINOUS CUFF (EG, ROTATOR CUFF) OPEN; ACUTE ProFee" 23410 CDM 982 RC 23410 HCPCS facility both 1685 1685 Gross Charge Type: NIHD_Hosp_Profee_Price T2 ALPHA TIBIAL NAIL 11X380MM 23411136 CDM 278 RC facility both 4446 4446 Gross Charge Type: NIHD_Hosp_Profee_Price T2 ALPHA TIBIAL NAIL 11X380MM 23411136 CDM 278 RC facility both 4446 4446 Gross Charge Type: NIHD_Hosp_Profee_Price 23430 TENODESIS OF LONG TENDON OF BICEPS ProFee 23430 CDM 982 RC 23430 HCPCS facility both 1548 1548 Gross Charge Type: NIHD_Hosp_Profee_Price 23430 TENODESIS OF LONG TENDON OF BICEPS ProFee 23430 CDM 982 RC 23430 HCPCS facility both 1548 1548 Gross Charge Type: NIHD_Hosp_Profee_Price 23440 RESECTION OR TRANSPLANTATION OF LONG TENDON OF BICEPS ProFee 23440 CDM 982 RC 23440 HCPCS facility both 2382 2382 Gross Charge Type: NIHD_Hosp_Profee_Price 23440 RESECTION OR TRANSPLANTATION OF LONG TENDON OF BICEPS ProFee 23440 CDM 982 RC 23440 HCPCS facility both 2382 2382 Gross Charge Type: NIHD_Hosp_Profee_Price "23466 CAPSULORRHAPHY, GLENOHUMERAL JOINT, ANY TYPE MULTI-DIRECTIONAL INSTABILITY ProFee" 23466 CDM 23466 HCPCS facility both 1691 1691 Gross Charge Type: NIHD_Hosp_Profee_Price "23466 CAPSULORRHAPHY, GLENOHUMERAL JOINT, ANY TYPE MULTI-DIRECTIONAL INSTABILITY ProFee" 23466 CDM 23466 HCPCS facility both 1691 1691 Gross Charge Type: NIHD_Hosp_Profee_Price "23470 ARTHROPLASTY, GLENOHUMERAL JOINT; HEMIARTHROPLASTY ProFee" 23470 CDM 982 RC 23470 HCPCS facility both 2101 2101 Gross Charge Type: NIHD_Hosp_Profee_Price "23470 ARTHROPLASTY, GLENOHUMERAL JOINT; HEMIARTHROPLASTY ProFee" 23470 CDM 982 RC 23470 HCPCS facility both 2101 2101 Gross Charge Type: NIHD_Hosp_Profee_Price "23472 ARTHROPLASTY, GLENOHUMERAL JOINT; TOTAL SHOULDER (GLENOID AND PROXIMAL HUMERAL REPLACE ProFee" 23472 CDM 982 RC 23472 HCPCS facility both 2994 2994 Gross Charge Type: NIHD_Hosp_Profee_Price "23472 ARTHROPLASTY, GLENOHUMERAL JOINT; TOTAL SHOULDER (GLENOID AND PROXIMAL HUMERAL REPLACE ProFee" 23472 CDM 982 RC 23472 HCPCS facility both 2994 2994 Gross Charge Type: NIHD_Hosp_Profee_Price "23474 REVISION OF TOTAL SHOULDER ARTHROPLASTY, INCLUDING ALLOGRAFT WHEN PERFORMED; HUMERAL A ProFee" 23474 CDM 982 RC 23474 HCPCS facility both 3181 3181 Gross Charge Type: NIHD_Hosp_Profee_Price "23474 REVISION OF TOTAL SHOULDER ARTHROPLASTY, INCLUDING ALLOGRAFT WHEN PERFORMED; HUMERAL A ProFee" 23474 CDM 982 RC 23474 HCPCS facility both 3181 3181 Gross Charge Type: NIHD_Hosp_Profee_Price 23500 Closed treatment of clavicular fracture; without manipulation 235001 CDM 521 RC 23500 HCPCS facility both 698 698 Gross Charge Type: NIHD_Clinic_Price 23500 CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION TechFee 235002 CDM 450 RC facility both 1137 1137 Gross Charge Type: NIHD_Hosp_Profee_Price 23500 CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION TechFee 235002 CDM 450 RC facility both 1137 1137 Gross Charge Type: NIHD_Hosp_Profee_Price T2 IMN LOCKING DRILL 4.2X380MM 23514236 CDM 278 RC facility both 399 399 Gross Charge Type: NIHD_Hosp_Profee_Price T2 IMN LOCKING DRILL 4.2X380MM 23514236 CDM 278 RC facility both 399 399 Gross Charge Type: NIHD_Hosp_Profee_Price "23515 OPEN TREATMENT OF CLAVICULAR FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED ProFee" 23515 CDM 982 RC 23515 HCPCS facility both 1473 1473 Gross Charge Type: NIHD_Hosp_Profee_Price "23515 OPEN TREATMENT OF CLAVICULAR FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED ProFee" 23515 CDM 982 RC 23515 HCPCS facility both 1473 1473 Gross Charge Type: NIHD_Hosp_Profee_Price "Cent Venous Catheter, Double Lumen, 7 Fr x 16 cm" 2352334 CDM 278 RC facility both 54 54 Gross Charge Type: NIHD_Hosp_Profee_Price "Cent Venous Catheter, Double Lumen, 7 Fr x 16 cm" 2352334 CDM 278 RC facility both 54 54 Gross Charge Type: NIHD_Hosp_Profee_Price 23525 CLOSED TREATMENT OF STERNOCLAVICULAR DISLOCATION; WITH MANIPULATION ProFee 23525 CDM 982 RC 23525 HCPCS facility both 700 700 Gross Charge Type: NIHD_Hosp_Profee_Price 23525 CLOSED TREATMENT OF STERNOCLAVICULAR DISLOCATION; WITH MANIPULATION ProFee 23525 CDM 982 RC 23525 HCPCS facility both 700 700 Gross Charge Type: NIHD_Hosp_Profee_Price Pericardio Catheter Set 2354309 CDM 272 RC facility both 317 317 Gross Charge Type: NIHD_Hosp_Profee_Price Pericardio Catheter Set 2354309 CDM 272 RC facility both 317 317 Gross Charge Type: NIHD_Hosp_Profee_Price "23550 OPEN TREATMENT OF ACROMIOCLAVICULAR DISLOCATION, ACUTE OR CHRONIC; ProFee" 23550 CDM 975 RC 23550 HCPCS facility both 1002 1002 Gross Charge Type: NIHD_Hosp_Profee_Price "23550 OPEN TREATMENT OF ACROMIOCLAVICULAR DISLOCATION, ACUTE OR CHRONIC; ProFee" 23550 CDM 975 RC 23550 HCPCS facility both 1002 1002 Gross Charge Type: NIHD_Hosp_Profee_Price 23570 Closed treatment of scapular fracture; without manipulation 235701 CDM 521 RC 23570 HCPCS facility both 831 831 Gross Charge Type: NIHD_Clinic_Price 23570 CLOSED TREATMENT OF SCAPULAR FRACTURE; WITHOUT MANIPULATION ProFee 235702 CDM 982 RC 23570 HCPCS facility both 483 483 Gross Charge Type: NIHD_Hosp_Profee_Price 23570 CLOSED TREATMENT OF SCAPULAR FRACTURE; WITHOUT MANIPULATION ProFee 235702 CDM 982 RC 23570 HCPCS facility both 483 483 Gross Charge Type: NIHD_Hosp_Profee_Price "23585 OPEN TREATMENT OF SCAPULAR FRACTURE (BODY, GLENOID OR ACROMION) INCLUDES INTERNAL FIXA ProFee" 23585 CDM 982 RC 23585 HCPCS facility both 1809 1809 Gross Charge Type: NIHD_Hosp_Profee_Price "23585 OPEN TREATMENT OF SCAPULAR FRACTURE (BODY, GLENOID OR ACROMION) INCLUDES INTERNAL FIXA ProFee" 23585 CDM 982 RC 23585 HCPCS facility both 1809 1809 Gross Charge Type: NIHD_Hosp_Profee_Price 23600 Closed treatment of proximal humeral fracture; without manipulation 236001 CDM 521 RC 23600 HCPCS facility both 1064 1064 Gross Charge Type: NIHD_Clinic_Price 23600 CLOSED TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE; WITHOUT M ProFee 236002 CDM 982 RC 23600 HCPCS facility both 575 575 Gross Charge Type: NIHD_Hosp_Profee_Price 23600 CLOSED TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE; WITHOUT M ProFee 236002 CDM 982 RC 23600 HCPCS facility both 575 575 Gross Charge Type: NIHD_Hosp_Profee_Price 23605 CLOSED TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE; WITH MANI ProFee 23605 CDM 982 RC 23605 HCPCS facility both 963 963 Gross Charge Type: NIHD_Hosp_Profee_Price 23605 CLOSED TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE; WITH MANI ProFee 23605 CDM 982 RC 23605 HCPCS facility both 963 963 Gross Charge Type: NIHD_Hosp_Profee_Price T2 IMN LOCKING SCREW 5 X 37.5 23605037 CDM 278 RC facility both 531 531 Gross Charge Type: NIHD_Hosp_Profee_Price T2 IMN LOCKING SCREW 5 X 37.5 23605037 CDM 278 RC facility both 531 531 Gross Charge Type: NIHD_Hosp_Profee_Price T2 IMN LOCKING SCREW 5X40MM 23605040 CDM 278 RC facility both 531 531 Gross Charge Type: NIHD_Hosp_Profee_Price T2 IMN LOCKING SCREW 5X40MM 23605040 CDM 278 RC facility both 531 531 Gross Charge Type: NIHD_Hosp_Profee_Price T2 IMN LOCKING SCREW 5X42.5MM 23605042 CDM 278 RC facility both 531 531 Gross Charge Type: NIHD_Hosp_Profee_Price T2 IMN LOCKING SCREW 5X42.5MM 23605042 CDM 278 RC facility both 531 531 Gross Charge Type: NIHD_Hosp_Profee_Price T2 IMN LOCKING SCREW 05X50MM 23605050 CDM 278 RC facility both 531 531 Gross Charge Type: NIHD_Hosp_Profee_Price T2 IMN LOCKING SCREW 05X50MM 23605050 CDM 278 RC facility both 531 531 Gross Charge Type: NIHD_Hosp_Profee_Price "23615 OPEN TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE, INCLUDES IN ProFee" 23615 CDM 982 RC 23615 HCPCS facility both 1872 1872 Gross Charge Type: NIHD_Hosp_Profee_Price "23615 OPEN TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE, INCLUDES IN ProFee" 23615 CDM 982 RC 23615 HCPCS facility both 1872 1872 Gross Charge Type: NIHD_Hosp_Profee_Price "23616 OPEN TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE, INCLUDES IN ProFee" 23616 CDM 982 RC 23616 HCPCS facility both 2558 2558 Gross Charge Type: NIHD_Hosp_Profee_Price "23616 OPEN TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE, INCLUDES IN ProFee" 23616 CDM 982 RC 23616 HCPCS facility both 2558 2558 Gross Charge Type: NIHD_Hosp_Profee_Price 23620 Closed treatment of greater humeral tuberosity fracture; without manipulation 23620 CDM 521 RC 23620 HCPCS facility both 931 931 Gross Charge Type: NIHD_Clinic_Price "23630 OPEN TREATMENT OF GREATER HUMERAL TUBEROSITY FRACTURE, INCLUDES INTERNAL FIXATION, WHE ProFee" 23630 CDM 982 RC 23630 HCPCS facility both 1623 1623 Gross Charge Type: NIHD_Hosp_Profee_Price "23630 OPEN TREATMENT OF GREATER HUMERAL TUBEROSITY FRACTURE, INCLUDES INTERNAL FIXATION, WHE ProFee" 23630 CDM 982 RC 23630 HCPCS facility both 1623 1623 Gross Charge Type: NIHD_Hosp_Profee_Price 23650 CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES TechFee 236501 CDM 450 RC facility both 924 924 Gross Charge Type: NIHD_Hosp_Profee_Price 23650 CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES TechFee 236501 CDM 450 RC facility both 924 924 Gross Charge Type: NIHD_Hosp_Profee_Price "23650 CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH MANIPULATION; WITHOUT ANESTHESIA ProFee" 236502 CDM 982 RC 23650 HCPCS facility both 649 649 Gross Charge Type: NIHD_Hosp_Profee_Price "23650 CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH MANIPULATION; WITHOUT ANESTHESIA ProFee" 236502 CDM 982 RC 23650 HCPCS facility both 649 649 Gross Charge Type: NIHD_Hosp_Profee_Price 23655 CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES TechFee 236551 CDM 450 RC facility both 2234 2234 Gross Charge Type: NIHD_Hosp_Profee_Price 23655 CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES TechFee 236551 CDM 450 RC facility both 2234 2234 Gross Charge Type: NIHD_Hosp_Profee_Price "23655 CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH MANIPULATION; REQUIRING ANESTHESIA ProFee" 236552 CDM 982 RC 23655 HCPCS facility both 837 837 Gross Charge Type: NIHD_Hosp_Profee_Price "23655 CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH MANIPULATION; REQUIRING ANESTHESIA ProFee" 236552 CDM 982 RC 23655 HCPCS facility both 837 837 Gross Charge Type: NIHD_Hosp_Profee_Price 23665 CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MANJ TechFee 236651 CDM 450 RC facility both 1685 1685 Gross Charge Type: NIHD_Hosp_Profee_Price 23665 CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MANJ TechFee 236651 CDM 450 RC facility both 1685 1685 Gross Charge Type: NIHD_Hosp_Profee_Price "23665 CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH FRACTURE OF GREATER HUMERAL TUBEROSITY, ProFee" 236652 CDM 982 RC 23665 HCPCS facility both 874 874 Gross Charge Type: NIHD_Hosp_Profee_Price "23665 CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH FRACTURE OF GREATER HUMERAL TUBEROSITY, ProFee" 236652 CDM 982 RC 23665 HCPCS facility both 874 874 Gross Charge Type: NIHD_Hosp_Profee_Price 23675 CLTX SHOULDER DISLC W/SURG/ANTMCL NECK FX W/ ProFee 23675 CDM 23675 HCPCS facility both 770 770 Gross Charge Type: NIHD_Hosp_Profee_Price 23675 CLTX SHOULDER DISLC W/SURG/ANTMCL NECK FX W/ ProFee 23675 CDM 23675 HCPCS facility both 770 770 Gross Charge Type: NIHD_Hosp_Profee_Price 23675 CLTX SHOULDER DISLC W/SURG/ANTMCL NECK FX W/MANJ TechFee 236751 CDM 450 RC facility both 2087 2087 Gross Charge Type: NIHD_Hosp_Profee_Price 23675 CLTX SHOULDER DISLC W/SURG/ANTMCL NECK FX W/MANJ TechFee 236751 CDM 450 RC facility both 2087 2087 Gross Charge Type: NIHD_Hosp_Profee_Price "23700 MANIPULATION UNDER ANESTHESIA, SHOULDER JOINT, INCLUDING APPLICATION OF FIXATION APPAR ProFee" 23700 CDM 982 RC 23700 HCPCS facility both 400 400 Gross Charge Type: NIHD_Hosp_Profee_Price "23700 MANIPULATION UNDER ANESTHESIA, SHOULDER JOINT, INCLUDING APPLICATION OF FIXATION APPAR ProFee" 23700 CDM 982 RC 23700 HCPCS facility both 400 400 Gross Charge Type: NIHD_Hosp_Profee_Price "23929 UNLISTED PROCEDURE, SHOULDER ProFee" 23929 CDM 982 RC 23929 HCPCS facility both 2184 2184 Gross Charge Type: NIHD_Hosp_Profee_Price "23929 UNLISTED PROCEDURE, SHOULDER ProFee" 23929 CDM 982 RC 23929 HCPCS facility both 2184 2184 Gross Charge Type: NIHD_Hosp_Profee_Price "23930 INCISION AND DRAINAGE, UPPER ARM OR ELBOW AREA; DEEP ABSCESS OR HEMATOMA ProFee" 23930 CDM 982 RC 23930 HCPCS facility both 425 425 Gross Charge Type: NIHD_Hosp_Profee_Price "23930 INCISION AND DRAINAGE, UPPER ARM OR ELBOW AREA; DEEP ABSCESS OR HEMATOMA ProFee" 23930 CDM 982 RC 23930 HCPCS facility both 425 425 Gross Charge Type: NIHD_Hosp_Profee_Price "23931 Incision and drainage, upper arm or elbow area; bursa" 239311 CDM 521 RC 23931 HCPCS facility both 301 301 Gross Charge Type: NIHD_RHC_Price "23931 Incision and drainage, upper arm or elbow area; bursa" 239311 CDM 521 RC 23931 HCPCS facility both 301 301 Gross Charge Type: NIHD_Clinic_Price "23931 INCISION AND DRAINAGE, UPPER ARM OR ELBOW AREA; BURSA ProFee" 239312 CDM 982 RC 23931 HCPCS facility both 301 301 Gross Charge Type: NIHD_Hosp_Profee_Price "23931 INCISION AND DRAINAGE, UPPER ARM OR ELBOW AREA; BURSA ProFee" 239312 CDM 982 RC 23931 HCPCS facility both 301 301 Gross Charge Type: NIHD_Hosp_Profee_Price ZONENAVIGATOR SYSTEM HANDLE 2400000 CDM 271 RC facility both 750 750 Gross Charge Type: NIHD_Hosp_Profee_Price ZONENAVIGATOR SYSTEM HANDLE 2400000 CDM 271 RC facility both 750 750 Gross Charge Type: NIHD_Hosp_Profee_Price PLASMA BUTTON 12-30 INCHES (UROLOGY) 2400123 CDM 278 RC facility both 1800 1800 Gross Charge Type: NIHD_Hosp_Profee_Price PLASMA BUTTON 12-30 INCHES (UROLOGY) 2400123 CDM 278 RC facility both 1800 1800 Gross Charge Type: NIHD_Hosp_Profee_Price INTERNAL NEUROSTIMULATOR BATTERY (STAGE 2) 2400124 CDM 278 RC facility both 44517 44517 Gross Charge Type: NIHD_Hosp_Profee_Price INTERNAL NEUROSTIMULATOR BATTERY (STAGE 2) 2400124 CDM 278 RC facility both 44517 44517 Gross Charge Type: NIHD_Hosp_Profee_Price BLADDER STIMULATOR COMMUNICATION HANDPIECE (STAGE 2) 2400125 CDM 278 RC facility both 6600 6600 Gross Charge Type: NIHD_Hosp_Profee_Price BLADDER STIMULATOR COMMUNICATION HANDPIECE (STAGE 2) 2400125 CDM 278 RC facility both 6600 6600 Gross Charge Type: NIHD_Hosp_Profee_Price EXTERNAL NEUROSTIMULATOR (STAGE 2) 2400126 CDM 270 RC facility both 1386 1386 Gross Charge Type: NIHD_Hosp_Profee_Price EXTERNAL NEUROSTIMULATOR (STAGE 2) 2400126 CDM 270 RC facility both 1386 1386 Gross Charge Type: NIHD_Hosp_Profee_Price BLADDER STIMULATOR LEAD KIT 2400127 CDM 278 RC facility both 15777 15777 Gross Charge Type: NIHD_Hosp_Profee_Price BLADDER STIMULATOR LEAD KIT 2400127 CDM 278 RC facility both 15777 15777 Gross Charge Type: NIHD_Hosp_Profee_Price BLADDER STIMULATOR ENVELOPE ( STAGE 2) 2400128 CDM facility both 4485 4485 Gross Charge Type: NIHD_Hosp_Profee_Price BLADDER STIMULATOR ENVELOPE ( STAGE 2) 2400128 CDM facility both 4485 4485 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON IOL PANOPTIX CNWTTO 13.5 2400130 CDM 276 RC facility both 995 995 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON IOL PANOPTIX CNWTTO 13.5 2400130 CDM 276 RC facility both 995 995 Gross Charge Type: NIHD_Hosp_Profee_Price AMNIOEFFECT SKIN GRAFT 2.0 X 3.0 (sample only) 2400132 CDM 636 RC facility both 0.01 0.01 Gross Charge Type: NIHD_Hosp_Profee_Price AMNIOEFFECT SKIN GRAFT 2.0 X 3.0 (sample only) 2400132 CDM 636 RC facility both 0.01 0.01 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON PANOPTIX TORIX IOL CNWTT6 21.5 2400140 CDM 276 RC facility both 1015 1015 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON PANOPTIX TORIX IOL CNWTT6 21.5 2400140 CDM 276 RC facility both 1015 1015 Gross Charge Type: NIHD_Hosp_Profee_Price INTRAOCULAR LENS GLIDE 2400158 CDM 272 RC facility both 519 519 Gross Charge Type: NIHD_Hosp_Profee_Price INTRAOCULAR LENS GLIDE 2400158 CDM 272 RC facility both 519 519 Gross Charge Type: NIHD_Hosp_Profee_Price MALYUGIN RING 2.0-6.25 (EYES CASES) 2400159 CDM 272 RC facility both 426 426 Gross Charge Type: NIHD_Hosp_Profee_Price MALYUGIN RING 2.0-6.25 (EYES CASES) 2400159 CDM 272 RC facility both 426 426 Gross Charge Type: NIHD_Hosp_Profee_Price PERIPHERAL NERVE EVALUATION BASIC WIRE TEST KIT 2400199 CDM 278 RC facility both 189 189 Gross Charge Type: NIHD_Hosp_Profee_Price PERIPHERAL NERVE EVALUATION BASIC WIRE TEST KIT 2400199 CDM 278 RC facility both 189 189 Gross Charge Type: NIHD_Hosp_Profee_Price EXTERNAL NEURO STIMULATOR (BLADDER INTERSTIM) 2400200 CDM 278 RC facility both 1386 1386 Gross Charge Type: NIHD_Hosp_Profee_Price EXTERNAL NEURO STIMULATOR (BLADDER INTERSTIM) 2400200 CDM 278 RC facility both 1386 1386 Gross Charge Type: NIHD_Hosp_Profee_Price SMOKEEVAC FILTERED TUBE SET AIR SEAL 2400205 CDM 272 RC facility both 225 225 Gross Charge Type: NIHD_Hosp_Profee_Price SMOKEEVAC FILTERED TUBE SET AIR SEAL 2400205 CDM 272 RC facility both 225 225 Gross Charge Type: NIHD_Hosp_Profee_Price UROLOGY ELECTRODE QUICK FIRE 12 ULTRA THIN BLADDER LOOP MEDIUM 2400252 CDM 272 RC facility both 897 897 Gross Charge Type: NIHD_Hosp_Profee_Price UROLOGY ELECTRODE QUICK FIRE 12 ULTRA THIN BLADDER LOOP MEDIUM 2400252 CDM 272 RC facility both 897 897 Gross Charge Type: NIHD_Hosp_Profee_Price UROLOGY ELECTRODE CUTTING 12 DEG UNIVERSAL QUICK FIRE MEDIUM LOOP WITH SHORTER LENGTH 2400254 CDM 272 RC facility both 897 897 Gross Charge Type: NIHD_Hosp_Profee_Price UROLOGY ELECTRODE CUTTING 12 DEG UNIVERSAL QUICK FIRE MEDIUM LOOP WITH SHORTER LENGTH 2400254 CDM 272 RC facility both 897 897 Gross Charge Type: NIHD_Hosp_Profee_Price ELECTRODE HEMI VAPORIZATION OVAL TIP 2400255 CDM 272 RC facility both 897 897 Gross Charge Type: NIHD_Hosp_Profee_Price ELECTRODE HEMI VAPORIZATION OVAL TIP 2400255 CDM 272 RC facility both 897 897 Gross Charge Type: NIHD_Hosp_Profee_Price SIGNIA POWER SHELL FOR POWER HANDLE 2400256 CDM 272 RC facility both 1824 1824 Gross Charge Type: NIHD_Hosp_Profee_Price SIGNIA POWER SHELL FOR POWER HANDLE 2400256 CDM 272 RC facility both 1824 1824 Gross Charge Type: NIHD_Hosp_Profee_Price UROLIFT 2 IMPLANT CARTRIDGE 2400350 CDM 278 RC facility both 13800 13800 Gross Charge Type: NIHD_Hosp_Profee_Price UROLIFT 2 IMPLANT CARTRIDGE 2400350 CDM 278 RC facility both 13800 13800 Gross Charge Type: NIHD_Hosp_Profee_Price UROLIFT 2 CARTRIDGE HANDLE KIT 2400351 CDM 278 RC facility both 3450 3450 Gross Charge Type: NIHD_Hosp_Profee_Price UROLIFT 2 CARTRIDGE HANDLE KIT 2400351 CDM 278 RC facility both 3450 3450 Gross Charge Type: NIHD_Hosp_Profee_Price GELPORT HAND ASSIST LAPAROSCOPIC SYSTEM 2400352 CDM 272 RC facility both 2145 2145 Gross Charge Type: NIHD_Hosp_Profee_Price GELPORT HAND ASSIST LAPAROSCOPIC SYSTEM 2400352 CDM 272 RC facility both 2145 2145 Gross Charge Type: NIHD_Hosp_Profee_Price TRIATHLON ASYMMETRIC PATELLA SZ A-29 X 9MM 2400610 CDM 278 RC facility both 5334 5334 Gross Charge Type: NIHD_Hosp_Profee_Price TRIATHLON ASYMMETRIC PATELLA SZ A-29 X 9MM 2400610 CDM 278 RC facility both 5334 5334 Gross Charge Type: NIHD_Hosp_Profee_Price GST WHITE VASCULAR RELOAD 60 MM 6 ROW FOR ECHELON FLEX POWERED STAPLER 2400700 CDM 278 RC facility both 723 723 Gross Charge Type: NIHD_Hosp_Profee_Price GST WHITE VASCULAR RELOAD 60 MM 6 ROW FOR ECHELON FLEX POWERED STAPLER 2400700 CDM 278 RC facility both 723 723 Gross Charge Type: NIHD_Hosp_Profee_Price HIP STEM INSIGNIA STANDARD OFFSET SZE 2 2400710 CDM 278 RC facility both 31500 31500 Gross Charge Type: NIHD_Hosp_Profee_Price HIP STEM INSIGNIA STANDARD OFFSET SZE 2 2400710 CDM 278 RC facility both 31500 31500 Gross Charge Type: NIHD_Hosp_Profee_Price "24071 EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOW AREA, SUBCUTANEOUS; 3 CM OR GREATER ProFee" 24071 CDM 982 RC 24071 HCPCS facility both 749 749 Gross Charge Type: NIHD_Hosp_Profee_Price "24071 EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOW AREA, SUBCUTANEOUS; 3 CM OR GREATER ProFee" 24071 CDM 982 RC 24071 HCPCS facility both 749 749 Gross Charge Type: NIHD_Hosp_Profee_Price "24075 Excision, tumor, soft tissue of upper arm or elbow area, subcutaneous; less than 3 cm" 24075 CDM 521 RC 24075 HCPCS facility both 2425 2425 Gross Charge Type: NIHD_Clinic_Price "24076 EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOW AREA, SUBFASCIAL (EG, INTRAMUSCULAR ProFee" 24076 CDM 982 RC 24076 HCPCS facility both 826 826 Gross Charge Type: NIHD_Hosp_Profee_Price "24076 EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOW AREA, SUBFASCIAL (EG, INTRAMUSCULAR ProFee" 24076 CDM 982 RC 24076 HCPCS facility both 826 826 Gross Charge Type: NIHD_Hosp_Profee_Price "24105 EXCISION, OLECRANON BURSA ProFee" 24105 CDM 982 RC 24105 HCPCS facility both 749 749 Gross Charge Type: NIHD_Hosp_Profee_Price "24105 EXCISION, OLECRANON BURSA ProFee" 24105 CDM 982 RC 24105 HCPCS facility both 749 749 Gross Charge Type: NIHD_Hosp_Profee_Price 24200 Removal foreign body/upper arm/subcutaneous 24200 CDM 24200 HCPCS facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price 24200 Removal foreign body/upper arm/subcutaneous 24200 CDM 24200 HCPCS facility both 217 217 Gross Charge Type: NIHD_Hosp_Profee_Price 24201 REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEEP 24201 CDM 982 RC 24201 HCPCS facility both 1251 1251 Gross Charge Type: NIHD_Hosp_Profee_Price 24201 REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEEP 24201 CDM 982 RC 24201 HCPCS facility both 1251 1251 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Elbow Right - Report 242201 CDM 982 RC 24220 HCPCS facility both 26RT 181 181 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Elbow Right - Report 242201 CDM 982 RC 24220 HCPCS facility both 26RT 181 181 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Elbow Left - Report 242202 CDM 982 RC 24220 HCPCS facility both 26LT 181 181 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Elbow Left - Report 242202 CDM 982 RC 24220 HCPCS facility both 26LT 181 181 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Elbow Left 242203 CDM 761 RC facility both TCLT 629 629 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Elbow Left 242203 CDM 761 RC facility both TCLT 629 629 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Elbow Right 242204 CDM 761 RC facility both TCRT 629 629 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Elbow Right 242204 CDM 761 RC facility both TCRT 629 629 Gross Charge Type: NIHD_Hosp_Profee_Price "24341 REPAIR, TENDON OR MUSCLE, UPPER ARM OR ELBOW, EACH TENDON OR MUSCLE, PRIMARY OR SECOND ProFee" 24341 CDM 982 RC 24341 HCPCS facility both 1560 1560 Gross Charge Type: NIHD_Hosp_Profee_Price "24341 REPAIR, TENDON OR MUSCLE, UPPER ARM OR ELBOW, EACH TENDON OR MUSCLE, PRIMARY OR SECOND ProFee" 24341 CDM 982 RC 24341 HCPCS facility both 1560 1560 Gross Charge Type: NIHD_Hosp_Profee_Price "24342 REINSERTION OF RUPTURED BICEPS OR TRICEPS TENDON, DISTAL, WITH OR WITHOUT TENDON GRAFT ProFee" 24342 CDM 982 RC 24342 HCPCS facility both 1623 1623 Gross Charge Type: NIHD_Hosp_Profee_Price "24342 REINSERTION OF RUPTURED BICEPS OR TRICEPS TENDON, DISTAL, WITH OR WITHOUT TENDON GRAFT ProFee" 24342 CDM 982 RC 24342 HCPCS facility both 1623 1623 Gross Charge Type: NIHD_Hosp_Profee_Price "24358 TENOTOMY, ELBOW, LATERAL OR MEDIAL (EG, EPICONDYLITIS, TENNIS ELBOW, GOLFER'S ELBOW); ProFee" 24358 CDM 982 RC 24358 HCPCS facility both 1075 1075 Gross Charge Type: NIHD_Hosp_Profee_Price "24358 TENOTOMY, ELBOW, LATERAL OR MEDIAL (EG, EPICONDYLITIS, TENNIS ELBOW, GOLFER'S ELBOW); ProFee" 24358 CDM 982 RC 24358 HCPCS facility both 1075 1075 Gross Charge Type: NIHD_Hosp_Profee_Price "24359 TENOTOMY, ELBOW, LATERAL OR MEDIAL (EG, EPICONDYLITIS, TENNIS ELBOW, GOLFER'S ELBOW); ProFee" 24359 CDM 982 RC 24359 HCPCS facility both 1155 1155 Gross Charge Type: NIHD_Hosp_Profee_Price "24359 TENOTOMY, ELBOW, LATERAL OR MEDIAL (EG, EPICONDYLITIS, TENNIS ELBOW, GOLFER'S ELBOW); ProFee" 24359 CDM 982 RC 24359 HCPCS facility both 1155 1155 Gross Charge Type: NIHD_Hosp_Profee_Price "24366 ARTHROPLASTY, RADIAL HEAD; WITH IMPLANT ProFee" 24366 CDM 982 RC 24366 HCPCS facility both 1198 1198 Gross Charge Type: NIHD_Hosp_Profee_Price "24366 ARTHROPLASTY, RADIAL HEAD; WITH IMPLANT ProFee" 24366 CDM 982 RC 24366 HCPCS facility both 1198 1198 Gross Charge Type: NIHD_Hosp_Profee_Price "24430 REPAIR OF NONUNION OR MALUNION, HUMERUS; WITHOUT GRAFT (EG, COMPRESSION TECHNIQUE) ProFee" 24430 CDM 982 RC 24430 HCPCS facility both 2121 2121 Gross Charge Type: NIHD_Hosp_Profee_Price "24430 REPAIR OF NONUNION OR MALUNION, HUMERUS; WITHOUT GRAFT (EG, COMPRESSION TECHNIQUE) ProFee" 24430 CDM 982 RC 24430 HCPCS facility both 2121 2121 Gross Charge Type: NIHD_Hosp_Profee_Price 24500 CLOSED TREATMENT OF HUMERAL SHAFT FRACTURE; WITHOUT MANIPULATION ProFee 24500 CDM 982 RC 24500 HCPCS facility both 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price 24500 CLOSED TREATMENT OF HUMERAL SHAFT FRACTURE; WITHOUT MANIPULATION ProFee 24500 CDM 982 RC 24500 HCPCS facility both 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price "24505 Closed treatment of humeral shaft fracture; with manipulation, w/wo skeletal traction" 245051 CDM 521 RC 24505 HCPCS facility both 910 910 Gross Charge Type: NIHD_RHC_Price "24505 Closed treatment of humeral shaft fracture; with manipulation, w/wo skeletal traction" 245051 CDM 521 RC 24505 HCPCS facility both 911 911 Gross Charge Type: NIHD_Clinic_Price 24505 CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ TechFee 245052 CDM 450 RC facility both 999 999 Gross Charge Type: NIHD_Hosp_Profee_Price 24505 CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ TechFee 245052 CDM 450 RC facility both 999 999 Gross Charge Type: NIHD_Hosp_Profee_Price "24505 CLOSED TREATMENT OF HUMERAL SHAFT FRACTURE; WITH MANIPULATION, WITH OR WITHOUT SKELETA ProFee" 245053 CDM 982 RC 24505 HCPCS facility both 900 900 Gross Charge Type: NIHD_Hosp_Profee_Price "24505 CLOSED TREATMENT OF HUMERAL SHAFT FRACTURE; WITH MANIPULATION, WITH OR WITHOUT SKELETA ProFee" 245053 CDM 982 RC 24505 HCPCS facility both 900 900 Gross Charge Type: NIHD_Hosp_Profee_Price "24515 OPEN TREATMENT OF HUMERAL SHAFT FRACTURE WITH PLATE/SCREWS, WITH OR WITHOUT CERCLAGE ProFee" 24515 CDM 982 RC 24515 HCPCS facility both 1809 1809 Gross Charge Type: NIHD_Hosp_Profee_Price "24515 OPEN TREATMENT OF HUMERAL SHAFT FRACTURE WITH PLATE/SCREWS, WITH OR WITHOUT CERCLAGE ProFee" 24515 CDM 982 RC 24515 HCPCS facility both 1809 1809 Gross Charge Type: NIHD_Hosp_Profee_Price 24516 ASST IMN SHAFT 24516 CDM 982 RC 24516 HCPCS facility both 440 440 Gross Charge Type: NIHD_Hosp_Profee_Price 24516 ASST IMN SHAFT 24516 CDM 982 RC 24516 HCPCS facility both 440 440 Gross Charge Type: NIHD_Hosp_Profee_Price "24530 Closed tx supra/transcondylar humeral fx, w/wo intercondylar extension; w/o manip" 24530 CDM 521 RC 24530 HCPCS facility both 1409 1409 Gross Charge Type: NIHD_Clinic_Price "24535 Closed tx supra/transcondylar humeral fx, w/wo intercondylar extension; w/ manip" 24535 CDM 521 RC 24535 HCPCS facility both 955 955 Gross Charge Type: NIHD_RHC_Price "24535 Closed tx supra/transcondylar humeral fx, w/wo intercondylar extension; w/ manip" 24535 CDM 521 RC 24535 HCPCS facility both 955 955 Gross Charge Type: NIHD_Clinic_Price "24535 CLOSED TREATMENT OF SUPRACONDYLAR OR TRANSCONDYLAR HUMERAL FRACTURE, WITH OR WITHOUT I ProFee" 245351 CDM 982 RC 24535 HCPCS facility both 1851 1851 Gross Charge Type: NIHD_Hosp_Profee_Price "24535 CLOSED TREATMENT OF SUPRACONDYLAR OR TRANSCONDYLAR HUMERAL FRACTURE, WITH OR WITHOUT I ProFee" 245351 CDM 982 RC 24535 HCPCS facility both 1851 1851 Gross Charge Type: NIHD_Hosp_Profee_Price "24538 PERCUTANEOUS SKELETAL FIXATION OF SUPRACONDYLAR OR TRANSCONDYLAR HUMERAL FRACTURE, WIT ProFee" 24538 CDM 982 RC 24538 HCPCS facility both 1560 1560 Gross Charge Type: NIHD_Hosp_Profee_Price "24538 PERCUTANEOUS SKELETAL FIXATION OF SUPRACONDYLAR OR TRANSCONDYLAR HUMERAL FRACTURE, WIT ProFee" 24538 CDM 982 RC 24538 HCPCS facility both 1560 1560 Gross Charge Type: NIHD_Hosp_Profee_Price "24545 OPEN TREATMENT OF HUMERAL SUPRACONDYLAR OR TRANSCONDYLAR FRACTURE, INCLUDES INTERNAL F ProFee" 24545 CDM 982 RC 24545 HCPCS facility both 1934 1934 Gross Charge Type: NIHD_Hosp_Profee_Price "24545 OPEN TREATMENT OF HUMERAL SUPRACONDYLAR OR TRANSCONDYLAR FRACTURE, INCLUDES INTERNAL F ProFee" 24545 CDM 982 RC 24545 HCPCS facility both 1934 1934 Gross Charge Type: NIHD_Hosp_Profee_Price "24560 Closed treatment of humeral epicondylar fracture, medial or lateral; without manipulation" 24560 CDM 521 RC 24560 HCPCS facility both 529 529 Gross Charge Type: NIHD_RHC_Price "24560 Closed treatment of humeral epicondylar fracture, medial or lateral; without manipulation" 24560 CDM 521 RC 24560 HCPCS facility both 529 529 Gross Charge Type: NIHD_Clinic_Price "24575 OPEN TREATMENT OF HUMERAL EPICONDYLAR FRACTURE, MEDIAL OR LATERAL, INCLUDES INTERNAL F ProFee" 24575 CDM 982 RC 24575 HCPCS facility both 1398 1398 Gross Charge Type: NIHD_Hosp_Profee_Price "24575 OPEN TREATMENT OF HUMERAL EPICONDYLAR FRACTURE, MEDIAL OR LATERAL, INCLUDES INTERNAL F ProFee" 24575 CDM 982 RC 24575 HCPCS facility both 1398 1398 Gross Charge Type: NIHD_Hosp_Profee_Price "24576 Closed treatment of humeral condylar fracture, medial or lateral; without manipulation" 24576 CDM 521 RC 24576 HCPCS facility both 552 552 Gross Charge Type: NIHD_RHC_Price "24576 Closed treatment of humeral condylar fracture, medial or lateral; without manipulation" 24576 CDM 521 RC 24576 HCPCS facility both 552 552 Gross Charge Type: NIHD_Clinic_Price "24579 OPEN TREATMENT OF HUMERAL CONDYLAR FRACTURE, MEDIAL OR LATERAL, INCLUDES INTERNAL FIXA ProFee" 24579 CDM 982 RC 24579 HCPCS facility both 1747 1747 Gross Charge Type: NIHD_Hosp_Profee_Price "24579 OPEN TREATMENT OF HUMERAL CONDYLAR FRACTURE, MEDIAL OR LATERAL, INCLUDES INTERNAL FIXA ProFee" 24579 CDM 982 RC 24579 HCPCS facility both 1747 1747 Gross Charge Type: NIHD_Hosp_Profee_Price 24586 OPEN TREATMENT OF PERIARTICULAR FRACTURE AND/OR DISLOCATION OF THE ELBOW (FRACTURE DIS ProFee 24586 CDM 982 RC 24586 HCPCS facility both 2184 2184 Gross Charge Type: NIHD_Hosp_Profee_Price 24586 OPEN TREATMENT OF PERIARTICULAR FRACTURE AND/OR DISLOCATION OF THE ELBOW (FRACTURE DIS ProFee 24586 CDM 982 RC 24586 HCPCS facility both 2184 2184 Gross Charge Type: NIHD_Hosp_Profee_Price 24600 TREATMENT CLOSED ELBOW DISLOCATION W/O ANES TechFee 246001 CDM 450 RC facility both 551 551 Gross Charge Type: NIHD_Hosp_Profee_Price 24600 TREATMENT CLOSED ELBOW DISLOCATION W/O ANES TechFee 246001 CDM 450 RC facility both 551 551 Gross Charge Type: NIHD_Hosp_Profee_Price 24600 TREATMENT OF CLOSED ELBOW DISLOCATION; WITHOUT ANESTHESIA ProFee 246002 CDM 982 RC 24600 HCPCS facility both 624 624 Gross Charge Type: NIHD_Hosp_Profee_Price 24600 TREATMENT OF CLOSED ELBOW DISLOCATION; WITHOUT ANESTHESIA ProFee 246002 CDM 982 RC 24600 HCPCS facility both 624 624 Gross Charge Type: NIHD_Hosp_Profee_Price 24605 TREATMENT OF CLOSED ELBOW DISLOCATION; REQUIRING ANESTHESIA ProFee 24605 CDM 982 RC 24605 HCPCS facility both 936 936 Gross Charge Type: NIHD_Hosp_Profee_Price 24605 TREATMENT OF CLOSED ELBOW DISLOCATION; REQUIRING ANESTHESIA ProFee 24605 CDM 982 RC 24605 HCPCS facility both 936 936 Gross Charge Type: NIHD_Hosp_Profee_Price 24635 OPEN TREATMENT OF MONTEGGIA TYPE OF FRACTURE DISLOCATION AT ELBOW (FRACTURE PROXIMAL E ProFee 24635 CDM 982 RC 24635 HCPCS facility both 1398 1398 Gross Charge Type: NIHD_Hosp_Profee_Price 24635 OPEN TREATMENT OF MONTEGGIA TYPE OF FRACTURE DISLOCATION AT ELBOW (FRACTURE PROXIMAL E ProFee 24635 CDM 982 RC 24635 HCPCS facility both 1398 1398 Gross Charge Type: NIHD_Hosp_Profee_Price "24640 Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation" 246401 CDM 521 RC 24640 HCPCS facility both 599 599 Gross Charge Type: NIHD_RHC_Price "24640 Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation" 246401 CDM 521 RC 24640 HCPCS facility both 600 600 Gross Charge Type: NIHD_Clinic_Price 24640 CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ TechFee 246402 CDM 450 RC facility both 551 551 Gross Charge Type: NIHD_Hosp_Profee_Price 24640 CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ TechFee 246402 CDM 450 RC facility both 551 551 Gross Charge Type: NIHD_Hosp_Profee_Price "24640 CLOSED TREATMENT OF RADIAL HEAD SUBLUXATION IN CHILD, NURSEMAID ELBOW, WITH MANIPULATI ProFee" 246403 CDM 982 RC 24640 HCPCS facility both 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price "24640 CLOSED TREATMENT OF RADIAL HEAD SUBLUXATION IN CHILD, NURSEMAID ELBOW, WITH MANIPULATI ProFee" 246403 CDM 982 RC 24640 HCPCS facility both 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price 24650 Closed treatment of radial head or neck fracture; without manipulation 246501 CDM 521 RC 24650 HCPCS facility both 1076 1076 Gross Charge Type: NIHD_Clinic_Price 24650 CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION TechFee 246502 CDM 450 RC facility both 663 663 Gross Charge Type: NIHD_Hosp_Profee_Price 24650 CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION TechFee 246502 CDM 450 RC facility both 663 663 Gross Charge Type: NIHD_Hosp_Profee_Price 24650 CLOSED TREATMENT OF RADIAL HEAD OR NECK FRACTURE; WITHOUT MANIPULATION ProFee 246503 CDM 982 RC 24650 HCPCS facility both 1100 1100 Gross Charge Type: NIHD_Hosp_Profee_Price 24650 CLOSED TREATMENT OF RADIAL HEAD OR NECK FRACTURE; WITHOUT MANIPULATION ProFee 246503 CDM 982 RC 24650 HCPCS facility both 1100 1100 Gross Charge Type: NIHD_Hosp_Profee_Price 24655 - Radial Head/Neck w/ Manipulation 246551 CDM 450 RC facility both 676 676 Gross Charge Type: NIHD_Hosp_Profee_Price 24655 - Radial Head/Neck w/ Manipulation 246551 CDM 450 RC facility both 676 676 Gross Charge Type: NIHD_Hosp_Profee_Price 24655 CLOSED TREATMENT OF RADIAL HEAD OR NECK FRACTURE; WITH MANIPULATION ProFee 246552 CDM 982 RC 24655 HCPCS facility both 707 707 Gross Charge Type: NIHD_Hosp_Profee_Price 24655 CLOSED TREATMENT OF RADIAL HEAD OR NECK FRACTURE; WITH MANIPULATION ProFee 246552 CDM 982 RC 24655 HCPCS facility both 707 707 Gross Charge Type: NIHD_Hosp_Profee_Price "24665 OPEN TREATMENT OF RADIAL HEAD OR NECK FRACTURE, INCLUDES INTERNAL FIXATION OR RADIAL H ProFee" 24665 CDM 982 RC 24665 HCPCS facility both 1373 1373 Gross Charge Type: NIHD_Hosp_Profee_Price "24665 OPEN TREATMENT OF RADIAL HEAD OR NECK FRACTURE, INCLUDES INTERNAL FIXATION OR RADIAL H ProFee" 24665 CDM 982 RC 24665 HCPCS facility both 1373 1373 Gross Charge Type: NIHD_Hosp_Profee_Price "24666 OPEN TREATMENT OF RADIAL HEAD OR NECK FRACTURE, INCLUDES INTERNAL FIXATION OR RADIAL H ProFee" 24666 CDM 982 RC 24666 HCPCS facility both 1110 1110 Gross Charge Type: NIHD_Hosp_Profee_Price "24666 OPEN TREATMENT OF RADIAL HEAD OR NECK FRACTURE, INCLUDES INTERNAL FIXATION OR RADIAL H ProFee" 24666 CDM 982 RC 24666 HCPCS facility both 1110 1110 Gross Charge Type: NIHD_Hosp_Profee_Price "24670 CLOSED TREATMENT OF ULNAR FRACTURE, PROXIMAL END (EG, OLECRANON OR CORONOID PROCESS[ES ProFee" 24670 CDM 982 RC 24670 HCPCS facility both 624 624 Gross Charge Type: NIHD_Hosp_Profee_Price "24670 CLOSED TREATMENT OF ULNAR FRACTURE, PROXIMAL END (EG, OLECRANON OR CORONOID PROCESS[ES ProFee" 24670 CDM 982 RC 24670 HCPCS facility both 624 624 Gross Charge Type: NIHD_Hosp_Profee_Price "24675 CLOSED TREATMENT OF ULNAR FRACTURE, PROXIMAL END (EG, OLECRANON OR CORONOID PROCESS[ES ProFee" 24675 CDM 982 RC 24675 HCPCS facility both 2208 2208 Gross Charge Type: NIHD_Hosp_Profee_Price "24675 CLOSED TREATMENT OF ULNAR FRACTURE, PROXIMAL END (EG, OLECRANON OR CORONOID PROCESS[ES ProFee" 24675 CDM 982 RC 24675 HCPCS facility both 2208 2208 Gross Charge Type: NIHD_Hosp_Profee_Price "24685 OPEN TREATMENT OF ULNAR FRACTURE, PROXIMAL END (EG, OLECRANON OR CORONOID PROCESS[ES]) ProFee" 24685 CDM 982 RC 24685 HCPCS facility both 1373 1373 Gross Charge Type: NIHD_Hosp_Profee_Price "24685 OPEN TREATMENT OF ULNAR FRACTURE, PROXIMAL END (EG, OLECRANON OR CORONOID PROCESS[ES]) ProFee" 24685 CDM 982 RC 24685 HCPCS facility both 1373 1373 Gross Charge Type: NIHD_Hosp_Profee_Price EpiFix 4x4cm SHEET 2472316 CDM 636 RC facility both 543 543 Gross Charge Type: NIHD_Hosp_Profee_Price EpiFix 4x4cm SHEET 2472316 CDM 636 RC facility both 543 543 Gross Charge Type: NIHD_Hosp_Profee_Price "25000 INCISION, EXTENSOR TENDON SHEATH, WRIST (EG, DEQUERVAINS DISEASE) ProFee" 25000 CDM 982 RC 25000 HCPCS facility both 621 621 Gross Charge Type: NIHD_Hosp_Profee_Price "25000 INCISION, EXTENSOR TENDON SHEATH, WRIST (EG, DEQUERVAINS DISEASE) ProFee" 25000 CDM 982 RC 25000 HCPCS facility both 621 621 Gross Charge Type: NIHD_Hosp_Profee_Price TRIATHLON CRUCIATE RETAINING FEMORAL SZ #1 LEFT 2500111 CDM 278 RC facility both 23508 23508 Gross Charge Type: NIHD_Hosp_Profee_Price TRIATHLON CRUCIATE RETAINING FEMORAL SZ #1 LEFT 2500111 CDM 278 RC facility both 23508 23508 Gross Charge Type: NIHD_Hosp_Profee_Price TRIATHLON BEARING INSERT SIZE #2 X 12MM 2500112 CDM 278 RC facility both 11346 11346 Gross Charge Type: NIHD_Hosp_Profee_Price TRIATHLON BEARING INSERT SIZE #2 X 12MM 2500112 CDM 278 RC facility both 11346 11346 Gross Charge Type: NIHD_Hosp_Profee_Price MONOCRYL 0 SUTURE 27INCHES LONG SH NEEDLE 2500120 CDM 272 RC facility both 15 15 Gross Charge Type: NIHD_Hosp_Profee_Price MONOCRYL 0 SUTURE 27INCHES LONG SH NEEDLE 2500120 CDM 272 RC facility both 15 15 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW LOW PROFILE CORTICAL 2.7X 24 2500121 CDM 278 RC facility both 135 135 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW LOW PROFILE CORTICAL 2.7X 24 2500121 CDM 278 RC facility both 135 135 Gross Charge Type: NIHD_Hosp_Profee_Price Comprehensive VRS Glenoid with F.A.S.T. 2500350 CDM 278 RC facility both 33651 33651 Gross Charge Type: NIHD_Hosp_Profee_Price Comprehensive VRS Glenoid with F.A.S.T. 2500350 CDM 278 RC facility both 33651 33651 Gross Charge Type: NIHD_Hosp_Profee_Price "25020 DECOMPRESSION FASCIOTOMY, FOREARM AND/OR WRIST, FLEXOR OR EXTENSOR COMPARTMENT; WITHOU ProFee" 25020 CDM 982 RC 25020 HCPCS facility both 1225 1225 Gross Charge Type: NIHD_Hosp_Profee_Price "25020 DECOMPRESSION FASCIOTOMY, FOREARM AND/OR WRIST, FLEXOR OR EXTENSOR COMPARTMENT; WITHOU ProFee" 25020 CDM 982 RC 25020 HCPCS facility both 1225 1225 Gross Charge Type: NIHD_Hosp_Profee_Price Q2Roller Lateral Turning Device 2502409 CDM 272 RC facility both 333 333 Gross Charge Type: NIHD_Hosp_Profee_Price Q2Roller Lateral Turning Device 2502409 CDM 272 RC facility both 333 333 Gross Charge Type: NIHD_Hosp_Profee_Price "25028 INCISION AND DRAINAGE, FOREARM AND/OR WRIST; DEEP ABSCESS OR HEMATOMA ProFee" 25028 CDM 982 RC 25028 HCPCS facility both 1075 1075 Gross Charge Type: NIHD_Hosp_Profee_Price "25028 INCISION AND DRAINAGE, FOREARM AND/OR WRIST; DEEP ABSCESS OR HEMATOMA ProFee" 25028 CDM 982 RC 25028 HCPCS facility both 1075 1075 Gross Charge Type: NIHD_Hosp_Profee_Price "25040 ARTHROTOMY, RADIOCARPAL OR MIDCARPAL JOINT, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF ProFee" 25040 CDM 982 RC 25040 HCPCS facility both 1061 1061 Gross Charge Type: NIHD_Hosp_Profee_Price "25040 ARTHROTOMY, RADIOCARPAL OR MIDCARPAL JOINT, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF ProFee" 25040 CDM 982 RC 25040 HCPCS facility both 1061 1061 Gross Charge Type: NIHD_Hosp_Profee_Price "25075 Excision, tumor, soft tissue of forearm and/or wrist area, subcutaneous; less than 3 cm" 25075 CDM 521 RC 25075 HCPCS facility both 1852 1852 Gross Charge Type: NIHD_Clinic_Price "25076 EXCISION, TUMOR, SOFT TISSUE OF FOREARM AND/OR WRIST AREA, SUBFASCIAL (EG, INTRAMUSCUL ProFee" 25076 CDM 982 RC 25076 HCPCS facility both 1606.02 1606.02 Gross Charge Type: NIHD_Hosp_Profee_Price "25076 EXCISION, TUMOR, SOFT TISSUE OF FOREARM AND/OR WRIST AREA, SUBFASCIAL (EG, INTRAMUSCUL ProFee" 25076 CDM 982 RC 25076 HCPCS facility both 1606.02 1606.02 Gross Charge Type: NIHD_Hosp_Profee_Price "25101 ARTHROTOMY, WRIST JOINT; WITH JOINT EXPLORATION, WITH OR WITHOUT BIOPSY, WITH OR WITHO ProFee" 25101 CDM 982 RC 25101 HCPCS facility both 714 714 Gross Charge Type: NIHD_Hosp_Profee_Price "25101 ARTHROTOMY, WRIST JOINT; WITH JOINT EXPLORATION, WITH OR WITHOUT BIOPSY, WITH OR WITHO ProFee" 25101 CDM 982 RC 25101 HCPCS facility both 714 714 Gross Charge Type: NIHD_Hosp_Profee_Price "25111 EXCISION OF GANGLION, WRIST (DORSAL OR VOLAR); PRIMARY ProFee" 25111 CDM 982 RC 25111 HCPCS facility both 676 676 Gross Charge Type: NIHD_Hosp_Profee_Price "25111 EXCISION OF GANGLION, WRIST (DORSAL OR VOLAR); PRIMARY ProFee" 25111 CDM 982 RC 25111 HCPCS facility both 676 676 Gross Charge Type: NIHD_Hosp_Profee_Price "25115 RADICAL EXCISION OF BURSA, SYNOVIA OF WRIST, OR FOREARM TENDON SHEATHS (EG, TENOSYNOVI ProFee" 25115 CDM 982 RC 25115 HCPCS facility both 1333 1333 Gross Charge Type: NIHD_Hosp_Profee_Price "25115 RADICAL EXCISION OF BURSA, SYNOVIA OF WRIST, OR FOREARM TENDON SHEATHS (EG, TENOSYNOVI ProFee" 25115 CDM 982 RC 25115 HCPCS facility both 1333 1333 Gross Charge Type: NIHD_Hosp_Profee_Price "25118 SYNOVECTOMY, EXTENSOR TENDON SHEATH, WRIST, SINGLE COMPARTMENT; ProFee" 25118 CDM 982 RC 25118 HCPCS facility both 1244 1244 Gross Charge Type: NIHD_Hosp_Profee_Price "25118 SYNOVECTOMY, EXTENSOR TENDON SHEATH, WRIST, SINGLE COMPARTMENT; ProFee" 25118 CDM 982 RC 25118 HCPCS facility both 1244 1244 Gross Charge Type: NIHD_Hosp_Profee_Price 25120 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF RADIUS OR ULNA (EXCLUDING HEAD O ProFee 25120 CDM 982 RC 25120 HCPCS facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price 25120 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF RADIUS OR ULNA (EXCLUDING HEAD O ProFee 25120 CDM 982 RC 25120 HCPCS facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "XI RELOAD,SUREFORM 60 3.5 Blue" 2523701 CDM 272 RC facility both 723 723 Gross Charge Type: NIHD_Hosp_Profee_Price "XI RELOAD,SUREFORM 60 3.5 Blue" 2523701 CDM 272 RC facility both 723 723 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Wrist Right - Report 252461 CDM 982 RC 25246 HCPCS facility both 26RT 133 133 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Wrist Right - Report 252461 CDM 982 RC 25246 HCPCS facility both 26RT 133 133 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Wrist Left 252463 CDM 320 RC facility both 133 133 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Wrist Left 252463 CDM 320 RC facility both 133 133 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Wrist Right 252465 CDM 320 RC facility both 133 133 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Wrist Right 252465 CDM 320 RC facility both 133 133 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Wrist Left - Report 252466 CDM 982 RC 25246 HCPCS facility both 26LT 133 133 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Wrist Left - Report 252466 CDM 982 RC 25246 HCPCS facility both 26LT 133 133 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Wrist Left 252467 CDM 361 RC facility both TCLT 793 793 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Wrist Left 252467 CDM 361 RC facility both TCLT 793 793 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Wrist Right 252468 CDM 361 RC facility both TCRT 793 793 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Wrist Right 252468 CDM 361 RC facility both TCRT 793 793 Gross Charge Type: NIHD_Hosp_Profee_Price "25260 REPAIR, TENDON OR MUSCLE, FLEXOR, FOREARM AND/OR WRIST; PRIMARY, SINGLE, EACH TENDON O ProFee" 25260 CDM 982 RC 25260 HCPCS facility both 1151 1151 Gross Charge Type: NIHD_Hosp_Profee_Price "25260 REPAIR, TENDON OR MUSCLE, FLEXOR, FOREARM AND/OR WRIST; PRIMARY, SINGLE, EACH TENDON O ProFee" 25260 CDM 982 RC 25260 HCPCS facility both 1151 1151 Gross Charge Type: NIHD_Hosp_Profee_Price AcrySof IQ PanOptix Trifocal IOL 8.0 2526509 CDM 276 RC facility both 995 995 Gross Charge Type: NIHD_Hosp_Profee_Price AcrySof IQ PanOptix Trifocal IOL 8.0 2526509 CDM 276 RC facility both 995 995 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON PANOPTIX TORIC IOL CNWTT4 7.0 2526510 CDM 276 RC facility both 995 995 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON PANOPTIX TORIC IOL CNWTT4 7.0 2526510 CDM 276 RC facility both 995 995 Gross Charge Type: NIHD_Hosp_Profee_Price "25270 REPAIR, TENDON OR MUSCLE, EXTENSOR, FOREARM AND/OR WRIST; PRIMARY, SINGLE, EACH TENDON ProFee" 25270 CDM 982 RC 25270 HCPCS facility both 757 757 Gross Charge Type: NIHD_Hosp_Profee_Price "25270 REPAIR, TENDON OR MUSCLE, EXTENSOR, FOREARM AND/OR WRIST; PRIMARY, SINGLE, EACH TENDON ProFee" 25270 CDM 982 RC 25270 HCPCS facility both 757 757 Gross Charge Type: NIHD_Hosp_Profee_Price Pressure Monitoring Kit with Single Pressure Transducer 2527457 CDM 272 RC facility both 58 58 Gross Charge Type: NIHD_Hosp_Profee_Price Pressure Monitoring Kit with Single Pressure Transducer 2527457 CDM 272 RC facility both 58 58 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON PANOPTIX TORIC IOL CNWTT412.5 2528111 CDM 276 RC facility both 995 995 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON PANOPTIX TORIC IOL CNWTT412.5 2528111 CDM 276 RC facility both 995 995 Gross Charge Type: NIHD_Hosp_Profee_Price "25295 TENOLYSIS, FLEXOR OR EXTENSOR TENDON, FOREARM AND/OR WRIST, SINGLE, EACH TENDON ProFee" 25295 CDM 982 RC 25295 HCPCS facility both 808 808 Gross Charge Type: NIHD_Hosp_Profee_Price "25295 TENOLYSIS, FLEXOR OR EXTENSOR TENDON, FOREARM AND/OR WRIST, SINGLE, EACH TENDON ProFee" 25295 CDM 982 RC 25295 HCPCS facility both 808 808 Gross Charge Type: NIHD_Hosp_Profee_Price "25312 TENDON TRANSPLANTATION OR TRANSFER, FLEXOR OR EXTENSOR, FOREARM AND/OR WRIST, SINGLE; ProFee" 25312 CDM 975 RC 25312 HCPCS facility both 1088 1088 Gross Charge Type: NIHD_Hosp_Profee_Price "25312 TENDON TRANSPLANTATION OR TRANSFER, FLEXOR OR EXTENSOR, FOREARM AND/OR WRIST, SINGLE; ProFee" 25312 CDM 975 RC 25312 HCPCS facility both 1088 1088 Gross Charge Type: NIHD_Hosp_Profee_Price "Puracol Plus AG+ Collagen Wound Dressing with Silver, 2"" W x 2.22"" L, in Educational Packaging" 2540496 CDM 272 RC facility both 21 21 Gross Charge Type: NIHD_Hosp_Profee_Price "Puracol Plus AG+ Collagen Wound Dressing with Silver, 2"" W x 2.22"" L, in Educational Packaging" 2540496 CDM 272 RC facility both 21 21 Gross Charge Type: NIHD_Hosp_Profee_Price "25415 REPAIR OF NONUNION OR MALUNION, RADIUS AND ULNA; WITHOUT GRAFT (EG, COMPRESSION TECHNI ProFee" 25415 CDM 982 RC 25415 HCPCS facility both 1997 1997 Gross Charge Type: NIHD_Hosp_Profee_Price "25415 REPAIR OF NONUNION OR MALUNION, RADIUS AND ULNA; WITHOUT GRAFT (EG, COMPRESSION TECHNI ProFee" 25415 CDM 982 RC 25415 HCPCS facility both 1997 1997 Gross Charge Type: NIHD_Hosp_Profee_Price Compartment Pressure Monitoring Kit 2542393 CDM 272 RC facility both 212 212 Gross Charge Type: NIHD_Hosp_Profee_Price Compartment Pressure Monitoring Kit 2542393 CDM 272 RC facility both 212 212 Gross Charge Type: NIHD_Hosp_Profee_Price "Nonadhering Dressing, Silicone, 3"" x 4.25""" 2542464 CDM 272 RC facility both 37 37 Gross Charge Type: NIHD_Hosp_Profee_Price "Nonadhering Dressing, Silicone, 3"" x 4.25""" 2542464 CDM 272 RC facility both 37 37 Gross Charge Type: NIHD_Hosp_Profee_Price Matrix AG 4.34 x 4.34 Dressing 2544344 CDM 272 RC facility both 47 47 Gross Charge Type: NIHD_Hosp_Profee_Price Matrix AG 4.34 x 4.34 Dressing 2544344 CDM 272 RC facility both 47 47 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON VIVITY IOL CNWETO 12.5 2544600 CDM 276 RC facility both 1015 1015 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON VIVITY IOL CNWETO 12.5 2544600 CDM 276 RC facility both 1015 1015 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON VIVITY IOL CNWETO 13.0 2544601 CDM 276 RC facility both 1015 1015 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON VIVITY IOL CNWETO 13.0 2544601 CDM 276 RC facility both 1015 1015 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON VIVITY IOL CNWETO 13.5 2544602 CDM 276 RC facility both 1015 1015 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON VIVITY IOL CNWETO 13.5 2544602 CDM 276 RC facility both 1015 1015 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON VIVITY IOL CNWETO 20.0 2544603 CDM 276 RC facility both 1015 1015 Gross Charge Type: NIHD_Hosp_Profee_Price CLAREON VIVITY IOL CNWETO 20.0 2544603 CDM 276 RC facility both 1015 1015 Gross Charge Type: NIHD_Hosp_Profee_Price "25447 ARTHROPLASTY, INTERPOSITION, INTERCARPAL OR CARPOMETACARPAL JOINTS ProFee" 25447 CDM 982 RC 25447 HCPCS facility both 1264 1264 Gross Charge Type: NIHD_Hosp_Profee_Price "25447 ARTHROPLASTY, INTERPOSITION, INTERCARPAL OR CARPOMETACARPAL JOINTS ProFee" 25447 CDM 982 RC 25447 HCPCS facility both 1264 1264 Gross Charge Type: NIHD_Hosp_Profee_Price 25505 CLOSED TREATMENT OF RADIAL SHAFT FRACTURE; WITH MANIPULATION ProFee 25505 CDM 982 RC 25505 HCPCS facility both 924 924 Gross Charge Type: NIHD_Hosp_Profee_Price 25505 CLOSED TREATMENT OF RADIAL SHAFT FRACTURE; WITH MANIPULATION ProFee 25505 CDM 982 RC 25505 HCPCS facility both 924 924 Gross Charge Type: NIHD_Hosp_Profee_Price "25515 OPEN TREATMENT OF RADIAL SHAFT FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED ProFee" 25515 CDM 982 RC 25515 HCPCS facility both 1398 1398 Gross Charge Type: NIHD_Hosp_Profee_Price "25515 OPEN TREATMENT OF RADIAL SHAFT FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED ProFee" 25515 CDM 982 RC 25515 HCPCS facility both 1398 1398 Gross Charge Type: NIHD_Hosp_Profee_Price 25520 CLOSED TREATMENT OF RADIAL SHAFT FRACTURE AND CLOSED TREATMENT OF DISLOCATION OF DISTA ProFee 25520 CDM 982 RC 25520 HCPCS facility both 982 982 Gross Charge Type: NIHD_Hosp_Profee_Price 25520 CLOSED TREATMENT OF RADIAL SHAFT FRACTURE AND CLOSED TREATMENT OF DISLOCATION OF DISTA ProFee 25520 CDM 982 RC 25520 HCPCS facility both 982 982 Gross Charge Type: NIHD_Hosp_Profee_Price "25525 OPEN TREATMENT OF RADIAL SHAFT FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, A ProFee" 25525 CDM 982 RC 25525 HCPCS facility both 1652 1652 Gross Charge Type: NIHD_Hosp_Profee_Price "25525 OPEN TREATMENT OF RADIAL SHAFT FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, A ProFee" 25525 CDM 982 RC 25525 HCPCS facility both 1652 1652 Gross Charge Type: NIHD_Hosp_Profee_Price "25526 OPEN TREATMENT OF RADIAL SHAFT FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, A ProFee" 25526 CDM 982 RC 25526 HCPCS facility both 1728 1728 Gross Charge Type: NIHD_Hosp_Profee_Price "25526 OPEN TREATMENT OF RADIAL SHAFT FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, A ProFee" 25526 CDM 982 RC 25526 HCPCS facility both 1728 1728 Gross Charge Type: NIHD_Hosp_Profee_Price 25530 CLOSED TREATMENT OF ULNAR SHAFT FRACTURE; WITHOUT MANIPULATION ProFee 25530 CDM 982 RC 25530 HCPCS facility both 423 423 Gross Charge Type: NIHD_Hosp_Profee_Price 25530 CLOSED TREATMENT OF ULNAR SHAFT FRACTURE; WITHOUT MANIPULATION ProFee 25530 CDM 982 RC 25530 HCPCS facility both 423 423 Gross Charge Type: NIHD_Hosp_Profee_Price 25530 Closed treatment of ulnar shaft fracture; without manipulation 255301 CDM 521 RC 25530 HCPCS facility both 415 415 Gross Charge Type: NIHD_RHC_Price 25530 Closed treatment of ulnar shaft fracture; without manipulation 255301 CDM 521 RC 25530 HCPCS facility both 415 415 Gross Charge Type: NIHD_Clinic_Price 25535 CLOSED TREATMENT OF ULNAR SHAFT FRACTURE; WITH MANIPULATION ProFee 25535 CDM 982 RC 25535 HCPCS facility both 837 837 Gross Charge Type: NIHD_Hosp_Profee_Price 25535 CLOSED TREATMENT OF ULNAR SHAFT FRACTURE; WITH MANIPULATION ProFee 25535 CDM 982 RC 25535 HCPCS facility both 837 837 Gross Charge Type: NIHD_Hosp_Profee_Price Suture Anchor 2.5mm PEEK 2554377 CDM 272 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price Suture Anchor 2.5mm PEEK 2554377 CDM 272 RC facility both 1080 1080 Gross Charge Type: NIHD_Hosp_Profee_Price "25545 OPEN TREATMENT OF ULNAR SHAFT FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED ProFee" 25545 CDM 982 RC 25545 HCPCS facility both 1310 1310 Gross Charge Type: NIHD_Hosp_Profee_Price "25545 OPEN TREATMENT OF ULNAR SHAFT FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED ProFee" 25545 CDM 982 RC 25545 HCPCS facility both 1310 1310 Gross Charge Type: NIHD_Hosp_Profee_Price 25565 CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ TechFee 255651 CDM 450 RC facility both 563 563 Gross Charge Type: NIHD_Hosp_Profee_Price 25565 CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ TechFee 255651 CDM 450 RC facility both 563 563 Gross Charge Type: NIHD_Hosp_Profee_Price 25565 CLOSED TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES; WITH MANIPULATION ProFee 255652 CDM 982 RC 25565 HCPCS facility both 1086 1086 Gross Charge Type: NIHD_Hosp_Profee_Price 25565 CLOSED TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES; WITH MANIPULATION ProFee 255652 CDM 982 RC 25565 HCPCS facility both 1086 1086 Gross Charge Type: NIHD_Hosp_Profee_Price "25575 OPEN TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES, WITH INTERNAL FIXATION, WHEN PERFO ProFee" 25575 CDM 982 RC 25575 HCPCS facility both 1872 1872 Gross Charge Type: NIHD_Hosp_Profee_Price "25575 OPEN TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES, WITH INTERNAL FIXATION, WHEN PERFO ProFee" 25575 CDM 982 RC 25575 HCPCS facility both 1872 1872 Gross Charge Type: NIHD_Hosp_Profee_Price 25600 Closed treatment of distal radial fracture; without manipulation 256001 CDM 521 RC 25600 HCPCS facility both 983 983 Gross Charge Type: NIHD_Clinic_Price 25600 CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ TechFee 256002 CDM 450 RC facility both 613 613 Gross Charge Type: NIHD_Hosp_Profee_Price 25600 CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ TechFee 256002 CDM 450 RC facility both 613 613 Gross Charge Type: NIHD_Hosp_Profee_Price "25600 CLOSED TREATMENT OF DISTAL RADIAL FRACTURE (EG, COLLES OR SMITH TYPE) OR EPIPHYSEAL SE ProFee" 256003 CDM 982 RC 25600 HCPCS facility both 656 656 Gross Charge Type: NIHD_Hosp_Profee_Price "25600 CLOSED TREATMENT OF DISTAL RADIAL FRACTURE (EG, COLLES OR SMITH TYPE) OR EPIPHYSEAL SE ProFee" 256003 CDM 982 RC 25600 HCPCS facility both 656 656 Gross Charge Type: NIHD_Hosp_Profee_Price 25605 Closed treatment of distal radial fracture; with manipulation 256051 CDM 521 RC 25605 HCPCS facility both 2124 2124 Gross Charge Type: NIHD_Clinic_Price 25605 CLTX DSTL RDL FX/EPIPHYSL SEP W/MANJ WHEN PERF TechFee 256052 CDM 450 RC facility both 676 676 Gross Charge Type: NIHD_Hosp_Profee_Price 25605 CLTX DSTL RDL FX/EPIPHYSL SEP W/MANJ WHEN PERF TechFee 256052 CDM 450 RC facility both 676 676 Gross Charge Type: NIHD_Hosp_Profee_Price "25605 CLOSED TREATMENT OF DISTAL RADIAL FRACTURE (EG, COLLES OR SMITH TYPE) OR EPIPHYSEAL SE ProFee" 256053 CDM 982 RC 25605 HCPCS facility both 1124 1124 Gross Charge Type: NIHD_Hosp_Profee_Price "25605 CLOSED TREATMENT OF DISTAL RADIAL FRACTURE (EG, COLLES OR SMITH TYPE) OR EPIPHYSEAL SE ProFee" 256053 CDM 982 RC 25605 HCPCS facility both 1124 1124 Gross Charge Type: NIHD_Hosp_Profee_Price 25606 PERCUTANEOUS SKELETAL FIXATION OF DISTAL RADIAL FRACTURE OR EPIPHYSEAL SEPARATION ProFee 25606 CDM 982 RC 25606 HCPCS facility both 1248 1248 Gross Charge Type: NIHD_Hosp_Profee_Price 25606 PERCUTANEOUS SKELETAL FIXATION OF DISTAL RADIAL FRACTURE OR EPIPHYSEAL SEPARATION ProFee 25606 CDM 982 RC 25606 HCPCS facility both 1248 1248 Gross Charge Type: NIHD_Hosp_Profee_Price "25607 OPEN TREATMENT OF DISTAL RADIAL EXTRA-ARTICULAR FRACTURE OR EPIPHYSEAL SEPARATION, WIT ProFee" 25607 CDM 982 RC 25607 HCPCS facility both 1560 1560 Gross Charge Type: NIHD_Hosp_Profee_Price "25607 OPEN TREATMENT OF DISTAL RADIAL EXTRA-ARTICULAR FRACTURE OR EPIPHYSEAL SEPARATION, WIT ProFee" 25607 CDM 982 RC 25607 HCPCS facility both 1560 1560 Gross Charge Type: NIHD_Hosp_Profee_Price 25608 OPEN TREATMENT OF DISTAL RADIAL INTRA-ARTICULAR FRACTURE OR EPIPHYSEAL SEPARATION; WIT ProFee 25608 CDM 982 RC 25608 HCPCS facility both 1747 1747 Gross Charge Type: NIHD_Hosp_Profee_Price 25608 OPEN TREATMENT OF DISTAL RADIAL INTRA-ARTICULAR FRACTURE OR EPIPHYSEAL SEPARATION; WIT ProFee 25608 CDM 982 RC 25608 HCPCS facility both 1747 1747 Gross Charge Type: NIHD_Hosp_Profee_Price 25609 OPEN TREATMENT OF DISTAL RADIAL INTRA-ARTICULAR FRACTURE OR EPIPHYSEAL SEPARATION; WIT ProFee 25609 CDM 982 RC 25609 HCPCS facility both 2184 2184 Gross Charge Type: NIHD_Hosp_Profee_Price 25609 OPEN TREATMENT OF DISTAL RADIAL INTRA-ARTICULAR FRACTURE OR EPIPHYSEAL SEPARATION; WIT ProFee 25609 CDM 982 RC 25609 HCPCS facility both 2184 2184 Gross Charge Type: NIHD_Hosp_Profee_Price 25624 CLOSED TREATMENT OF CARPAL SCAPHOID (NAVICULAR) FRACTURE; WITH MANIPULATION ProFee 25624 CDM 982 RC 25624 HCPCS facility both 874 874 Gross Charge Type: NIHD_Hosp_Profee_Price 25624 CLOSED TREATMENT OF CARPAL SCAPHOID (NAVICULAR) FRACTURE; WITH MANIPULATION ProFee 25624 CDM 982 RC 25624 HCPCS facility both 874 874 Gross Charge Type: NIHD_Hosp_Profee_Price "25628 OPEN TREATMENT OF CARPAL SCAPHOID (NAVICULAR) FRACTURE, INCLUDES INTERNAL FIXATION, WH ProFee" 25628 CDM 982 RC 25628 HCPCS facility both 1523 1523 Gross Charge Type: NIHD_Hosp_Profee_Price "25628 OPEN TREATMENT OF CARPAL SCAPHOID (NAVICULAR) FRACTURE, INCLUDES INTERNAL FIXATION, WH ProFee" 25628 CDM 982 RC 25628 HCPCS facility both 1523 1523 Gross Charge Type: NIHD_Hosp_Profee_Price 25630 Closed treatment of carpal bone fracture; without manipulation 25630 CDM 521 RC 25630 HCPCS facility both 547 547 Gross Charge Type: NIHD_RHC_Price 25630 Closed treatment of carpal bone fracture; without manipulation 25630 CDM 521 RC 25630 HCPCS facility both 547 547 Gross Charge Type: NIHD_Clinic_Price "25645 OPEN TREATMENT OF CARPAL BONE FRACTURE (OTHER THAN CARPAL SCAPHOID [NAVICULAR]), EACH ProFee" 25645 CDM 982 RC 25645 HCPCS facility both 1187 1187 Gross Charge Type: NIHD_Hosp_Profee_Price "25645 OPEN TREATMENT OF CARPAL BONE FRACTURE (OTHER THAN CARPAL SCAPHOID [NAVICULAR]), EACH ProFee" 25645 CDM 982 RC 25645 HCPCS facility both 1187 1187 Gross Charge Type: NIHD_Hosp_Profee_Price 25650 Closed treatment of ulnar styloid fracture 25650 CDM 521 RC 25650 HCPCS facility both 523 523 Gross Charge Type: NIHD_RHC_Price 25650 Closed treatment of ulnar styloid fracture 25650 CDM 521 RC 25650 HCPCS facility both 523 523 Gross Charge Type: NIHD_Clinic_Price 25651 PERCUTANEOUS SKELETAL FIXATION OF ULNAR STYLOID FRACTURE ProFee 25651 CDM 982 RC 25651 HCPCS facility both 887 887 Gross Charge Type: NIHD_Hosp_Profee_Price 25651 PERCUTANEOUS SKELETAL FIXATION OF ULNAR STYLOID FRACTURE ProFee 25651 CDM 982 RC 25651 HCPCS facility both 887 887 Gross Charge Type: NIHD_Hosp_Profee_Price 25652 OPEN TREATMENT OF ULNAR STYLOID FRACTURE ProFee 25652 CDM 982 RC 25652 HCPCS facility both 1135 1135 Gross Charge Type: NIHD_Hosp_Profee_Price 25652 OPEN TREATMENT OF ULNAR STYLOID FRACTURE ProFee 25652 CDM 982 RC 25652 HCPCS facility both 1135 1135 Gross Charge Type: NIHD_Hosp_Profee_Price "25680 CLOSED TREATMENT OF TRANS-SCAPHOPERILUNAR TYPE OF FRACTURE DISLOCATION, WITH MANIPULAT ProFee" 25680 CDM 982 RC 25680 HCPCS facility both 950 950 Gross Charge Type: NIHD_Hosp_Profee_Price "25680 CLOSED TREATMENT OF TRANS-SCAPHOPERILUNAR TYPE OF FRACTURE DISLOCATION, WITH MANIPULAT ProFee" 25680 CDM 982 RC 25680 HCPCS facility both 950 950 Gross Charge Type: NIHD_Hosp_Profee_Price "25690 CLOSED TREATMENT OF LUNATE DISLOCATION, WITH MANIPULATION ProFee" 25690 CDM 25690 HCPCS facility both 758 758 Gross Charge Type: NIHD_Hosp_Profee_Price "25690 CLOSED TREATMENT OF LUNATE DISLOCATION, WITH MANIPULATION ProFee" 25690 CDM 25690 HCPCS facility both 758 758 Gross Charge Type: NIHD_Hosp_Profee_Price 25690 CLOSED TX LUNATE DISLOCATION W/MANIPULATION TechFee 256901 CDM 450 RC facility both 2087 2087 Gross Charge Type: NIHD_Hosp_Profee_Price 25690 CLOSED TX LUNATE DISLOCATION W/MANIPULATION TechFee 256901 CDM 450 RC facility both 2087 2087 Gross Charge Type: NIHD_Hosp_Profee_Price Clavicle Non Locking Screw 3.5 x 12 2570503 CDM 278 RC facility both 225 225 Gross Charge Type: NIHD_Hosp_Profee_Price Clavicle Non Locking Screw 3.5 x 12 2570503 CDM 278 RC facility both 225 225 Gross Charge Type: NIHD_Hosp_Profee_Price Polar Care Kodiak Cold Therapy Kit with Intelli-Flo Knee Pad Knee 2574338 CDM 272 RC facility both 234 234 Gross Charge Type: NIHD_Hosp_Profee_Price Polar Care Kodiak Cold Therapy Kit with Intelli-Flo Knee Pad Knee 2574338 CDM 272 RC facility both 234 234 Gross Charge Type: NIHD_Hosp_Profee_Price EpiCord 2x3cm 2590299 CDM 636 RC facility both 545 545 Gross Charge Type: NIHD_Hosp_Profee_Price EpiCord 2x3cm 2590299 CDM 636 RC facility both 545 545 Gross Charge Type: NIHD_Hosp_Profee_Price Bio-A Tissue Reinforcement 9x15 2590307 CDM 278 RC facility both 2048 2048 Gross Charge Type: NIHD_Hosp_Profee_Price Bio-A Tissue Reinforcement 9x15 2590307 CDM 278 RC facility both 2048 2048 Gross Charge Type: NIHD_Hosp_Profee_Price Clareon Panoptix Toric IOL CNWTT4 14.5 2596454 CDM 276 RC facility both 995 995 Gross Charge Type: NIHD_Hosp_Profee_Price Clareon Panoptix Toric IOL CNWTT4 14.5 2596454 CDM 276 RC facility both 995 995 Gross Charge Type: NIHD_Hosp_Profee_Price Locking Screw 2.7mm x 16 2598758 CDM 278 RC facility both 414 414 Gross Charge Type: NIHD_Hosp_Profee_Price Locking Screw 2.7mm x 16 2598758 CDM 278 RC facility both 414 414 Gross Charge Type: NIHD_Hosp_Profee_Price Locking Screw 2.7mm x 8mm 2600543 CDM 278 RC facility both 414 414 Gross Charge Type: NIHD_Hosp_Profee_Price Locking Screw 2.7mm x 8mm 2600543 CDM 278 RC facility both 414 414 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 FULL THREAD 3.5mm / L8mm 2600544 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price BONE SCREW T10 FULL THREAD 3.5mm / L8mm 2600544 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L44" 2600638 CDM 278 RC facility both 225 225 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L44" 2600638 CDM 278 RC facility both 225 225 Gross Charge Type: NIHD_Hosp_Profee_Price 26010 Drainage of finger abscess; simple 260101 CDM 521 RC 26010 HCPCS facility both 526 526 Gross Charge Type: NIHD_RHC_Price 26010 Drainage of finger abscess; simple 260101 CDM 521 RC 26010 HCPCS facility both 526 526 Gross Charge Type: NIHD_Clinic_Price 26010 DRAINAGE FINGER ABSCESS SIMPLE TechFee 260102 CDM 450 RC facility both 406 406 Gross Charge Type: NIHD_Hosp_Profee_Price 26010 DRAINAGE FINGER ABSCESS SIMPLE TechFee 260102 CDM 450 RC facility both 406 406 Gross Charge Type: NIHD_Hosp_Profee_Price 26010 DRAINAGE FINGER TIP ABSCESS SI CHARGE 260104 CDM 761 RC facility both 712 712 Gross Charge Type: NIHD_Hosp_Profee_Price 26010 DRAINAGE FINGER TIP ABSCESS SI CHARGE 260104 CDM 761 RC facility both 712 712 Gross Charge Type: NIHD_Hosp_Profee_Price 26010 DRAINAGE OF FINGER ABSCESS; SIMPLE ProFee 260105 CDM 982 RC 26010 HCPCS facility both 244 244 Gross Charge Type: NIHD_Hosp_Profee_Price 26010 DRAINAGE OF FINGER ABSCESS; SIMPLE ProFee 260105 CDM 982 RC 26010 HCPCS facility both 244 244 Gross Charge Type: NIHD_Hosp_Profee_Price 26011 DRAINAGE FINGER TIP ABSCESS CO CHARGE 26011 CDM 761 RC facility both 1078 1078 Gross Charge Type: NIHD_Hosp_Profee_Price 26011 DRAINAGE FINGER TIP ABSCESS CO CHARGE 26011 CDM 761 RC facility both 1078 1078 Gross Charge Type: NIHD_Hosp_Profee_Price 26011 DRAINAGE FINGER ABSCESS COMPLICATED TechFee 260111 CDM 450 RC facility both 2879 2879 Gross Charge Type: NIHD_Hosp_Profee_Price 26011 DRAINAGE FINGER ABSCESS COMPLICATED TechFee 260111 CDM 450 RC facility both 2879 2879 Gross Charge Type: NIHD_Hosp_Profee_Price "26011 DRAINAGE OF FINGER ABSCESS; COMPLICATED (EG, FELON) ProFee" 260112 CDM 982 RC 26011 HCPCS facility both 1174 1174 Gross Charge Type: NIHD_Hosp_Profee_Price "26011 DRAINAGE OF FINGER ABSCESS; COMPLICATED (EG, FELON) ProFee" 260112 CDM 982 RC 26011 HCPCS facility both 1174 1174 Gross Charge Type: NIHD_Hosp_Profee_Price "26020 DRAINAGE OF TENDON SHEATH, DIGIT AND/OR PALM, EACH ProFee" 26020 CDM 982 RC 26020 HCPCS facility both 924 924 Gross Charge Type: NIHD_Hosp_Profee_Price "26020 DRAINAGE OF TENDON SHEATH, DIGIT AND/OR PALM, EACH ProFee" 26020 CDM 982 RC 26020 HCPCS facility both 924 924 Gross Charge Type: NIHD_Hosp_Profee_Price "26025 DRAINAGE OF PALMAR BURSA; SINGLE, BURSA ProFee" 26025 CDM 982 RC 26025 HCPCS facility both 771 771 Gross Charge Type: NIHD_Hosp_Profee_Price "26025 DRAINAGE OF PALMAR BURSA; SINGLE, BURSA ProFee" 26025 CDM 982 RC 26025 HCPCS facility both 771 771 Gross Charge Type: NIHD_Hosp_Profee_Price "26034 INCISION, BONE CORTEX, HAND OR FINGER (EG, OSTEOMYELITIS OR BONE ABSCESS) ProFee" 26034 CDM 26034 HCPCS facility both 847 847 Gross Charge Type: NIHD_Hosp_Profee_Price "26034 INCISION, BONE CORTEX, HAND OR FINGER (EG, OSTEOMYELITIS OR BONE ABSCESS) ProFee" 26034 CDM 26034 HCPCS facility both 847 847 Gross Charge Type: NIHD_Hosp_Profee_Price "26045 FASCIOTOMY, PALMAR (EG, DUPUYTREN'S CONTRACTURE); OPEN, PARTIAL ProFee" 26045 CDM 982 RC 26045 HCPCS facility both 853 853 Gross Charge Type: NIHD_Hosp_Profee_Price "26045 FASCIOTOMY, PALMAR (EG, DUPUYTREN'S CONTRACTURE); OPEN, PARTIAL ProFee" 26045 CDM 982 RC 26045 HCPCS facility both 853 853 Gross Charge Type: NIHD_Hosp_Profee_Price "26055 TENDON SHEATH INCISION (EG, FOR TRIGGER FINGER) ProFee" 26055 CDM 982 RC 26055 HCPCS facility both 1211 1211 Gross Charge Type: NIHD_Hosp_Profee_Price "26055 TENDON SHEATH INCISION (EG, FOR TRIGGER FINGER) ProFee" 26055 CDM 982 RC 26055 HCPCS facility both 1211 1211 Gross Charge Type: NIHD_Hosp_Profee_Price "26075 ARTHROTOMY, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF LOOSE OR FOREIGN BODY; METACARPO ProFee" 26075 CDM 982 RC 26075 HCPCS facility both 595 595 Gross Charge Type: NIHD_Hosp_Profee_Price "26075 ARTHROTOMY, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF LOOSE OR FOREIGN BODY; METACARPO ProFee" 26075 CDM 982 RC 26075 HCPCS facility both 595 595 Gross Charge Type: NIHD_Hosp_Profee_Price "26080 ARTHROTOMY, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF LOOSE OR FOREIGN BODY; INTERPHAL ProFee" 26080 CDM 982 RC 26080 HCPCS facility both 799 799 Gross Charge Type: NIHD_Hosp_Profee_Price "26080 ARTHROTOMY, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF LOOSE OR FOREIGN BODY; INTERPHAL ProFee" 26080 CDM 982 RC 26080 HCPCS facility both 799 799 Gross Charge Type: NIHD_Hosp_Profee_Price TOGGLELOC 2.9MM W/NDLS 2608960 CDM 278 RC facility both 1676 1676 Gross Charge Type: NIHD_Hosp_Profee_Price TOGGLELOC 2.9MM W/NDLS 2608960 CDM 278 RC facility both 1676 1676 Gross Charge Type: NIHD_Hosp_Profee_Price "26111 EXCISION, TUMOR OR VASCULAR MALFORMATION, SOFT TISSUE OF HAND OR FINGER, SUBCUTANEOUS; ProFee" 26111 CDM 982 RC 26111 HCPCS facility both 764 764 Gross Charge Type: NIHD_Hosp_Profee_Price "26111 EXCISION, TUMOR OR VASCULAR MALFORMATION, SOFT TISSUE OF HAND OR FINGER, SUBCUTANEOUS; ProFee" 26111 CDM 982 RC 26111 HCPCS facility both 764 764 Gross Charge Type: NIHD_Hosp_Profee_Price "26115 EXCISION, TUMOR OR VASCULAR MALFORMATION, SOFT TISSUE OF HAND OR FINGER, SUBCUTANEOUS; ProFee" 26115 CDM 982 RC 26115 HCPCS facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price "26115 EXCISION, TUMOR OR VASCULAR MALFORMATION, SOFT TISSUE OF HAND OR FINGER, SUBCUTANEOUS; ProFee" 26115 CDM 982 RC 26115 HCPCS facility both 612 612 Gross Charge Type: NIHD_Hosp_Profee_Price "26160 EXCISION OF LESION OF TENDON SHEATH OR JOINT CAPSULE (EG, CYST, MUCOUS CYST, OR GANGLI ProFee" 26160 CDM 982 RC 26160 HCPCS facility both 1211 1211 Gross Charge Type: NIHD_Hosp_Profee_Price "26160 EXCISION OF LESION OF TENDON SHEATH OR JOINT CAPSULE (EG, CYST, MUCOUS CYST, OR GANGLI ProFee" 26160 CDM 982 RC 26160 HCPCS facility both 1211 1211 Gross Charge Type: NIHD_Hosp_Profee_Price Triathalon Cruciate Retaining Femoral sz7 LFT CR 2616340 CDM 278 RC facility both 20521 20521 Gross Charge Type: NIHD_Hosp_Profee_Price Triathalon Cruciate Retaining Femoral sz7 LFT CR 2616340 CDM 278 RC facility both 20521 20521 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T8 Full Thread, 2.4mm/L20mm" 2616368 CDM 278 RC facility both 390 390 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T8 Full Thread, 2.4mm/L20mm" 2616368 CDM 278 RC facility both 390 390 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T8 Full Thread, 2.4mm/L24mm" 2616369 CDM 278 RC facility both 328 328 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T8 Full Thread, 2.4mm/L24mm" 2616369 CDM 278 RC facility both 328 328 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T8 Full Thread, 2.4mm/L26mm" 2616370 CDM 278 RC facility both 328 328 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T8 Full Thread, 2.4mm/L26mm" 2616370 CDM 278 RC facility both 328 328 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT-CS SZ 7X10MM 2617002 CDM 278 RC facility both 9904 9904 Gross Charge Type: NIHD_Hosp_Profee_Price TIBIAL BEARING INSERT-CS SZ 7X10MM 2617002 CDM 278 RC facility both 9904 9904 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T8 Full Thread, 2.4mm/L22mm" 2617050 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T8 Full Thread, 2.4mm/L22mm" 2617050 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T8 Full Thread, 2.4mm/L24mm" 2617051 CDM 278 RC facility both 228 228 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T8 Full Thread, 2.4mm/L24mm" 2617051 CDM 278 RC facility both 228 228 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T8 Full Thread, 2.4mm/L28mm" 2617052 CDM 278 RC facility both 328 328 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T8 Full Thread, 2.4mm/L28mm" 2617052 CDM 278 RC facility both 328 328 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T8 Full Thread, 2.4mm/L32mm" 2617055 CDM 278 RC facility both 228 228 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T8 Full Thread, 2.4mm/L32mm" 2617055 CDM 278 RC facility both 228 228 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw,T8 Full Thread, 2.7mm/L16mm" 2617058 CDM 278 RC facility both 328 328 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw,T8 Full Thread, 2.7mm/L16mm" 2617058 CDM 278 RC facility both 328 328 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw,T8 Full Thread, 2.7mm/L22mm" 2617059 CDM 278 RC facility both 372 372 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw,T8 Full Thread, 2.7mm/L22mm" 2617059 CDM 278 RC facility both 372 372 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T8 Full Thread, 2.7mm/L12mm" 2617218 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T8 Full Thread, 2.7mm/L12mm" 2617218 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T8 Full Thread, 2.7mm/L14mm" 2617219 CDM 278 RC facility both 218 218 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T8 Full Thread, 2.7mm/L14mm" 2617219 CDM 278 RC facility both 218 218 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T8 Full Thread, 2.7mm/L18mm" 2617220 CDM 278 RC facility both 218 218 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T8 Full Thread, 2.7mm/L18mm" 2617220 CDM 278 RC facility both 218 218 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T8 Full Thread, 2.7mm/L20mm" 2617221 CDM 278 RC facility both 218 218 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T8 Full Thread, 2.7mm/L20mm" 2617221 CDM 278 RC facility both 218 218 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L14mm" 2617227 CDM 278 RC facility both 414 414 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L14mm" 2617227 CDM 278 RC facility both 414 414 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L22mm" 2617228 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L22mm" 2617228 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L24mm" 2617229 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L24mm" 2617229 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L32mm" 2617231 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L32mm" 2617231 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L34mm" 2617232 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L34mm" 2617232 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L36mm" 2617233 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L36mm" 2617233 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L46mm" 2617269 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L46mm" 2617269 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L48mm" 2617270 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L48mm" 2617270 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L50mm" 2617271 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L50mm" 2617271 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L55mm" 2617272 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L55mm" 2617272 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L60mm" 2617273 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L60mm" 2617273 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T10 Full Thread, 2.7mm/L10mm" 2617275 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T10 Full Thread, 2.7mm/L10mm" 2617275 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T10 Full Thread, 2.7mm/L22mm" 2617277 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T10 Full Thread, 2.7mm/L22mm" 2617277 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T10 Full Thread, 2.7mm/L26mm" 2617279 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T10 Full Thread, 2.7mm/L26mm" 2617279 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T10 Full Thread, 2.7mm/L28mm" 2617280 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T10 Full Thread, 2.7mm/L28mm" 2617280 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T10 Full Thread, 2.7mm/L30mm" 2617281 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T10 Full Thread, 2.7mm/L30mm" 2617281 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T10 Full Thread, 2.7mm/L36mm" 2617282 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T10 Full Thread, 2.7mm/L36mm" 2617282 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L18mm" 2617323 CDM 278 RC facility both 380 380 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L18mm" 2617323 CDM 278 RC facility both 380 380 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L22mm" 2617324 CDM 278 RC facility both 380 380 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L22mm" 2617324 CDM 278 RC facility both 380 380 Gross Charge Type: NIHD_Hosp_Profee_Price RADIAL STEM 8.0X4.0MM 2617342 CDM 278 RC facility both 8273 8273 Gross Charge Type: NIHD_Hosp_Profee_Price RADIAL STEM 8.0X4.0MM 2617342 CDM 278 RC facility both 8273 8273 Gross Charge Type: NIHD_Hosp_Profee_Price RADIAL HEAD 22.0MM RIGHT 2617344 CDM 278 RC facility both 14131 14131 Gross Charge Type: NIHD_Hosp_Profee_Price RADIAL HEAD 22.0MM RIGHT 2617344 CDM 278 RC facility both 14131 14131 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L36mm" 2617350 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L36mm" 2617350 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L38mm" 2617351 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L38mm" 2617351 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L40mm" 2617352 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L40mm" 2617352 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L42mm" 2617353 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L42mm" 2617353 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L44mm" 2617354 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L44mm" 2617354 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L46mm" 2617355 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L46mm" 2617355 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L48mm" 2617356 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L48mm" 2617356 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L26mm" 2617358 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L26mm" 2617358 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L28mm" 2617384 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L28mm" 2617384 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L70mm" 2617386 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L70mm" 2617386 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T8 Full Thread, 2.4mm/L16mm" 2618358 CDM 278 RC facility both 390 390 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T8 Full Thread, 2.4mm/L16mm" 2618358 CDM 278 RC facility both 390 390 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T8 Full Thread, 2.4mm/L18mm" 2618359 CDM 278 RC facility both 390 390 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T8 Full Thread, 2.4mm/L18mm" 2618359 CDM 278 RC facility both 390 390 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T8 Full Thread, 2.4mm/L22mm" 2618360 CDM 278 RC facility both 328 328 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T8 Full Thread, 2.4mm/L22mm" 2618360 CDM 278 RC facility both 328 328 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T8 Full Thread, 2.4mm/L16mm" 2618982 CDM 278 RC facility both 228 228 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T8 Full Thread, 2.4mm/L16mm" 2618982 CDM 278 RC facility both 228 228 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw,T8 Full Thread, 2.7mm/L10mm" 2618988 CDM 278 RC facility both 372 372 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw,T8 Full Thread, 2.7mm/L10mm" 2618988 CDM 278 RC facility both 372 372 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw,T8 Full Thread, 2.7mm/L12mm" 2618989 CDM 278 RC facility both 340 340 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw,T8 Full Thread, 2.7mm/L12mm" 2618989 CDM 278 RC facility both 340 340 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw,T8 Full Thread, 2.7mm/L14mm" 2618990 CDM 278 RC facility both 372 372 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw,T8 Full Thread, 2.7mm/L14mm" 2618990 CDM 278 RC facility both 372 372 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw,T8 Full Thread, 2.7mm/L18mm" 2618991 CDM 278 RC facility both 372 372 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw,T8 Full Thread, 2.7mm/L18mm" 2618991 CDM 278 RC facility both 372 372 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw,T8 Full Thread, 2.7mm/L26mm" 2620325 CDM 278 RC facility both 425 425 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw,T8 Full Thread, 2.7mm/L26mm" 2620325 CDM 278 RC facility both 425 425 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T8 Full Thread, 2.7mm/L16mm" 2620336 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T8 Full Thread, 2.7mm/L16mm" 2620336 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T8 Full Thread, 2.7mm/L22mm" 2620337 CDM 278 RC facility both 218 218 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T8 Full Thread, 2.7mm/L22mm" 2620337 CDM 278 RC facility both 218 218 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T8 Full Thread, 2.7mm/L26mm" 2620338 CDM 278 RC facility both 218 218 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T8 Full Thread, 2.7mm/L26mm" 2620338 CDM 278 RC facility both 218 218 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T8 Full Thread, 2.7mm/L30mm" 2620340 CDM 272 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T8 Full Thread, 2.7mm/L30mm" 2620340 CDM 272 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L10mm" 2620347 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L10mm" 2620347 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L18mm" 2620348 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L18mm" 2620348 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L20mm" 2620349 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L20mm" 2620349 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L26mm" 2620350 CDM 278 RC facility both 414 414 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L26mm" 2620350 CDM 278 RC facility both 414 414 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L28mm" 2620351 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L28mm" 2620351 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L30mm" 2620352 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L30mm" 2620352 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L38mm" 2620353 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L38mm" 2620353 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L40mm" 2620355 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L40mm" 2620355 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L42mm" 2620389 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L42mm" 2620389 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L44mm" 2620390 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L44mm" 2620390 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L65mm" 2620391 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L65mm" 2620391 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L70mm" 2620393 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw, T10 Full Thread, 2.7mm/L70mm" 2620393 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T10 Full Thread, 2.7mm/L12mm" 2620394 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T10 Full Thread, 2.7mm/L12mm" 2620394 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T10 Full Thread, 2.7mm/L14mm" 2620395 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T10 Full Thread, 2.7mm/L14mm" 2620395 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T10 Full Thread, 2.7mm/L16mm" 2620396 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T10 Full Thread, 2.7mm/L16mm" 2620396 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T10 Full Thread, 2.7mm/L18mm" 2620397 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T10 Full Thread, 2.7mm/L18mm" 2620397 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T10 Full Thread, 2.7mm/L24mm" 2620398 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T10 Full Thread, 2.7mm/L24mm" 2620398 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T10 Full Thread, 2.7mm/L32mm" 2620399 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T10 Full Thread, 2.7mm/L32mm" 2620399 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T10 Full Thread, 2.7mm/L34mm" 2620400 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw, T10 Full Thread, 2.7mm/L34mm" 2620400 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L20mm" 2620452 CDM 278 RC facility both 414 414 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L20mm" 2620452 CDM 278 RC facility both 414 414 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L50mm" 2620473 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L50mm" 2620473 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L55mm" 2620474 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L55mm" 2620474 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L60mm" 2620475 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L60mm" 2620475 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L70mm" 2620476 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Locking Screw VariAx2 T10, Full Thread, 3.5mm / L70mm" 2620476 CDM 278 RC facility both 365 365 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L10mm" 2620477 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L10mm" 2620477 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L20mm" 2620478 CDM 278 RC facility both 225 225 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L20mm" 2620478 CDM 278 RC facility both 225 225 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L22mm" 2620479 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L22mm" 2620479 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L24mm" 2620481 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L24mm" 2620481 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L42mm" 2620485 CDM 278 RC facility both 225 225 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L42mm" 2620485 CDM 278 RC facility both 225 225 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L48mm" 2620486 CDM 278 RC facility both 225 225 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L48mm" 2620486 CDM 278 RC facility both 225 225 Gross Charge Type: NIHD_Hosp_Profee_Price Precision thin long med blade 9.0 x 0.38 x 18.5 2620498 CDM 272 RC facility both 64 64 Gross Charge Type: NIHD_Hosp_Profee_Price Precision thin long med blade 9.0 x 0.38 x 18.5 2620498 CDM 272 RC facility both 64 64 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L34mm" 2620504 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L34mm" 2620504 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L38mm" 2620506 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L38mm" 2620506 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L40mm" 2620507 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L40mm" 2620507 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L60mm" 2620510 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L60mm" 2620510 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L65mm" 2620511 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price "Bone Screw VariAx2 T10, Full Thread, 3.5mm / L65mm" 2620511 CDM 278 RC facility both 199 199 Gross Charge Type: NIHD_Hosp_Profee_Price Cannulated Screw 7.3mm Thread 16MM Length 85mm 2620540 CDM 278 RC facility both 765 765 Gross Charge Type: NIHD_Hosp_Profee_Price Cannulated Screw 7.3mm Thread 16MM Length 85mm 2620540 CDM 278 RC facility both 765 765 Gross Charge Type: NIHD_Hosp_Profee_Price Cannulated Screw 7.3mm Thread 16MM Length 90mm 2620541 CDM 278 RC facility both 765 765 Gross Charge Type: NIHD_Hosp_Profee_Price Cannulated Screw 7.3mm Thread 16MM Length 90mm 2620541 CDM 278 RC facility both 765 765 Gross Charge Type: NIHD_Hosp_Profee_Price Attune CRS RP INSRT SZ 6 22MM 2621782 CDM 278 RC facility both 19078 19078 Gross Charge Type: NIHD_Hosp_Profee_Price Attune CRS RP INSRT SZ 6 22MM 2621782 CDM 278 RC facility both 19078 19078 Gross Charge Type: NIHD_Hosp_Profee_Price Cannulated Screw 7.3mm Thread 16MM Length 80mm 2622303 CDM 278 RC facility both 765 765 Gross Charge Type: NIHD_Hosp_Profee_Price Cannulated Screw 7.3mm Thread 16MM Length 80mm 2622303 CDM 278 RC facility both 765 765 Gross Charge Type: NIHD_Hosp_Profee_Price "26236 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELI ProFee" 26236 CDM 982 RC 26236 HCPCS facility both 874 874 Gross Charge Type: NIHD_Hosp_Profee_Price "26236 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELI ProFee" 26236 CDM 982 RC 26236 HCPCS facility both 874 874 Gross Charge Type: NIHD_Hosp_Profee_Price Attune CRS RP INSRT SZ 6 24MM 2630718 CDM 278 RC facility both 19078 19078 Gross Charge Type: NIHD_Hosp_Profee_Price Attune CRS RP INSRT SZ 6 24MM 2630718 CDM 278 RC facility both 19078 19078 Gross Charge Type: NIHD_Hosp_Profee_Price 26320 REMOVAL OF IMPLANT FROM FINGER OR HAND ProFee 26320 CDM 982 RC 26320 HCPCS facility both 700 700 Gross Charge Type: NIHD_Hosp_Profee_Price 26320 REMOVAL OF IMPLANT FROM FINGER OR HAND ProFee 26320 CDM 982 RC 26320 HCPCS facility both 700 700 Gross Charge Type: NIHD_Hosp_Profee_Price "26341 Manipulation, palmar fascial cord, post enzyme injection, single cord" 26341 CDM 521 RC 26341 HCPCS facility both 393 393 Gross Charge Type: NIHD_RHC_Price "26341 Manipulation, palmar fascial cord, post enzyme injection, single cord" 26341 CDM 521 RC 26341 HCPCS facility both 393 393 Gross Charge Type: NIHD_Clinic_Price T2 NUT FOR CONDYLE SCREW 05MM 2634487 CDM 278 RC facility both 380 380 Gross Charge Type: NIHD_Hosp_Profee_Price T2 NUT FOR CONDYLE SCREW 05MM 2634487 CDM 278 RC facility both 380 380 Gross Charge Type: NIHD_Hosp_Profee_Price T2 CONDYLE SCREW 5mmX60mm 2634488 CDM 278 RC facility both 380 380 Gross Charge Type: NIHD_Hosp_Profee_Price T2 CONDYLE SCREW 5mmX60mm 2634488 CDM 278 RC facility both 380 380 Gross Charge Type: NIHD_Hosp_Profee_Price T2 CONDYLE SCREW 5mmX70mm 2634489 CDM 278 RC facility both 380 380 Gross Charge Type: NIHD_Hosp_Profee_Price T2 CONDYLE SCREW 5mmX70mm 2634489 CDM 278 RC facility both 380 380 Gross Charge Type: NIHD_Hosp_Profee_Price T2 CONDYLE SCREW 5mmX75mm 2634490 CDM 278 RC facility both 380 380 Gross Charge Type: NIHD_Hosp_Profee_Price T2 CONDYLE SCREW 5mmX75mm 2634490 CDM 278 RC facility both 380 380 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT AO 0.26X220MM 2634618 CDM 278 RC facility both 325 325 Gross Charge Type: NIHD_Hosp_Profee_Price DRILL BIT AO 0.26X220MM 2634618 CDM 278 RC facility both 325 325 Gross Charge Type: NIHD_Hosp_Profee_Price "26350 REPAIR OR ADVANCEMENT, FLEXOR TENDON, NOT IN ZONE 2 DIGITAL FLEXOR TENDON SHEATH (EG, ProFee" 26350 CDM 982 RC 26350 HCPCS facility both 1299 1299 Gross Charge Type: NIHD_Hosp_Profee_Price "26350 REPAIR OR ADVANCEMENT, FLEXOR TENDON, NOT IN ZONE 2 DIGITAL FLEXOR TENDON SHEATH (EG, ProFee" 26350 CDM 982 RC 26350 HCPCS facility both 1299 1299 Gross Charge Type: NIHD_Hosp_Profee_Price "26356 REPAIR OR ADVANCEMENT, FLEXOR TENDON, IN ZONE 2 DIGITAL FLEXOR TENDON SHEATH (EG, NO M ProFee" 26356 CDM 982 RC 26356 HCPCS facility both 1220 1220 Gross Charge Type: NIHD_Hosp_Profee_Price "26356 REPAIR OR ADVANCEMENT, FLEXOR TENDON, IN ZONE 2 DIGITAL FLEXOR TENDON SHEATH (EG, NO M ProFee" 26356 CDM 982 RC 26356 HCPCS facility both 1220 1220 Gross Charge Type: NIHD_Hosp_Profee_Price "26370 REPAIR OR ADVANCEMENT OF PROFUNDUS TENDON, WITH INTACT SUPERFICIALIS TENDON; PRIMARY, ProFee" 26370 CDM 982 RC 26370 HCPCS facility both 1367 1367 Gross Charge Type: NIHD_Hosp_Profee_Price "26370 REPAIR OR ADVANCEMENT OF PROFUNDUS TENDON, WITH INTACT SUPERFICIALIS TENDON; PRIMARY, ProFee" 26370 CDM 982 RC 26370 HCPCS facility both 1367 1367 Gross Charge Type: NIHD_Hosp_Profee_Price Comprehensive VRS Mini Taper Adapter 2637613 CDM 278 RC facility both 524 524 Gross Charge Type: NIHD_Hosp_Profee_Price Comprehensive VRS Mini Taper Adapter 2637613 CDM 278 RC facility both 524 524 Gross Charge Type: NIHD_Hosp_Profee_Price DRESSING PURAPLY AM 3X4 CM 2637681 CDM 636 RC facility both 273 273 Gross Charge Type: NIHD_Hosp_Profee_Price DRESSING PURAPLY AM 3X4 CM 2637681 CDM 636 RC facility both 273 273 Gross Charge Type: NIHD_Hosp_Profee_Price "AlloSync Pure, 10.0cc" 2638311 CDM 278 RC facility both 4452 4452 Gross Charge Type: NIHD_Hosp_Profee_Price "AlloSync Pure, 10.0cc" 2638311 CDM 278 RC facility both 4452 4452 Gross Charge Type: NIHD_Hosp_Profee_Price "AlloSync injectable fibers, 5cc" 2638312 CDM 278 RC facility both 1964 1964 Gross Charge Type: NIHD_Hosp_Profee_Price "AlloSync injectable fibers, 5cc" 2638312 CDM 278 RC facility both 1964 1964 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW LO-PRO TI 3.5MMX18MM 2639262 CDM 278 RC facility both 157 157 Gross Charge Type: NIHD_Hosp_Profee_Price SCREW LO-PRO TI 3.5MMX18MM 2639262 CDM 278 RC facility both 157 157 Gross Charge Type: NIHD_Hosp_Profee_Price Comprehensive VRS Drill 2640354 CDM 272 RC facility both 131 131 Gross Charge Type: NIHD_Hosp_Profee_Price Comprehensive VRS Drill 2640354 CDM 272 RC facility both 131 131 Gross Charge Type: NIHD_Hosp_Profee_Price "Comprehensive VRS Glenoid Reamer Guide, Bone & Implant Model" 2640356 CDM 278 RC facility both 2383 2383 Gross Charge Type: NIHD_Hosp_Profee_Price "Comprehensive VRS Glenoid Reamer Guide, Bone & Implant Model" 2640356 CDM 278 RC facility both 2383 2383 Gross Charge Type: NIHD_Hosp_Profee_Price "26410 REPAIR, EXTENSOR TENDON, HAND, PRIMARY OR SECONDARY; WITHOUT FREE GRAFT, EACH TENDON ProFee" 26410 CDM 982 RC 26410 HCPCS facility both 1162 1162 Gross Charge Type: NIHD_Hosp_Profee_Price "26410 REPAIR, EXTENSOR TENDON, HAND, PRIMARY OR SECONDARY; WITHOUT FREE GRAFT, EACH TENDON ProFee" 26410 CDM 982 RC 26410 HCPCS facility both 1162 1162 Gross Charge Type: NIHD_Hosp_Profee_Price "26418 REPAIR, EXTENSOR TENDON, FINGER, PRIMARY OR SECONDARY; WITHOUT FREE GRAFT, EACH TENDON ProFee" 26418 CDM 982 RC 26418 HCPCS facility both 1061 1061 Gross Charge Type: NIHD_Hosp_Profee_Price "26418 REPAIR, EXTENSOR TENDON, FINGER, PRIMARY OR SECONDARY; WITHOUT FREE GRAFT, EACH TENDON ProFee" 26418 CDM 982 RC 26418 HCPCS facility both 1061 1061 Gross Charge Type: NIHD_Hosp_Profee_Price Clareon Panoptix Toric IOL CNWTT6 20.0 2642416 CDM 276 RC facility both 995 995 Gross Charge Type: NIHD_Hosp_Profee_Price Clareon Panoptix Toric IOL CNWTT6 20.0 2642416 CDM 276 RC facility both 995 995 Gross Charge Type: NIHD_Hosp_Profee_Price Locking Compression Plate 8 Hole L155MM 5.0MM 2642471 CDM 278 RC facility both 5981 5981 Gross Charge Type: NIHD_Hosp_Profee_Price Locking Compression Plate 8 Hole L155MM 5.0MM 2642471 CDM 278 RC facility both 5981 5981 Gross Charge Type: NIHD_Hosp_Profee_Price "26445 TENOLYSIS, EXTENSOR TENDON, HAND OR FINGER, EACH TENDON ProFee" 26445 CDM 982 RC 26445 HCPCS facility both 1148 1148 Gross Charge Type: NIHD_Hosp_Profee_Price "26445 TENOLYSIS, EXTENSOR TENDON, HAND OR FINGER, EACH TENDON ProFee" 26445 CDM 982 RC 26445 HCPCS facility both 1148 1148 Gross Charge Type: NIHD_Hosp_Profee_Price "26455 TENOTOMY, FLEXOR, FINGER, OPEN, EACH TENDON ProFee" 26455 CDM 982 RC 26455 HCPCS facility both 812 812 Gross Charge Type: NIHD_Hosp_Profee_Price "26455 TENOTOMY, FLEXOR, FINGER, OPEN, EACH TENDON ProFee" 26455 CDM 982 RC 26455 HCPCS facility both 812 812 Gross Charge Type: NIHD_Hosp_Profee_Price "26474 TENODESIS; OF DISTAL JOINT, EACH JOINT ProFee" 26474 CDM 982 RC 26474 HCPCS facility both 1099 1099 Gross Charge Type: NIHD_Hosp_Profee_Price "26474 TENODESIS; OF DISTAL JOINT, EACH JOINT ProFee" 26474 CDM 982 RC 26474 HCPCS facility both 1099 1099 Gross Charge Type: NIHD_Hosp_Profee_Price "26480 TRANSFER OR TRANSPLANT OF TENDON, CARPOMETACARPAL AREA OR DORSUM OF HAND; WITHOUT FREE ProFee" 26480 CDM 982 RC 26480 HCPCS facility both 12314 12314 Gross Charge Type: NIHD_Hosp_Profee_Price "26480 TRANSFER OR TRANSPLANT OF TENDON, CARPOMETACARPAL AREA OR DORSUM OF HAND; WITHOUT FREE ProFee" 26480 CDM 982 RC 26480 HCPCS facility both 12314 12314 Gross Charge Type: NIHD_Hosp_Profee_Price "26540 REPAIR OF COLLATERAL LIGAMENT, METACARPOPHALANGEAL OR INTERPHALANGEAL JOINT ProFee" 26540 CDM 982 RC 26540 HCPCS facility both 1095 1095 Gross Charge Type: NIHD_Hosp_Profee_Price "26540 REPAIR OF COLLATERAL LIGAMENT, METACARPOPHALANGEAL OR INTERPHALANGEAL JOINT ProFee" 26540 CDM 982 RC 26540 HCPCS facility both 1095 1095 Gross Charge Type: NIHD_Hosp_Profee_Price "26546 REPAIR NON-UNION, METACARPAL OR PHALANX (INCLUDES OBTAINING BONE GRAFT WITH OR WITHOUT ProFee" 26546 CDM 982 RC 26546 HCPCS facility both 1804 1804 Gross Charge Type: NIHD_Hosp_Profee_Price "26546 REPAIR NON-UNION, METACARPAL OR PHALANX (INCLUDES OBTAINING BONE GRAFT WITH OR WITHOUT ProFee" 26546 CDM 982 RC 26546 HCPCS facility both 1804 1804 Gross Charge Type: NIHD_Hosp_Profee_Price "26600 Closed treatment of metacarpal fracture, single; without manipulation, each bone" 266001 CDM 521 RC 26600 HCPCS facility both 851 851 Gross Charge Type: NIHD_Clinic_Price 26600 CLTX METACARPAL FX W/O MANIPULATION EACH BONE TechFee 266002 CDM 450 RC facility both 484 484 Gross Charge Type: NIHD_Hosp_Profee_Price 26600 CLTX METACARPAL FX W/O MANIPULATION EACH BONE TechFee 266002 CDM 450 RC facility both 484 484 Gross Charge Type: NIHD_Hosp_Profee_Price "26600 CLOSED TREATMENT OF METACARPAL FRACTURE, SINGLE; WITHOUT MANIPULATION, EACH BONE ProFee" 266003 CDM 982 RC 26600 HCPCS facility both 588 588 Gross Charge Type: NIHD_Hosp_Profee_Price "26600 CLOSED TREATMENT OF METACARPAL FRACTURE, SINGLE; WITHOUT MANIPULATION, EACH BONE ProFee" 266003 CDM 982 RC 26600 HCPCS facility both 588 588 Gross Charge Type: NIHD_Hosp_Profee_Price "Xtrasorb Superabsorbent Wound Dressing, Sterile, 6"" x 9""" 2660326 CDM 272 RC facility both 16 16 Gross Charge Type: NIHD_Hosp_Profee_Price "Xtrasorb Superabsorbent Wound Dressing, Sterile, 6"" x 9""" 2660326 CDM 272 RC facility both 16 16 Gross Charge Type: NIHD_Hosp_Profee_Price "26605 Closed treatment of metacarpal fracture, single; with manipulation, each bone" 266051 CDM 521 RC 26605 HCPCS facility both 1104 1104 Gross Charge Type: NIHD_Clinic_Price 26605 CLTX METACARPAL FX W/MANIPULATION EACH BONE TechFee 266052 CDM 450 RC facility both 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price 26605 CLTX METACARPAL FX W/MANIPULATION EACH BONE TechFee 266052 CDM 450 RC facility both 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price "26605 CLOSED TREATMENT OF METACARPAL FRACTURE, SINGLE; WITH MANIPULATION, EACH BONE ProFee" 266053 CDM 982 RC 26605 HCPCS facility both 1498 1498 Gross Charge Type: NIHD_Hosp_Profee_Price "26605 CLOSED TREATMENT OF METACARPAL FRACTURE, SINGLE; WITH MANIPULATION, EACH BONE ProFee" 266053 CDM 982 RC 26605 HCPCS facility both 1498 1498 Gross Charge Type: NIHD_Hosp_Profee_Price "26608 PERCUTANEOUS SKELETAL FIXATION OF METACARPAL FRACTURE, EACH BONE ProFee" 26608 CDM 982 RC 26608 HCPCS facility both 999 999 Gross Charge Type: NIHD_Hosp_Profee_Price "26608 PERCUTANEOUS SKELETAL FIXATION OF METACARPAL FRACTURE, EACH BONE ProFee" 26608 CDM 982 RC 26608 HCPCS facility both 999 999 Gross Charge Type: NIHD_Hosp_Profee_Price "26615 OPEN TREATMENT OF METACARPAL FRACTURE, SINGLE, INCLUDES INTERNAL FIXATION, WHEN PERFOR ProFee" 26615 CDM 982 RC 26615 HCPCS facility both 1225 1225 Gross Charge Type: NIHD_Hosp_Profee_Price "26615 OPEN TREATMENT OF METACARPAL FRACTURE, SINGLE, INCLUDES INTERNAL FIXATION, WHEN PERFOR ProFee" 26615 CDM 982 RC 26615 HCPCS facility both 1225 1225 Gross Charge Type: NIHD_Hosp_Profee_Price HIP STEM INSIGNIA STANDARD OFFSET SZE 7 2661710 CDM 278 RC facility both 22060 22060 Gross Charge Type: NIHD_Hosp_Profee_Price HIP STEM INSIGNIA STANDARD OFFSET SZE 7 2661710 CDM 278 RC facility both 22060 22060 Gross Charge Type: NIHD_Hosp_Profee_Price RHS Short Radial Stem DIA 8MM Neck 16MM 2661751 CDM 278 RC facility both 12086 12086 Gross Charge Type: NIHD_Hosp_Profee_Price RHS Short Radial Stem DIA 8MM Neck 16MM 2661751 CDM 278 RC facility both 12086 12086 Gross Charge Type: NIHD_Hosp_Profee_Price Flexiva Pulse ID Trac Tip Fiber 2663335 CDM 278 RC facility both 1035 1035 Gross Charge Type: NIHD_Hosp_Profee_Price Flexiva Pulse ID Trac Tip Fiber 2663335 CDM 278 RC facility both 1035 1035 Gross Charge Type: NIHD_Hosp_Profee_Price Flexiva Pulse ID 242 Fiber 2663336 CDM 278 RC facility both 848 848 Gross Charge Type: NIHD_Hosp_Profee_Price Flexiva Pulse ID 242 Fiber 2663336 CDM 278 RC facility both 848 848 Gross Charge Type: NIHD_Hosp_Profee_Price Micro Dual Cut (9.0 x 0.38 x 25.0mm) 2663497 CDM 272 RC facility both 84 84 Gross Charge Type: NIHD_Hosp_Profee_Price Micro Dual Cut (9.0 x 0.38 x 25.0mm) 2663497 CDM 272 RC facility both 84 84 Gross Charge Type: NIHD_Hosp_Profee_Price HIP STEM INSIGNIA STANDARD OFFSET SZE 8 2663543 CDM 278 RC facility both 26688 26688 Gross Charge Type: NIHD_Hosp_Profee_Price HIP STEM INSIGNIA STANDARD OFFSET SZE 8 2663543 CDM 278 RC facility both 26688 26688 Gross Charge Type: NIHD_Hosp_Profee_Price Percuflex Locking Nephr Cath 10.3 X 28 2663678 CDM 272 RC facility both 173 173 Gross Charge Type: NIHD_Hosp_Profee_Price Percuflex Locking Nephr Cath 10.3 X 28 2663678 CDM 272 RC facility both 173 173 Gross Charge Type: NIHD_Hosp_Profee_Price "26641 CLOSED TREATMENT OF CARPOMETACARPAL DISLOCATION, THUMB, WITH MANIPULATION ProFee" 26641 CDM 982 RC 26641 HCPCS facility both 501 501 Gross Charge Type: NIHD_Hosp_Profee_Price "26641 CLOSED TREATMENT OF CARPOMETACARPAL DISLOCATION, THUMB, WITH MANIPULATION ProFee" 26641 CDM 982 RC 26641 HCPCS facility both 501 501 Gross Charge Type: NIHD_Hosp_Profee_Price "26650 PERCUTANEOUS SKELETAL FIXATION OF CARPOMETACARPAL FRACTURE DISLOCATION, THUMB (BENNETT ProFee" 26650 CDM 982 RC 26650 HCPCS facility both 999 999 Gross Charge Type: NIHD_Hosp_Profee_Price "26650 PERCUTANEOUS SKELETAL FIXATION OF CARPOMETACARPAL FRACTURE DISLOCATION, THUMB (BENNETT ProFee" 26650 CDM 982 RC 26650 HCPCS facility both 999 999 Gross Charge Type: NIHD_Hosp_Profee_Price PrecisionPoint Transperineal Access System 2666388 CDM 272 RC facility both 37 37 Gross Charge Type: NIHD_Hosp_Profee_Price PrecisionPoint Transperineal Access System 2666388 CDM 272 RC facility both 37 37 Gross Charge Type: NIHD_Hosp_Profee_Price RHS Radial Head DIA 20MM 2666389 CDM 278 RC facility both 6510 6510 Gross Charge Type: NIHD_Hosp_Profee_Price RHS Radial Head DIA 20MM 2666389 CDM 278 RC facility both 6510 6510 Gross Charge Type: NIHD_Hosp_Profee_Price "26665 OPEN TREATMENT OF CARPOMETACARPAL FRACTURE DISLOCATION, THUMB (BENNETT FRACTURE), INCL ProFee" 26665 CDM 982 RC 26665 HCPCS facility both 1310 1310 Gross Charge Type: NIHD_Hosp_Profee_Price "26665 OPEN TREATMENT OF CARPOMETACARPAL FRACTURE DISLOCATION, THUMB (BENNETT FRACTURE), INCL ProFee" 26665 CDM 982 RC 26665 HCPCS facility both 1310 1310 Gross Charge Type: NIHD_Hosp_Profee_Price 26670 CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES TechFee 26670 CDM 450 RC facility both 620 620 Gross Charge Type: NIHD_Hosp_Profee_Price 26670 CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES TechFee 26670 CDM 450 RC facility both 620 620 Gross Charge Type: NIHD_Hosp_Profee_Price 26670 CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES ProFee 266701 CDM 981 RC 26670 HCPCS facility both 485 485 Gross Charge Type: NIHD_Hosp_Profee_Price 26670 CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES ProFee 266701 CDM 981 RC 26670 HCPCS facility both 485 485 Gross Charge Type: NIHD_Hosp_Profee_Price "26675 CLOSED TREATMENT OF CARPOMETACARPAL DISLOCATION, OTHER THAN THUMB, WITH MANIPULATION, ProFee" 26675 CDM 982 RC 26675 HCPCS facility both 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price "26675 CLOSED TREATMENT OF CARPOMETACARPAL DISLOCATION, OTHER THAN THUMB, WITH MANIPULATION, ProFee" 26675 CDM 982 RC 26675 HCPCS facility both 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price "26676 PERCUTANEOUS SKELETAL FIXATION OF CARPOMETACARPAL DISLOCATION, OTHER THAN THUMB, WITH ProFee" 26676 CDM 982 RC 26676 HCPCS facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "26676 PERCUTANEOUS SKELETAL FIXATION OF CARPOMETACARPAL DISLOCATION, OTHER THAN THUMB, WITH ProFee" 26676 CDM 982 RC 26676 HCPCS facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "Universal Hook with Cautery Tip, 32 cm" 2668447 CDM 272 RC facility both 66 66 Gross Charge Type: NIHD_Hosp_Profee_Price "Universal Hook with Cautery Tip, 32 cm" 2668447 CDM 272 RC facility both 66 66 Gross Charge Type: NIHD_Hosp_Profee_Price 8/10 DILATOR/ SHEATH SET 2668458 CDM 272 RC facility both 87 87 Gross Charge Type: NIHD_Hosp_Profee_Price 8/10 DILATOR/ SHEATH SET 2668458 CDM 272 RC facility both 87 87 Gross Charge Type: NIHD_Hosp_Profee_Price "26685 OPEN TREATMENT OF CARPOMETACARPAL DISLOCATION, OTHER THAN THUMB; INCLUDES INTERNAL FIX ProFee" 26685 CDM 982 RC 26685 HCPCS facility both 1225 1225 Gross Charge Type: NIHD_Hosp_Profee_Price "26685 OPEN TREATMENT OF CARPOMETACARPAL DISLOCATION, OTHER THAN THUMB; INCLUDES INTERNAL FIX ProFee" 26685 CDM 982 RC 26685 HCPCS facility both 1225 1225 Gross Charge Type: NIHD_Hosp_Profee_Price 26700 CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES TechFee 267001 CDM 450 RC facility both 476 476 Gross Charge Type: NIHD_Hosp_Profee_Price 26700 CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES TechFee 267001 CDM 450 RC facility both 476 476 Gross Charge Type: NIHD_Hosp_Profee_Price "26700 CLOSED TREATMENT OF METACARPOPHALANGEAL DISLOCATION, SINGLE, WITH MANIPULATION; WITHOU ProFee" 267002 CDM 982 RC 26700 HCPCS facility both 936 936 Gross Charge Type: NIHD_Hosp_Profee_Price "26700 CLOSED TREATMENT OF METACARPOPHALANGEAL DISLOCATION, SINGLE, WITH MANIPULATION; WITHOU ProFee" 267002 CDM 982 RC 26700 HCPCS facility both 936 936 Gross Charge Type: NIHD_Hosp_Profee_Price CONMED SUCTION IRRIGATOR ELECTROSURGICAL SYSTEM 2670409 CDM 272 RC facility both 118 118 Gross Charge Type: NIHD_Hosp_Profee_Price CONMED SUCTION IRRIGATOR ELECTROSURGICAL SYSTEM 2670409 CDM 272 RC facility both 118 118 Gross Charge Type: NIHD_Hosp_Profee_Price "26720 Closed treatment of phalangeal shaft fx, proximal/middle phalanx w/o manipulation, each" 267201 CDM 521 RC 26720 HCPCS facility both 531 531 Gross Charge Type: NIHD_Clinic_Price 26720 CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA TechFee 267202 CDM 450 RC facility both 788 788 Gross Charge Type: NIHD_Hosp_Profee_Price 26720 CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA TechFee 267202 CDM 450 RC facility both 788 788 Gross Charge Type: NIHD_Hosp_Profee_Price "26720 CLOSED TREATMENT OF PHALANGEAL SHAFT FRACTURE, PROXIMAL OR MIDDLE PHALANX, FINGER OR T ProFee" 267203 CDM 982 RC 26720 HCPCS facility both 638 638 Gross Charge Type: NIHD_Hosp_Profee_Price "26720 CLOSED TREATMENT OF PHALANGEAL SHAFT FRACTURE, PROXIMAL OR MIDDLE PHALANX, FINGER OR T ProFee" 267203 CDM 982 RC 26720 HCPCS facility both 638 638 Gross Charge Type: NIHD_Hosp_Profee_Price "26725 Closed treatment of phalangeal shaft fracture, proximal/middle phalanx with manipulation each" 267251 CDM 521 RC 26725 HCPCS facility both 604 604 Gross Charge Type: NIHD_RHC_Price "26725 Closed treatment of phalangeal shaft fracture, proximal/middle phalanx with manipulation each" 267251 CDM 521 RC 26725 HCPCS facility both 604 604 Gross Charge Type: NIHD_Clinic_Price 26725 CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA TechFee 267252 CDM 450 RC facility both 924 924 Gross Charge Type: NIHD_Hosp_Profee_Price 26725 CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA TechFee 267252 CDM 450 RC facility both 924 924 Gross Charge Type: NIHD_Hosp_Profee_Price "26725 CLOSED TREATMENT OF PHALANGEAL SHAFT FRACTURE, PROXIMAL OR MIDDLE PHALANX, FINGER OR T ProFee" 267253 CDM 982 RC 26725 HCPCS facility both 555 555 Gross Charge Type: NIHD_Hosp_Profee_Price "26725 CLOSED TREATMENT OF PHALANGEAL SHAFT FRACTURE, PROXIMAL OR MIDDLE PHALANX, FINGER OR T ProFee" 267253 CDM 982 RC 26725 HCPCS facility both 555 555 Gross Charge Type: NIHD_Hosp_Profee_Price "26727 PERCUTANEOUS SKELETAL FIXATION OF UNSTABLE PHALANGEAL SHAFT FRACTURE, PROXIMAL OR MIDD ProFee" 26727 CDM 982 RC 26727 HCPCS facility both 999 999 Gross Charge Type: NIHD_Hosp_Profee_Price "26727 PERCUTANEOUS SKELETAL FIXATION OF UNSTABLE PHALANGEAL SHAFT FRACTURE, PROXIMAL OR MIDD ProFee" 26727 CDM 982 RC 26727 HCPCS facility both 999 999 Gross Charge Type: NIHD_Hosp_Profee_Price "26735 OPEN TREATMENT OF PHALANGEAL SHAFT FRACTURE, PROXIMAL OR MIDDLE PHALANX, FINGER OR THU ProFee" 26735 CDM 982 RC 26735 HCPCS facility both 1261 1261 Gross Charge Type: NIHD_Hosp_Profee_Price "26735 OPEN TREATMENT OF PHALANGEAL SHAFT FRACTURE, PROXIMAL OR MIDDLE PHALANX, FINGER OR THU ProFee" 26735 CDM 982 RC 26735 HCPCS facility both 1261 1261 Gross Charge Type: NIHD_Hosp_Profee_Price Comprehensive VRS Glenoid Bone And Implant Model 2674479 CDM 278 RC facility both 2383 2383 Gross Charge Type: NIHD_Hosp_Profee_Price Comprehensive VRS Glenoid Bone And Implant Model 2674479 CDM 278 RC facility both 2383 2383 Gross Charge Type: NIHD_Hosp_Profee_Price "26746 OPEN TREATMENT OF ARTICULAR FRACTURE, INVOLVING METACARPOPHALANGEAL OR INTERPHALANGEAL ProFee" 26746 CDM 982 RC 26746 HCPCS facility both 1560 1560 Gross Charge Type: NIHD_Hosp_Profee_Price "26746 OPEN TREATMENT OF ARTICULAR FRACTURE, INVOLVING METACARPOPHALANGEAL OR INTERPHALANGEAL ProFee" 26746 CDM 982 RC 26746 HCPCS facility both 1560 1560 Gross Charge Type: NIHD_Hosp_Profee_Price 26755 CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA TechFee 267551 CDM 450 RC facility both 525 525 Gross Charge Type: NIHD_Hosp_Profee_Price 26755 CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA TechFee 267551 CDM 450 RC facility both 525 525 Gross Charge Type: NIHD_Hosp_Profee_Price "26755 CLOSED TREATMENT OF DISTAL PHALANGEAL FRACTURE, FINGER OR THUMB; WITH MANIPULATION, EA ProFee" 267552 CDM 982 RC 26755 HCPCS facility both 874 874 Gross Charge Type: NIHD_Hosp_Profee_Price "26755 CLOSED TREATMENT OF DISTAL PHALANGEAL FRACTURE, FINGER OR THUMB; WITH MANIPULATION, EA ProFee" 267552 CDM 982 RC 26755 HCPCS facility both 874 874 Gross Charge Type: NIHD_Hosp_Profee_Price "26765 OPEN TREATMENT OF DISTAL PHALANGEAL FRACTURE, FINGER OR THUMB, INCLUDES INTERNAL FIXAT ProFee" 26765 CDM 982 RC 26765 HCPCS facility both 936 936 Gross Charge Type: NIHD_Hosp_Profee_Price "26765 OPEN TREATMENT OF DISTAL PHALANGEAL FRACTURE, FINGER OR THUMB, INCLUDES INTERNAL FIXAT ProFee" 26765 CDM 982 RC 26765 HCPCS facility both 936 936 Gross Charge Type: NIHD_Hosp_Profee_Price 26770 CLTX IPHAL JT DISLC W/MANJ 267701 CDM 450 RC facility both 575 575 Gross Charge Type: NIHD_Hosp_Profee_Price 26770 CLTX IPHAL JT DISLC W/MANJ 267701 CDM 450 RC facility both 575 575 Gross Charge Type: NIHD_Hosp_Profee_Price "26770 CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION, SINGLE, WITH MANIPULATION; WITH ProFee" 267702 CDM 982 RC 26770 HCPCS facility both 663 663 Gross Charge Type: NIHD_Hosp_Profee_Price "26770 CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION, SINGLE, WITH MANIPULATION; WITH ProFee" 267702 CDM 982 RC 26770 HCPCS facility both 663 663 Gross Charge Type: NIHD_Hosp_Profee_Price "26775 CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION, SINGLE, WITH MANIPULATION; REQU ProFee" 26775 CDM 982 RC 26775 HCPCS facility both 712 712 Gross Charge Type: NIHD_Hosp_Profee_Price "26775 CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION, SINGLE, WITH MANIPULATION; REQU ProFee" 26775 CDM 982 RC 26775 HCPCS facility both 712 712 Gross Charge Type: NIHD_Hosp_Profee_Price "26785 OPEN TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION, INCLUDES INTERNAL FIXATION, WHEN ProFee" 26785 CDM 982 RC 26785 HCPCS facility both 1023 1023 Gross Charge Type: NIHD_Hosp_Profee_Price "26785 OPEN TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION, INCLUDES INTERNAL FIXATION, WHEN ProFee" 26785 CDM 982 RC 26785 HCPCS facility both 1023 1023 Gross Charge Type: NIHD_Hosp_Profee_Price "26860 ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR WITHOUT INTERNAL FIXATION; ProFee" 26860 CDM 982 RC 26860 HCPCS facility both 1037 1037 Gross Charge Type: NIHD_Hosp_Profee_Price "26860 ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR WITHOUT INTERNAL FIXATION; ProFee" 26860 CDM 982 RC 26860 HCPCS facility both 1037 1037 Gross Charge Type: NIHD_Hosp_Profee_Price 26951 AMP F/TH 1/2 JT/PHALANX W/NEURECT W/DIR CLSR TechFee 269511 CDM 450 RC facility both 2994 2994 Gross Charge Type: NIHD_Hosp_Profee_Price 26951 AMP F/TH 1/2 JT/PHALANX W/NEURECT W/DIR CLSR TechFee 269511 CDM 450 RC facility both 2994 2994 Gross Charge Type: NIHD_Hosp_Profee_Price "26951 AMPUTATION, FINGER OR THUMB, PRIMARY OR SECONDARY, ANY JOINT OR PHALANX, SINGLE, INCLU ProFee" 269512 CDM 982 RC 26951 HCPCS facility both 1373 1373 Gross Charge Type: NIHD_Hosp_Profee_Price "26951 AMPUTATION, FINGER OR THUMB, PRIMARY OR SECONDARY, ANY JOINT OR PHALANX, SINGLE, INCLU ProFee" 269512 CDM 982 RC 26951 HCPCS facility both 1373 1373 Gross Charge Type: NIHD_Hosp_Profee_Price "26952 AMPUTATION, FINGER OR THUMB, PRIMARY OR SECONDARY, ANY JOINT OR PHALANX, SINGLE, INCLU ProFee" 26952 CDM 982 RC 26952 HCPCS facility both 1070 1070 Gross Charge Type: NIHD_Hosp_Profee_Price "26952 AMPUTATION, FINGER OR THUMB, PRIMARY OR SECONDARY, ANY JOINT OR PHALANX, SINGLE, INCLU ProFee" 26952 CDM 982 RC 26952 HCPCS facility both 1070 1070 Gross Charge Type: NIHD_Hosp_Profee_Price "26990 INCISION AND DRAINAGE, PELVIS OR HIP JOINT AREA; DEEP ABSCESS OR HEMATOMA ProFee" 26990 CDM 26990 HCPCS facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "26990 INCISION AND DRAINAGE, PELVIS OR HIP JOINT AREA; DEEP ABSCESS OR HEMATOMA ProFee" 26990 CDM 26990 HCPCS facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "27025 FASCIOTOMY, HIP OR THIGH, ANY TYPE ProFee" 27025 CDM 982 RC 27025 HCPCS facility both 1384 1384 Gross Charge Type: NIHD_Hosp_Profee_Price "27025 FASCIOTOMY, HIP OR THIGH, ANY TYPE ProFee" 27025 CDM 982 RC 27025 HCPCS facility both 1384 1384 Gross Charge Type: NIHD_Hosp_Profee_Price "27030 ARTHROTOMY, HIP, WITH DRAINAGE (EG, INFECTION) ProFee" 27030 CDM 982 RC 27030 HCPCS facility both 1934 1934 Gross Charge Type: NIHD_Hosp_Profee_Price "27030 ARTHROTOMY, HIP, WITH DRAINAGE (EG, INFECTION) ProFee" 27030 CDM 982 RC 27030 HCPCS facility both 1934 1934 Gross Charge Type: NIHD_Hosp_Profee_Price "27033 ARTHROTOMY, HIP, INCLUDING EXPLORATION OR REMOVAL OF LOOSE OR FOREIGN BODY ProFee" 27033 CDM 982 RC 27033 HCPCS facility both 1997 1997 Gross Charge Type: NIHD_Hosp_Profee_Price "27033 ARTHROTOMY, HIP, INCLUDING EXPLORATION OR REMOVAL OF LOOSE OR FOREIGN BODY ProFee" 27033 CDM 982 RC 27033 HCPCS facility both 1997 1997 Gross Charge Type: NIHD_Hosp_Profee_Price CT Biopsy Pelvis/Hip 270401 CDM 761 RC facility both TC 2147 2147 Gross Charge Type: NIHD_Hosp_Profee_Price CT Biopsy Pelvis/Hip 270401 CDM 761 RC facility both TC 2147 2147 Gross Charge Type: NIHD_Hosp_Profee_Price CT Biopsy Pelvis/Hip - Report 270402 CDM 982 RC 27040 HCPCS facility both 26 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price CT Biopsy Pelvis/Hip - Report 270402 CDM 982 RC 27040 HCPCS facility both 26 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price US Biopsy Soft Tissue Pelvis/Hip 270403 CDM 761 RC facility both TC 2147 2147 Gross Charge Type: NIHD_Hosp_Profee_Price US Biopsy Soft Tissue Pelvis/Hip 270403 CDM 761 RC facility both TC 2147 2147 Gross Charge Type: NIHD_Hosp_Profee_Price US Biopsy Soft Tissue Pelvis/Hip - Report 270404 CDM 982 RC 27040 HCPCS facility both 26 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price US Biopsy Soft Tissue Pelvis/Hip - Report 270404 CDM 982 RC 27040 HCPCS facility both 26 600 600 Gross Charge Type: NIHD_Hosp_Profee_Price 27062 EXCISION; TROCHANTERIC BURSA OR CALCIFICATION ProFee 27062 CDM 982 RC 27062 HCPCS facility both 694 694 Gross Charge Type: NIHD_Hosp_Profee_Price 27062 EXCISION; TROCHANTERIC BURSA OR CALCIFICATION ProFee 27062 CDM 982 RC 27062 HCPCS facility both 694 694 Gross Charge Type: NIHD_Hosp_Profee_Price CT Sacroiliac Joint Injection Left - Report 270692 CDM 982 RC 27096 HCPCS facility both 26 351 351 Gross Charge Type: NIHD_Hosp_Profee_Price CT Sacroiliac Joint Injection Left - Report 270692 CDM 982 RC 27096 HCPCS facility both 26 351 351 Gross Charge Type: NIHD_Hosp_Profee_Price "27080 COCCYGECTOMY, PRIMARY ProFee" 27080 CDM 982 RC 27080 HCPCS facility both 924 924 Gross Charge Type: NIHD_Hosp_Profee_Price "27080 COCCYGECTOMY, PRIMARY ProFee" 27080 CDM 982 RC 27080 HCPCS facility both 924 924 Gross Charge Type: NIHD_Hosp_Profee_Price "27091 REMOVAL OF HIP PROSTHESIS; COMPLICATED, INCLUDING TOTAL HIP PROSTHESIS, METHYLMETHACRY ProFee" 27091 CDM 982 RC 27091 HCPCS facility both 3306 3306 Gross Charge Type: NIHD_Hosp_Profee_Price "27091 REMOVAL OF HIP PROSTHESIS; COMPLICATED, INCLUDING TOTAL HIP PROSTHESIS, METHYLMETHACRY ProFee" 27091 CDM 982 RC 27091 HCPCS facility both 3306 3306 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Hip Left 270931 CDM 322 RC facility both TCLT 754 754 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Hip Left 270931 CDM 322 RC facility both TCLT 754 754 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Hip Right 270933 CDM 322 RC facility both TCRT 754 754 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Hip Right 270933 CDM 322 RC facility both TCRT 754 754 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Hip Right - Report 270935 CDM 982 RC 27093 HCPCS facility both 26RT 264 264 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Hip Right - Report 270935 CDM 982 RC 27093 HCPCS facility both 26RT 264 264 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Hip Left - Report 270936 CDM 982 RC 27093 HCPCS facility both 26LT 264 264 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Hip Left - Report 270936 CDM 982 RC 27093 HCPCS facility both 26LT 264 264 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Hip Left 270937 CDM 322 RC facility both TCLT 754 754 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Hip Left 270937 CDM 322 RC facility both TCLT 754 754 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Hip Right 270938 CDM 322 RC facility both TCRT 754 754 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Hip Right 270938 CDM 322 RC facility both TCRT 754 754 Gross Charge Type: NIHD_Hosp_Profee_Price CT Sacroiliac Joint Injection 270961 CDM 320 RC facility both TC 653 653 Gross Charge Type: NIHD_Hosp_Profee_Price CT Sacroiliac Joint Injection 270961 CDM 320 RC facility both TC 653 653 Gross Charge Type: NIHD_Hosp_Profee_Price CT Sacroiliac Joint Injection Bilateral 2709612 CDM 320 RC facility both TC 653 653 Gross Charge Type: NIHD_Hosp_Profee_Price CT Sacroiliac Joint Injection Bilateral 2709612 CDM 320 RC facility both TC 653 653 Gross Charge Type: NIHD_Hosp_Profee_Price CT Sacroiliac Joint Injection Left 2709613 CDM 320 RC facility both TC 653 653 Gross Charge Type: NIHD_Hosp_Profee_Price CT Sacroiliac Joint Injection Left 2709613 CDM 320 RC facility both TC 653 653 Gross Charge Type: NIHD_Hosp_Profee_Price CT Sacroiliac Joint Injection Right 2709614 CDM 320 RC facility both TC 653 653 Gross Charge Type: NIHD_Hosp_Profee_Price CT Sacroiliac Joint Injection Right 2709614 CDM 320 RC facility both TC 653 653 Gross Charge Type: NIHD_Hosp_Profee_Price XR Sacroiliac Joint Injection Bilateral 2709615 CDM 320 RC facility both TC 653 653 Gross Charge Type: NIHD_Hosp_Profee_Price XR Sacroiliac Joint Injection Bilateral 2709615 CDM 320 RC facility both TC 653 653 Gross Charge Type: NIHD_Hosp_Profee_Price XR Sacroiliac Joint Injection Left 2709616 CDM 320 RC facility both TC 653 653 Gross Charge Type: NIHD_Hosp_Profee_Price XR Sacroiliac Joint Injection Left 2709616 CDM 320 RC facility both TC 653 653 Gross Charge Type: NIHD_Hosp_Profee_Price XR Sacroiliac Joint Injection Right 2709617 CDM 320 RC facility both TC 653 653 Gross Charge Type: NIHD_Hosp_Profee_Price XR Sacroiliac Joint Injection Right 2709617 CDM 320 RC facility both TC 653 653 Gross Charge Type: NIHD_Hosp_Profee_Price CT Sacroiliac Joint Injection - Report 270962 CDM 982 RC 27096 HCPCS facility both 26 351 351 Gross Charge Type: NIHD_Hosp_Profee_Price CT Sacroiliac Joint Injection - Report 270962 CDM 982 RC 27096 HCPCS facility both 26 351 351 Gross Charge Type: NIHD_Hosp_Profee_Price CT Sacroiliac Joint Injection Bilateral - Report 2709623 CDM 982 RC 27096 HCPCS facility both 2650 351 351 Gross Charge Type: NIHD_Hosp_Profee_Price CT Sacroiliac Joint Injection Bilateral - Report 2709623 CDM 982 RC 27096 HCPCS facility both 2650 351 351 Gross Charge Type: NIHD_Hosp_Profee_Price CT Sacroiliac Joint Injection Right - Report 2709624 CDM 982 RC 27096 HCPCS facility both 26 351 351 Gross Charge Type: NIHD_Hosp_Profee_Price CT Sacroiliac Joint Injection Right - Report 2709624 CDM 982 RC 27096 HCPCS facility both 26 351 351 Gross Charge Type: NIHD_Hosp_Profee_Price XR Sacroiliac Joint Injection Bilateral - Report 2709625 CDM 982 RC 27096 HCPCS facility both 2650 351 351 Gross Charge Type: NIHD_Hosp_Profee_Price XR Sacroiliac Joint Injection Bilateral - Report 2709625 CDM 982 RC 27096 HCPCS facility both 2650 351 351 Gross Charge Type: NIHD_Hosp_Profee_Price XR Sacroiliac Joint Injection Left - Report 2709626 CDM 982 RC 27096 HCPCS facility both 26 351 351 Gross Charge Type: NIHD_Hosp_Profee_Price XR Sacroiliac Joint Injection Left - Report 2709626 CDM 982 RC 27096 HCPCS facility both 26 351 351 Gross Charge Type: NIHD_Hosp_Profee_Price XR Sacroiliac Joint Injection Right - Report 2709627 CDM 982 RC 27096 HCPCS facility both 26 351 351 Gross Charge Type: NIHD_Hosp_Profee_Price XR Sacroiliac Joint Injection Right - Report 2709627 CDM 982 RC 27096 HCPCS facility both 26 351 351 Gross Charge Type: NIHD_Hosp_Profee_Price "27130 ARTHROPLASTY, ACETABULAR AND PROXIMAL FEMORAL PROSTHETIC REPLACEMENT (TOTAL HIP ARTHRO ProFee" 27130 CDM 982 RC 27130 HCPCS facility both 2807 2807 Gross Charge Type: NIHD_Hosp_Profee_Price "27130 ARTHROPLASTY, ACETABULAR AND PROXIMAL FEMORAL PROSTHETIC REPLACEMENT (TOTAL HIP ARTHRO ProFee" 27130 CDM 982 RC 27130 HCPCS facility both 2807 2807 Gross Charge Type: NIHD_Hosp_Profee_Price "27132 CONVERSION OF PREVIOUS HIP SURGERY TO TOTAL HIP ARTHROPLASTY, WITH OR WITHOUT AUTOGRAF ProFee" 27132 CDM 982 RC 27132 HCPCS facility both 3493 3493 Gross Charge Type: NIHD_Hosp_Profee_Price "27132 CONVERSION OF PREVIOUS HIP SURGERY TO TOTAL HIP ARTHROPLASTY, WITH OR WITHOUT AUTOGRAF ProFee" 27132 CDM 982 RC 27132 HCPCS facility both 3493 3493 Gross Charge Type: NIHD_Hosp_Profee_Price "27134 REVISION OF TOTAL HIP ARTHROPLASTY; BOTH COMPONENTS, WITH OR WITHOUT AUTOGRAFT OR ALLO ProFee" 27134 CDM 982 RC 27134 HCPCS facility both 3992 3992 Gross Charge Type: NIHD_Hosp_Profee_Price "27134 REVISION OF TOTAL HIP ARTHROPLASTY; BOTH COMPONENTS, WITH OR WITHOUT AUTOGRAFT OR ALLO ProFee" 27134 CDM 982 RC 27134 HCPCS facility both 3992 3992 Gross Charge Type: NIHD_Hosp_Profee_Price "27138 REVISION OF TOTAL HIP ARTHROPLASTY; FEMORAL COMPONENT ONLY, WITH OR WITHOUT ALLOGRAFT ProFee" 27138 CDM 982 RC 27138 HCPCS facility both 3118 3118 Gross Charge Type: NIHD_Hosp_Profee_Price "27138 REVISION OF TOTAL HIP ARTHROPLASTY; FEMORAL COMPONENT ONLY, WITH OR WITHOUT ALLOGRAFT ProFee" 27138 CDM 982 RC 27138 HCPCS facility both 3118 3118 Gross Charge Type: NIHD_Hosp_Profee_Price "27176 TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; BY SINGLE OR MULTIPLE PINNING, IN SITU ProFee" 27176 CDM 982 RC 27176 HCPCS facility both 1716 1716 Gross Charge Type: NIHD_Hosp_Profee_Price "27176 TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; BY SINGLE OR MULTIPLE PINNING, IN SITU ProFee" 27176 CDM 982 RC 27176 HCPCS facility both 1716 1716 Gross Charge Type: NIHD_Hosp_Profee_Price "27187 PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR WIRING) WITH OR WITHOUT METHYLMET ProFee" 27187 CDM 975 RC 27187 HCPCS facility both 1725 1725 Gross Charge Type: NIHD_Hosp_Profee_Price "27187 PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR WIRING) WITH OR WITHOUT METHYLMET ProFee" 27187 CDM 975 RC 27187 HCPCS facility both 1725 1725 Gross Charge Type: NIHD_Hosp_Profee_Price "27197 CLOSED TREATMENT OF POSTERIOR PELVIC RING FRACTURE(S), DISLOCATION(S), DIASTASIS OR SU ProFee" 27197 CDM 982 RC 27197 HCPCS facility both 219 219 Gross Charge Type: NIHD_Hosp_Profee_Price "27197 CLOSED TREATMENT OF POSTERIOR PELVIC RING FRACTURE(S), DISLOCATION(S), DIASTASIS OR SU ProFee" 27197 CDM 982 RC 27197 HCPCS facility both 219 219 Gross Charge Type: NIHD_Hosp_Profee_Price "27197 Closed treatment of posterior pelvic ring fracture(s), dislocation(s), w/o manipulation" 271971 CDM 520 RC 27197 HCPCS facility both 206 206 Gross Charge Type: NIHD_RHC_Price "27197 Closed treatment of posterior pelvic ring fracture(s), dislocation(s), w/o manipulation" 271971 CDM 520 RC 27197 HCPCS facility both 206 206 Gross Charge Type: NIHD_Clinic_Price 27220 CLOSED TREATMENT OF ACETABULUM (HIP SOCKET) FRACTURE(S); WITHOUT MANIPULATION ProFee 27220 CDM 982 RC 27220 HCPCS facility both 987 987 Gross Charge Type: NIHD_Hosp_Profee_Price 27220 CLOSED TREATMENT OF ACETABULUM (HIP SOCKET) FRACTURE(S); WITHOUT MANIPULATION ProFee 27220 CDM 982 RC 27220 HCPCS facility both 987 987 Gross Charge Type: NIHD_Hosp_Profee_Price "27235 PERCUTANEOUS SKELETAL FIXATION OF FEMORAL FRACTURE, PROXIMAL END, NECK ProFee" 27235 CDM 982 RC 27235 HCPCS facility both 1872 1872 Gross Charge Type: NIHD_Hosp_Profee_Price "27235 PERCUTANEOUS SKELETAL FIXATION OF FEMORAL FRACTURE, PROXIMAL END, NECK ProFee" 27235 CDM 982 RC 27235 HCPCS facility both 1872 1872 Gross Charge Type: NIHD_Hosp_Profee_Price "27236 OPEN TREATMENT OF FEMORAL FRACTURE, PROXIMAL END, NECK, INTERNAL FIXATION OR PROSTHETI ProFee" 27236 CDM 982 RC 27236 HCPCS facility both 2495 2495 Gross Charge Type: NIHD_Hosp_Profee_Price "27236 OPEN TREATMENT OF FEMORAL FRACTURE, PROXIMAL END, NECK, INTERNAL FIXATION OR PROSTHETI ProFee" 27236 CDM 982 RC 27236 HCPCS facility both 2495 2495 Gross Charge Type: NIHD_Hosp_Profee_Price "27244 TREATMENT OF INTERTROCHANTERIC, PERITROCHANTERIC, OR SUBTROCHANTERIC FEMORAL FRACTURE; ProFee" 27244 CDM 982 RC 27244 HCPCS facility both 2495 2495 Gross Charge Type: NIHD_Hosp_Profee_Price "27244 TREATMENT OF INTERTROCHANTERIC, PERITROCHANTERIC, OR SUBTROCHANTERIC FEMORAL FRACTURE; ProFee" 27244 CDM 982 RC 27244 HCPCS facility both 2495 2495 Gross Charge Type: NIHD_Hosp_Profee_Price "27245 TREATMENT OF INTERTROCHANTERIC, PERITROCHANTERIC, OR SUBTROCHANTERIC FEMORAL FRACTURE; ProFee" 27245 CDM 982 RC 27245 HCPCS facility both 2558 2558 Gross Charge Type: NIHD_Hosp_Profee_Price "27245 TREATMENT OF INTERTROCHANTERIC, PERITROCHANTERIC, OR SUBTROCHANTERIC FEMORAL FRACTURE; ProFee" 27245 CDM 982 RC 27245 HCPCS facility both 2558 2558 Gross Charge Type: NIHD_Hosp_Profee_Price "27246 CLOSED TREATMENT OF GREATER TROCHANTERIC FRACTURE, WITHOUT MANIPULATION ProFee" 27246 CDM 982 RC 27246 HCPCS facility both 680 680 Gross Charge Type: NIHD_Hosp_Profee_Price "27246 CLOSED TREATMENT OF GREATER TROCHANTERIC FRACTURE, WITHOUT MANIPULATION ProFee" 27246 CDM 982 RC 27246 HCPCS facility both 680 680 Gross Charge Type: NIHD_Hosp_Profee_Price "27248 OPEN TREATMENT OF GREATER TROCHANTERIC FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERF ProFee" 27248 CDM 982 RC 27248 HCPCS facility both 1306 1306 Gross Charge Type: NIHD_Hosp_Profee_Price "27248 OPEN TREATMENT OF GREATER TROCHANTERIC FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERF ProFee" 27248 CDM 982 RC 27248 HCPCS facility both 1306 1306 Gross Charge Type: NIHD_Hosp_Profee_Price 27250 CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA TechFee 272501 CDM 450 RC facility both 768 768 Gross Charge Type: NIHD_Hosp_Profee_Price 27250 CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA TechFee 272501 CDM 450 RC facility both 768 768 Gross Charge Type: NIHD_Hosp_Profee_Price "27250 CLOSED TREATMENT OF HIP DISLOCATION, TRAUMATIC; WITHOUT ANESTHESIA ProFee" 272502 CDM 982 RC 27250 HCPCS facility both 307 307 Gross Charge Type: NIHD_Hosp_Profee_Price "27250 CLOSED TREATMENT OF HIP DISLOCATION, TRAUMATIC; WITHOUT ANESTHESIA ProFee" 272502 CDM 982 RC 27250 HCPCS facility both 307 307 Gross Charge Type: NIHD_Hosp_Profee_Price 27265 CLTX POST HIP ARTHRP DISLC W/O ANES TechFee 272651 CDM 450 RC facility both 400 400 Gross Charge Type: NIHD_Hosp_Profee_Price 27265 CLTX POST HIP ARTHRP DISLC W/O ANES TechFee 272651 CDM 450 RC facility both 400 400 Gross Charge Type: NIHD_Hosp_Profee_Price 27265 CLOSED TREATMENT OF POST HIP ARTHROPLASTY DISLOCATION; WITHOUT ANESTHESIA ProFee 272652 CDM 982 RC 27265 HCPCS facility both 851 851 Gross Charge Type: NIHD_Hosp_Profee_Price 27265 CLOSED TREATMENT OF POST HIP ARTHROPLASTY DISLOCATION; WITHOUT ANESTHESIA ProFee 272652 CDM 982 RC 27265 HCPCS facility both 851 851 Gross Charge Type: NIHD_Hosp_Profee_Price 27266 CLTX POST HIP ARTHRP DISLC REQ ANES TechFee 272661 CDM 450 RC facility both 3586 3586 Gross Charge Type: NIHD_Hosp_Profee_Price 27266 CLTX POST HIP ARTHRP DISLC REQ ANES TechFee 272661 CDM 450 RC facility both 3586 3586 Gross Charge Type: NIHD_Hosp_Profee_Price 27266 CLOSED TREATMENT OF POST HIP ARTHROPLASTY DISLOCATION; REQUIRING REGIONAL OR GENERAL A ProFee 272662 CDM 982 RC 27266 HCPCS facility both 1872 1872 Gross Charge Type: NIHD_Hosp_Profee_Price 27266 CLOSED TREATMENT OF POST HIP ARTHROPLASTY DISLOCATION; REQUIRING REGIONAL OR GENERAL A ProFee 272662 CDM 982 RC 27266 HCPCS facility both 1872 1872 Gross Charge Type: NIHD_Hosp_Profee_Price "27275 MANIPULATION, HIP JOINT, REQUIRING GENERAL ANESTHESIA ProFee" 27275 CDM 982 RC 27275 HCPCS facility both 363 363 Gross Charge Type: NIHD_Hosp_Profee_Price "27275 MANIPULATION, HIP JOINT, REQUIRING GENERAL ANESTHESIA ProFee" 27275 CDM 982 RC 27275 HCPCS facility both 363 363 Gross Charge Type: NIHD_Hosp_Profee_Price "27299 UNLISTED PROCEDURE, PELVIS OR HIP JOINT ProFee" 27299 CDM 982 RC 27299 HCPCS facility both 1043 1043 Gross Charge Type: NIHD_Hosp_Profee_Price "27299 UNLISTED PROCEDURE, PELVIS OR HIP JOINT ProFee" 27299 CDM 982 RC 27299 HCPCS facility both 1043 1043 Gross Charge Type: NIHD_Hosp_Profee_Price "27301 Incision and drainage, deep abscess, bursa, or hematoma, thigh or knee region" 273011 CDM 521 RC 27301 HCPCS facility both 3777 3777 Gross Charge Type: NIHD_Clinic_Price "27301 INCISION AND DRAINAGE, DEEP ABSCESS, BURSA, OR HEMATOMA, THIGH OR KNEE REGION ProFee" 273012 CDM 982 RC 27301 HCPCS facility both 912 912 Gross Charge Type: NIHD_Hosp_Profee_Price "27301 INCISION AND DRAINAGE, DEEP ABSCESS, BURSA, OR HEMATOMA, THIGH OR KNEE REGION ProFee" 273012 CDM 982 RC 27301 HCPCS facility both 912 912 Gross Charge Type: NIHD_Hosp_Profee_Price "27310 ARTHROTOMY, KNEE, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF FOREIGN BODY (EG, INFECTIO ProFee" 27310 CDM 982 RC 27310 HCPCS facility both 1498 1498 Gross Charge Type: NIHD_Hosp_Profee_Price "27310 ARTHROTOMY, KNEE, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF FOREIGN BODY (EG, INFECTIO ProFee" 27310 CDM 982 RC 27310 HCPCS facility both 1498 1498 Gross Charge Type: NIHD_Hosp_Profee_Price "27334 ARTHROTOMY, WITH SYNOVECTOMY, KNEE; ANTERIOR OR POSTERIOR ProFee" 27334 CDM 982 RC 27334 HCPCS facility both 1248 1248 Gross Charge Type: NIHD_Hosp_Profee_Price "27334 ARTHROTOMY, WITH SYNOVECTOMY, KNEE; ANTERIOR OR POSTERIOR ProFee" 27334 CDM 982 RC 27334 HCPCS facility both 1248 1248 Gross Charge Type: NIHD_Hosp_Profee_Price "27335 ARTHROTOMY, WITH SYNOVECTOMY, KNEE; ANTERIOR AND POSTERIOR INCLUDING POPLITEAL AREA ProFee" 27335 CDM 982 RC 27335 HCPCS facility both 1398 1398 Gross Charge Type: NIHD_Hosp_Profee_Price "27335 ARTHROTOMY, WITH SYNOVECTOMY, KNEE; ANTERIOR AND POSTERIOR INCLUDING POPLITEAL AREA ProFee" 27335 CDM 982 RC 27335 HCPCS facility both 1398 1398 Gross Charge Type: NIHD_Hosp_Profee_Price "27337 EXCISION, TUMOR, SOFT TISSUE OF THIGH OR KNEE AREA, SUBCUTANEOUS; 3 CM OR GREATER ProFee" 27337 CDM 982 RC 27337 HCPCS facility both 936 936 Gross Charge Type: NIHD_Hosp_Profee_Price "27337 EXCISION, TUMOR, SOFT TISSUE OF THIGH OR KNEE AREA, SUBCUTANEOUS; 3 CM OR GREATER ProFee" 27337 CDM 982 RC 27337 HCPCS facility both 936 936 Gross Charge Type: NIHD_Hosp_Profee_Price "27340 EXCISION, PREPATELLAR BURSA ProFee" 27340 CDM 982 RC 27340 HCPCS facility both 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price "27340 EXCISION, PREPATELLAR BURSA ProFee" 27340 CDM 982 RC 27340 HCPCS facility both 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Knee Right - Report 273691 CDM 960 RC 27369 HCPCS facility both 26RT 188 188 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Knee Right - Report 273691 CDM 960 RC 27369 HCPCS facility both 26RT 188 188 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Knee Left - Report 273692 CDM 960 RC 27369 HCPCS facility both 26LT 188 188 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Knee Left - Report 273692 CDM 960 RC 27369 HCPCS facility both 26LT 188 188 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Knee Left 273693 CDM 322 RC facility both TCLT 629 629 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Knee Left 273693 CDM 322 RC facility both TCLT 629 629 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Knee Right 273694 CDM 322 RC facility both TCRT 629 629 Gross Charge Type: NIHD_Hosp_Profee_Price XR Arthrogram Injection Knee Right 273694 CDM 322 RC facility both TCRT 629 629 Gross Charge Type: NIHD_Hosp_Profee_Price "27372 REMOVAL OF FOREIGN BODY, DEEP, THIGH REGION OR KNEE AREA TechFee" 27372 CDM 982 RC 27372 HCPCS facility both 700 700 Gross Charge Type: NIHD_Hosp_Profee_Price "27372 REMOVAL OF FOREIGN BODY, DEEP, THIGH REGION OR KNEE AREA TechFee" 27372 CDM 982 RC 27372 HCPCS facility both 700 700 Gross Charge Type: NIHD_Hosp_Profee_Price 27380 SUTURE OF INFRAPATELLAR TENDON; PRIMARY ProFee 27380 CDM 982 RC 27380 HCPCS facility both 1248 1248 Gross Charge Type: NIHD_Hosp_Profee_Price 27380 SUTURE OF INFRAPATELLAR TENDON; PRIMARY ProFee 27380 CDM 982 RC 27380 HCPCS facility both 1248 1248 Gross Charge Type: NIHD_Hosp_Profee_Price 27385 SUTURE OF QUADRICEPS OR HAMSTRING MUSCLE RUPTURE; PRIMARY ProFee 27385 CDM 982 RC 27385 HCPCS facility both 1181 1181 Gross Charge Type: NIHD_Hosp_Profee_Price 27385 SUTURE OF QUADRICEPS OR HAMSTRING MUSCLE RUPTURE; PRIMARY ProFee 27385 CDM 982 RC 27385 HCPCS facility both 1181 1181 Gross Charge Type: NIHD_Hosp_Profee_Price 27393 LENGTHENING OF HAMSTRING TENDON; SINGLE TENDON ProFee 27393 CDM 975 RC 27393 HCPCS facility both 883 883 Gross Charge Type: NIHD_Hosp_Profee_Price 27393 LENGTHENING OF HAMSTRING TENDON; SINGLE TENDON ProFee 27393 CDM 975 RC 27393 HCPCS facility both 883 883 Gross Charge Type: NIHD_Hosp_Profee_Price 27415 OSTEOCHONDRAL ALLOGRAFT KNEE OPEN 27415 CDM 982 RC 27415 HCPCS facility both 616 616 Gross Charge Type: NIHD_Hosp_Profee_Price 27415 OSTEOCHONDRAL ALLOGRAFT KNEE OPEN 27415 CDM 982 RC 27415 HCPCS facility both 616 616 Gross Charge Type: NIHD_Hosp_Profee_Price RENOVARP® PARACENTESIS KIT 2741596 CDM facility both 286 286 Gross Charge Type: NIHD_Hosp_Profee_Price RENOVARP® PARACENTESIS KIT 2741596 CDM facility both 286 286 Gross Charge Type: NIHD_Hosp_Profee_Price "27416 OSTEOCHONDRAL AUTOGRAFT(S), KNEE, OPEN (EG, MOSAICPLASTY) (INCLUDES HARVESTING OF AUTO ProFee" 27416 CDM 982 RC 27416 HCPCS facility both 1705 1705 Gross Charge Type: NIHD_Hosp_Profee_Price "27416 OSTEOCHONDRAL AUTOGRAFT(S), KNEE, OPEN (EG, MOSAICPLASTY) (INCLUDES HARVESTING OF AUTO ProFee" 27416 CDM 982 RC 27416 HCPCS facility both 1705 1705 Gross Charge Type: NIHD_Hosp_Profee_Price "27418 ANTERIOR TIBIAL TUBERCLEPLASTY (EG, MAQUET TYPE PROCEDURE) ProFee" 27418 CDM 982 RC 27418 HCPCS facility both 1494 1494 Gross Charge Type: NIHD_Hosp_Profee_Price "27418 ANTERIOR TIBIAL TUBERCLEPLASTY (EG, MAQUET TYPE PROCEDURE) ProFee" 27418 CDM 982 RC 27418 HCPCS facility both 1494 1494 Gross Charge Type: NIHD_Hosp_Profee_Price "27420 RECONSTRUCTION OF DISLOCATING PATELLA; (EG, HAUSER TYPE PROCEDURE) ProFee" 27420 CDM 975 RC 27420 HCPCS facility both 1307 1307 Gross Charge Type: NIHD_Hosp_Profee_Price "27420 RECONSTRUCTION OF DISLOCATING PATELLA; (EG, HAUSER TYPE PROCEDURE) ProFee" 27420 CDM 975 RC 27420 HCPCS facility both 1307 1307 Gross Charge Type: NIHD_Hosp_Profee_Price 27422 RECONSTRUCTION OF DISLOCATING PATELLA; WITH EXTENSOR REALIGNMENT AND/OR MUSCLE ADVANCE ProFee 27422 CDM 982 RC 27422 HCPCS facility both 1296 1296 Gross Charge Type: NIHD_Hosp_Profee_Price 27422 RECONSTRUCTION OF DISLOCATING PATELLA; WITH EXTENSOR REALIGNMENT AND/OR MUSCLE ADVANCE ProFee 27422 CDM 982 RC 27422 HCPCS facility both 1296 1296 Gross Charge Type: NIHD_Hosp_Profee_Price "27425 LATERAL RETINACULAR RELEASE, OPEN ProFee" 27425 CDM 982 RC 27425 HCPCS facility both 819 819 Gross Charge Type: NIHD_Hosp_Profee_Price "27425 LATERAL RETINACULAR RELEASE, OPEN ProFee" 27425 CDM 982 RC 27425 HCPCS facility both 819 819 Gross Charge Type: NIHD_Hosp_Profee_Price "27427 LIGAMENTOUS RECONSTRUCTION (AUGMENTATION), KNEE; EXTRA-ARTICULAR ProFee" 27427 CDM 982 RC 27427 HCPCS facility both 1435 1435 Gross Charge Type: NIHD_Hosp_Profee_Price "27427 LIGAMENTOUS RECONSTRUCTION (AUGMENTATION), KNEE; EXTRA-ARTICULAR ProFee" 27427 CDM 982 RC 27427 HCPCS facility both 1435 1435 Gross Charge Type: NIHD_Hosp_Profee_Price "27428 Ligamentous reconstruction (augmentation), knee; intra-articular (open)" 27428 CDM 982 RC 27428 HCPCS facility both 2309 2309 Gross Charge Type: NIHD_Hosp_Profee_Price "27428 Ligamentous reconstruction (augmentation), knee; intra-articular (open)" 27428 CDM 982 RC 27428 HCPCS facility both 2309 2309 Gross Charge Type: NIHD_Hosp_Profee_Price "27430 QUADRICEPSPLASTY (EG, BENNETT OR THOMPSON TYPE) ProFee" 27430 CDM 982 RC 27430 HCPCS facility both 1373 1373 Gross Charge Type: NIHD_Hosp_Profee_Price "27430 QUADRICEPSPLASTY (EG, BENNETT OR THOMPSON TYPE) ProFee" 27430 CDM 982 RC 27430 HCPCS facility both 1373 1373 Gross Charge Type: NIHD_Hosp_Profee_Price "27447 ARTHROPLASTY, KNEE, CONDYLE AND PLATEAU; MEDIAL AND LATERAL COMPARTMENTS WITH OR WITHO ProFee" 27447 CDM 982 RC 27447 HCPCS facility both 2807 2807 Gross Charge Type: NIHD_Hosp_Profee_Price "27447 ARTHROPLASTY, KNEE, CONDYLE AND PLATEAU; MEDIAL AND LATERAL COMPARTMENTS WITH OR WITHO ProFee" 27447 CDM 982 RC 27447 HCPCS facility both 2807 2807 Gross Charge Type: NIHD_Hosp_Profee_Price "27455 OSTEOTOMY, PROXIMAL TIBIA, INCLUDING FIBULAR EXCISION OR OSTEOTOMY (INCLUDES CORRECTIO ProFee" 27455 CDM 975 RC 27455 HCPCS facility both 1669 1669 Gross Charge Type: NIHD_Hosp_Profee_Price "27455 OSTEOTOMY, PROXIMAL TIBIA, INCLUDING FIBULAR EXCISION OR OSTEOTOMY (INCLUDES CORRECTIO ProFee" 27455 CDM 975 RC 27455 HCPCS facility both 1669 1669 Gross Charge Type: NIHD_Hosp_Profee_Price "27457 OSTEOTOMY, PROXIMAL TIBIA, INCLUDING FIBULAR EXCISION OR OSTEOTOMY (INCLUDES CORRECTIO ProFee" 27457 CDM 982 RC 27457 HCPCS facility both 1997 1997 Gross Charge Type: NIHD_Hosp_Profee_Price "27457 OSTEOTOMY, PROXIMAL TIBIA, INCLUDING FIBULAR EXCISION OR OSTEOTOMY (INCLUDES CORRECTIO ProFee" 27457 CDM 982 RC 27457 HCPCS facility both 1997 1997 Gross Charge Type: NIHD_Hosp_Profee_Price "27470 REPAIR, NONUNION OR MALUNION, FEMUR, DISTAL TO HEAD AND NECK; WITHOUT GRAFT (EG, COMPR ProFee" 27470 CDM 982 RC 27470 HCPCS facility both 2372 2372 Gross Charge Type: NIHD_Hosp_Profee_Price "27470 REPAIR, NONUNION OR MALUNION, FEMUR, DISTAL TO HEAD AND NECK; WITHOUT GRAFT (EG, COMPR ProFee" 27470 CDM 982 RC 27470 HCPCS facility both 2372 2372 Gross Charge Type: NIHD_Hosp_Profee_Price "27472 REPAIR, NONUNION OR MALUNION, FEMUR, DISTAL TO HEAD AND NECK; WITH ILIAC OR OTHER AUTO ProFee" 27472 CDM 982 RC 27472 HCPCS facility both 2495 2495 Gross Charge Type: NIHD_Hosp_Profee_Price "27472 REPAIR, NONUNION OR MALUNION, FEMUR, DISTAL TO HEAD AND NECK; WITH ILIAC OR OTHER AUTO ProFee" 27472 CDM 982 RC 27472 HCPCS facility both 2495 2495 Gross Charge Type: NIHD_Hosp_Profee_Price "27486 REVISION OF TOTAL KNEE ARTHROPLASTY, WITH OR WITHOUT ALLOGRAFT; 1 COMPONENT ProFee" 27486 CDM 982 RC 27486 HCPCS facility both 2933 2933 Gross Charge Type: NIHD_Hosp_Profee_Price "27486 REVISION OF TOTAL KNEE ARTHROPLASTY, WITH OR WITHOUT ALLOGRAFT; 1 COMPONENT ProFee" 27486 CDM 982 RC 27486 HCPCS facility both 2933 2933 Gross Charge Type: NIHD_Hosp_Profee_Price "27487 REVISION OF TOTAL KNEE ARTHROPLASTY, WITH OR WITHOUT ALLOGRAFT; FEMORAL AND ENTIRE TIB ProFee" 27487 CDM 982 RC 27487 HCPCS facility both 3680 3680 Gross Charge Type: NIHD_Hosp_Profee_Price "27487 REVISION OF TOTAL KNEE ARTHROPLASTY, WITH OR WITHOUT ALLOGRAFT; FEMORAL AND ENTIRE TIB ProFee" 27487 CDM 982 RC 27487 HCPCS facility both 3680 3680 Gross Charge Type: NIHD_Hosp_Profee_Price "27488 REMOVAL OF PROSTHESIS, INCLUDING TOTAL KNEE PROSTHESIS, METHYLMETHACRYLATE WITH OR WIT ProFee" 27488 CDM 982 RC 27488 HCPCS facility both 2521 2521 Gross Charge Type: NIHD_Hosp_Profee_Price "27488 REMOVAL OF PROSTHESIS, INCLUDING TOTAL KNEE PROSTHESIS, METHYLMETHACRYLATE WITH OR WIT ProFee" 27488 CDM 982 RC 27488 HCPCS facility both 2521 2521 Gross Charge Type: NIHD_Hosp_Profee_Price "27496 DECOMPRESSION FASCIOTOMY, THIGH AND/OR KNEE, 1 COMPARTMENT (FLEXOR OR EXTENSOR OR ADDU ProFee" 27496 CDM 982 RC 27496 HCPCS facility both 1110 1110 Gross Charge Type: NIHD_Hosp_Profee_Price "27496 DECOMPRESSION FASCIOTOMY, THIGH AND/OR KNEE, 1 COMPARTMENT (FLEXOR OR EXTENSOR OR ADDU ProFee" 27496 CDM 982 RC 27496 HCPCS facility both 1110 1110 Gross Charge Type: NIHD_Hosp_Profee_Price "27500 CLOSED TREAT FEMORAL SHAFT FRACTURE, WITHOUT MANIPULATION TechFee" 275001 CDM 450 RC facility both 1060 1060 Gross Charge Type: NIHD_Hosp_Profee_Price "27500 CLOSED TREAT FEMORAL SHAFT FRACTURE, WITHOUT MANIPULATION TechFee" 275001 CDM 450 RC facility both 1060 1060 Gross Charge Type: NIHD_Hosp_Profee_Price "27500 CLOSED TREATMENT OF FEMORAL SHAFT FRACTURE, WITHOUT MANIPULATION ProFee" 275002 CDM 982 RC 27500 HCPCS facility both 838 838 Gross Charge Type: NIHD_Hosp_Profee_Price "27500 CLOSED TREATMENT OF FEMORAL SHAFT FRACTURE, WITHOUT MANIPULATION ProFee" 275002 CDM 982 RC 27500 HCPCS facility both 838 838 Gross Charge Type: NIHD_Hosp_Profee_Price 27502 CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ TechFee 27502 CDM 450 RC facility both 2033 2033 Gross Charge Type: NIHD_Hosp_Profee_Price 27502 CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ TechFee 27502 CDM 450 RC facility both 2033 2033 Gross Charge Type: NIHD_Hosp_Profee_Price 27502 CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL T ProFee 275021 CDM 27502 HCPCS facility both 810 810 Gross Charge Type: NIHD_Hosp_Profee_Price 27502 CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL T ProFee 275021 CDM 27502 HCPCS facility both 810 810 Gross Charge Type: NIHD_Hosp_Profee_Price "27506 OPEN TREATMENT OF FEMORAL SHAFT FRACTURE, WITH OR WITHOUT EXTERNAL FIXATION, WITH INSE ProFee" 27506 CDM 982 RC 27506 HCPCS facility both 2807 2807 Gross Charge Type: NIHD_Hosp_Profee_Price "27506 OPEN TREATMENT OF FEMORAL SHAFT FRACTURE, WITH OR WITHOUT EXTERNAL FIXATION, WITH INSE ProFee" 27506 CDM 982 RC 27506 HCPCS facility both 2807 2807 Gross Charge Type: NIHD_Hosp_Profee_Price "27507 OPEN TREATMENT OF FEMORAL SHAFT FRACTURE WITH PLATE/SCREWS, WITH OR WITHOUT CERCLAGE ProFee" 27507 CDM 982 RC 27507 HCPCS facility both 1997 1997 Gross Charge Type: NIHD_Hosp_Profee_Price "27507 OPEN TREATMENT OF FEMORAL SHAFT FRACTURE WITH PLATE/SCREWS, WITH OR WITHOUT CERCLAGE ProFee" 27507 CDM 982 RC 27507 HCPCS facility both 1997 1997 Gross Charge Type: NIHD_Hosp_Profee_Price "27509 PERCUTANEOUS SKELETAL FIXATION OF FEMORAL FRACTURE, DISTAL END, MEDIAL OR LATERAL COND ProFee" 27509 CDM 982 RC 27509 HCPCS facility both 1274 1274 Gross Charge Type: NIHD_Hosp_Profee_Price "27509 PERCUTANEOUS SKELETAL FIXATION OF FEMORAL FRACTURE, DISTAL END, MEDIAL OR LATERAL COND ProFee" 27509 CDM 982 RC 27509 HCPCS facility both 1274 1274 Gross Charge Type: NIHD_Hosp_Profee_Price "27510 CLOSED TREATMENT OF FEMORAL FRACTURE, DISTAL END, MEDIAL OR LATERAL CONDYLE, WITH MANI ProFee" 27510 CDM 982 RC 27510 HCPCS facility both 1237 1237 Gross Charge Type: NIHD_Hosp_Profee_Price "27510 CLOSED TREATMENT OF FEMORAL FRACTURE, DISTAL END, MEDIAL OR LATERAL CONDYLE, WITH MANI ProFee" 27510 CDM 982 RC 27510 HCPCS facility both 1237 1237 Gross Charge Type: NIHD_Hosp_Profee_Price 27511 OPEN TREATMENT OF FEMORAL SUPRACONDYLAR OR TRANSCONDYLAR FRACTURE WITHOUT INTERCONDYLA ProFee 27511 CDM 982 RC 27511 HCPCS facility both 2097 2097 Gross Charge Type: NIHD_Hosp_Profee_Price 27511 OPEN TREATMENT OF FEMORAL SUPRACONDYLAR OR TRANSCONDYLAR FRACTURE WITHOUT INTERCONDYLA ProFee 27511 CDM 982 RC 27511 HCPCS facility both 2097 2097 Gross Charge Type: NIHD_Hosp_Profee_Price 27513 OPEN TREATMENT OF FEMORAL SUPRACONDYLAR OR TRANSCONDYLAR FRACTURE WITH INTERCONDYLAR E ProFee 27513 CDM 982 RC 27513 HCPCS facility both 2558 2558 Gross Charge Type: NIHD_Hosp_Profee_Price 27513 OPEN TREATMENT OF FEMORAL SUPRACONDYLAR OR TRANSCONDYLAR FRACTURE WITH INTERCONDYLAR E ProFee 27513 CDM 982 RC 27513 HCPCS facility both 2558 2558 Gross Charge Type: NIHD_Hosp_Profee_Price "27514 OPEN TREATMENT OF FEMORAL FRACTURE, DISTAL END, MEDIAL OR LATERAL CONDYLE, INCLUDES IN ProFee" 27514 CDM 982 RC 27514 HCPCS facility both 1892 1892 Gross Charge Type: NIHD_Hosp_Profee_Price "27514 OPEN TREATMENT OF FEMORAL FRACTURE, DISTAL END, MEDIAL OR LATERAL CONDYLE, INCLUDES IN ProFee" 27514 CDM 982 RC 27514 HCPCS facility both 1892 1892 Gross Charge Type: NIHD_Hosp_Profee_Price "27520 Closed treatment of patellar fracture, without manipulation" 27520 CDM 521 RC 27520 HCPCS facility both 1048 1048 Gross Charge Type: NIHD_Clinic_Price "27524 OPEN TREATMENT OF PATELLAR FRACTURE, WITH INTERNAL FIXATION AND/OR PARTIAL OR COMPLETE ProFee" 27524 CDM 982 RC 27524 HCPCS facility both 1560 1560 Gross Charge Type: NIHD_Hosp_Profee_Price "27524 OPEN TREATMENT OF PATELLAR FRACTURE, WITH INTERNAL FIXATION AND/OR PARTIAL OR COMPLETE ProFee" 27524 CDM 982 RC 27524 HCPCS facility both 1560 1560 Gross Charge Type: NIHD_Hosp_Profee_Price "27530 Closed treatment of tibial fracture, proximal (plateau); without manipulation" 275301 CDM 521 RC 27530 HCPCS facility both 1355 1355 Gross Charge Type: NIHD_Clinic_Price "27530 CLOSED TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); WITHOUT MANIPULATION ProFee" 275302 CDM 982 RC 27530 HCPCS facility both 525 525 Gross Charge Type: NIHD_Hosp_Profee_Price "27530 CLOSED TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); WITHOUT MANIPULATION ProFee" 275302 CDM 982 RC 27530 HCPCS facility both 525 525 Gross Charge Type: NIHD_Hosp_Profee_Price "27532 CLOSED TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); WITH OR WITHOUT MANIPULATION, ProFee" 27532 CDM 982 RC 27532 HCPCS facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "27532 CLOSED TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); WITH OR WITHOUT MANIPULATION, ProFee" 27532 CDM 982 RC 27532 HCPCS facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "27535 OPEN TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); UNICONDYLAR, INCLUDES INTERNAL ProFee" 27535 CDM 982 RC 27535 HCPCS facility both 1872 1872 Gross Charge Type: NIHD_Hosp_Profee_Price "27535 OPEN TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); UNICONDYLAR, INCLUDES INTERNAL ProFee" 27535 CDM 982 RC 27535 HCPCS facility both 1872 1872 Gross Charge Type: NIHD_Hosp_Profee_Price "27536 OPEN TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); BICONDYLAR, WITH OR WITHOUT INT ProFee" 27536 CDM 982 RC 27536 HCPCS facility both 2090 2090 Gross Charge Type: NIHD_Hosp_Profee_Price "27536 OPEN TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); BICONDYLAR, WITH OR WITHOUT INT ProFee" 27536 CDM 982 RC 27536 HCPCS facility both 2090 2090 Gross Charge Type: NIHD_Hosp_Profee_Price "27540 OPEN TREATMENT OF INTERCONDYLAR SPINE(S) AND/OR TUBEROSITY FRACTURE(S) OF THE KNEE, IN ProFee" 27540 CDM 982 RC 27540 HCPCS facility both 1418 1418 Gross Charge Type: NIHD_Hosp_Profee_Price "27540 OPEN TREATMENT OF INTERCONDYLAR SPINE(S) AND/OR TUBEROSITY FRACTURE(S) OF THE KNEE, IN ProFee" 27540 CDM 982 RC 27540 HCPCS facility both 1418 1418 Gross Charge Type: NIHD_Hosp_Profee_Price 27550 CLOSED TX KNEE DISLOCATION W/O ANESTHESIA TechFee 27550_450 CDM 450 RC facility both 525 525 Gross Charge Type: NIHD_Hosp_Profee_Price 27550 CLOSED TX KNEE DISLOCATION W/O ANESTHESIA TechFee 27550_450 CDM 450 RC facility both 525 525 Gross Charge Type: NIHD_Hosp_Profee_Price 27550 CLOSED TX KNEE DISLOCATION W/O ANESTHESIA ProFee 27550_982 CDM 982 RC 27550 HCPCS facility both 727 727 Gross Charge Type: NIHD_Hosp_Profee_Price 27550 CLOSED TX KNEE DISLOCATION W/O ANESTHESIA ProFee 27550_982 CDM 982 RC 27550 HCPCS facility both 727 727 Gross Charge Type: NIHD_Hosp_Profee_Price 27552 CLOSED TREATMENT OF KNEE DISLOCATION; REQUIRING ANESTHESIA ProFee 27552 CDM 982 RC 27552 HCPCS facility both 1248 1248 Gross Charge Type: NIHD_Hosp_Profee_Price 27552 CLOSED TREATMENT OF KNEE DISLOCATION; REQUIRING ANESTHESIA ProFee 27552 CDM 982 RC 27552 HCPCS facility both 1248 1248 Gross Charge Type: NIHD_Hosp_Profee_Price 27560 CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA TechFee 275601 CDM 450 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price 27560 CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA TechFee 275601 CDM 450 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price 27560 CLOSED TREATMENT OF PATELLAR DISLOCATION; WITHOUT ANESTHESIA ProFee 275602 CDM 982 RC 27560 HCPCS facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price 27560 CLOSED TREATMENT OF PATELLAR DISLOCATION; WITHOUT ANESTHESIA ProFee 275602 CDM 982 RC 27560 HCPCS facility both 1050 1050 Gross Charge Type: NIHD_Hosp_Profee_Price "27566 OPEN TREATMENT OF PATELLAR DISLOCATION, WITH OR WITHOUT PARTIAL OR TOTAL PATELLECTOMY ProFee" 27566 CDM 27566 HCPCS facility both 1339 1339 Gross Charge Type: NIHD_Hosp_Profee_Price "27566 OPEN TREATMENT OF PATELLAR DISLOCATION, WITH OR WITHOUT PARTIAL OR TOTAL PATELLECTOMY ProFee" 27566 CDM 27566 HCPCS facility both 1339 1339 Gross Charge Type: NIHD_Hosp_Profee_Price 27570 MANIPULATION OF KNEE JOINT UNDER GENERAL ANESTHESIA (INCLUDES APPLICATION OF TRACTION ProFee 27570 CDM 975 RC 27570 HCPCS facility both 267 267 Gross Charge Type: NIHD_Hosp_Profee_Price 27570 MANIPULATION OF KNEE JOINT UNDER GENERAL ANESTHESIA (INCLUDES APPLICATION OF TRACTION ProFee 27570 CDM 975 RC 27570 HCPCS facility both 267 267 Gross Charge Type: NIHD_Hosp_Profee_Price "27590 AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL; ProFee" 27590 CDM 982 RC 27590 HCPCS facility both 1411 1411 Gross Charge Type: NIHD_Hosp_Profee_Price "27590 AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL; ProFee" 27590 CDM 982 RC 27590 HCPCS facility both 1411 1411 Gross Charge Type: NIHD_Hosp_Profee_Price 27598 DISARTICULATION AT KNEE ProFee 27598 CDM 982 RC 27598 HCPCS facility both 1205 1205 Gross Charge Type: NIHD_Hosp_Profee_Price 27598 DISARTICULATION AT KNEE ProFee 27598 CDM 982 RC 27598 HCPCS facility both 1205 1205 Gross Charge Type: NIHD_Hosp_Profee_Price "27602 DECOMPRESSION FASCIOTOMY, LEG; ANTERIOR AND/OR LATERAL, AND POSTERIOR COMPARTMENT(S) ProFee" 27602 CDM 982 RC 27602 HCPCS facility both 1023 1023 Gross Charge Type: NIHD_Hosp_Profee_Price "27602 DECOMPRESSION FASCIOTOMY, LEG; ANTERIOR AND/OR LATERAL, AND POSTERIOR COMPARTMENT(S) ProFee" 27602 CDM 982 RC 27602 HCPCS facility both 1023 1023 Gross Charge Type: NIHD_Hosp_Profee_Price "27603 INCISION AND DRAINAGE, LEG OR ANKLE; DEEP ABSCESS OR HEMATOMA ProFee" 27603 CDM 982 RC 27603 HCPCS facility both 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price "27603 INCISION AND DRAINAGE, LEG OR ANKLE; DEEP ABSCESS OR HEMATOMA ProFee" 27603 CDM 982 RC 27603 HCPCS facility both 775 775 Gross Charge Type: NIHD_Hosp_Profee_Price "27606 TENOTOMY, PERCUTANEOUS, ACHILLES TENDON (SEPARATE PROCEDURE); GENERAL ANESTHESIA ProFee" 27606 CDM 982 RC 27606 HCPCS facility both 414 414 Gross Charge Type: NIHD_Hosp_Profee_Price "27606 TENOTOMY, PERCUTANEOUS, ACHILLES TENDON (SEPARATE PROCEDURE); GENERAL ANESTHESIA ProFee" 27606 CDM 982 RC 27606 HCPCS facility both 414 414 Gross Charge Type: NIHD_Hosp_Profee_Price "27610 ARTHROTOMY, ANKLE, INCLUDING EXPLORATION, DRAINAGE, OR REMOVAL OF FOREIGN BODY ProFee" 27610 CDM 982 RC 27610 HCPCS facility both 1211 1211 Gross Charge Type: NIHD_Hosp_Profee_Price "27610 ARTHROTOMY, ANKLE, INCLUDING EXPLORATION, DRAINAGE, OR REMOVAL OF FOREIGN BODY ProFee" 27610 CDM 982 RC 27610 HCPCS facility both 1211 1211 Gross Charge Type: NIHD_Hosp_Profee_Price "27618 Excision, tumor, soft tissue of leg or ankle area, subcutaneous; less than 3 cm" 276181 CDM 521 RC 27618 HCPCS facility both 649 649 Gross Charge Type: NIHD_Clinic_Price "27618 EXCISION, TUMOR, SOFT TISSUE OF LEG OR ANKLE AREA, SUBCUTANEOUS; LESS THAN 3 CM ProFee" 276182 CDM 982 RC 27618 HCPCS facility both 649 649 Gross Charge Type: NIHD_Hosp_Profee_Price "27618 EXCISION, TUMOR, SOFT TISSUE OF LEG OR ANKLE AREA, SUBCUTANEOUS; LESS THAN 3 CM ProFee" 276182 CDM 982 RC 27618 HCPCS facility both 649 649 Gross Charge Type: NIHD_Hosp_Profee_Price "27619 Excision, tumor, soft tissue of leg or ankle area, subfascial; less than 5 cm" 276191 CDM 521 RC 27619 HCPCS facility both 936 936 Gross Charge Type: NIHD_Clinic_Price "27619 EXCISION, TUMOR, SOFT TISSUE OF LEG OR ANKLE AREA, SUBFASCIAL (EG, INTRAMUSCULAR); LES ProFee" 276192 CDM 982 RC 27619 HCPCS facility both 936 936 Gross Charge Type: NIHD_Hosp_Profee_Price "27619 EXCISION, TUMOR, SOFT TISSUE OF LEG OR ANKLE AREA, SUBFASCIAL (EG, INTRAMUSCULAR); LES ProFee" 276192 CDM 982 RC 27619 HCPCS facility both 936 936 Gross Charge Type: NIHD_Hosp_Profee_Price "27620 ARTHROTOMY, ANKLE, WITH JOINT EXPLORATION, WITH OR WITHOUT BIOPSY, WITH OR WITHOUT REM ProFee" 27620 CDM 982 RC 27620 HCPCS facility both 793 793 Gross Charge Type: NIHD_Hosp_Profee_Price "27620 ARTHROTOMY, ANKLE, WITH JOINT EXPLORATION, WITH OR WITHOUT BIOPSY, WITH OR WITHOUT REM ProFee" 27620 CDM 982 RC 27620 HCPCS facility both 793 793 Gross Charge Type: NIHD_Hosp_Profee_Price "27630 EXCISION OF LESION OF TENDON SHEATH OR CAPSULE (EG, CYST OR GANGLION), LEG AND/OR ANKL ProFee" 27630 CDM 982 RC 27630 HCPCS facility both 668 668 Gross Charge Type: NIHD_Hosp_Profee_Price "27630 EXCISION OF LESION OF TENDON SHEATH OR CAPSULE (EG, CYST OR GANGLION), LEG AND/OR ANKL ProFee" 27630 CDM 982 RC 27630 HCPCS facility both 668 668 Gross Charge Type: NIHD_Hosp_Profee_Price "27635 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TIBIA OR FIBULA; ProFee" 27635 CDM 982 RC 27635 HCPCS facility both 1211 1211 Gross Charge Type: NIHD_Hosp_Profee_Price "27635 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TIBIA OR FIBULA; ProFee" 27635 CDM 982 RC 27635 HCPCS facility both 1211 1211 Gross Charge Type: NIHD_Hosp_Profee_Price "27650 REPAIR, PRIMARY, OPEN OR PERCUTANEOUS, RUPTURED ACHILLES TENDON; ProFee" 27650 CDM 982 RC 27650 HCPCS facility both 1373 1373 Gross Charge Type: NIHD_Hosp_Profee_Price "27650 REPAIR, PRIMARY, OPEN OR PERCUTANEOUS, RUPTURED ACHILLES TENDON; ProFee" 27650 CDM 982 RC 27650 HCPCS facility both 1373 1373 Gross Charge Type: NIHD_Hosp_Profee_Price "27664 REPAIR, EXTENSOR TENDON, LEG; PRIMARY, WITHOUT GRAFT, EACH TENDON ProFee" 27664 CDM 982 RC 27664 HCPCS facility both 726 726 Gross Charge Type: NIHD_Hosp_Profee_Price "27664 REPAIR, EXTENSOR TENDON, LEG; PRIMARY, WITHOUT GRAFT, EACH TENDON ProFee" 27664 CDM 982 RC 27664 HCPCS facility both 726 726 Gross Charge Type: NIHD_Hosp_Profee_Price "27680 TENOLYSIS, FLEXOR OR EXTENSOR TENDON, LEG AND/OR ANKLE; SINGLE, EACH TENDON ProFee" 27680 CDM 982 RC 27680 HCPCS facility both 779 779 Gross Charge Type: NIHD_Hosp_Profee_Price "27680 TENOLYSIS, FLEXOR OR EXTENSOR TENDON, LEG AND/OR ANKLE; SINGLE, EACH TENDON ProFee" 27680 CDM 982 RC 27680 HCPCS facility both 779 779 Gross Charge Type: NIHD_Hosp_Profee_Price "27685 LENGTHENING OR SHORTENING OF TENDON, LEG OR ANKLE; SINGLE TENDON (SEPARATE PROCEDURE) ProFee" 27685 CDM 982 RC 27685 HCPCS facility both 1398 1398 Gross Charge Type: NIHD_Hosp_Profee_Price "27685 LENGTHENING OR SHORTENING OF TENDON, LEG OR ANKLE; SINGLE TENDON (SEPARATE PROCEDURE) ProFee" 27685 CDM 982 RC 27685 HCPCS facility both 1398 1398 Gross Charge Type: NIHD_Hosp_Profee_Price 27707 OSTEOTOMY; FIBULA ProFee 27707 CDM 982 RC 27707 HCPCS facility both 812 812 Gross Charge Type: NIHD_Hosp_Profee_Price 27707 OSTEOTOMY; FIBULA ProFee 27707 CDM 982 RC 27707 HCPCS facility both 812 812 Gross Charge Type: NIHD_Hosp_Profee_Price 27726 REPAIR OF FIBULA NONUNION AND/OR MALUNION WITH INTERNAL FIXATION ProFee 27726 CDM 982 RC 27726 HCPCS facility both 1997 1997 Gross Charge Type: NIHD_Hosp_Profee_Price 27726 REPAIR OF FIBULA NONUNION AND/OR MALUNION WITH INTERNAL FIXATION ProFee 27726 CDM 982 RC 27726 HCPCS facility both 1997 1997 Gross Charge Type: NIHD_Hosp_Profee_Price 27750 Closed treatment of tibial shaft fracture; without manipulation 277501 CDM 521 RC 27750 HCPCS facility both 1096 1096 Gross Charge Type: NIHD_Clinic_Price 27750 CLOSED TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE); WITHOUT ProFee 277502 CDM 982 RC 27750 HCPCS facility both 581 581 Gross Charge Type: NIHD_Hosp_Profee_Price 27750 CLOSED TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE); WITHOUT ProFee 277502 CDM 982 RC 27750 HCPCS facility both 581 581 Gross Charge Type: NIHD_Hosp_Profee_Price 27752 CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ TechFee 277521 CDM 450 RC facility both 363 363 Gross Charge Type: NIHD_Hosp_Profee_Price 27752 CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ TechFee 277521 CDM 450 RC facility both 363 363 Gross Charge Type: NIHD_Hosp_Profee_Price 27752 CLOSED TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE); WITH MAN ProFee 277522 CDM 982 RC 27752 HCPCS facility both 1124 1124 Gross Charge Type: NIHD_Hosp_Profee_Price 27752 CLOSED TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE); WITH MAN ProFee 277522 CDM 982 RC 27752 HCPCS facility both 1124 1124 Gross Charge Type: NIHD_Hosp_Profee_Price 27756 PERCUTANEOUS SKELETAL FIXATION OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACT ProFee 27756 CDM 982 RC 27756 HCPCS facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price 27756 PERCUTANEOUS SKELETAL FIXATION OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACT ProFee 27756 CDM 982 RC 27756 HCPCS facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "27758 OPEN TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE), WITH PLATE ProFee" 27758 CDM 982 RC 27758 HCPCS facility both 1872 1872 Gross Charge Type: NIHD_Hosp_Profee_Price "27758 OPEN TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE), WITH PLATE ProFee" 27758 CDM 982 RC 27758 HCPCS facility both 1872 1872 Gross Charge Type: NIHD_Hosp_Profee_Price 27759 TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE) BY INTRAMEDULLAR ProFee 27759 CDM 982 RC 27759 HCPCS facility both 2059 2059 Gross Charge Type: NIHD_Hosp_Profee_Price 27759 TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE) BY INTRAMEDULLAR ProFee 27759 CDM 982 RC 27759 HCPCS facility both 2059 2059 Gross Charge Type: NIHD_Hosp_Profee_Price 27760 Closed treatment of medial malleolus fracture; without manipulation 27760 CDM 521 RC 27760 HCPCS facility both 1037 1037 Gross Charge Type: NIHD_Clinic_Price "27762 CLOSED TREATMENT OF MEDIAL MALLEOLUS FRACTURE; WITH MANIPULATION, WITH OR WITHOUT SKIN ProFee" 27762 CDM 982 RC 27762 HCPCS facility both 999 999 Gross Charge Type: NIHD_Hosp_Profee_Price "27762 CLOSED TREATMENT OF MEDIAL MALLEOLUS FRACTURE; WITH MANIPULATION, WITH OR WITHOUT SKIN ProFee" 27762 CDM 982 RC 27762 HCPCS facility both 999 999 Gross Charge Type: NIHD_Hosp_Profee_Price "27766 OPEN TREATMENT OF MEDIAL MALLEOLUS FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORME ProFee" 27766 CDM 982 RC 27766 HCPCS facility both 1106 1106 Gross Charge Type: NIHD_Hosp_Profee_Price "27766 OPEN TREATMENT OF MEDIAL MALLEOLUS FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORME ProFee" 27766 CDM 982 RC 27766 HCPCS facility both 1106 1106 Gross Charge Type: NIHD_Hosp_Profee_Price 27768 CLOSED TREATMENT OF POSTERIOR MALLEOLUS FRACTURE; WITH MANIPULATION ProFee 27768 CDM 982 RC 27768 HCPCS facility both 791 791 Gross Charge Type: NIHD_Hosp_Profee_Price 27768 CLOSED TREATMENT OF POSTERIOR MALLEOLUS FRACTURE; WITH MANIPULATION ProFee 27768 CDM 982 RC 27768 HCPCS facility both 791 791 Gross Charge Type: NIHD_Hosp_Profee_Price "27769 OPEN TREATMENT OF POSTERIOR MALLEOLUS FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFO ProFee" 27769 CDM 982 RC 27769 HCPCS facility both 1274 1274 Gross Charge Type: NIHD_Hosp_Profee_Price "27769 OPEN TREATMENT OF POSTERIOR MALLEOLUS FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFO ProFee" 27769 CDM 982 RC 27769 HCPCS facility both 1274 1274 Gross Charge Type: NIHD_Hosp_Profee_Price 27781 CLOSED TREATMENT OF PROXIMAL FIBULA OR SHAFT FRACTURE; WITH MANIPULATION ProFee 27781 CDM 982 RC 27781 HCPCS facility both 874 874 Gross Charge Type: NIHD_Hosp_Profee_Price 27781 CLOSED TREATMENT OF PROXIMAL FIBULA OR SHAFT FRACTURE; WITH MANIPULATION ProFee 27781 CDM 982 RC 27781 HCPCS facility both 874 874 Gross Charge Type: NIHD_Hosp_Profee_Price 27781 CLTX PROX FIBULA/SHFT FX W/MANJ TechFee 277811 CDM 450 RC facility both 2353 2353 Gross Charge Type: NIHD_Hosp_Profee_Price 27781 CLTX PROX FIBULA/SHFT FX W/MANJ TechFee 277811 CDM 450 RC facility both 2353 2353 Gross Charge Type: NIHD_Hosp_Profee_Price 27786 Closed treatment of distal fibular fracture (lateral malleolus); without manipulation 27786 CDM 521 RC 27786 HCPCS facility both 922 922 Gross Charge Type: NIHD_Clinic_Price 27788 CLOSED TREATMENT OF DISTAL FIBULAR FRACTURE (LATERAL MALLEOLUS); WITH MANIPULATION ProFee 27788 CDM 982 RC 27788 HCPCS facility both 1747 1747 Gross Charge Type: NIHD_Hosp_Profee_Price 27788 CLOSED TREATMENT OF DISTAL FIBULAR FRACTURE (LATERAL MALLEOLUS); WITH MANIPULATION ProFee 27788 CDM 982 RC 27788 HCPCS facility both 1747 1747 Gross Charge Type: NIHD_Hosp_Profee_Price 27788 CLTX DSTL FIBULAR FX LAT MALLS W/MANJ TechFee 277881 CDM 450 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price 27788 CLTX DSTL FIBULAR FX LAT MALLS W/MANJ TechFee 277881 CDM 450 RC facility both 885 885 Gross Charge Type: NIHD_Hosp_Profee_Price "27792 OPEN TREATMENT OF DISTAL FIBULAR FRACTURE (LATERAL MALLEOLUS), INCLUDES INTERNAL FIXAT ProFee" 27792 CDM 982 RC 27792 HCPCS facility both 1373 1373 Gross Charge Type: NIHD_Hosp_Profee_Price "27792 OPEN TREATMENT OF DISTAL FIBULAR FRACTURE (LATERAL MALLEOLUS), INCLUDES INTERNAL FIXAT ProFee" 27792 CDM 982 RC 27792 HCPCS facility both 1373 1373 Gross Charge Type: NIHD_Hosp_Profee_Price 27808 Closed treatment of bimalleolar ankle fracture; without manipulation 27808 CDM 521 RC 27808 HCPCS facility both 1037 1037 Gross Charge Type: NIHD_Clinic_Price 27810 Closed treatment of bimalleolar ankle fracture; with manipulation 278101 CDM 521 RC 27810 HCPCS facility both 2372 2372 Gross Charge Type: NIHD_Clinic_Price 27810 CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/MANJ TechFee 278102 CDM 450 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price 27810 CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/MANJ TechFee 278102 CDM 450 RC facility both 375 375 Gross Charge Type: NIHD_Hosp_Profee_Price "27810 CLOSED TREATMENT OF BIMALLEOLAR ANKLE FRACTURE (EG, LATERAL AND MEDIAL MALLEOLI, OR LA ProFee" 278103 CDM 982 RC 27810 HCPCS facility both 851 851 Gross Charge Type: NIHD_Hosp_Profee_Price "27810 CLOSED TREATMENT OF BIMALLEOLAR ANKLE FRACTURE (EG, LATERAL AND MEDIAL MALLEOLI, OR LA ProFee" 278103 CDM 982 RC 27810 HCPCS facility both 851 851 Gross Charge Type: NIHD_Hosp_Profee_Price "27814 OPEN TREATMENT OF BIMALLEOLAR ANKLE FRACTURE (EG, LATERAL AND MEDIAL MALLEOLI, OR LATE ProFee" 27814 CDM 982 RC 27814 HCPCS facility both 1623 1623 Gross Charge Type: NIHD_Hosp_Profee_Price "27814 OPEN TREATMENT OF BIMALLEOLAR ANKLE FRACTURE (EG, LATERAL AND MEDIAL MALLEOLI, OR LATE ProFee" 27814 CDM 982 RC 27814 HCPCS facility both 1623 1623 Gross Charge Type: NIHD_Hosp_Profee_Price 27816 CLOSED TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE; WITHOUT MANIPULATION ProFee 27816 CDM 982 RC 27816 HCPCS facility both 538 538 Gross Charge Type: NIHD_Hosp_Profee_Price 27816 CLOSED TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE; WITHOUT MANIPULATION ProFee 27816 CDM 982 RC 27816 HCPCS facility both 538 538 Gross Charge Type: NIHD_Hosp_Profee_Price 27818 CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION TechFee 278181 CDM 450 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price 27818 CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION TechFee 278181 CDM 450 RC facility both 345 345 Gross Charge Type: NIHD_Hosp_Profee_Price 27818 CLOSED TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE; WITH MANIPULATION ProFee 278182 CDM 982 RC 27818 HCPCS facility both 999 999 Gross Charge Type: NIHD_Hosp_Profee_Price 27818 CLOSED TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE; WITH MANIPULATION ProFee 278182 CDM 982 RC 27818 HCPCS facility both 999 999 Gross Charge Type: NIHD_Hosp_Profee_Price "27822 OPEN TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFOR ProFee" 27822 CDM 982 RC 27822 HCPCS facility both 1747 1747 Gross Charge Type: NIHD_Hosp_Profee_Price "27822 OPEN TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFOR ProFee" 27822 CDM 982 RC 27822 HCPCS facility both 1747 1747 Gross Charge Type: NIHD_Hosp_Profee_Price "27823 OPEN TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFOR ProFee" 27823 CDM 982 RC 27823 HCPCS facility both 1997 1997 Gross Charge Type: NIHD_Hosp_Profee_Price "27823 OPEN TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFOR ProFee" 27823 CDM 982 RC 27823 HCPCS facility both 1997 1997 Gross Charge Type: NIHD_Hosp_Profee_Price "27824 CLOSED TREATMENT OF FRACTURE OF WEIGHT BEARING ARTICULAR PORTION OF DISTAL TIBIA (EG, ProFee" 27824 CDM 982 RC 27824 HCPCS facility both 1261 1261 Gross Charge Type: NIHD_Hosp_Profee_Price "27824 CLOSED TREATMENT OF FRACTURE OF WEIGHT BEARING ARTICULAR PORTION OF DISTAL TIBIA (EG, ProFee" 27824 CDM 982 RC 27824 HCPCS facility both 1261 1261 Gross Charge Type: NIHD_Hosp_Profee_Price "27824 Closed treatment of fracture of articular distal tibia, w/wo anesthesia; w/o manipulation" 278241 CDM 521 RC 27824 HCPCS facility both 495 495 Gross Charge Type: NIHD_RHC_Price "27824 Closed treatment of fracture of articular distal tibia, w/wo anesthesia; w/o manipulation" 278241 CDM 521 RC 27824 HCPCS facility both 495 495 Gross Charge Type: NIHD_Clinic_Price "27825 CLOSED TREATMENT OF FRACTURE OF WEIGHT BEARING ARTICULAR PORTION OF DISTAL TIBIA (EG, ProFee" 27825 CDM 982 RC 27825 HCPCS facility both 1124 1124 Gross Charge Type: NIHD_Hosp_Profee_Price "27825 CLOSED TREATMENT OF FRACTURE OF WEIGHT BEARING ARTICULAR PORTION OF DISTAL TIBIA (EG, ProFee" 27825 CDM 982 RC 27825 HCPCS facility both 1124 1124 Gross Charge Type: NIHD_Hosp_Profee_Price 27825 CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ TechFee 278251 CDM 450 RC facility both 3864 3864 Gross Charge Type: NIHD_Hosp_Profee_Price 27825 CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ TechFee 278251 CDM 450 RC facility both 3864 3864 Gross Charge Type: NIHD_Hosp_Profee_Price 27827 OPEN TREATMENT OF FRACTURE OF WEIGHT BEARING ARTICULAR SURFACE/PORTION OF DISTAL TIBIA ProFee 27827 CDM 982 RC 27827 HCPCS facility both 2005 2005 Gross Charge Type: NIHD_Hosp_Profee_Price 27827 OPEN TREATMENT OF